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Sokolenko AP, Bakaeva EK, Venina AR, Kuligina ES, Romanko AA, Aleksakhina SN, Belysheva YV, Belogubova EV, Stepanov IA, Zaitseva OA, Yatsuk OS, Togo AV, Khamgokov ZM, Kadyrova AO, Pirmagomedov AS, Bolieva MB, Epkhiev AA, Tsutsaev AK, Chakhieva MD, Khabrieva KM, Khabriev IM, Murachuev MA, Buttaeva BN, Baboshkina LS, Bayramkulova FI, Katchiev IR, Alieva LK, Raskin GA, Orlov SV, Khachmamuk ZK, Levonyan KR, Gichko DM, Kirtbaya DV, Degtyariov AM, Sultanova LV, Musayeva HS, Belyaev AM, Imyanitov EN. Ethnicity-specific BRCA1, BRCA2, PALB2, and ATM pathogenic alleles in breast and ovarian cancer patients from the North Caucasus. Breast Cancer Res Treat 2024; 203:307-315. [PMID: 37851290 DOI: 10.1007/s10549-023-07135-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Mountain areas of the North Caucasus host several large ethnic communities that have preserved their national identity over the centuries. METHODS This study involved high-grade serous ovarian cancer (HGSOC) and breast cancer (BC) patients from Dagestan (HGSOC: 37; BC: 198), Kabardino-Balkaria (HGSOC: 68; BC: 155), North Ossetia (HGSOC: 51; BC: 104), Chechnya (HGSOC: 68; BC: 79), Ingushetia (HGSOC: 19; BC: 103), Karachay-Cherkessia (HGSOC: 13; BC: 47), and several Armenian settlements (HGSOC: 16; BC: 101). The group of BC patients was enriched by young-onset and/or family history-positive and/or bilateral and/or receptor triple-negative cases. The entire coding region of BRCA1, BRCA2, PALB2, and ATM genes was analyzed by next-generation sequencing. RESULTS A significant contribution of BRCA1/2 pathogenic variants (PVs) to HGSOC and BC development was observed across all North Caucasus regions (HGSOC: 19-39%; BC: 6-13%). Founder alleles were identified in all ethnic groups studied, e.g., BRCA1 c.3629_3630delAG in Chechens, BRCA2 c.6341delC in North Ossetians, BRCA2 c.5351dupA in Ingush, and BRCA1 c.2907_2910delTAAA in Karachays. Some BRCA1/2 alleles, particularly BRCA2 c.9895C > T, were shared by several nationalities. ATM PVs were detected in 14 patients, with c.1673delG and c.8876_8879delACTG alleles occurring twice each. PALB2 heterozygosity was observed in 5 subjects, with one variant seen in 2 unrelated women. CONCLUSION This study adds to the evidence for the global-wide contribution of BRCA1/2 genes to HGSOC and BC morbidity, although the spectrum of their PVs is a subject of ethnicity-specific variations. The data on founder BRCA1/2 alleles may be considered when adjusting the BRCA1/2 testing procedure to the ethnic origin of patients.
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Affiliation(s)
- Anna P Sokolenko
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758.
- St. Petersburg Pediatric Medical University, St. Petersburg, Russia.
