内镜超声引导下细针抽吸获得的临床前胰腺癌模型显示 KRAS 野生型肿瘤对 panitumumab 的敏感性。

Endoscopic ultrasound-guided fine-needle aspirate-derived preclinical pancreatic cancer models reveal panitumumab sensitivity in KRAS wild-type tumors.

机构信息

Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, VIC, 3168, Australia.

Department of Molecular Translational Science, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia.

出版信息

Int J Cancer. 2017 May 15;140(10):2331-2343. doi: 10.1002/ijc.30648. Epub 2017 Feb 28.

Abstract

Pancreatic cancer (PC) is largely refractory to existing therapies used in unselected patient trials, thus emphasizing the pressing need for new approaches for patient selection in personalized medicine. KRAS mutations occur in 90% of PC patients and confer resistance to epidermal growth factor receptor (EGFR) inhibitors (e.g., panitumumab), suggesting that KRAS wild-type PC patients may benefit from targeted panitumumab therapy. Here, we use tumor tissue procured by endoscopic ultrasound-guided fine-needle aspirate (EUS-FNA) to compare the in vivo sensitivity in patient-derived xenografts (PDXs) of KRAS wild-type and mutant PC tumors to panitumumab, and to profile the molecular signature of these tumors in patients with metastatic or localized disease. Specifically, RNASeq of EUS-FNA-derived tumor RNA from localized (n = 20) and metastatic (n = 20) PC cases revealed a comparable transcriptome profile. Screening the KRAS mutation status of tumor genomic DNA obtained from EUS-FNAs stratified PC patients into either KRAS wild-type or mutant cohorts, and the engraftment of representative KRAS wild-type and mutant EUS-FNA tumor samples into NOD/SCID mice revealed that the growth of KRAS wild-type, but not mutant, PDXs was selectively suppressed with panitumumab. Furthermore, in silico transcriptome interrogation of The Cancer Genome Atlas (TCGA)-derived KRAS wild-type (n = 38) and mutant (n = 132) PC tumors revealed 391 differentially expressed genes. Taken together, our study validates EUS-FNA for the application of a novel translational pipeline comprising KRAS mutation screening and PDXs, applicable to all PC patients, to evaluate personalized anti-EGFR therapy in patients with KRAS wild-type tumors.

摘要

胰腺癌(PC)对现有疗法具有广泛的抗性,这些疗法在非选择性患者试验中使用,因此强调了在个性化医疗中为患者选择提供新方法的迫切需要。90%的 PC 患者存在 KRAS 突变,并且对表皮生长因子受体(EGFR)抑制剂(例如,panitumumab)具有抗性,这表明 KRAS 野生型 PC 患者可能受益于靶向 panitumumab 治疗。在这里,我们使用内镜超声引导下细针抽吸(EUS-FNA)获得的肿瘤组织,比较 KRAS 野生型和突变型 PC 肿瘤的患者来源异种移植物(PDX)对 panitumumab 的体内敏感性,并对患有转移性或局限性疾病的患者的这些肿瘤的分子特征进行分析。具体来说,对来自局限性(n = 20)和转移性(n = 20)PC 病例的 EUS-FNA 衍生肿瘤 RNA 的 RNASeq 显示出可比的转录组谱。对从 EUS-FNAs 获得的肿瘤基因组 DNA 的 KRAS 突变状态进行筛选,将 PC 患者分层为 KRAS 野生型或突变型队列,并且代表性的 KRAS 野生型和突变型 EUS-FNA 肿瘤样本的植入到 NOD/SCID 小鼠中,表明 KRAS 野生型,而不是突变型,PDX 的生长选择性地被 panitumumab 抑制。此外,对来自癌症基因组图谱(TCGA)的 KRAS 野生型(n = 38)和突变型(n = 132)PC 肿瘤的转录组进行计算分析揭示了 391 个差异表达基因。综上所述,我们的研究验证了 EUS-FNA 在应用包括 KRAS 突变筛选和 PDX 在内的新型转化管道中的应用,该管道适用于所有 PC 患者,用于评估 KRAS 野生型肿瘤患者的个性化抗 EGFR 治疗。

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