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Sahakian N, Castinetti F, Romanet P. Molecular Basis and Natural History of Medullary Thyroid Cancer: It is (Almost) All in the RET. Cancers (Basel) 2023; 15:4865. [PMID: 37835559 PMCID: PMC10572078 DOI: 10.3390/cancers15194865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Medullary thyroid cancer (MTC) is a rare disease, which can be either sporadic (roughly 75% of cases) or genetically determined (multiple endocrine neoplasia type 2, due to REarranged during Transfection RET germline mutations, 25% of cases). Interestingly, RET pathogenic variants (mainly M918T) have also been reported in aggressive forms of sporadic MTC, suggesting the importance of RET signalling pathways in the pathogenesis of MTC. The initial theory of RET codon-related MTC aggressiveness has been recently questioned by studies suggesting that this would only define the age at disease onset rather than the aggressiveness of MTC. Other factors might however impact the natural history of the disease, such as RET polymorphisms, epigenetic factors, environmental factors, MET (mesenchymal-epithelial transition) alterations, or even other genetic alterations such as RAS family (HRAS, KRAS, NRAS) genetic alterations. This review will detail the molecular bases of MTC, focusing on RET pathways, and the potential mechanisms that explain the phenotypic intra- and interfamilial heterogeneity.
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Affiliation(s)
- Nicolas Sahakian
- Aix Marseille Univ, APHM, INSERM, MMG, La Conception University Hospital, Department of Endocrinology, Marseille, France; (N.S.); (F.C.)
| | - Frédéric Castinetti
- Aix Marseille Univ, APHM, INSERM, MMG, La Conception University Hospital, Department of Endocrinology, Marseille, France; (N.S.); (F.C.)
| | - Pauline Romanet
- Aix Marseille Univ, APHM, INSERM, MMG, La Conception University Hospital, Laboratory of Molecular Biology, Marseille, France
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Kubo H, Tsurutani Y, Sunouchi T, Hoshino Y, Hirose R, Katsuragawa S, Kimura N, Saito J, Nishikawa T. A Case of 123I-Metaiodobenzylguanidine Scintigraphy-Negative Pheochromocytoma with a Tumor-Developing Mutation in the RET Gene. J Clin Med 2022; 11:jcm11154624. [PMID: 35956242 PMCID: PMC9369916 DOI: 10.3390/jcm11154624] [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: 07/14/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
Pheochromocytoma (PCC) is rare catecholamine-producing endocrine tumor that metastasizes in approximately 10% of cases. As a functional imaging of PCC, 123I-metaiodobenzylguanidine (MIBG) scintigraphy was established, and some cases of PCC exhibit negative accumulation on MIBG scintigraphy, indicating a high risk of metastasis. Additionally, germline genetic variants of PCC are evident in approximately 30% of cases, although the genotype-phenotype correlation in PCC, especially the association between genetic mutations and MIBG scintigraphy, remains unclear. A 33-year-old man was admitted to our hospital for further examination for hypertension. He was diagnosed with sporadic PCC, and left adrenalectomy was performed. The adrenal tumor was negative on MIBG scintigraphy. Histology of the tumor revealed a moderately differentiated PCC. Target gene testing revealed a mutation in RET (c.2071G > A). This mutation has been reported to be a tumor-developing gene involved in the pathogenesis of PCC. Moreover, the RET mutation is the only gene mutation reported in a previous study of PCC with negative results on MIBG scintigraphy, except for the SDHB gene mutation, which is a common mutation in metastatic PCC. Correctively, the present RET gene mutation may be associated to MIBG-scintigraphy negative PCC and its pathophysiology. Clinicians should follow such cases more cautiously in clinical practice.
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Affiliation(s)
- Haremaru Kubo
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan
| | - Yuya Tsurutani
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan
- Correspondence:
| | - Takashi Sunouchi
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan
| | - Yoshitomo Hoshino
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan
| | - Rei Hirose
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan
| | - Sho Katsuragawa
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan
| | - Noriko Kimura
- Division of Clinical Research, Pathology Section, National Hospital Organization, Hakodate Hospital, Hakodate 041-8512, Japan
| | - Jun Saito
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan
| | - Tetsuo Nishikawa
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan
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Modifier Role of Common RET Variants in Sporadic Medullary Thyroid Carcinoma. Int J Mol Sci 2021; 22:ijms222111794. [PMID: 34769224 PMCID: PMC8583971 DOI: 10.3390/ijms222111794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/18/2021] [Accepted: 10/27/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Although the disease-causing effect of pathogenic variants in the gene RET has been unambiguously identified, there is a lack of consensus regarding the possible impact of common variants in this gene. Our study aimed to test whether variants in exons 10, 11, and 13–16 that are commonly detected during routine diagnostic testing might have any modifying effect on MTC. Methods: In sporadic MTC patients with no pathogenic variants but with or without common variants in RET, the following variants were evaluated: rs1799939 (p.G691S), rs1800861 (p.L769=), rs1800862 (p.S836=), rs2472737 in intron 14, and rs1800863 (p.S904=). Results: After Bonferroni correction, none of the variants were statistically significantly associated with disease outcome when analysed independently. The MTC group was divided into three genetically different clusters by unsupervised k-means clustering. Those clusters differed significantly in the age at diagnosis. A trend towards the association of given clusters with metabolic disorders and with remission state was identified. Conclusions: Although common variants in RET are not responsible for the risk of MTC, their analysis might turn out useful in the prediction of a patient’s clinical outcome. Importantly, this analysis would come with no additional cost in laboratories with a diagnostic procedure based on exon sequencing.
