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Naderi E, Schack LMH, Welsh C, Sim AYL, Aguado-Barrera ME, Dudding T, Summersgil H, Martínez-Calvo L, Ong EHW, Odding Y, Varela-Pazos A, Steenbakkers RJHM, Crijns APG, Jena R, Pring M, Dennis J, Lobato-Busto R, Alsner J, Ness A, Nutting C, Thomson DJ, Gómez-Caamaño A, Eriksen JG, Thomas SJ, Bates AM, Overgaard J, Cascallar-Caneda LM, Duprez F, Barnett GC, Dorling L, Chua MLK, Vega A, West CML, Langendijk JA, Nicolaj Andreassen C, Alizadeh BZ. Meta-GWAS identifies the heritability of acute radiation-induced toxicities in head and neck cancer. Radiother Oncol 2022; 176:138-148. [PMID: 36191651 DOI: 10.1016/j.radonc.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE We aimed to the genetic components and susceptibility variants associated with acute radiation-induced toxicities (RITs) in patients with head and neck cancer (HNC). MATERIALS AND METHODS We performed the largest meta-GWAS of seven European cohorts (n = 4,042). Patients were scored weekly during radiotherapy for acute RITs including dysphagia, mucositis, and xerostomia. We analyzed the effect of variants on the average burden (measured as area under curve, AUC) per each RIT, and standardized total average acute toxicity (STATacute) score using a multivariate linear regression. We tested suggestive variants (p < 1.0x10-5) in discovery set (three cohorts; n = 2,640) in a replication set (four cohorts; n = 1,402). We meta-analysed all cohorts to calculate RITs specific SNP-based heritability, and effect of polygenic risk scores (PRSs), and genetic correlations among RITS. RESULTS From 393 suggestive SNPs identified in discovery set; 37 were nominally significant (preplication < 0.05) in replication set, but none reached genome-wide significance (pcombined < 5 × 10-8). In-silico functional analyses identified "3'-5'-exoribonuclease activity" (FDR = 1.6e-10) for dysphagia, "inositol phosphate-mediated signalling" for mucositis (FDR = 2.20e-09), and "drug catabolic process" for STATacute (FDR = 3.57e-12) as the most enriched pathways by the RIT specific suggestive genes. The SNP-based heritability (±standard error) was 29 ± 0.08 % for dysphagia, 9 ± 0.12 % (mucositis) and 27 ± 0.09 % (STATacute). Positive genetic correlation was rg = 0.65 (p = 0.048) between dysphagia and STATacute. PRSs explained limited variation of dysphagia (3 %), mucositis (2.5 %), and STATacute (0.4 %). CONCLUSION In HNC patients, acute RITs are modestly heritable, sharing 10 % genetic susceptibility, when PRS explains < 3 % of their variance. We identified numerus suggestive SNPs, which remain to be replicated in larger studies.
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Affiliation(s)
- Elnaz Naderi
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, the Netherlands; Department of Epidemiology, University Medical Center Groningen, Groningen, the Netherlands.
| | - Line M H Schack
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Oncology, Regional Hospital West Jutland, Gødstrup, Denmark
| | - Ceilidh Welsh
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Adelene Y L Sim
- Division of Radiation Oncology, Dept of Head and Neck and Thoracic Cancers, Duke-NUS Medical School, Singapore, Singapore; Division of Medical Sciences, National Cancer Centre, Singapore
| | - Miguel E Aguado-Barrera
- Fundación Pública Galega Medicina Xenómica (FPGMX), Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Tom Dudding
- Bristol Dental School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Holly Summersgil
- Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, UK
| | - Laura Martínez-Calvo
- Fundación Pública Galega Medicina Xenómica (FPGMX), Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Enya H W Ong
- Division of Medical Sciences, National Cancer Centre, Singapore
| | - Yasmin Odding
- University Hospitals Bristol and Weston, Bristol, UK
| | - Ana Varela-Pazos
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Roel J H M Steenbakkers
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - Anne P G Crijns
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - Rajesh Jena
- Department of Oncology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Miranda Pring
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Ramón Lobato-Busto
- Department of Medical Physics, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Andy Ness
- Bristol Dental School, University of Bristol, Bristol, UK
| | | | - David J Thomson
- Christie Hospital NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Antonio Gómez-Caamaño
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Jesper G Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Steve J Thomas
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Amy M Bates
- Department of Oncology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Luis M Cascallar-Caneda
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Fréderic Duprez
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Gillian C Barnett
- Department of Oncology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Melvin L K Chua
- Division of Radiation Oncology, Dept of Head and Neck and Thoracic Cancers, Duke-NUS Medical School, Singapore, Singapore; Division of Radiation Oncology, National Cancer Centre, Singapore
| | - Ana Vega
- Fundación Pública Galega Medicina Xenómica (FPGMX), Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Catharine M L West
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust Hospital, Manchester, UK
| | - Johannes A Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - Christian Nicolaj Andreassen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark; Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University Medical Center Groningen, Groningen, the Netherlands.
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