1
|
Heriyanto DS, Yoshuantari N, Akbariani G, Lau V, Hanini H, Hidayati Z, Arief MZ, Gunawan AN, Ridwanuloh AM, Kusharyoto W, Handaya AY, Ilyas M, Kurnianda J, Hutajulu SH, Susanti S. High Probability of Lynch Syndrome Among Colorectal Cancer Patients Is Associated With Higher Occurrence of KRAS and PIK3CA Mutations. World J Oncol 2024; 15:612-624. [PMID: 38993255 PMCID: PMC11236368 DOI: 10.14740/wjon1843] [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: 02/23/2024] [Accepted: 05/25/2024] [Indexed: 07/13/2024] Open
Abstract
Background In Indonesia, early-onset colorectal cancer (EOCRC) rates are higher in patients < 50 years old compared to Western populations, possibly due to a higher frequency of Lynch syndrome (LS) in CRC patients. We aimed to examine the association of KRAS and PIK3CA mutations with LS. Methods In this retrospective cross-sectional single-center study, the PCR-HRM-based test was used for screening of microsatellite instability (MSI) mononucleotide markers (BAT25, BAT26, BCAT25, MYB, EWSR1), MLH1 promoter methylation, and oncogene mutations of BRAF (V600E), KRAS (exon 2 and 3), and PIK3CA (exon 9 and 20) in FFPE DNA samples. Results All the samples (n = 244) were from Dr. Sardjito General Hospital Yogyakarta, Indonesia. KRAS and PIK3CA mutations were found in 151/244 (61.88%) and 107/244 (43.85%) of samples, respectively. KRAS and PIK3CA mutations were significantly associated with MSI status in 32/42 (76.19%) and 25/42 (59.52%) of samples, respectively. KRAS mutation was significantly associated with LS status in 26/32 (81.25%) of samples. The PIK3CA mutation was present in a higher proportion in LS samples of 19/32 (59.38%), but not statistically significant. Clinicopathology showed that KRAS mutation was significantly associated with right-sided CRC and higher histology grade in 39/151 (25.83%) and 24/151 (16.44%) samples, respectively. PIK3CA mutation was significantly associated with female sex and lower levels of tumor-infiltrating lymphocytes in 62/107 (57.94%) and 26/107 (30.23%) samples, respectively. KRAS and PIK3CA mutations did not significantly affect overall survival (120 months) in LS and non-LS patients. Conclusions The high probability of LS in Indonesian CRC patients is associated with KRAS and PIK3CA mutations.
Collapse
Affiliation(s)
- Didik Setyo Heriyanto
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital Yogyakarta, Indonesia
- Collaboration Research Center for Precision Oncology based Omics - PKR PrOmics, Yogyakarta, Indonesia
| | - Naomi Yoshuantari
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital Yogyakarta, Indonesia
| | - Gilang Akbariani
- Pathgen Diagnostik Teknologi, Ir. Soekarno Science and Technology Park, National Research and Innovation Agency Republic of Indonesia, Bogor, Indonesia
| | - Vincent Lau
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital Yogyakarta, Indonesia
| | - Hanifa Hanini
- Pathgen Diagnostik Teknologi, Ir. Soekarno Science and Technology Park, National Research and Innovation Agency Republic of Indonesia, Bogor, Indonesia
| | - Zulfa Hidayati
- Pathgen Diagnostik Teknologi, Ir. Soekarno Science and Technology Park, National Research and Innovation Agency Republic of Indonesia, Bogor, Indonesia
| | - Muhammad Zulfikar Arief
- Pathgen Diagnostik Teknologi, Ir. Soekarno Science and Technology Park, National Research and Innovation Agency Republic of Indonesia, Bogor, Indonesia
| | - Andrew Nobiantoro Gunawan
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital Yogyakarta, Indonesia
| | - Asep Muhamad Ridwanuloh
- Research Center for Genetic Engineering, Research Organization for Life Sciences and Environment, National Research and Innovation Agency Republic of Indonesia, Ir. Soekarno Science and Technology Park, Bogor, Indonesia
| | - Wien Kusharyoto
- Research Center for Genetic Engineering, Research Organization for Life Sciences and Environment, National Research and Innovation Agency Republic of Indonesia, Ir. Soekarno Science and Technology Park, Bogor, Indonesia
| | - Adeodatus Yuda Handaya
- Division of Digestive Surgeon, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital Yogyakarta, Indonesia
| | - Mohammad Ilyas
- Molecular Pathology Research Group, Academic Unit of Translational Medical Science, Biodiscovery Institute, School of Medicine, University of Nottingham, Nottingham, UK
| | - Johan Kurnianda
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Susanti Susanti
- Pathgen Diagnostik Teknologi, Ir. Soekarno Science and Technology Park, National Research and Innovation Agency Republic of Indonesia, Bogor, Indonesia
- Molecular Pathology Research Group, Academic Unit of Translational Medical Science, Biodiscovery Institute, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Muhammadiyah Purwokerto, Indonesia
| |
Collapse
|
2
|