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Rashid FA, Khan MS, Tabassum S, Aiman A, Jadoon MH. Discrepancies of RET gene and risk of differentiated thyroid carcinoma. Cancer Biomark 2021; 33:111-121. [PMID: 34366324 DOI: 10.3233/cbm-210088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Somatic variations in rearranged during transfection (RET) proto-oncogene acts to influence Thyroid cancer (TC) in a low penetrance manner, but their effects tend to vary between different populations. OBJECTIVE This case-control study was aimed to evaluate effect of RET G691S, S904S and L769L single nucleotide polymorphisms (SNPs) on the risk for differentiated thyroid carcinoma (DTC). METHODS A total of 180 patients and 220 controls were genotyped by Polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP). Di-Deoxy Sanger sequencing was performed on 100 samples with variations and 20 wild samples for each amplified exon. In addition, In Silico tools were used to evaluate structural and functional impact of individual SNPs in disease progression. RESULTS In RET G691S/L769L/S904S SNPs, frequency of variant genotypes in DTC cases was 61.1%, 54.4% and 76.6% as compared to 45.9%, 43.6% and 89.09% in controls respectively (P⩽ 0.05). In Silico analysis revealed that different protein formed due to G691S substitution decreases the stability of 3D structure of protein. The RET G691S and L769L SNP followed "Dominant" but RET S904S SNP confirmed an "Additive" mode of inheritance. CONCLUSION RET G691S/L769L/S904S SNPs are significantly associated with DTC with G691S SNP declining the stability of final protein product.
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Affiliation(s)
- Faiza A Rashid
- Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
| | - Mosin S Khan
- Government Medical College Srinagar and Associated Hospitals, Srinagar, India
| | - Sobia Tabassum
- Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
| | - Aiffa Aiman
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, India
| | - Maharij H Jadoon
- Research Centre for Modeling and Simulation, National University of Science and Technology, Islamabad, Pakistan
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Mishra V, Kowtal P, Rane P, Sarin R. Genetic risk association of CDKN1A and RET gene SNPs with medullary thyroid carcinoma: Results from the largest MTC cohort and meta-analysis. Cancer Med 2019; 8:6151-6161. [PMID: 31408923 PMCID: PMC6792509 DOI: 10.1002/cam4.2443] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 12/26/2022] Open
Abstract
Background Medullary thyroid carcinoma (MTC) is a rare subtype of thyroid cancer. Other than gain‐of‐function RET mutations, no other genetic, lifestyle or environmental risk associations have been established for MTC. Several case‐control studies and meta‐analysis have examined the risk association of different SNPs with MTC in different populations but with contradictory or inconclusive results. Methods In a large cohort of 438 Indian MTC cases and 489 gender and ethnicity matched healthy controls from 1000 genome project, a comprehensive risk association of 13 SNPs of three pathways—detoxification, cell cycle regulation and RET was performed along with meta‐analysis of RET SNPs. Results Multivariate logistic regression analysis identified a protective risk association of CDKN1ASer31Arg SNP with both hereditary (OR 0.26; 95% confidence interval [CI] 0.13‐0.55; P < .001) and sporadic MTC (OR 0.53; 95% CI 0.36‐0.78; P = .001). An increased risk association was identified for NAT2Y94Y SNP (OR 1.62, 95% CI 1.17‐2.25, P = .004) and CDKN2A3′UTR SNP (OR 1.89, 95% CI 1.19‐2.98, P = .006) with sporadic MTC and RET S904S with hereditary MTC (OR 2.82, 95% CI 1.64‐4.86, P < .001). Meta‐analysis of RET SNPs including our cohort identified increased risk association of all four RET SNPs with MTC. Conclusion In this largest SNP risk association study for MTC and the only risk association study of the 13 most commonly studied MTC associated SNPs in a single cohort of this rare cancer, a significant protective risk association of CDKN1ASer31Arg SNP with MTC was shown for the first time. Meta‐analysis identified significant risk association of all four RET SNPs, not observed in previous meta‐analysis.
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Affiliation(s)
- Vasudha Mishra
- Sarin Lab, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Pradnya Kowtal
- Sarin Lab, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Pallavi Rane
- Clinical Research Centre (CRC), Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
| | - Rajiv Sarin
- Sarin Lab, Advanced Centre for Treatment Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India.,Homi Bhabha National Institute, Mumbai, India.,Cancer Genetics Clinic, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
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Mulligan LM. 65 YEARS OF THE DOUBLE HELIX: Exploiting insights on the RET receptor for personalized cancer medicine. Endocr Relat Cancer 2018; 25:T189-T200. [PMID: 29743166 DOI: 10.1530/erc-18-0141] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/08/2018] [Indexed: 12/20/2022]
Abstract
The focus of precision cancer medicine is the use of patient genetic signatures to predict disease occurrence and course and tailor approaches to individualized treatment to improve patient outcomes. The rearranged during transfection (RET) receptor tyrosine kinase represents a paradigm for the power of personalized cancer management to change cancer impact and improve quality of life. Oncogenic activation of RET occurs through several mechanisms including activating mutations and increased or aberrant expression. Activating RET mutations found in the inherited cancer syndrome multiple endocrine neoplasia 2 permit early diagnosis, predict disease course and guide disease management to optimize patient survival. Rearrangements of RET found in thyroid and lung tumors provide insights on potential disease aggressiveness and offer opportunities for RET-targeted therapy. Aberrant RET expression in a subset of cases is associated with tumor dissemination, resistance to therapies and/or poorer prognosis in multiple cancers. The potential of RET targeting through repurposing of small-molecule multikinase inhibitors, selective RET inhibitors or other novel approaches provides exciting opportunities to individualize therapies across multiple pathologies where RET oncogenicity contributes to cancer outcomes.
