Mutations in the RAS/MAPK Pathway Drive Replication Repair-Deficient Hypermutated Tumors and Confer Sensitivity to MEK Inhibition

被引:31
作者
Campbell, Brittany B. [1 ,2 ]
Galati, Melissa A. [1 ,2 ]
Stone, Simone C. [3 ]
Riemenschneider, Alexandra N. [2 ,4 ]
Edwards, Melissa [1 ,2 ]
Sudhaman, Sumedha [1 ,2 ,3 ]
Siddaway, Robert [2 ,5 ]
Komosa, Martin [1 ,2 ]
Nunes, Nuno M. [1 ,2 ]
Nobre, Liana [1 ,2 ]
Morrissy, A. Sorana [6 ]
Zatzman, Matthew [1 ,7 ]
Zapotocky, Michal [2 ,8 ,9 ,10 ]
Joksimovic, Lazar [1 ,2 ]
Kalimuthu, Sangeetha N. [11 ,12 ]
Samuel, David [13 ]
Mason, Gary [14 ]
Bouffet, Eric [8 ]
Morgenstern, Daniel A. [8 ]
Aronson, Melyssa [15 ]
Durno, Carol [15 ]
Malkin, David [1 ,8 ]
Maris, John M. [16 ,17 ,18 ]
Taylor, Michael D. [2 ,4 ,19 ]
Shlien, Adam [1 ,7 ]
Pugh, Trevor J. [3 ,20 ,21 ]
Ohashi, Pamela S. [3 ,22 ]
Hawkins, Cynthia E. [2 ,5 ,7 ]
Tabori, Uri [1 ,2 ,3 ]
机构
[1] Hosp Sick Children, Program Genet & Genome Biol, Toronto, ON, Canada
[2] Hosp Sick Children, Arthur & Sonia Labatt Brain Tumour Res Ctr, Toronto, ON, Canada
[3] Univ Hlth Network, Princess Margaret Canc Ctr, Toronto, ON, Canada
[4] Hosp Sick Children, Dev & Stem Cell Biol Program, Toronto, ON, Canada
[5] Hosp Sick Children, Program Cell Biol, Toronto, ON, Canada
[6] Univ Calgary, Charbonneau Canc Inst, Calgary, AB, Canada
[7] Univ Toronto, Fac Med, Dept Lab Med & Pathobiol, Toronto, ON, Canada
[8] Univ Toronto, Hosp Sick Children, Dept Pediat, Div Hematol Oncol, Toronto, ON, Canada
[9] Charles Univ Prague, Fac Med 2, Prague, Czech Republic
[10] Univ Hosp Motol, Prague, Czech Republic
[11] Univ Hlth Network, Dept Pathol, Lab Med Program, Toronto, ON, Canada
[12] Univ Toronto, Toronto, ON, Canada
[13] Valley Childrens Hosp, Dept Hematol Oncol, Madera, CA USA
[14] Childrens Hosp Pittsburgh UPMC, Dept Pediat Hematol Oncol, Pittsburgh, PA USA
[15] Mt Sinai Hosp, Zane Cohen Ctr Digest Dis, Toronto, ON, Canada
[16] Univ Penn, Div Oncol, Philadelphia, PA 19104 USA
[17] Univ Penn, Childrens Hosp Philadelphia, Ctr Childhood Canc Res, Philadelphia, PA 19104 USA
[18] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA
[19] Hosp Sick Children, Div Neurosurg, Toronto, ON, Canada
[20] Univ Toronto, Dept Med Biophys, Toronto, ON, Canada
[21] Ontario Inst Canc Res, Toronto, ON, Canada
[22] Univ Toronto, Dept Immunol, Toronto, ON, Canada
关键词
GERMLINE MUTATIONS; SOMATIC MUTATIONS; MSH6; MUTATIONS; CELL-CARCINOMA; PD-1; BLOCKADE; CANCER; SIGNATURES; POLE; GLIOBLASTOMA; SELUMETINIB;
D O I
10.1158/2159-8290.CD-20-1050
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The RAS/MAPK pathway is an emerging targeted pathway across a spectrum of both adult and pediatric cancers. Typically, this is associated with a single, well-characterized point mutation in an oncogene. Hypermutant tumors that harbor many somatic mutations may obscure the interpretation of such targetable genomic events. We find that replication repair-deficient (RRD) cancers, which are universally hypermutant and affect children born with RRD cancer predisposition, are enriched for RAS/MAPK mutations (P = 10(-8)). These mutations are not random, exist in subclones, and increase in allelic frequency over time. The RAS/MAPK pathway is activated both transcriptionally and at the protein level in patient-derived RRD tumors, and these tumors responded to MEK inhibition in vitro and in vivo. Treatment of patients with RAS/MAPK hypermutant gliomas reveals durable responses to MEK inhibition. Our observations suggest that hypermutant tumors may be addicted to oncogenic pathways, resulting in favorable response to targeted therapies. SIGNIFICANCE: Tumors harboring a single RAS/MAPK driver mutation are targeted individually for therapeutic purposes. We find that in RRD hypermutant cancers, mutations in the RAS/MAPK pathway are enriched, highly expressed, and result in sensitivity to MEK inhibitors. Targeting an oncogenic pathway may provide therapeutic options for these hypermutant polyclonal cancers.
引用
收藏
页码:1454 / 1467
页数:14
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