Andi Darma Putra

Expression of miR-92a and miR-125b and Their Association with Chemoradiotherapy Response in Locally Advanced Cervical Cancer

Cervical cancer remains a major cause of morbidity and mortality, with most cases in Indonesia diagnosed at a locally advanced stage. Although concurrent chemoradiotherapy is the standard treatment, response varies. Dysregulation of microRNAs (miRNAs), particularly oncogenic miR-92a and tumor suppressor miR-125b, may contribute to treatment resistance. This study aimed to evaluate the association between miR-92a and miR-125b expression and chemoradiotherapy response in locally advanced cervical cancer. This single-center retrospective cohort study included patients with stage IB3–IVA cervical cancer treated with chemoradiotherapy between 2019 and 2025. miRNA expression levels were measured from pretreatment tumor biopsy specimens. Poor response was defined as incomplete response or disease progression after treatment. Appropriate comparative, predictive, and survival analyses were performed. Sixty-eight patients were included. Poor response was significantly associated with underweight body mass index, elevated miR-92a, and reduced miR-125b expression (p < 0.05). High miR-92a and low miR-125b expression were also associated with shorter overall survival (p < 0.001). A combined model incorporating BMI, miR-92a, and miR-125b showed good predictive performance. Elevated miR-92a and reduced miR-125b are associated with poor treatment response and worse survival. These miRNAs may support risk stratification and treatment personalization in locally advanced cervical cancer.

Minimal Residual Disease Detection: Bridging Molecular and Clinical Strategies for Recurrence Prevention in Gynecologic Cancers

Gynecologic cancers remain a major global health burden, particularly in low- and middle-income countries, with high incidence and mortality rates around 45–50%. The detection of minimal residual disease (MRD) is transforming the management of recurrence risk in gynecologic cancers through highly sensitive molecular technologies. MRD encompasses small populations of residual cancer cells or post-treatment molecular traces but remain undetectable by conventional methods. Its detection relies on circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), and advanced next-generation sequencing (NGS), with ctDNA-based MRD assays having sensitivity levels between 85% and over 99%. Other technologies, such as liquid biopsies and digital PCR, are also in development. MRD status has demonstrated high predictors of recurrence and survival with positive MRD strongly associated with poor outcomes and negative MRD indicates sustained remission. However, MRD detection faces significant limitations, such as tumor heterogeneity, inconstant ctDNA levels, technical issues of false-negative results, and limited clinical accessibility. Therefore, this review presents current evidence regarding the molecular detection of MRD in gynecologic malignancies and assesses its prognostic and predictive relevance. Ultimately, MRD continuous integration into clinical practice offers a promising modality to enable early relapse detection, more precise therapeutic decision-making, and the improvement of personalized medicine access to gynecologic cancers worldwide.