| | - Elvina Kh Bakaeva
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Aigul R Venina
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Ekaterina Sh Kuligina
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Alexandr A Romanko
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Svetlana N Aleksakhina
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Yana V Belysheva
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Evgeniya V Belogubova
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Ilya A Stepanov
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Olga A Zaitseva
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Olga S Yatsuk
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Alexandr V Togo
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Zaur M Khamgokov
- Republican Cancer Center, The Kabardino-Balkarian Republic, Nalchik, Russia
| | - Azinat O Kadyrova
- Republican Cancer Center, The Kabardino-Balkarian Republic, Nalchik, Russia
| | | | - Marina B Bolieva
- Republican Cancer Center, The Republic of North Ossetia-Alania, Vladikavkaz, Russia
| | - Alexandr A Epkhiev
- Republican Cancer Center, The Republic of North Ossetia-Alania, Vladikavkaz, Russia
| | - Aslan K Tsutsaev
- Republican Cancer Center, The Republic of North Ossetia-Alania, Vladikavkaz, Russia
| | | | | | - Idris M Khabriev
- Republican Cancer Center, The Republic of Ingushetia, Pliyevo, Russia
| | - Mirza A Murachuev
- Republican Cancer Center, The Republic of Dagestan, Makhachkala, Russia
| | - Bella N Buttaeva
- Republican Bureau of Pathology, The Republic of Dagestan, Makhachkala, Russia
| | - Liliya S Baboshkina
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | | | - Islam R Katchiev
- Republican Cancer Center, The Karachay-Cherkess Republic, Cherkessk, Russia
| | - Lina Kh Alieva
- Republican Cancer Center, The Karachay-Cherkess Republic, Cherkessk, Russia
| | - Grigory A Raskin
- Dr. Sergey Berezin Medical Institute of Biological Systems, St. Petersburg, Russia
| | - Sergey V Orlov
- I.P. Pavlov St.-Petersburg State Medical University, St. Petersburg, Russia
| | | | | | | | | | | | | | - Hedi S Musayeva
- Republican Cancer Center, Grozny, The Chechen Republic, Russia
| | - Alexey M Belyaev
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
| | - Evgeny N Imyanitov
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, Leningradskaya, 68, Pesochny-2, St. Petersburg, Russia, 197758
- St. Petersburg Pediatric Medical University, St. Petersburg, Russia
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2
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Qin Z, Li J, Tam B, Sinha S, Zhao B, Bhaskaran SP, Huang T, Wu X, Chian JS, Guo M, Kou SH, Lei H, Zhang L, Wang X, Lagniton PNP, Xiao F, Jiang X, Wang SM. Ethnic-specificity, evolution origin and deleteriousness of Asian BRCA variation revealed by over 7500 BRCA variants derived from Asian population. Int J Cancer 2023; 152:1159-1173. [PMID: 36385461 PMCID: PMC10098510 DOI: 10.1002/ijc.34359] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/23/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
Pathogenic variation in BRCA1 and BRCA2 (BRCA) causes high risk of breast and ovarian cancer, and BRCA variation data are important markers for BRCA-related clinical cancer applications. However, comprehensive BRCA variation data are lacking from the Asian population despite its large population size, heterogenous genetic background and diversified living environment across the Asia continent. We performed a systematic study on BRCA variation in Asian population including extensive data mining, standardization, annotation and characterization. We identified 7587 BRCA variants from 685 592 Asian individuals in 40 Asia countries and regions, including 1762 clinically actionable pathogenic variants and 4915 functionally unknown variants (https://genemutation.fhs.um.edu.mo/Asian-BRCA/). We observed the highly ethnic-specific nature of Asian BRCA variants between Asian and non-Asian populations and within Asian populations, highlighting that the current European descendant population-based BRCA data is inadequate to reflect BRCA variation in the Asian population. We also provided archeological evidence for the evolutionary origin and arising time of Asian BRCA variation. We further provided structural-based evidence for the deleterious variants enriched within the functionally unknown Asian BRCA variants. The data from our study provide a current view of BRCA variation in the Asian population and a rich resource to guide clinical applications of BRCA-related cancer for the Asian population.
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Affiliation(s)
- Zixin Qin
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Jiaheng Li
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Benjamin Tam
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Siddharth Sinha
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Bojin Zhao
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Shanmuga Priya Bhaskaran
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Teng Huang
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xiaobing Wu
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Jia Sheng Chian
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Maoni Guo
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Si Hoi Kou
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Huijun Lei
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Li Zhang
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xiaoyu Wang
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Philip Naderev P Lagniton
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Fengxia Xiao
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xinyang Jiang
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - San Ming Wang
- Ministry of Education Frontiers Science Center for Precision Oncology, Cancer Centre and Institute of Translational Medicine, Department of Public Health and Medical Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
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3
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Kechin A, Boyarskikh U, Barinov A, Tanas A, Kazakova S, Zhevlova A, Khrapov E, Subbotin S, Mishukova O, Kekeeva T, Demidova I, Filipenko M. A spectrum of BRCA1 and BRCA2 germline deleterious variants in ovarian cancer in Russia. Breast Cancer Res Treat 2023; 197:387-395. [PMID: 36367610 DOI: 10.1007/s10549-022-06782-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/23/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE Pathogenic variants (PVs) in BRCA1 and BRCA2 genes are essential biomarkers of an increased breast and ovarian cancer risk and tumor sensitivity to poly ADP ribose polymerase inhibitors. In Russia, eight PVs were thought to be the most common, among which BRCA1 c.5266dup is the most frequently identified one. METHODS We show the distribution of BRCA1/2 PVs identified with quantitative PCR and targeted next-generation sequencing in 1399 ovarian cancer patients recruited into the study from 72 Russian regions in 2015-2021. RESULTS The most abundant PVs were c.5266dup (41.0%), c.4035del (7.0%), c.1961del (6.3%), c.181 T > G (5.2%), c.3756_3759del (1.8%), c.3700_3704del (1.5%), and c.68_69del (1.5%), all found in BRCA1 and known to be recurrent in Russia. Several other frequent PVs were identified: c.5152 + 1G > T (1.2%), c.1687C > T (1.0%), c.4689C > G (0.9%), c.1510del (0.6%), c.2285_2286del (0.6%) in the BRCA1 gene; and c.5286 T > G (1.2%), c.2808_2811del (0.8%), c.3847_3848del (0.8%), c.658_659del (0.7%), c.7879A > T (0.6%), in the BRCA2 gene. For the most common PV in the BRCA2 gene c.5286 T > G, we suggested that it arose about 700 years ago and is a new founder mutation. CONCLUSION This study extends our knowledge about the BRCA1 and BRCA2 pathogenic variants variability.
