Introduction/Background Based on definition by ESMO rare cancers have incidence <6/100,000/year).

Till date cervical cancers are treated as per stage of disease, regardless of histopathological classification .

We highlight unmet need of targeted therapy for these cancers as we head towards tumor biology driven, era of precision oncology

Methodology Study design : Retrospective study on uncommon cervical histologies collected over 3 years, from January 2018 to December 2021 from electronic medical records of Dr B.Borooah Cancer Institute.

Out of the 1524 new cases of cervical cancer registered, eleven patients with rare histologies were found, two were excluded due to lack of follow up. (table 1)

Data on incidence, different behaviors, response rates of these uncommon subtypes diagnosed on extensive IHC was collected . All cases were managed after discussion in multidisciplinary tumour board based on evidence so far.

Results We depict nine extremely rare variants (up to 1% incidence ) (table 1) Reported incidence in literature: 0.5% sarcomatoid, rhabdomyosarcoma 9%, malignant melanoma less than 1%, neuroendocrine up to 2%, and large cell neuroendocrine is even rare (12% of all neuroendocrine )glassy cell 1%, carcinosarcoma about 70 cases reported till date.

All cases are presented in advanced stages. (table 2), In spite of various multimodal chemotherapy regimens,we saw dismal outcomes. (OS range 3 -11 months )

Out of these Angiosarcoma and PrimaryT-cell-lymphoma are third only cases ever reported.

Rhabdomyosarcoma responded well to VIE Regimen. Large cell neuroendocrine was worst with 3 months OS.

Conclusion With conventional management prognosis of rare subtypes is dismal. Precsion oncology is the road ahead for tailored treatment of aggressive histologies.

Widespread establishment of rare cancer registries to meticulously record past present and future of each rare subtype is prudent .

Disclosures none