Venegas-Rodríguez JL, Hernández-Sandoval JA, Gutiérrez-Angulo M, Moreno-Ortiz JM, González-Mercado A, Peregrina-Sandoval J, Ramírez-Plascencia HHF, Flores-López BA, Alvizo-Rodríguez CR, Valenzuela-Pérez JA, Cervantes-Ortiz S, Ayala-Madrigal MDLL. KRAS Exon 2 Mutations in Patients with Sporadic Colorectal Cancer: Prevalence Variations in Mexican and Latin American Populations. Cancers (Basel) 2024; 16:2323. [PMID: 39001385 PMCID: PMC11240588 DOI: 10.3390/cancers16132323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 06/02/2024] [Accepted: 06/21/2024] [Indexed: 07/16/2024] Open
Abstract
We searched for the prevalence of actionable somatic mutations in exon 2 of the KRAS gene in western Mexican patients with CRC. Tumor tissue DNA samples from 150 patients with sporadic CRC recruited at the Civil Hospital of Guadalajara were analyzed. Mutations in exon 2 of the KRAS gene were identified using Sanger sequencing, and the data were analyzed considering clinical-pathological characteristics. Variants in codon 12 (rs121913529 G>A, G>C, and G>T) and codon 13 (rs112445441 G>A) were detected in 26 patients (with a prevalence of 17%). No significant associations were found between these variants and clinical-pathological characteristics (p > 0.05). Furthermore, a comprehensive search was carried out in PubMed/NCBI and Google for the prevalence of KRAS exon 2 mutations in Latin American populations. The 17 studies included 12,604 CRC patients, with an overall prevalence of 30% (95% CI = 0.26-0.35), although the prevalence ranged from 13 to 43% across the different data sources. Determining the variation and frequency of KRAS alleles in CRC patients will enhance their potential to receive targeted treatments and contribute to the understanding of the genomic profile of CRC.
Collapse
Affiliation(s)
- José Luis Venegas-Rodríguez
- Instituto de Genética Humana “Dr. Enrique Corona Rivera”, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (J.L.V.-R.); (J.A.H.-S.); (M.G.-A.); (J.M.M.-O.); (A.G.-M.)
- Programa de Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Jesús Arturo Hernández-Sandoval
- Instituto de Genética Humana “Dr. Enrique Corona Rivera”, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (J.L.V.-R.); (J.A.H.-S.); (M.G.-A.); (J.M.M.-O.); (A.G.-M.)
- Programa de Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Melva Gutiérrez-Angulo
- Instituto de Genética Humana “Dr. Enrique Corona Rivera”, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (J.L.V.-R.); (J.A.H.-S.); (M.G.-A.); (J.M.M.-O.); (A.G.-M.)
- Programa de Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
- Departamento de Ciencias de la Salud, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47600, Jalisco, Mexico
| | - José Miguel Moreno-Ortiz
- Instituto de Genética Humana “Dr. Enrique Corona Rivera”, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (J.L.V.-R.); (J.A.H.-S.); (M.G.-A.); (J.M.M.-O.); (A.G.-M.)
- Programa de Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Anahí González-Mercado
- Instituto de Genética Humana “Dr. Enrique Corona Rivera”, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (J.L.V.-R.); (J.A.H.-S.); (M.G.-A.); (J.M.M.-O.); (A.G.-M.)
- Programa de Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Jorge Peregrina-Sandoval
- Departamento de Biología Celular y Molecular, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Zapopan 44600, Jalisco, Mexico;
| | | | - Beatriz Armida Flores-López
- Departamento de Ciclo de Vida, Facultad de Medicina, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico;
| | | | - Jesús Alonso Valenzuela-Pérez
- Servicio de Colon y Recto, Hospital Civil “Dr. Juan I. Menchaca”, Guadalajara 44340, Jalisco, Mexico; (J.A.V.-P.); (S.C.-O.)
| | - Sergio Cervantes-Ortiz
- Servicio de Colon y Recto, Hospital Civil “Dr. Juan I. Menchaca”, Guadalajara 44340, Jalisco, Mexico; (J.A.V.-P.); (S.C.-O.)
| | - María de la Luz Ayala-Madrigal
- Instituto de Genética Humana “Dr. Enrique Corona Rivera”, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (J.L.V.-R.); (J.A.H.-S.); (M.G.-A.); (J.M.M.-O.); (A.G.-M.)
- Programa de Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| |
Collapse
|
3
|
Zhou Y, Wu S, Qu FJ. Therapeutic strategies targeting the epidermal growth factor receptor signaling pathway in metastatic colorectal cancer. World J Gastrointest Oncol 2024; 16:2362-2379. [PMID: 38994135 PMCID: PMC11236217 DOI: 10.4251/wjgo.v16.i6.2362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/13/2024] [Accepted: 04/01/2024] [Indexed: 06/14/2024] Open
Abstract
More than 1.9 million new colorectal cancer (CRC) cases and 935000 deaths were estimated to occur worldwide in 2020, representing about one in ten cancer cases and deaths. Overall, colorectal ranks third in incidence, but second in mortality. More than half of the patients are in advanced stages at diagnosis. Treatment options are complex because of the heterogeneity of the patient population, including different molecular subtypes. Treatments have included conventional fluorouracil-based chemotherapy, targeted therapy, immunotherapy, etc. In recent years, with the development of genetic testing technology, more and more targeted drugs have been applied to the treatment of CRC, which has further prolonged the survival of metastatic CRC patients.