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Affiliation(s)
- Andrey Kechin
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russia. .,Novosibirsk State University, Novosibirsk, 630090, Russia.
| | - Ulyana Boyarskikh
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russia
| | - Alexey Barinov
- Moscow City Oncology Hospital No 62 of the Moscow Health Department, Istra, 143423, Russia
| | - Alexander Tanas
- Research Centre for Medical Genetics, Moscow, 115522, Russia
| | | | | | - Evgeniy Khrapov
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russia
| | - Sergey Subbotin
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russia
| | - Olga Mishukova
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russia
| | - Tatiana Kekeeva
- Research Centre for Medical Genetics, Moscow, 115522, Russia
| | - Irina Demidova
- Moscow City Oncology Hospital No 62 of the Moscow Health Department, Istra, 143423, Russia
| | - Maxim Filipenko
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russia.,Novosibirsk State University, Novosibirsk, 630090, Russia
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4
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Carnevali I, Tedaldi G, Pensotti V, Sahnane N, Micello D, Rovera F, Sessa F, Tibiletti MG. Case Report: Male Lobular Breast Cancer in Hereditary Cancer Syndromes. Front Oncol 2022; 12:891426. [PMID: 35686104 PMCID: PMC9171007 DOI: 10.3389/fonc.2022.891426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background Lobular breast carcinoma (LBC) is considered an exceptionally rare disease in men, including only 1% of all male breast malignancies. The majority of LBCs have negative immunohistochemical staining for E-cadherin (CDH1) expression, and the loss of CDH1 function was traditionally implicated in the tumorigenesis of diffuse gastric cancer as well as LBC. It is well recognized that LBC in women could be involved in both hereditary breast and ovarian cancer (HBOC) and hereditary diffuse gastric cancer (HDGC) syndromes; however, there are no data present in literature about the involvement of male LBC in these inherited conditions. Methods BRCA1, BRCA2, and CDH1 genes were performed on DNA from peripheral blood using next-generation sequencing (NGS), Sanger sequencing, and multiplex ligation-dependent probe amplification analyses. BRCA2 and CDH1 somatic gene analyses were performed on breast tumoral DNA using the NGS sequencing approach. Results and conclusions Here, we describe two men affected by LBC, the carriers of a pathogenic variant of BRCA2 and CDH1 genes, respectively. Our data, including somatic and germline results, demonstrate a strong relationship between male LBC and HBOC/HDGC syndromes, excluding a sporadic origin of LBC in these two patients. Male LBC could represent a sentinel cancer for inherited syndrome identification, and early identification of cancer susceptibility could improve cancer prevention both for men and women in these families. The history of the LBC patient carrier of the CDH1 variant suggests to include male LBC genetic testing criteria and male breast surveillance in HDGC guidelines.