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Affiliation(s)
- Lois M Mulligan
- Division of Cancer Biology and GeneticsCancer Research Institute, Queen's University, Kingston, Ontario, Canada
- Department of Pathology and Molecular MedicineQueen's University, Kingston, Ontario, Canada
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Kaczmarek-Ryś M, Ziemnicka K, Pławski A, Budny B, Michalak M, Hryhorowicz S, Hoppe-Gołębiewska J, Boruń P, Gołąb M, Czetwertyńska M, Sromek M, Szalata M, Ruchała M, Słomski R. Modifying impact of RET gene haplotypes on medullary thyroid carcinoma clinical course. Endocr Relat Cancer 2018; 25:421-436. [PMID: 29386230 DOI: 10.1530/erc-17-0452] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 01/31/2018] [Indexed: 12/16/2022]
Abstract
The clinical course of medullary thyroid carcinoma (MTC) associated with the MEN2A syndrome as well as of sporadic MTC shows considerable heterogeneity. The disease picture varies not only between the same RET proto-oncogene mutation carriers but also among sporadic MTC patients with no RET germinal mutations, which suggests the involvement of additional modulators of the disease. However, genetic factors responsible for this heterogeneity of the MTC clinical course still remain unknown. The aim of this study was to determine if polymorphic variants or specific haplotypes of the RET gene may modify the MTC clinical course. We genotyped the following loci: c.73+9277T>C, c.135G>A, c.1296A>G, c.2071G>A, c.2307T>C, c.2508C>T and c.2712C>G in 142 MTC patients and controls. We demonstrated considerable differences in the genotypes distribution within c.73+9277T>C, c.135G>A and c.2307T>C loci Our results show that the c.73+9277T variant associated with a decreased activity of the MCS+9.7 RET enhancer is rare in hereditary MTC patients with primary hyperparathyroidism, and thus, may influence the MTC clinical picture. The decreased activity of the RET promoter enhancer reduces RET expression level and may counterbalance the activating mutation in this gene. Frequent co-occurrence of the c.73+9277T allele with p.E768D, p.Y791F, p.V804M or p.R844Q RET mutations may be associated with their attenuation and milder clinical picture of the disease. Haplotypes analysis showed that C-G-A-G-T-(C)-C (c.73+9277T>C - c.135G>A - c.1296A>G - c.2071G>A - c.2307T>G - (c.2508C>T) - c.2712C>G) alleles combination predisposes to pheochromocytomas and primary hyperparathyroidism. We consider that RET haplotypes defining may become an auxiliary diagnostic tool in MTC patients.
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Affiliation(s)
| | - Katarzyna Ziemnicka
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Pławski
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznań, Poland
| | - Bartłomiej Budny
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | - Paweł Boruń
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Monika Gołąb
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Czetwertyńska
- Department of Nuclear Medicine and Endocrine Oncology, Maria Skłodowska-Curie Institute - Oncology Centre, Warsaw, Poland
| | - Maria Sromek
- Department of Immunology, Maria Sklodowska-Curie Institute - Oncology Centre, Warsaw, Poland
| | - Marlena Szalata
- Department of Biochemistry and Biotechnology, Poznan University of Life Sciences, Poznan, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Ryszard Słomski
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
- Department of Biochemistry and Biotechnology, Poznan University of Life Sciences, Poznan, Poland
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8
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Genetic diagnosis of a Chinese multiple endocrine neoplasia type 2A family through whole genome sequencing. J Biosci 2018; 42:209-218. [PMID: 28569245 DOI: 10.1007/s12038-017-9686-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Approximately 98% of patients with multiple endocrine neoplasia type 2A (MEN 2A) have an identifiable RET mutation. Prophylactic or early total thyroidectomy or pheochromocytoma/parathyroid removal in patients can be preventative or curative and has become standard management. The general strategy for RET screening on family members at risk is to sequence the most commonly affected exons and, if negative, to extend sequencing to additional exons. However, different families with MEN 2A due to the same RET mutation often have significant variability in the clinical exhibition of disease and aggressiveness of the MTC, which implies additional genetic loci exsit beyond RET coding region. Whole genome sequencing (WGS) greatly expands the breadth of screening from genes associated with a particular disease to the whole genome and, potentially, all the information that the genome contains about diseases or traits. This is presumably due to additive effect of disease modifying factors. In this study, we performed WGS on a typical Chinese MEN 2A proband and identified the pathogenic RET p.C634R mutation. We also identified several neutral variants within RET and pheochromocytoma-related genes. Moreover, we found several interesting structural variants including genetic deletions (RSPO1, OVCH2 and AP3S1, etc.) and fusion transcripts (FSIP1-BAZ2A, etc.).
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Lebeault M, Pinson S, Guillaud-Bataille M, Gimenez-Roqueplo AP, Carrie A, Barbu V, Pigny P, Bezieau S, Rey JM, Delvincourt C, Giraud S, Veyrat-Durebex C, Saulnier P, Bouzamondo N, Chabbert M, Blin J, Mohamed A, Romanet P, Borson-Chazot F, Rohmer V, Barlier A, Mirebeau-Prunier D. Nationwide French Study of RET Variants Detected from 2003 to 2013 Suggests a Possible Influence of Polymorphisms as Modifiers. Thyroid 2017; 27:1511-1522. [PMID: 28946813 DOI: 10.1089/thy.2016.0399] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The presence of single nucleotide polymorphisms (SNPs) in the REarranged during Transfection (RET) gene has been investigated with regard to their potential role in the development or progression of medullary thyroid cancer or pheochromocytomas (PHEO) in patients with the multiple endocrine neoplasia type 2 (MEN2) syndrome. The aim of this study was to evaluate the spectrum of RET variants in France between 2003 and 2013, and to evaluate the impact of SNPs on the MEN2 A phenotype. METHODS In this retrospective cohort study, RET variants were screened in 5109 index cases, and RET pathogenic variants were screened in 2214 relatives. Exons 5, 8, 10, 11, 13, 14, 15, and 16 were characterized by Sanger sequencing. RET pathogenic variants, RET variants with unknown functional significance (VUS), and four RET SNP variants-G691S (rs1799939), L769L (rs1800861), S836S (rs1800862), and S904S (rs1800863)-were characterized and are reported in index cases. In silico analysis and classification following the recommendation of the American College of Medical Genetics and Genomics was performed for RET VUS. Each patient's age at the time of diagnosis, sex, and the endocrine neoplasias present at molecular diagnosis were recorded. RESULTS Twenty-six single VUS in RET without any well-defined risk profiles were found in 33 patients. Nine of these were considered probably pathogenic, 11 of uncertain significance, and six as probably benign. Three double pathogenic variants found in three patients were classified as pathogenic. A study of the entire cohort showed that patients carrying pathogenic variants or VUS in RET together with PHEO were diagnosed earlier than the others. The presence of the G691S SNP, or a combination of SNPs, increased the risk of developing PHEO but did not modify the date of the diagnosis. No association was found between SNPs and medullary thyroid cancer or hyperparathyroidism. CONCLUSIONS The findings propose a classification of 15 of the 26 VUS in RET without any well-defined risk profiles and suggest that the G691S SNP, or a combination of SNPs, may be associated with the development of PHEO.
