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Vendrell JA, Quantin X, Serre I, Solassol J. Combination of tissue and liquid biopsy molecular profiling to detect transformation to small cell lung carcinoma during osimertinib treatment. Ther Adv Med Oncol 2020; 12:1758835920974192. [PMID: 33414847 PMCID: PMC7750569 DOI: 10.1177/1758835920974192] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/23/2020] [Indexed: 12/17/2022] Open
Abstract
Background: Histological transformation of advanced non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC) is one of the mechanisms of resistance to third-generation tyrosine kinase inhibitors (TKIs), such as osimertinib. This acquired TKI resistance is linked to the high degree of tumor heterogeneity and adaptive cellular signaling pathways, including epidermal growth factor receptor (EGFR)-dependent pathways, observed in NSCLC. Methods: Here, we investigated a series of paired pre- and post-histological transformation biopsies obtained from three patients initially having a NSCLC with an EGFRactivating mutation treated with first-generation TKI, who then received osimertinib as second-line after EGFRT790M resistance and, lastly, developed a histological transformation to SCLC. Both tissue and liquid biopsies were analyzed using large panel sequencing approaches at various time points to reconstruct the clonal evolutionary history of the tumor. Results: Our complementary analysis of tumor tissue and circulating tumor DNA samples allowed us to better characterize the histological and molecular alterations associated with resistance to osimertinib. SCLC transformation was linked to the presence of several concomitant gene alterations, including EGFR, TP53 and RB1, but also to specific signal bypass, such as EGFR and MET amplifications and activation of the PI3K/AKT/mTOR pathway. Conclusion: Our report emphasizes the mutational landscape of SCLC histological transformation and highlights the importance of combining tissue and liquid biopsy profiling before and during osimertinib treatment to predict such histological transformation.
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Affiliation(s)
- Julie A Vendrell
- Laboratoire de Biologie des Tumeurs Solides, Département de Pathologie et Oncobiologie, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Xavier Quantin
- IRCM, INSERM, Univ Montpellier, ICM, Montpellier, France
| | - Isabelle Serre
- Laboratoire d'Anatomopathologie, Département de Pathologie et Oncobiologie, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Jérôme Solassol
- Laboratoire de Biologie des Tumeurs Solides, Hôpital Arnaud de Villeneuve, CHU de Montpellier, 371, avenue du Doyen Gaston Giraud, Montpellier cedex 5, 34295, France; IRCM, INSERM, Univ Montpellier, ICM, Montpellier, France
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Blateau P, Coyaud E, Laurent E, Béganton B, Ducros V, Chauchard G, Vendrell JA, Solassol J. TERT Promoter Mutation as an Independent Prognostic Marker for Poor Prognosis MAPK Inhibitors-Treated Melanoma. Cancers (Basel) 2020; 12:E2224. [PMID: 32784823 PMCID: PMC7463448 DOI: 10.3390/cancers12082224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/23/2020] [Accepted: 08/03/2020] [Indexed: 01/09/2023] Open
Abstract
Although the development of mitogen-activated protein kinase (MAPK) inhibitors has greatly improved the prognosis of BRAFV600 cutaneous melanomas, the identification of molecular indicators for mutated patients at risk of early progression remains a major issue. Using an amplicon-based next-generation-sequencing (NGS) assay that targets cancer-related genes, we investigated co-occurring alterations in 89 melanoma samples. We analyzed both their association with clinicopathological variables and clinical significance in terms of progression-free survival (PFS) and overall survival (OS) according to BRAF genotyping. Among co-occurring mutations, TERT promoter was the most frequently mutated gene. Although no significant difference in PFS was observed in the presence or absence of co-occurring alterations to BRAFV600, there was a trend of longer PFS for patients harboring TERT c.-124C>T mutation. Of most interest, this mutation is an independent marker of good prognosis in subgroups of patients with poor prognosis (presence of brain metastasis and elevated level of lactate dehydrogenase, LDH). Moreover, combination of elevated LDH level, presence of brain metastasis, and TERT c.-124C>T mutation was identified as the best fit model for predicting clinical outcome. Our work revealed the potential interest of c.-124C>T status determination in order to refine the prognosis of BRAFV600 melanoma under mitogen-activated protein kinase (MAPK) inhibitors.
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Affiliation(s)
- Pauline Blateau
- Laboratoire de Biologie des Tumeurs Solides, Département de Pathologie et Oncobiologie, Centre Hospitalier Universitaire de Montpellier, 34000 Montpellier, France; (P.B.); (B.B.); (V.D.); (G.C.); (J.A.V.)