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Affiliation(s)
- Ileana Carnevali
- Unit of Pathology, Ospedale di Circolo, Azienda Socio Sanitaria Territoriale (ASST)-Sette Laghi, Varese, Italy.,Research Center for the Study of Hereditary and Familial Tumors, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Gianluca Tedaldi
- Biosciences Laboratory, Istituto Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" - Istituto Romagnolo per lo Studio dei Tumori (IRST) S.r.l., Meldola, Italy
| | | | - Nora Sahnane
- Unit of Pathology, Ospedale di Circolo, Azienda Socio Sanitaria Territoriale (ASST)-Sette Laghi, Varese, Italy.,Research Center for the Study of Hereditary and Familial Tumors, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Donata Micello
- Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
| | - Francesca Rovera
- Research Center for the Study of Hereditary and Familial Tumors, Department of Medicine and Surgery, University of Insubria, Varese, Italy.,Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Fausto Sessa
- Unit of Pathology, Ospedale di Circolo, Azienda Socio Sanitaria Territoriale (ASST)-Sette Laghi, Varese, Italy.,Research Center for the Study of Hereditary and Familial Tumors, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Maria Grazia Tibiletti
- Unit of Pathology, Ospedale di Circolo, Azienda Socio Sanitaria Territoriale (ASST)-Sette Laghi, Varese, Italy.,Research Center for the Study of Hereditary and Familial Tumors, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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5
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Rubinson D, Wolpin BM, Warsofsky IS, Ryan DP, Perez K, Rahma O, Singh H, Yurgelun MB, Shapiro GI, Aguirre AJ, D'Andrea AD, Cleary JM. Durable clinical benefit from PARP inhibition in a platinum-sensitive, BRCA2-mutated pancreatic cancer patient after earlier progression on placebo treatment on the POLO trial: a case report. J Gastrointest Oncol 2021; 12:3133-3140. [PMID: 35070436 DOI: 10.21037/jgo-21-197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/26/2021] [Indexed: 12/27/2022] Open
Abstract
Metastatic pancreatic adenocarcinoma is a deadly malignancy with limited treatment options. Based on the results of the phase 3 POLO trial, the PARP inhibitor olaparib was approved by the Food and Drug Administration as a maintenance therapy in germline BRCA1- and BRCA2-mutated metastatic pancreatic cancer patients whose cancers had not progressed on first-line platinum-based chemotherapy. While this approval was a step forward, there have been criticisms of the POLO study leaving doubts in the field about the effectiveness of PARP inhibition in pancreatic cancer. Here, we describe a patient with a germline BRCA2-mutated, metastatic pancreatic cancer who was randomized to the placebo-arm of the POLO trial. After progressing on the placebo-arm of the POLO study, her cancer again responded to platinum-based chemotherapy and has since been successfully treated for 4 years with off-protocol maintenance olaparib. The presence of placebo treatment in this case serves as an internal control demonstrating the efficacy of PARP inhibition in this patient. This case highlights the potential of PARP inhibitor maintenance therapy in appropriately selected metastatic pancreatic cancer patients.
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Affiliation(s)
- Douglas Rubinson
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Brian M Wolpin
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Ilana S Warsofsky
- Department of Radiology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - David P Ryan
- Department of Hematology/Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Kimberly Perez
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Osama Rahma
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Harshabad Singh
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Matthew B Yurgelun
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Geoffrey I Shapiro
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Andrew J Aguirre
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Alan D D'Andrea
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.,Center for DNA Damage and Repair, Dana-Farber Cancer Institute, Boston, MA, USA
| | - James M Cleary
- Department of Medical Oncology, Dana-Farber Brigham and Women's Cancer Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
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6
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Apostolou P, Fostira F, Kouroussis C, Kalfakakou D, Delimitsou A, Agelaki S, Androulakis N, Christodoulou C, Kalbakis K, Kalykaki A, Sanidas E, Papadimitriou C, Vamvakas L, Georgoulias V, Mavroudis D, Yannoukakos D, Konstantopoulou I, Saloustros E. BRCA1 and BRCA2 germline testing in Cretan isolates reveals novel and strong founder effects. Int J Cancer 2020; 147:1334-1342. [PMID: 32022259 DOI: 10.1002/ijc.32903] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/15/2020] [Accepted: 01/23/2020] [Indexed: 12/14/2022]
Abstract
Germline BRCA1 and BRCA2 loss-of-function variants have been linked to increased breast and ovarian cancer risk, with more than 5,000 distinct pathogenic variants being reported worldwide. Among individuals of Greek descent, the BRCA1/2 variant spectrum is heterogeneous, but characterized by strong founder effects. As patients from certain geographical regions of Greece (like Crete) were underrepresented in previous studies, we hypothesized that isolated Cretans, a southern Greece islanders' population with distinct demographic, cultural and genetic features, could harbor founder BRCA1/2 mutations. A total of 304 breast or/and ovarian cancer patients of Cretan descent, fulfilling NCCN criteria for genetic testing, were tested by NGS or Sanger sequencing, followed by MLPA. Haplotype analysis was subsequently performed to investigate potential founder effects of recurrent alleles. Overall, 16.5% (50/304) of the tested patients carried 22 different pathogenic variants; 48% in BRCA1, 52% in BRCA2. Three variants, namely two in BRCA2 (Δexons 12 and 13 and c.7806-2A>T) and one in BRCA1 (c.5492del), constituting approximately half (48%) of all detected pathogenic variants, were shown to have a founder effect, with all carriers sharing common haplotypes. Remarkably, these variants were confined to Cretans and have not been identified in other regions of Greece. The high prevalence of specific BRCA1/2 pathogenic variants among Cretans, provides the possibility of cost- and time-efficient screening of the Cretan population. Integrating this knowledge in local public health services may have a significant impact on cancer prevention, and may serve as a starting point for the implementation of testing on a population level.