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Affiliation(s)
| | - Stéphane Pinson
- 2 Laboratoire de Génétique Moléculaire , CHU Lyon, Lyon France
- 3 Réseau TenGen , France
| | - Marine Guillaud-Bataille
- 3 Réseau TenGen , France
- 4 Département de Biologie et Pathologie Médicale, Gustave Roussy, Université de Paris-Saclay, Villejuif, France
| | - Anne-Paule Gimenez-Roqueplo
- 3 Réseau TenGen , France
- 5 Service de Génétique, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Alain Carrie
- 3 Réseau TenGen , France
- 6 Centre de Génétique Moléculaire Chromosomique, Assistance Publique Hôpitaux de Paris , Paris, France
| | - Véronique Barbu
- 3 Réseau TenGen , France
- 7 Laboratoire Commun de Biologie et Génétique Moléculaires , HUEP, SAT, AP-HP Paris, France
| | - Pascal Pigny
- 3 Réseau TenGen , France
- 8 Laboratoire de Biochimie et Oncologie Moléculaire , CHU Lille, Lille, France
| | - Stéphane Bezieau
- 3 Réseau TenGen , France
- 9 Laboratoire de Génétique Moléculaire , CHU Nantes, Nantes, France
| | - Jean-Marc Rey
- 3 Réseau TenGen , France
- 10 Laboratoire de Biopathologie Cellulaire et Tissulaire des Tumeurs , CHU Montpellier, Montpellier, France
| | - Chantal Delvincourt
- 3 Réseau TenGen , France
- 11 Laboratoire de Biologie Oncologique , CHU Reims, Reims, France
| | - Sophie Giraud
- 2 Laboratoire de Génétique Moléculaire , CHU Lyon, Lyon France
- 3 Réseau TenGen , France
| | - Charlotte Veyrat-Durebex
- 3 Réseau TenGen , France
- 12 UMR CNRS 6015-INSERMU1083, Laboratoire MITOVASC, Université d'Angers, Angers, France
- 13 Département de Biochimie et Génétique, CHU Angers , Angers, France
| | - Patrick Saulnier
- 14 Cellule de Méthodologie et Biostatistiques, Délégation à la Recherche Clinique et l'Innovation-DRCI, CHU Angers , Angers, France
| | - Nathalie Bouzamondo
- 3 Réseau TenGen , France
- 13 Département de Biochimie et Génétique, CHU Angers , Angers, France
| | - Marie Chabbert
- 12 UMR CNRS 6015-INSERMU1083, Laboratoire MITOVASC, Université d'Angers, Angers, France
| | - Julien Blin
- 15 Institut National du Cancer-INCa , Paris, France
| | - Amira Mohamed
- 3 Réseau TenGen , France
- 16 Aix Marseille Univ, CNRS, CRN2M, UMR 7286, and APHM La Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - Pauline Romanet
- 3 Réseau TenGen , France
- 16 Aix Marseille Univ, CNRS, CRN2M, UMR 7286, and APHM La Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - Francoise Borson-Chazot
- 3 Réseau TenGen , France
- 17 Hospices Civils de Lyon, Pôle IMER; Université Claude Bernard Lyon 1, HESPER EA 7425 Lyon, France
| | - Vincent Rohmer
- 1 Service d'Endocrinologie, CHU Angers , Angers, France
- 3 Réseau TenGen , France
| | - Anne Barlier
- 3 Réseau TenGen , France
- 16 Aix Marseille Univ, CNRS, CRN2M, UMR 7286, and APHM La Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - Delphine Mirebeau-Prunier
- 3 Réseau TenGen , France
- 12 UMR CNRS 6015-INSERMU1083, Laboratoire MITOVASC, Université d'Angers, Angers, France
- 13 Département de Biochimie et Génétique, CHU Angers , Angers, France
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Abstract
PURPOSE OF REVIEW Medullary thyroid carcinoma (MTC) comprises approximately 4% of all malignant thyroid neoplasms. Although the majority of patients have a good prognosis, a subgroup of patients develops progressive disease and requires systemic therapy. Here, we focused on the current MTC therapeutic approaches and discussed the advantages and disadvantages of molecular targeted therapies. RECENT FINDINGS Targeted molecular therapies that inhibit RET and other tyrosine kinase receptors involved in angiogenesis have been shown to improve progression-free survival in patients with advanced MTC. Two drugs, vandetanib and cabozantinib, have been approved for the treatment of progressive or symptomatic MTC, and several others have exhibited variable efficacy. No tyrosine kinase inhibitor has been shown to improve survival. Although no definitive recommendation can currently be made, cumulative data indicate that knowledge of the tumor mutational profile may facilitate improvements in targeted therapy for MTC. SUMMARY Tyrosine kinase inhibitors are effective therapeutic agents for the treatment of progressive MTC. Nevertheless, it is not clear who will benefit the most from therapy, and the decision regarding when and how to initiate the treatment should be made based on the patient's medical history and tumor behavior. Hopefully, in the near future, molecular profiling of MTC can be used to determine the most effective molecular therapeutic target.
