通过使用有限的二代测序定制检测板对无特殊分子特征(NSMP)的子宫内膜癌进行分子分层,可能有助于为PIK3CA靶向治疗有效选择患者。
Molecular substratification of endometrial carcinomas with no special molecular profile (NSMP) by using a limited NGS custom panel may facilitate effective patient selection for the PIK3CA-targeted therapy.
作者信息
Ondič Ondrej, Michalová Květoslava, Švajdler Marián, Presl Jiří, Kosťun Jan, Hájková Veronika, Martínek Petr, Michal Michal
机构信息
Department of Pathology, Medical Faculty in Pilsen, Charles University, Prague, Czech Republic.
Molecular Genetics Department, Bioptická Laboratoř s.r.o, Pilsen, Czech Republic.
出版信息
Virchows Arch. 2025 Apr;486(4):827-832. doi: 10.1007/s00428-024-03905-6. Epub 2024 Sep 5.
Endometrial carcinomas (EC) of no special molecular profile (NSMP) represent the largest molecular category of EC, comprising a mixture of tumors with different histology and molecular profiles. These facts likely point to different tumor biology, clinical outcomes, and targeted therapy responses within this molecular category. The PIK3CA is currently the only targetable kinase oncoprotein directly implicated in EC carcinogenesis. Investigating a unique single-institution cohort, we attempted to stratify NSMP ECs based on the presence of the PIK3CA pathogenic mutation. Those cases were further analyzed for other well-established-associated oncogenic driver gene mutations. Histological and clinical variables were also correlated in each case. Altogether, 175 ECs were prospectively tested by a limited custom NGS panel containing ARID1A, BCOR, BRCA1, BRCA2, CTNNB1, KRAS, MLH1, MSH2, MSH6, NRAS, PIK3CA, PMS2, POLD1, POLE, PTEN,and TP53 genes. We identified 24 PIK3CA mutated cases in the group of 80 NSMP ECs, with another co-occurring mutation in at least one oncogenic driver gene (CTNNB1, PTEN, ARID1A, KRAS, BCOR, PMS2) in 19 cases. In conclusion, a limited NGS panel can effectively test EC tissue for specific pathogenetically relevant oncogene mutations. The NSMP EC category contains 30% of the PIK3CA mutated cases. Of those, 21% contain the PIK3CA mutation as a sole EC-associated oncogene mutation, while 79% harbor at least one more mutated gene. These findings may inform future healthcare planning and improve the effectiveness of EC patient selection for the PIK3CA-targeted therapy.
无特殊分子特征(NSMP)的子宫内膜癌(EC)是EC中最大的分子类别,包括具有不同组织学和分子特征的肿瘤混合物。这些事实可能表明该分子类别内存在不同的肿瘤生物学、临床结局和靶向治疗反应。PIK3CA是目前唯一直接参与EC致癌作用的可靶向激酶癌蛋白。通过研究一个独特的单机构队列,我们试图根据PIK3CA致病突变的存在对NSMP EC进行分层。对这些病例进一步分析其他已确定的相关致癌驱动基因突变。还对每个病例的组织学和临床变量进行了相关性分析。总共对175例EC进行了前瞻性检测,检测采用了一个有限的定制NGS面板,该面板包含ARID1A、BCOR、BRCA1、BRCA2、CTNNB1、KRAS、MLH1、MSH2、MSH6、NRAS、PIK3CA、PMS2、POLD1、POLE、PTEN和TP53基因。我们在80例NSMP EC组中鉴定出24例PIK3CA突变病例,其中19例在至少一个致癌驱动基因(CTNNB1、PTEN、ARID1A、KRAS、BCOR、PMS2)中还存在另一个共发突变。总之,一个有限的NGS面板可以有效地检测EC组织中特定的与发病机制相关的致癌基因突变。NSMP EC类别包含30%的PIK3CA突变病例。其中,21%的病例中PIK3CA突变是唯一与EC相关的致癌基因突变,而79%的病例至少还存在一个其他突变基因。这些发现可能为未来的医疗保健规划提供参考,并提高EC患者选择PIK3CA靶向治疗的有效性。
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