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Deng N, Goh LK, Wang H, Das K, Tao J, Tan IB, Zhang S, Lee M, Wu J, Lim KH, Lei Z, Goh G, Lim QY, Tan ALK, Sin Poh DY, Riahi S, Bell S, Shi MM, Linnartz R, Zhu F, Yeoh KG, Toh HC, Yong WP, Cheong HC, Rha SY, Boussioutas A, Grabsch H, Rozen S, Tan P. A comprehensive survey of genomic alterations in gastric cancer reveals systematic patterns of molecular exclusivity and co-occurrence among distinct therapeutic targets. Gut 2012; 61:673-84. [PMID: 22315472 PMCID: PMC3322587 DOI: 10.1136/gutjnl-2011-301839] [Citation(s) in RCA: 499] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Gastric cancer is a major gastrointestinal malignancy for which targeted therapies are emerging as treatment options. This study sought to identify the most prevalent molecular targets in gastric cancer and to elucidate systematic patterns of exclusivity and co-occurrence among these targets, through comprehensive genomic analysis of a large panel of gastric cancers. DESIGN Using high-resolution single nucleotide polymorphism arrays, copy number alterations were profiled in a panel of 233 gastric cancers (193 primary tumours, 40 cell lines) and 98 primary matched gastric non-malignant samples. For selected alterations, their impact on gene expression and clinical outcome were evaluated. RESULTS 22 recurrent focal alterations (13 amplifications and nine deletions) were identified. These included both known targets (FGFR2, ERBB2) and also novel genes in gastric cancer (KLF5, GATA6). Receptor tyrosine kinase (RTK)/RAS alterations were found to be frequent in gastric cancer. This study also demonstrates, for the first time, that these alterations occur in a mutually exclusive fashion, with KRAS gene amplifications highlighting a clinically relevant but previously underappreciated gastric cancer subgroup. FGFR2-amplified gastric cancers were also shown to be sensitive to dovitinib, an orally bioavailable FGFR/VEGFR targeting agent, potentially representing a subtype-specific therapy for FGFR2-amplified gastric cancers. CONCLUSION The study demonstrates the existence of five distinct gastric cancer patient subgroups, defined by the signature genomic alterations FGFR2 (9% of tumours), KRAS (9%), EGFR (8%), ERBB2 (7%) and MET (4%). Collectively, these subgroups suggest that at least 37% of gastric cancer patients may be potentially treatable by RTK/RAS directed therapies.
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Affiliation(s)
- Niantao Deng
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore.
| | - Liang Kee Goh
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore,Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Division of Medical Oncology, National Cancer Centre, Singapore
| | - Hannah Wang
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore
| | - Kakoli Das
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore
| | - Jiong Tao
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore,Department of Physiology, National University of Singapore, Singapore
| | - Iain Beehuat Tan
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore,NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore,Division of Medical Oncology, National Cancer Centre, Singapore
| | - Shenli Zhang
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore
| | - Minghui Lee
- Cellular and Molecular Research, National Cancer Centre, Singapore
| | - Jeanie Wu
- Cellular and Molecular Research, National Cancer Centre, Singapore
| | - Kiat Hon Lim
- Department of Pathology, Singapore General Hospital, Singapore
| | - Zhengdeng Lei
- Neuroscience and Behavioral Disorders, Duke-NUS Graduate Medical School, Singapore
| | - Glenn Goh
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore
| | - Qing-Yan Lim
- School of Biological Sciences, Nanyang Technological University, Singapore
| | - Angie Lay-Keng Tan
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore
| | - Dianne Yu Sin Poh
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore
| | - Sudep Riahi
- Section of Ophthalmology and Neuroscience, Leeds Institute for Molecular Medicine, Leeds, UK
| | - Sandra Bell
- Section of Ophthalmology and Neuroscience, Leeds Institute for Molecular Medicine, Leeds, UK
| | | | | | - Feng Zhu
- Department of Medicine, National University Health System, Singapore
| | - Khay Guan Yeoh
- Department of Medicine, National University Health System, Singapore
| | - Han Chong Toh
- Division of Medical Oncology, National Cancer Centre, Singapore
| | - Wei Peng Yong
- National Cancer Institute Singapore, National University Health System, Singapore
| | - Hyun Cheol Cheong
- Department of Internal Medicine, Yonsei Cancer Centre, Yonsei, South Korea
| | - Sun Young Rha
- Department of Internal Medicine, Yonsei Cancer Centre, Yonsei, South Korea
| | - Alex Boussioutas
- Cancer Genomics and Biochemistry Laboratory, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Heike Grabsch
- Department of Pathology and Tumour Biology, Leeds Institute for Molecular Medicine, Leeds, UK
| | - Steve Rozen
- Neuroscience and Behavioral Disorders, Duke-NUS Graduate Medical School, Singapore
| | - Patrick Tan
- Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore,Cellular and Molecular Research, National Cancer Centre, Singapore,Cancer Science Institute of Singapore, National University of Singapore, Singapore,Genome Institute of Singapore, Singapore
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