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Das S, Kelly D, Moran B, Han K, Mulligan N, Barrett C, Buckley PG, McMahon P, McCaffrey J, Van Essen HF, Connor K, Lambrechts D, Ylstra B, Gallagher WM, O'Connor DP, Kelly CM. Postmortem Examination of an Aggressive Case of Medullary Thyroid Carcinoma Characterized by Catastrophic Genomic Abnormalities. JCO Precis Oncol 2017; 1:1600063. [PMID: 32913965 DOI: 10.1200/po.16.00063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Sudipto Das
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Deirdre Kelly
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Bruce Moran
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Kathleen Han
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Niall Mulligan
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Ciara Barrett
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Patrick G Buckley
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Peter McMahon
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - John McCaffrey
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Hendrik F Van Essen
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Kate Connor
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Diether Lambrechts
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Bauke Ylstra
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - William M Gallagher
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Darran P O'Connor
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
| | - Catherine M Kelly
- , , , , , , , , , , , and , University College Dublin, Belfield; , , , and , Royal College of Surgeons in Ireland; , , , , , , and , Mater Misericordiae University Hospital; , Beaumont Hospital, Dublin, Ireland; and , Vrije Universiteit Medical Center, Amsterdam, the Netherlands; and , Vesailus Research Center, Vlaams Instituut voor Biotechnologie, Katholieke Universiteit, Leuven, Belgium
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Abstract
The pathogenesis of the development and progression of thyroid cancer (TC) is far from being clear at present. Accumulated evidence suggests that it is a complex polygenic disorder for which genetic factors play an important role in disease aetiology. Here we review the literature to report the genetic variations and alterations that have been described in the aetiology of TC. The functional effects of some mutations and single nucleotide polymorphisms on TC are validated, establishing the role of sequence variations in this cancer. However, large prospective studies are still required to evaluate the diagnostic and prognostic value of these genetic determinants in clinical practice.
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Ceolin L, Romitti M, Rodrigues Siqueira D, Vaz Ferreira C, Oliboni Scapineli J, Assis-Brazil B, Vieira Maximiano R, Dias Amarante T, de Souza Nunes MC, Weber G, Maia AL. Effect of 3'UTR RET Variants on RET mRNA Secondary Structure and Disease Presentation in Medullary Thyroid Carcinoma. PLoS One 2016; 11:e0147840. [PMID: 26829565 PMCID: PMC4734678 DOI: 10.1371/journal.pone.0147840] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 01/08/2016] [Indexed: 12/21/2022] Open
Abstract
Background The RET S836S variant has been associated with early onset and increased risk for metastatic disease in medullary thyroid carcinoma (MTC). However, the mechanism by which this variant modulates MTC pathogenesis is still open to discuss. Of interest, strong linkage disequilibrium (LD) between RET S836S and 3'UTR variants has been reported in Hirschsprung's disease patients. Objective To evaluate the frequency of the RET 3’UTR variants (rs76759170 and rs3026785) in MTC patients and to determine whether these variants are in LD with S836S polymorphism. Methods Our sample comprised 152 patients with sporadic MTC. The RET S836S and 3’UTR (rs76759170 and rs3026785) variants were genotyped using Custom TaqMan Genotyping Assays. Haplotypes were inferred using the phase 2.1 program. RET mRNA structure was assessed by Vienna Package. Results The mean age of MTC diagnosis was 48.5±15.5 years and 57.9% were women. The minor allele frequencies of RET polymorphisms were as follows: S836S, 5.6%; rs76759170, 5.6%; rs3026785, 6.2%. We observed a strong LD among S836S and 3’UTR variants (|D’| = -1, r2 = 1 and |D’| = -1, r2 = 0,967). Patients harboring the S836S/3’UTR variants presented a higher percentage of lymph node and distant metastasis (P = 0.013 and P<0.001, respectively). Accordingly, RNA folding analyses demonstrated different RNA secondary structure predictions for WT(TCCGT), S836S(TTCGT) or 3’UTR(GTCAC) haplotypes. The S836S/3’UTR haplotype presented a greater number of double helices sections and lower levels of minimal free energy when compared to the wild-type haplotype, suggesting that these variants provides the most thermodynamically stable mRNA structure, which may have functional consequences on the rate of mRNA degradation. Conclusion The RET S836S polymorphism is in LD with 3’UTR variants. In silico analysis indicate that the 3’UTR variants may affect the secondary structure of RET mRNA, suggesting that these variants might play a role in posttranscriptional control of the RET transcripts.
