Aberrant Expression of CYP2W1 in Pediatric Soft Tissue Sarcomas: Clinical Significance and a Potential Therapeutic Target

Pediatric soft tissue sarcomas (STS) are aggressive malignancies with poor prognoses, particularly in recurrent and metastatic cases. Standard therapies, such as cytotoxic chemotherapy, offer limited survival benefits and carry significant toxicities, highlighting the urgent need for innovative ther-apeutic approaches. CYP2W1, a tumor-associated monooxygenase enzyme, has emerged as a promising therapeutic target due to its aberrant expression in various cancers; however, its role in pediatric STS remains poorly understood. This study evaluated CYP2W1 expression in 42 primary pediatric STS samples across seven histological subtypes using qPCR and Western blot analyses, investigating its association with clinicopathological variables and survival outcomes. High CYP2W1 expression at both mRNA and protein levels was observed in 69% and 40.5% of STS tumor samples, respectively, compared to absent or negligible expression in matched normal tissues (p < 0.001). Aberrant CYP2W1 protein expression was predominantly found in synovial sarcoma and rhabdomyosarcoma subtypes, at 70% and 62.5%, respectively. Additionally, CYP2W1 ex-pression correlated with higher histological grade, advanced tumor stage, and showed a trend toward reduced overall survival (p = 0.082). These findings demonstrate that CYP2W1 is aberrantly expressed in a subset of pediatric STS, contributing to tumor aggressiveness and highlighting its potential as a promising therapeutic target for this malignancy.