Comprehensive Analysis of R-Spondin Fusions and <i>RNF43</i> Mutations Implicate Novel Therapeutic Options in Colorectal Cancer

  • Andreas Seeber
    1Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria.
  • Francesca Battaglin
    2Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
  • Kai Zimmer
    1Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria.
  • Florian Kocher
    1Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria.
  • Yasmine Baca
    3Caris Life Sciences, Phoenix, Arizona.
  • Joanne Xiu
    3Caris Life Sciences, Phoenix, Arizona.
  • Gilbert Spizzo
    1Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria.
  • Veronica Novotny-Diermayr
    5Experimental Drug Development Center (EDDC), A*Star, Singapore.
  • Dietmar Rieder
    6Biocenter, Institute of Bioinformatics, Medical University of Innsbruck, Innsbruck, Austria.
  • Alberto Puccini
    7Oncologia Medica 1, Ospedale Policlinico San Martino—IRCCS, Genova, Italy.
  • Jeff Swensen
    3Caris Life Sciences, Phoenix, Arizona.
  • Michelle Ellis
    3Caris Life Sciences, Phoenix, Arizona.
  • Richard M. Goldberg
    8West Virginia University Cancer Institute, Morgantown, West Virginia.
  • Axel Grothey
    9West Cancer Center, Germantown, Tennessee.
  • Anthony F. Shields
    10Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan.
  • John L. Marshall
    11Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC.
  • Benjamin A. Weinberg
    11Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC.
  • Paul E. Sackstein
    11Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC.
  • Kiat Hon Lim
    12Department of Molecular Pathology, Translational Pathology Center, Singapore General Hospital, Singapore.
  • Gek San Tan
    12Department of Molecular Pathology, Translational Pathology Center, Singapore General Hospital, Singapore.
  • Chadi Nabhan
    3Caris Life Sciences, Phoenix, Arizona.
  • W. Michael Korn
    3Caris Life Sciences, Phoenix, Arizona.
  • Arno Amann
    1Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria.
  • Zlatko Trajanoski
    6Biocenter, Institute of Bioinformatics, Medical University of Innsbruck, Innsbruck, Austria.
  • Martin D. Berger
    13Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Emil Lou
    14Division of Hematology and Oncology, University of Minnesota, Minneapolis, Minnesota.
  • Dominik Wolf
    1Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria.
  • Heinz-Josef Lenz
    2Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.

抄録

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Purpose:</jats:title> <jats:p>Gene fusions involving R-spondin (RSPOfp) and RNF43 mutations have been shown to drive Wnt-dependent tumor initiation in colorectal cancer. Herein, we aimed to characterize the molecular features of RSPOfp/RNF43 mutated (mut) compared with wild-type (WT) colorectal cancers to gain insights into potential rationales for therapeutic strategies.</jats:p> </jats:sec> <jats:sec> <jats:title>Experimental Design:</jats:title> <jats:p>A discovery cohort was classified for RSPOfp/RNF43 status using DNA/RNA sequencing and IHC. An independent cohort was used to validate our findings.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>The discovery cohort consisted of 7,245 colorectal cancer samples. RSPOfp and RNF43 mutations were detected in 1.3% (n = 94) and 6.1% (n = 443) of cases. We found 5 RSPO fusion events that had not previously been reported (e.g., IFNGR1–RSPO3). RNF43-mut tumors were associated with right-sided primary tumors. No RSPOfp tumors had RNF43 mutations. In comparison with WT colorectal cancers, RSPOfp tumors were characterized by a higher frequency of BRAF, BMPR1A, and SMAD4 mutations. APC mutations were observed in only a minority of RSPOfp-positive compared with WT cases (4.4% vs. 81.4%). Regarding RNF43 mutations, a higher rate of KMT2D and BRAF mutations were detectable compared with WT samples. Although RNF43 mutations were associated with a microsatellite instability (MSI-H)/mismatch repair deficiency (dMMR) phenotype (64.3%), and a tumor mutation burden ≥10 mt/Mb (65.8%), RSPOfp was not associated with MSI-H/dMMR. The validation cohort replicated our genetic findings.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>This is the largest series of RSPOfp/RNF43-mut colorectal cancers reported to date. Comprehensive molecular analyses asserted the unique molecular landscape associated with RSPO/RNF43 and suggested potential alternative strategies to overcome the low clinical impact of Wnt-targeted agents and immunotherapy.</jats:p> </jats:sec>

収録刊行物

  • Clinical Cancer Research

    Clinical Cancer Research 28 (9), 1863-1870, 2022-02-16

    American Association for Cancer Research (AACR)

被引用文献 (2)*注記

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