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Affiliation(s)
- Lucieli Ceolin
- Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Mirian Romitti
- Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Débora Rodrigues Siqueira
- Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Carla Vaz Ferreira
- Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Jessica Oliboni Scapineli
- Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Beatriz Assis-Brazil
- Pathology Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rodolfo Vieira Maximiano
- Department of Physics, Computational Biophysics Group, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Tauanne Dias Amarante
- Department of Physics, Computational Biophysics Group, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Miriam Celi de Souza Nunes
- Department of Physics, Computational Biophysics Group, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Gerald Weber
- Department of Physics, Computational Biophysics Group, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Luiza Maia
- Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- * E-mail:
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14
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Association of RET genetic polymorphisms and haplotypes with papillary thyroid carcinoma in the Portuguese population: a case-control study. PLoS One 2014; 9:e109822. [PMID: 25330015 PMCID: PMC4201446 DOI: 10.1371/journal.pone.0109822] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 09/12/2014] [Indexed: 12/21/2022] Open
Abstract
Thyroid cancer has a multifactorial aetiology resulting from the interaction of genetic and environmental factors. Several low penetrance susceptibility genes have been identified but their effects often vary between different populations. Somatic point mutations and translocations of the REarranged during Transfection (RET) proto-oncogene are frequently found in thyroid cancer. The aim of this case-control study was to determine the effect of four well known RET single nucleotide polymorphisms (SNPs) on the risk for differentiated thyroid carcinoma. A total of 545 Portuguese patients and 543 controls were genotyped by PCR and restriction enzyme analysis, for the following SNPs: G691S (exon 11, rs1799939 G/A), L769L (exon 13, rs1800861 T/G), S836S (exon 14, rs1800862 C/T), and S904S (exon 15, rs1800863 C/G). The minor allele of S836S was overrepresented in patients with papillary thyroid carcinoma (PTC) when compared to controls (OR 1.57; 95% CI 1.05–2.35; p = 0.026). The GGTC haplotype was also overrepresented in PTC (OR 2.51; 95% CI 1.07–5.91; p = 0.029). No associations were found in follicular thyroid carcinoma (FTC). Multivariate logistic regression analysis showed no differences regarding gender, age at diagnosis, lymph node or distant metastasis. However, a near significant overrepresentation of the minor alleles of G691S and S904S was found in patients with tumours greater than 10 mm of diameter at diagnosis. These data suggest that the RET S836S polymorphism in exon 14 and the GGTC haplotype are risk factors for PTC, but not FTC, and that the G691S/S904S polymorphisms might be associated with tumour behaviour.
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15
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Kinome sequencing reveals RET G691S polymorphism in human neuroendocrine lung cancer cell lines. Genes Genomics 2014; 36:829-841. [PMID: 25530832 DOI: 10.1007/s13258-014-0217-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Neuroendocrine (NE) lung tumors comprise 20-25% of all invasive lung malignancies. Currently, no effective treatments are available to cure these tumors, and it is necessary to identify a molecular alteration(s) that characterizes NE lung tumor cells. We aimed to identify a kinase mutation(s) associated with NE lung tumor by screening 517 kinase-encoding genes in human lung cancer cell lines. Our next-generation sequencing analysis of six NE lung tumor cell lines (four small cell lung cancer lines and two non-small cell lung cancer lines) and three non-NE lung tumor lines revealed various kinase mutations, including a nonsynonymous mutation in the proto-oncogene RET (c.2071G>A; p.G691S). Further evaluation of the RET polymorphism in total 15 lung cancer cell lines by capillary sequencing suggested that the frequency of the minor allele (A-allele) in NE lung tumor lines was significantly higher than its frequency in a reference population (p = 0.0001). However, no significant difference between non-NE lung tumor lines and a reference group was detected (p = 1.0). Nevertheless, neither RET expression levels were correlated with the levels of neuron-specific enolase (NSE), a key NE marker, nor vandetanib and cabozantinib, small molecule compounds that inhibit RET, affected NSE levels in lung cancer cells. Our data suggest a potential association of G691S RET polymorphism with NE lung tumor, proposing the necessity of more thorough evaluation of this possibility. The dataset of kinase mutation profiles in this report may help choosing cell line models for study of lung cancer.
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Siqueira DR, Ceolin L, Ferreira CV, Romitti M, Maia SC, Maciel LMZ, Maia AL. Role of RET genetic variants in MEN2-associated pheochromocytoma. Eur J Endocrinol 2014; 170:821-8. [PMID: 24616415 DOI: 10.1530/eje-14-0084] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND RET polymorphisms have been involved in the clinical presentation and prognosis of multiple endocrine neoplasia type 2 (MEN2)-associated medullary thyroid carcinoma. OBJECTIVE To investigate the effect of RET variants on the penetrance of pheochromocytoma (PHEO) in MEN2 patients. METHODS The RET variants L769L, S836S, and G691S/S904S were evaluated in a cohort of 153 MEN2 patients attending a tertiary teaching hospital. A comparison of RET variant frequencies between patients with and without PHEO was performed. Kaplan-Meier curves and Cox regression analysis were used to estimate the effect of RET variants on the age-dependent penetrance. RESULTS A total of 48 (31.4%) patients presented with MEN2-associated PHEOs. The mean age at diagnosis was 35.5±13.4 years, 60.4% of patients were women, and 92.8% had RET mutations at codon 634. The frequencies of RET polymorphisms were as follows: 20.1% L769L, 4.75% S836S, and 17.3% S904S/G691S. We did not observe any association between the frequencies of L769L, S836S, or S904S/G691S variants and PHEO development (all P>0.05). However, individuals carrying two RET polymorphic alleles had an increased estimated risk of PHEO (2.63; 95% CI, 1.4-5.0; P=0.004) and were younger at diagnosis when compared with those with one or no polymorphism (29.6±6.3 and 39.3±14.4 years respectively; P=0.006). Accordingly, additional analysis using Cox proportional hazard models demonstrated that the presence of two RET variants was associated with an increased risk for early PHEO development (hazard ratio, 5.99 (95% CI, 2.24-16.03); P<0.001). CONCLUSIONS RET polymorphic alleles have an additive effect on the estimated risk of age-related PHEO penetrance in MEN2 patients.