- Institut de Recherche en Cancérologie de Montpellier, INSERM, Université de Montpellier, Institut du Cancer de Montpellier, Université de Montpellier, 34000 Montpellier, France
| | - Etienne Coyaud
- Laboratoire Protéomique Réponse Inflammatoire Spectrométrie de Masse (PRISM), INSERM U1192, Université de Lille, Centre Hospitalier Universitaire Lille, F-59000 Lille, France; (E.C.); (E.L.)
| | - Estelle Laurent
- Laboratoire Protéomique Réponse Inflammatoire Spectrométrie de Masse (PRISM), INSERM U1192, Université de Lille, Centre Hospitalier Universitaire Lille, F-59000 Lille, France; (E.C.); (E.L.)
| | - Benoit Béganton
- Laboratoire de Biologie des Tumeurs Solides, Département de Pathologie et Oncobiologie, Centre Hospitalier Universitaire de Montpellier, 34000 Montpellier, France; (P.B.); (B.B.); (V.D.); (G.C.); (J.A.V.)
- Institut de Recherche en Cancérologie de Montpellier, INSERM, Université de Montpellier, Institut du Cancer de Montpellier, Université de Montpellier, 34000 Montpellier, France
| | - Vincent Ducros
- Laboratoire de Biologie des Tumeurs Solides, Département de Pathologie et Oncobiologie, Centre Hospitalier Universitaire de Montpellier, 34000 Montpellier, France; (P.B.); (B.B.); (V.D.); (G.C.); (J.A.V.)
| | - Géraldine Chauchard
- Laboratoire de Biologie des Tumeurs Solides, Département de Pathologie et Oncobiologie, Centre Hospitalier Universitaire de Montpellier, 34000 Montpellier, France; (P.B.); (B.B.); (V.D.); (G.C.); (J.A.V.)
| | - Julie A. Vendrell
- Laboratoire de Biologie des Tumeurs Solides, Département de Pathologie et Oncobiologie, Centre Hospitalier Universitaire de Montpellier, 34000 Montpellier, France; (P.B.); (B.B.); (V.D.); (G.C.); (J.A.V.)
| | - Jérôme Solassol
- Laboratoire de Biologie des Tumeurs Solides, Département de Pathologie et Oncobiologie, Centre Hospitalier Universitaire de Montpellier, 34000 Montpellier, France; (P.B.); (B.B.); (V.D.); (G.C.); (J.A.V.)
- Institut de Recherche en Cancérologie de Montpellier, INSERM, Université de Montpellier, Institut du Cancer de Montpellier, Université de Montpellier, 34000 Montpellier, France
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Escudié F, Van Goethem C, Grand D, Vendrell J, Vigier A, Brousset P, Evrard SM, Solassol J, Selves J. MIAmS: microsatellite instability detection on NGS amplicons data. Bioinformatics 2019; 36:btz797. [PMID: 31647522 DOI: 10.1093/bioinformatics/btz797] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 09/26/2019] [Accepted: 10/18/2019] [Indexed: 11/14/2022] Open
Abstract
MOTIVATION Microsatellite instability (MSI) is a molecular marker of DNA mismatch repair deficiency frequently at play in oncogenesis. MSI testing is used for diagnostic, prognostic and therapeutic purposes in several cancers. The current gold standard analysis for microsatellite status is based on length distribution analysis of multiplex-PCR generated DNA fragments from tumor samples which is a laborious and time consuming method. Next generation sequencing (NGS) using amplicon panels is an easy, accurate and scalable technique to determine both the microsatellite status and tumor genome mutations at the same time. Here, we describe MIAmS, an application designed to tag microsatellite status from amplicon NGS of tumor samples. Interestingly, this tool does not require paired normal tissue for comparison. In addition, this scalable application provides a user-friendly report for the interpretation of the results by biologists and exhibits a strong accuracy and robustness for determination of the MSI status. AVAILABILITY https://github.com/bialimed/miams. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online, evaluation data are available at http://www.ebi.ac.uk/ena/data/view/PRJEB31725.
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Affiliation(s)
- Frédéric Escudié
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, CHU Toulouse, France
| | - Charles Van Goethem
- Department of Pathology and Oncobiology, Laboratoire de biologie des tumeurs solides, CHU de Montpellier, Univ. Montpellier, France
| | - David Grand
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, CHU Toulouse, France
| | - Julie Vendrell
- Department of Pathology and Oncobiology, Laboratoire de biologie des tumeurs solides, CHU de Montpellier, Univ. Montpellier, France
| | - Anna Vigier
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, CHU Toulouse, France
| | - Pierre Brousset
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, CHU Toulouse, France
| | - Solène M Evrard
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, CHU Toulouse, France
| | - Jérôme Solassol
- Department of Pathology and Oncobiology, Laboratoire de biologie des tumeurs solides, CHU de Montpellier, Univ. Montpellier, France
| | - Janick Selves
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, CHU Toulouse, France
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