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Affiliation(s)
- Paraskevi Apostolou
- Molecular Diagnostics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos", Athens, Greece
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos", Athens, Greece
| | | | - Despoina Kalfakakou
- Molecular Diagnostics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos", Athens, Greece
| | - Angeliki Delimitsou
- Molecular Diagnostics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos", Athens, Greece
| | - Sofia Agelaki
- Laboratory of Translational Oncology, School of Medicine, University of Crete, Heraklion, Crete, Greece.,Department of Medical Oncology, School of Medicine, University Hospital of Heraklion, Crete, Greece
| | | | | | - Konstantinos Kalbakis
- Department of Medical Oncology, School of Medicine, University Hospital of Heraklion, Crete, Greece
| | - Antonia Kalykaki
- Department of Medical Oncology, School of Medicine, University Hospital of Heraklion, Crete, Greece
| | - Elias Sanidas
- Department of Surgery, School of Medicine, University of Crete, Heraklion, Greece
| | - Christos Papadimitriou
- Oncology Unit, Second Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lambros Vamvakas
- Department of Medical Oncology, School of Medicine, University Hospital of Heraklion, Crete, Greece
| | | | - Dimitris Mavroudis
- Laboratory of Translational Oncology, School of Medicine, University of Crete, Heraklion, Crete, Greece.,Department of Medical Oncology, School of Medicine, University Hospital of Heraklion, Crete, Greece
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos", Athens, Greece
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos", Athens, Greece
| | - Emmanouil Saloustros
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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7
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Sun Y, Li D, Su Y, Zhao H, Pang W, Zhao W, Wu S. Protective effect of hydrogen sulfide is mediated by negative regulation of epigenetic histone acetylation in Parkinson's disease. Arch Med Sci 2020; 19:1124-1135. [PMID: 37560727 PMCID: PMC10408026 DOI: 10.5114/aoms.2020.93121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/14/2019] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Derangements in monoaminergic transmission in the substantia nigra with disturbed signaling in the hypothalamic-pituitary-adrenal axis are the major characteristics of Parkinson's disease (PD). It has been reported that the administration of hydrogen sulfide (H2S) is in practice to treat PD because of its redundant nature in regulating various neuronal signals. Hence, the current investigation was performed to evaluate the hypothesis that H2S might exert protective action via the inhibition of epigenetic histone acetylation. MATERIAL AND METHODS To test this notion, 6-hydroxydopamine (6-OHDA) was used to induce PD and sodium hydrogen sulfide (SHS) was used as a H2S donor and tubastatin A (TSA) was tested in an in vivo rat model to delineate the signaling mechanism. RESULTS Induction of PD in rats demonstrated elevated oxidative stress with an evidenced decrease in antioxidant enzymes, while elevated pro-inflammatory cytokines and inflammatory mediators were observed in the striatum of PD rats compared to controls. On the other hand, elevated (p < 0.01) levels of dopamine, 3,4-dihydroxyphenylacetic acid (DOPAC), mRNA transcript of HDAC-2, -3, -4, -6 and total histone deacetylase (HDAC) were found with reduced levels of histone acetyltransferase (HAT) in the brain tissues of PD induced rats. CONCLUSIONS Diversely, H2S exposure reversed these alterations with reduced HDAC activity. Further, PD rats treated with HDAC inhibitor showed a dramatic upsurge in the level of tyrosine hydroxylase, with a decreased level of glial fibrillary acidic protein, α-synuclein, tumor necrosis factor α, and other cytokines. Thus the results of the study suggest that H2S exerts protection via inhibition of HDAC.
