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中国转移性结直肠癌患者的基因突变谱分析及其与临床病理特征和抗表皮生长因子受体(EGFR)治疗反应的相关性

Mutation profiling in chinese patients with metastatic colorectal cancer and its correlation with clinicopathological features and anti-EGFR treatment response.

作者信息

Li Zhe-Zhen, Wang Feng, Zhang Zi-Chen, Wang Fang, Zhao Qi, Zhang Dong-Sheng, Wang Feng-Hua, Wang Zhi-Qiang, Luo Hui-Yan, He Ming-Ming, Wang De-Shen, Jin Ying, Ren Chao, Qiu Miao-Zhen, Ren Jian, Pan Zhi-Zhong, Li Yu-Hong, Shao Jiao-Yong, Xu Rui-Hua

机构信息

Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China.

Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China.

出版信息

Oncotarget. 2016 May 10;7(19):28356-68. doi: 10.18632/oncotarget.8541.

Abstract

An increasing number of studies reveal the significance of genetic markers in guiding target treatment and refining prognosis. This retrospective observational study aims to assess the mutation profile of metastatic colorectal cancer (mCRC) in Chinese population with the help of MassARRAY® technique platform and OncoCarta™ Panel.322 Chinese patients with mCRC who received clinical molecular testing as part of their standard care were investigated. 80 patients received cetuximab palliative treatment. 238 common hot-spot mutations of 19 cancer related genes in the OncoCarta™ Panel were tested.44 mutations in 11 genes were detected in 156 cases (48.4%). At least one mutation was identified in 38.5% (124/322) of all tested cases, two concomitant mutations in 9.0% (29/322) and three mutations in 3 cases (<1%). KRAS was the most frequently mutated gene (34.8%), followed by PIK3CA (9.6%), NRAS (4.3%), BRAF (3.4%), EGFR (2.5%) and HRAS (1.2%). Less frequent mutations were detected in PDGFRA, RET, AKT1, FGFR1, and ERBB2. Co-mutation of RAS family subtypes was observed in 5 patients, and KRAS and BRAF concurrent mutation in 1 patient. KRAS, NRAS, BRAF and PIK3CA mutations had association with some clinicopathological features statistically. Patients identified as wild-type in all 19 genes had better objective response rate when treated with cetuximab.The clinical molecular testing with OncoCarta™ Panel supplemented the limited data of mCRC in Chinese population, and offered a clearer landscape of multiple gene mutational profile in not only clinically prognostic KRAS, NRAS, BRAF and PIK3CA genes, but also less frequent mutated genes. Knowledge of these multiple gene mutation patterns may give clues in exploring interesting accompanying co-occurrence relationship or mutually exclusive relationship between mutated genes, as well as in predicting benefit of all-wild-type patients from anti-EGFR treatment.

摘要

越来越多的研究揭示了基因标志物在指导靶向治疗和优化预后方面的重要性。这项回顾性观察研究旨在借助MassARRAY®技术平台和OncoCarta™检测板评估中国人群中转移性结直肠癌(mCRC)的突变谱。对322例接受临床分子检测作为标准治疗一部分的中国mCRC患者进行了调查。80例患者接受了西妥昔单抗姑息治疗。检测了OncoCarta™检测板中19个癌症相关基因的238个常见热点突变。156例(48.4%)检测到11个基因中的44个突变。所有检测病例中,38.5%(124/322)至少鉴定出一个突变,9.0%(29/322)有两个伴随突变,3例(<1%)有三个突变。KRAS是最常发生突变的基因(34.8%),其次是PIK3CA(9.6%)、NRAS(4.3%)、BRAF(3.4%)、EGFR(2.5%)和HRAS(1.2%)。在PDGFRA、RET、AKT1、FGFR1和ERBB2中检测到的突变频率较低。5例患者观察到RAS家族亚型的共突变,1例患者同时发生KRAS和BRAF突变。KRAS、NRAS、BRAF和PIK3CA突变与一些临床病理特征具有统计学关联。在所有19个基因中被鉴定为野生型的患者接受西妥昔单抗治疗时具有更好的客观缓解率。使用OncoCarta™检测板进行的临床分子检测补充了中国人群中mCRC的有限数据,并不仅在临床预后相关的KRAS、NRAS、BRAF和PIK3CA基因,而且在突变频率较低的基因方面,提供了更清晰的多基因突变谱图景。了解这些多基因突变模式可能为探索突变基因之间有趣的伴随共现关系或相互排斥关系提供线索,以及预测全野生型患者从抗EGFR治疗中获益的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c177/5053731/bce839327afc/oncotarget-07-28356-g001.jpg

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