Kim Yoonjung, Kim Juwon, Lee Hy-De, Jeong Joon, Lee Woochang, Lee Kyung-A
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
PLoS One. 2013 Oct 30;8(10):e79014. doi: 10.1371/journal.pone.0079014. eCollection 2013.
Anti-epidermal growth factor receptor (EGFR) therapy has been tried in triple negative breast cancer (TNBC) patients without evaluation of molecular and clinical predictors in several randomized clinical studies. Only fewer than 20% of metastatic TNBCs showed response to anti-EGFR therapy. In order to increase the overall response rate, first step would be to classify TNBC into good or poor responders according to oncogenic mutation profiles. This study provides the molecular characteristics of TNBCs including EGFR gene copy number changes and mutation status of EGFR and KRAS gene in Korean TNBC patients. Mutation analysis for EGFR, KRAS, BRAF and TP53 from a total of 105 TNBC tissue samples was performed by direct sequencing, peptide nucleic acid-mediated PCR clamping method and real-time PCR. Copy number changes of EGFR gene were evaluated using multiplex ligation-dependent probe amplification. Out of all 105 TNBCs, 15.2% (16/105) showed EGFR copy number changes. Among them, increased or decreased EGFR copy number was detected in 13 (5 single copy gain, 2 amplification and 4 high-copy number amplification) and 3 cases (3 hemizygous deletion), respectively. The mutation frequencies of KRAS, EGFR and TP53 gene were 1.9% (G12V and G12D), 1.0% (exon 19 del) and 31.4%, respectively. There was no BRAF V600E mutation found. Future studies are needed to evaluate the clinical outcomes of TNBC patients who undergo anti-EGFR therapy according to the genetic status of EGFR.
在多项随机临床研究中,已对三阴性乳腺癌(TNBC)患者尝试了抗表皮生长因子受体(EGFR)治疗,但未评估分子和临床预测指标。转移性TNBC中只有不到20%对抗EGFR治疗有反应。为了提高总体缓解率,第一步是根据致癌基因突变谱将TNBC分为反应良好或不良的患者。本研究提供了韩国TNBC患者中TNBC的分子特征,包括EGFR基因拷贝数变化以及EGFR和KRAS基因的突变状态。通过直接测序、肽核酸介导的PCR钳夹法和实时PCR对总共105个TNBC组织样本中的EGFR、KRAS、BRAF和TP53进行了突变分析。使用多重连接依赖探针扩增评估EGFR基因的拷贝数变化。在所有105例TNBC中,15.2%(16/105)显示EGFR拷贝数变化。其中,分别在13例(5例单拷贝增加、2例扩增和4例高拷贝数扩增)和3例(3例半合子缺失)中检测到EGFR拷贝数增加或减少。KRAS、EGFR和TP53基因的突变频率分别为1.9%(G12V和G12D)、1.0%(外显子19缺失)和31.4%。未发现BRAF V600E突变。需要进一步的研究来评估根据EGFR基因状态接受抗EGFR治疗的TNBC患者的临床结局。