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Affiliation(s)
- Yang Sun
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi, China
| | - Dai Li
- Department of Anesthesiology, Chang Hai Hospital, Naval Military Medical University, Shanghai, China
| | - Yuqiang Su
- Department of Anesthesiology, The Second Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi, China
| | - Haikang Zhao
- Department of Neurosurgery, The Second Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi, China
| | - Weiwei Pang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi, China
| | - Wei Zhao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi, China
| | - Shengjun Wu
- Department of Gynecology, The Second Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi, China
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8
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Solmaz AE, Onay H, Yeniay L, Gökmen E, Özdemir N, Alanyalı S, Oktay A, Özsaran Z, Kapkaç M, Özkınay F. BRCA1-BRCA2 mutation analysis results in 910 individuals: Mutation distribution and 8 novel mutations. Cancer Genet 2020; 241:20-24. [PMID: 31954625 DOI: 10.1016/j.cancergen.2019.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/12/2019] [Accepted: 12/27/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Aslı Ece Solmaz
- Ege University Faculty of Medicine, Department of Medical Genetic, 35100 Bornova, Izmir, Turkey.
| | - Hüseyin Onay
- Ege University Faculty of Medicine, Department of Medical Genetic, 35100 Bornova, Izmir, Turkey
| | - Levent Yeniay
- Ege University Faculty of Medicine, Department of General Surgery, Izmir, Turkey
| | - Erhan Gökmen
- Ege University Faculty of Medicine, Department of Medical Oncology, Izmir, Turkey
| | - Necmettin Özdemir
- Ege University Faculty of Medicine, Department of Pathology, Izmir, Turkey
| | - Senem Alanyalı
- Ege University Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey
| | - Ayşenur Oktay
- Ege University Faculty of Medicine, Department of Radiology, Izmir, Turkey
| | - Zeynep Özsaran
- Ege University Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey
| | - Murat Kapkaç
- Ege University Faculty of Medicine, Department of General Surgery, Izmir, Turkey
| | - Ferda Özkınay
- Ege University Faculty of Medicine, Department of Medical Genetic, 35100 Bornova, Izmir, Turkey
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Huszno J, Fiszer-Kierzkowska A, Pigłowski W, Mazur M. BRCA2 genemutation, c.2808_2811delACAA (p.Ala938Profs), in malebreastcancer - clinicopathologicalanalysisbased on a case report. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2019; 18:227-229. [PMID: 32132887 PMCID: PMC7045353 DOI: 10.5114/pm.2019.93120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/25/2019] [Indexed: 11/17/2022]
Abstract
Male breast cancer (MBC) is a rare disease that occurs in ~0.2% of all neoplasms among men. The risk of developing MBC is higher in men with a BRCA2 genetic mutation (7%). The aim of this study was to evaluate the association between c.2808_2811del ACAA (p.Ala938Profs) BRCA2 mutation in MBC and clinicopathological factors. A 75-year-old patient was admitted to the Genetic Outpatient Clinic with a diagnosis of right breast cancer and with a family history of cancer (two daughters who were diagnosed with breast cancer at ages 46 and 38 years). Postoperative histopathological examination revealed tumor type pT2 N1a Mx, NST NG-3 G-3, Ki-67 (75%), HER2 (+), ER (+++), PR (+++), invasive carcinoma and luminal B subtype. The complete coding sequences of the BRCA1 and BRCA2 genes were analyzed for genomic DNA material using next generation sequencing on the Ion Torrent platform. The c.2808_2811delACAA (p.Ala938Profs) mutation was observed in the BRCA2 gene. The presence of the c.2808_2811delACAA (p.Ala938Profs) mutation in the BRCA2 gene was confirmed using the Sanger method. The same BRCA2 gene mutation was reported in one of the patient's daughters. The detected mutation causes the frameshift mutation, resulting in the creation of an additional translation termination codon and the synthesis of an abnormal protein. This mutation was associated with a later age of disease, a higher histological degree, a higher mitotic index, a positive steroid receptor status and the luminal B subtype HER2- breast cancer.