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Affiliation(s)
- Débora Rodrigues Siqueira
- Endocrine DivisionThyroid Section, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, BrazilDepartment of Internal MedicineSchool of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Lucieli Ceolin
- Endocrine DivisionThyroid Section, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, BrazilDepartment of Internal MedicineSchool of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Carla Vaz Ferreira
- Endocrine DivisionThyroid Section, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, BrazilDepartment of Internal MedicineSchool of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Mírian Romitti
- Endocrine DivisionThyroid Section, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, BrazilDepartment of Internal MedicineSchool of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Silvana Cavalcante Maia
- Endocrine DivisionThyroid Section, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, BrazilDepartment of Internal MedicineSchool of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Léa Maria Zanini Maciel
- Endocrine DivisionThyroid Section, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, BrazilDepartment of Internal MedicineSchool of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Ana Luiza Maia
- Endocrine DivisionThyroid Section, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, BrazilDepartment of Internal MedicineSchool of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
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17
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Zhang Y, Wang S, Chen X, Huang S, Li J. Quantitative assessment of the association between L769L and S836S polymorphisms at RET gene and medullary thyroid carcinoma risk. Tumour Biol 2014; 35:6641-7. [PMID: 24699996 DOI: 10.1007/s13277-014-1878-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 03/20/2014] [Indexed: 11/28/2022] Open
Abstract
RET single nucleotide polymorphisms (SNPs) have been implicated in the pathogenesis and progression of medullary thyroid carcinoma (MTC). Epidemiologic studies have evaluated the association between RET L769L and S836S polymorphisms and predisposition to MTC. However, the results were inconclusive. A literature search was performed using the PubMed database for relevant studies published through October 31, 2013. A total of 13 eligible studies were selected for this meta-analysis, including 1,117 cases and 1,916 controls for L769L and 1,230 cases and 2,246 controls for S836S. The carrier frequency of the variant alleles was 26.3 % in patients with MTC and 24.6 % in controls for L769L polymorphism, and 6.6 % in patients with MTC and 5.0 % in controls for S836S polymorphism. In our pooled analysis of all these studies, the results of our meta-analysis suggested that the RET L769L variant was not significantly associated with an elevated MTC risk (odds ratio (OR) 1.06, 95 % confidence interval (CI) 0.94-1.19). And there was no evidence for the association between the S836S variant and MTC risk (OR 1.20, 95 % CI 0.97-1.49). Moreover, no significant differences were found when considering patients or controls heterozygous or homozygous for RET L769L and S836S polymorphisms. In conclusion, this meta-analysis suggests that RET L769L and S836S polymorphisms may not be associated with MTC development.
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Affiliation(s)
- Yuanqi Zhang
- Department of Thyroid Surgery, Affiliated hospital of Guangdong Medical College, Zhanjiang, Guangdong, China
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18
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Cabozantinib inhibits growth of androgen-sensitive and castration-resistant prostate cancer and affects bone remodeling. PLoS One 2013; 8:e78881. [PMID: 24205338 PMCID: PMC3808282 DOI: 10.1371/journal.pone.0078881] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/16/2013] [Indexed: 11/19/2022] Open
Abstract
Cabozantinib is an inhibitor of multiple receptor tyrosine kinases, including MET and VEGFR2. In a phase II clinical trial in advanced prostate cancer (PCa), cabozantinib treatment improved bone scans in 68% of evaluable patients. Our studies aimed to determine the expression of cabozantinib targets during PCa progression and to evaluate its efficacy in hormone-sensitive and castration-resistant PCa in preclinical models while delineating its effects on tumor and bone. Using immunohistochemistry and tissue microarrays containing normal prostate, primary PCa, and soft tissue and bone metastases, our data show that levels of MET, P-MET, and VEGFR2 are increasing during PCa progression. Our data also show that the expression of cabozantinib targets are particularly pronounced in bone metastases. To evaluate cabozantinib efficacy on PCa growth in the bone environment and in soft tissues we used androgen-sensitive LuCaP 23.1 and castration-resistant C4-2B PCa tumors. In vivo, cabozantinib inhibited the growth of PCa in bone as well as growth of subcutaneous tumors. Furthermore, cabozantinib treatment attenuated the bone response to the tumor and resulted in increased normal bone volume. In summary, the expression pattern of cabozantinib targets in primary and castration-resistant metastatic PCa, and its efficacy in two different models of PCa suggest that this agent has a strong potential for the effective treatment of PCa at different stages of the disease.
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19
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Barbieri RB, Bufalo NE, Cunha LL, Assumpção LVM, Maciel RMB, Cerutti JM, Ward LS. Genes of detoxification are important modulators of hereditary medullary thyroid carcinoma risk. Clin Endocrinol (Oxf) 2013; 79:288-93. [PMID: 23278115 DOI: 10.1111/cen.12136] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 10/29/2012] [Accepted: 12/17/2012] [Indexed: 01/12/2023]
Abstract
CONTEXT Different inherited profiles of genes involved in cellular mechanisms of activation and detoxification of carcinogenic products can provide specific protection or determine the risk for cancer. Low-penetrance polymorphic genes related to the biotransformation of environmental toxins have been associated with susceptibility to and the phenotype of, human tumours. OBJECTIVE To investigate the role of germline inheritance of polymorphisms in CYP1A2*F, CYP1A1 m1, GSTP1, NAT2 and TP53 genes in hereditary medullary thyroid carcinoma (HMTC) patients. DESIGN This study was developed in University of Campinas (Unicamp). PATIENTS We studied 132 patients with HMTC, 88 first-degree relatives of HMTC patients and 575 control individuals. MEASUREMENTS All patients with MTC and their relatives were sequenced for the RET gene and five genes were genotyped using TaqMan(®) system. RESULTS We observed that the inheritance of CYP1A2*F (OR = 2·10; 95% CI = 1·11-3·97; P = 0·022), GSTP1 (OR = 4·41; 95% CI = 2·47-7·88; P < 0·001) and NAT2 (OR = 2·54; 95% CI = 1·16-5·58; P = 0·020) variants increased the risk for HMTC. In addition, multiple regression analysis showed that the inheritance of GSTP1 polymorphisms was associated with the diagnosis in older patients (B = 8·0229; 95% IC = ± 5·5735; P = 0·0054). Concerning the group of HTMC relatives, CYP1A2*F (OR = 2:40; 95% CI = 1·19-4·86; P = 0·015), CYP1A1 m1 (OR = 2·79; 95% CI = 1:04-7·51; P = 0·042), GSTP1 (OR = 2·86; 95% IC = 1·53-5·32; P < 0·001) and NAT2 (OR = 2·25; 95% IC = 1·20-4·22; P = 0·012) were associated with HMTC risk. CONCLUSIONS We have demonstrated that the inheritance of specific genes determining the individual response to environmental toxins may contribute to the risk and phenotypic variability that exists in patients with HMTC. Moreover, we identified a group at risk in relatives of HMTC patients.