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Affiliation(s)
- Joanna Huszno
- Clinical and ExperimentalOncologyDepartment, Maria Skłodowska-Curie MemorialCancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Anna Fiszer-Kierzkowska
- Center for TranslationalResearch and MolecularBiology of Cancer, Maria Skłodowska-Curie MemorialCancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Wojciech Pigłowski
- Center for TranslationalResearch and MolecularBiology of Cancer, Maria Skłodowska-Curie MemorialCancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Magdalena Mazur
- Center for TranslationalResearch and MolecularBiology of Cancer, Maria Skłodowska-Curie MemorialCancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
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Fraile-Bethencourt E, Valenzuela-Palomo A, Díez-Gómez B, Goina E, Acedo A, Buratti E, Velasco EA. Mis-splicing in breast cancer: identification of pathogenic BRCA2 variants by systematic minigene assays. J Pathol 2019; 248:409-420. [PMID: 30883759 DOI: 10.1002/path.5268] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/21/2019] [Accepted: 03/11/2019] [Indexed: 12/21/2022]
Abstract
Splicing disruption is a common mechanism of gene inactivation associated with germline variants of susceptibility genes. To study the role of BRCA2 mis-splicing in hereditary breast/ovarian cancer (HBOC), we performed a comprehensive analysis of variants from BRCA2 exons 2-9, as well as the initial characterization of the regulatory mechanisms of such exons. A pSAD-based minigene with exons 2-9 was constructed and validated in MCF-7 cells, producing the expected transcript (1016-nt/V1-BRCA2_exons_2-9-V2). DNA variants from mutational databases were analyzed by NNSplice and Human Splicing Finder softwares. To refine ESE-variant prediction, we mapped the regulatory regions through a functional strategy whereby 26 exonic microdeletions were introduced into the minigene and tested in MCF-7 cells. Thus, we identified nine spliceogenic ESE-rich intervals where ESE-variants may be located. Combining bioinformatics and microdeletion assays, 83 variants were selected and genetically engineered in the minigene. Fifty-three changes impaired splicing: 28 variants disrupted the canonical sites, four created new ones, 10 abrogated enhancers, eight created silencers and three caused a double-effect. Notably, nine spliceogenic-ESE variants were located within ESE-containing intervals. Capillary electrophoresis and sequencing revealed more than 23 aberrant transcripts, where exon skipping was the most common event. Interestingly, variant c.67G>A triggered the usage of a noncanonical GC-donor 4-nt upstream. Thirty-six variants that induced severe anomalies (>60% aberrant transcripts) were analyzed according to the ACMG guidelines. Thus, 28 variants were classified as pathogenic, five as likely pathogenic and three as variants of uncertain significance. Interestingly, 13 VUS were reclassified as pathogenic or likely pathogenic variants. In conclusion, a large fraction of BRCA2 variants (∼64%) provoked splicing anomalies lending further support to the high prevalence of this disease-mechanism. The low accuracy of ESE-prediction algorithms may be circumvented by functional ESE-mapping that represents an optimal strategy to identify spliceogenic ESE-variants. Finally, systematic functional assays by minigenes depict a valuable tool for the initial characterization of splicing anomalies and the clinical interpretation of variants. © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Eugenia Fraile-Bethencourt
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular (CSIC-UVa), Valladolid, Spain
| | - Alberto Valenzuela-Palomo
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular (CSIC-UVa), Valladolid, Spain
| | - Beatriz Díez-Gómez
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular (CSIC-UVa), Valladolid, Spain
| | - Elisa Goina
- Molecular Pathology Group, International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Alberto Acedo
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular (CSIC-UVa), Valladolid, Spain
| | - Emanuele Buratti
- Molecular Pathology Group, International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Eladio A Velasco
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular (CSIC-UVa), Valladolid, Spain
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Fraile-Bethencourt E, Valenzuela-Palomo A, Díez-Gómez B, Acedo A, Velasco EA. Identification of Eight Spliceogenic Variants in BRCA2 Exon 16 by Minigene Assays. Front Genet 2018; 9:188. [PMID: 29881398 PMCID: PMC5977032 DOI: 10.3389/fgene.2018.00188] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/08/2018] [Indexed: 11/17/2022] Open
Abstract