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Affiliation(s)
- R B Barbieri
- Faculty of Medical Sciences, Laboratory of Cancer Molecular Genetics, University of Campinas (FCM-Unicamp), Campinas, Brazil
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20
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Toledo SPA, Lourenço DM, Toledo RA. A differential diagnosis of inherited endocrine tumors and their tumor counterparts. Clinics (Sao Paulo) 2013; 68:1039-56. [PMID: 23917672 PMCID: PMC3715026 DOI: 10.6061/clinics/2013(07)24] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 03/26/2013] [Indexed: 12/15/2022] Open
Abstract
Inherited endocrine tumors have been increasingly recognized in clinical practice, although some difficulties still exist in differentiating these conditions from their sporadic endocrine tumor counterparts. Here, we list the 12 main topics that could add helpful information and clues for performing an early differential diagnosis to distinguish between these conditions. The early diagnosis of patients with inherited endocrine tumors may be performed either clinically or by mutation analysis in at-risk individuals. Early detection usually has a large impact in tumor management, allowing preventive clinical or surgical therapy in most cases. Advice for the clinical and surgical management of inherited endocrine tumors is also discussed. In addition, recent clinical and genetic advances for 17 different forms of inherited endocrine tumors are briefly reviewed.
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Affiliation(s)
- Sergio P A Toledo
- Division of Endocrinology, Endocrine Genetics Unit (LIM-25), Faculdade de Medicina da Universidade de São Paulo, São Paulo/SP, Brazil.
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21
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Crona J, Verdugo AD, Granberg D, Welin S, Stålberg P, Hellman P, Björklund P. Next-generation sequencing in the clinical genetic screening of patients with pheochromocytoma and paraganglioma. Endocr Connect 2013; 2:104-11. [PMID: 23781326 PMCID: PMC3682230 DOI: 10.1530/ec-13-0009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 04/03/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recent findings have shown that up to 60% of pheochromocytomas (PCCs) and paragangliomas (PGLs) are caused by germline or somatic mutations in one of the 11 hitherto known susceptibility genes: SDHA, SDHB, SDHC, SDHD, SDHAF2, VHL, HIF2A (EPAS1), RET, NF1, TMEM127 and MAX. This list of genes is constantly growing and the 11 genes together consist of 144 exons. A genetic screening test is extensively time consuming and expensive. Hence, we introduce next-generation sequencing (NGS) as a time-efficient and cost-effective alternative. METHODS Tumour lesions from three patients with apparently sporadic PCC were subjected to whole exome sequencing utilizing Agilent Sureselect target enrichment system and Illumina Hi seq platform. Bioinformatics analysis was performed in-house using commercially available software. Variants in PCC and PGL susceptibility genes were identified. RESULTS We have identified 16 unique genetic variants in PCC susceptibility loci in three different PCC, spending less than a 30-min hands-on, in-house time. Two patients had one unique variant each that was classified as probably and possibly pathogenic: NF1 Arg304Ter and RET Tyr791Phe. The RET variant was verified by Sanger sequencing. CONCLUSIONS NGS can serve as a fast and cost-effective method in the clinical genetic screening of PCC. The bioinformatics analysis may be performed without expert skills. We identified process optimization, characterization of unknown variants and determination of additive effects of multiple variants as key issues to be addressed by future studies.
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Affiliation(s)
- Joakim Crona
- Department of Surgical SciencesUppsala UniversityS-751 85, UppsalaSweden
| | | | - Dan Granberg
- Department of Medical SciencesUppsala UniversityS-751 85, UppsalaSweden
| | - Staffan Welin
- Department of Medical SciencesUppsala UniversityS-751 85, UppsalaSweden
| | - Peter Stålberg
- Department of Surgical SciencesUppsala UniversityS-751 85, UppsalaSweden
| | - Per Hellman
- Department of Surgical SciencesUppsala UniversityS-751 85, UppsalaSweden
| | - Peyman Björklund
- Department of Surgical SciencesUppsala UniversityS-751 85, UppsalaSweden
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22
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Current World Literature. Curr Opin Oncol 2013; 25:99-104. [DOI: 10.1097/cco.0b013e32835c1381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Figlioli G, Landi S, Romei C, Elisei R, Gemignani F. Medullary thyroid carcinoma (MTC) and RET proto-oncogene: Mutation spectrum in the familial cases and a meta-analysis of studies on the sporadic form. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2013; 752:36-44. [DOI: 10.1016/j.mrrev.2012.09.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Revised: 09/28/2012] [Accepted: 09/29/2012] [Indexed: 12/16/2022]
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24
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Deshpande HA, Sheth K, Sosa JA, Roman S. Efficacy and tolerability of pharmacotherapy options for the treatment of medullary thyroid cancer. CLINICAL MEDICINE INSIGHTS-ONCOLOGY 2012; 6:355-62. [PMID: 23133319 PMCID: PMC3489097 DOI: 10.4137/cmo.s8305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Metastatic and unresectable medullary thyroid carcinoma (MTC) is often difficult to treat as it is relatively unresponsive to radiation and conventional chemotherapy. This emphasizes the importance of the development of targeted therapies for advanced MTC. Vandetanib was approved by the US Food and Drug Administration for the treatment of symptomatic or progressive MTC in patients with advanced disease in April 2011. This therapy proved to be a breakthrough in the management of MTC. We review the efficacy and safety of this novel treatment and other treatments that are being evaluated in this disease.
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Affiliation(s)
- H A Deshpande
- Yale University School of Medicine, New Haven, Connecticut, USA
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