Genetic testing of BRCA1 and BRCA2 identifies a large number of variants of uncertain clinical significance whose functional and clinical interpretations pose a challenge for genetic counseling. Interestingly, a relevant fraction of DNA variants can disrupt the splicing process in cancer susceptibility genes. We have tested more than 200 variants throughout 19 BRCA2 exons mostly by minigene assays, 54% of which displayed aberrant splicing, thus confirming the utility of this assay to check genetic variants in the absence of patient RNA. Our goal was to investigate BRCA2 exon 16 with a view to characterizing spliceogenic variants recorded at the mutational databases. Seventy-two different BIC and UMD variants were analyzed with NNSplice and Human Splicing Finder, 12 of which were selected because they were predicted to disrupt essential splice motifs: canonical splice sites (ss; eight variants) and exonic/intronic splicing enhancers (four variants). These 12 candidate variants were introduced into the BRCA2 minigene with seven exons (14–20) by site-directed mutagenesis and then transfected into MCF-7 cells. Seven variants (six intronic and one missense) induced complete abnormal splicing patterns: c.7618-2A>T, c.7618-2A>G, c.7618-1G>C, c.7618-1G>A, c.7805G>C, c.7805+1G>A, and c.7805+3A>C, as well as a partial anomalous outcome by c.7802A>G. They generated at least 10 different transcripts: Δ16p44 (alternative 3’ss 44-nt downstream; acceptor variants), Δ16 (exon 16-skipping; donor variants), Δ16p55 (alternative 3’ss 55-nt downstream), Δ16q4 (alternative 5’ss 4-nt upstream), Δ16q100 (alternative 5’ss 4-nt upstream), ▾16q20 (alternative 5’ss 20-nt downstream), as well as minor (Δ16p93 and Δ16,17p69) and uncharacterized transcripts of 893 and 954 nucleotides. Isoforms Δ16p44, Δ16, Δ16p55, Δ16q4, Δ16q100, and ▾16q20 introduced premature termination codons which presumably inactivate BRCA2. According to the guidelines the American College of Medical Genetics and Genomics these eight variants could be classified as pathogenic or likely pathogenic whereas the Evidence-based Network for the Interpretation of Germline Mutant Alleles rules suggested seven class 4 and one class 3 variants. In conclusion, our study highlights the relevance of splicing functional assays by hybrid minigenes for the clinical classification of genetic variations. Hence, we provide new data about spliceogenic variants of BRCA2 exon 16 that are directly correlated with breast cancer susceptibility.
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Affiliation(s)
- Eugenia Fraile-Bethencourt
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular, Consejo Superior de Investigaciones Científicas, Universidad de Valladolid, Valladolid, Spain
| | - Alberto Valenzuela-Palomo
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular, Consejo Superior de Investigaciones Científicas, Universidad de Valladolid, Valladolid, Spain
| | - Beatriz Díez-Gómez
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular, Consejo Superior de Investigaciones Científicas, Universidad de Valladolid, Valladolid, Spain
| | - Alberto Acedo
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular, Consejo Superior de Investigaciones Científicas, Universidad de Valladolid, Valladolid, Spain.,Biome Makers Inc., San Francisco, CA, United States
| | - Eladio A Velasco
- Splicing and Genetic Susceptibility to Cancer, Instituto de Biología y Genética Molecular, Consejo Superior de Investigaciones Científicas, Universidad de Valladolid, Valladolid, Spain
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12
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Mutational analysis of BRCA1/2 in a group of 134 consecutive ovarian cancer patients. Novel and recurrent BRCA1/2 alterations detected by next generation sequencing. J Appl Genet 2014; 56:193-8. [PMID: 25366421 PMCID: PMC4412280 DOI: 10.1007/s13353-014-0254-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/15/2014] [Accepted: 10/16/2014] [Indexed: 11/20/2022]
Abstract
The importance of proper mutational analysis of BRCA1/2 in individuals at risk for hereditary breast and ovarian cancer syndrome is widely accepted. Standard genetic screening includes targeted analysis of recurrent, population-specific mutations. The purpose of the study was to establish the frequency of germline BRCA1/2 mutations in a group of 134 unrelated patients with primary ovarian cancer. Next generation sequencing analysis revealed a presence of 20 (14.9 %) mutations, where 65 % (n = 13) were recurrent BRCA1 alterations included in the standard diagnostic panel in northern Poland. However, the remaining seven BRCA1/2 mutations (35 %) would be missed by the standard approach and were detected in unique patients. A substantial proportion (n = 5/12; 41 %) of mutation-positive individuals with complete family history reported no incidence of breast or ovarian cancer in their relatives. This observation, together with the raising perspectives for personalized therapy targeting BRCA1/2 signaling pathways indicates the necessity of comprehensive genetic screening in all ovarian cancer patients. However, due to the limited sensitivity of the standard genetic screening presented in this study (65 %) an application of next generation sequencing in molecular diagnostics of BRCA1/2 genes should be considered.
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