Collapse
Affiliation(s)
- Yi Zhou
- Department of Oncology, Affiliated Dalian Third People’s Hospital of Dalian Medical University, Dalian 116033, Liaoning Province, China
| | - Shuang Wu
- Department of Oncology, Affiliated Dalian Third People’s Hospital of Dalian Medical University, Dalian 116033, Liaoning Province, China
| | - Fan-Jie Qu
- Department of Oncology, Affiliated Dalian Third People’s Hospital of Dalian Medical University, Dalian 116033, Liaoning Province, China
| |
Collapse
|
4
|
He Q, Sun C, Pan Y. Whole‑exome sequencing reveals Lewis lung carcinoma is a hypermutated Kras/Nras-mutant cancer with extensive regional mutation clusters in its genome. Sci Rep 2024; 14:100. [PMID: 38167599 PMCID: PMC10762126 DOI: 10.1038/s41598-023-50703-2] [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: 02/08/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024] Open
Abstract
Lewis lung carcinoma (LLC), as a widely used preclinical cancer model, has still not been genetically and genomically characterized. Here, we performed a whole-exome sequencing analysis on the LLC cell line to elucidate its molecular characteristics and etiologies. Our data showed that LLC originated from a male mouse belonging to C57BL/6L (a transitional strain between C57BL/6J and C57BL/6N) and contains substantial somatic SNV and InDel mutations (> 20,000). Extensive regional mutation clusters are present in its genome, which were caused mainly by the mutational processes underlying the SBS1, SBS5, SBS15, SBS17a, and SBS21 signatures during frequent structural rearrangements. Thirty three deleterious mutations are present in 30 cancer genes including Kras, Nras, Trp53, Dcc, and Cacna1d. Cdkn2a and Cdkn2b are biallelically deleted from the genome. Five pathways (RTK/RAS, p53, cell cycle, TGFB, and Hippo) are oncogenically deregulated or affected. The major mutational processes in LLC include chromosomal instability, exposure to metabolic mutagens, spontaneous 5-methylcytosine deamination, defective DNA mismatch repair, and reactive oxygen species. Our data also suggest that LLC is a lung cancer similar to human lung adenocarcinoma. This study lays a molecular basis for the more targeted application of LLC in preclinical research.
Collapse
Affiliation(s)
- Quan He
- Department of Chemistry, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Cuirong Sun
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
| | - Yuanjiang Pan
- Department of Chemistry, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
| |
Collapse
|
5
|
El Zaitouni S, Laraqui A, Ghaouti M, Benzekri A, Kettani F, Bajjou T, Sekhsokh Y, Benmokhtar S, Jafari M, Baba W, Oukabli M, El Annaz H, Abi R, Tagajdid MR, El Kochri S, Lahlou IA, Ameziane El Hassani R, Ennibi K. KRAS, NRAS and BRAF Mutational Profile of Colorectal Cancer in a Series of Moroccan Patients. Cancer Control 2024; 31:10732748241262179. [PMID: 38875469 PMCID: PMC11179507 DOI: 10.1177/10732748241262179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024] Open
Abstract
OBJECTIVES The present study aimed to evaluate the frequencies of KRAS, NRAS, and BRAF mutations and their possible associations with clinicopathological features in 249 Moroccan patients with colorectal cancer (CRC). METHODS A retrospective investigation of a cohort of formalin-fixed paraffin-embedded tissues of 249 patients with CRC was screened for KRAS/NRAS/BRAF mutations using Idylla™ technology and pyrosequencing. RESULTS KRAS, NRAS, and BRAF mutations were revealed in 46.6% (116/249), 5.6% (14/249), and 2.4% (6/249) of patients. KRAS exon 2 mutations were identified in 87.9% of patients (102/116). KRAS G12D and G12 C were the most frequent, at 32.8% and 12.93%, respectively. Among the patients with KRAS exon 2 wild-type (wt), 27.6% (32/116) harbored additional KRAS mutations. Concurrent KRAS mutations were identified in 9.5% (11/116); including six in codon 146 (A146P/T/V), three in codon 61 (Q61H/L/R), one in codon 12 (G12 A and Q61H), and one in codon 13 (G13D and Q61 L). Among the NRAS exon 2 wt patients, 64.3% (9/14) harbored additional NRAS mutations. Concurrent NRAS mutations were identified in 28.6% (4/14) of NRAS-mutant patients. Since 3.2% wt KRAS were identified with NRAS mutations, concomitant KRAS and NRAS mutations were identified in 2.4% (6/249) of patients. KRAS mutations were higher in the >50-year-old age-group (P = .031), and the tumor location was revealed to be significantly associated with KRAS mutations (P = .028) predominantly in left colon (27.5%) and colon (42.2%) locations. NRAS mutations were most prevalent in the left colon (42.8%) and in well-differentiated tumors (64.2%). CONCLUSION Detection of KRAS mutations, particularly the G12 C subtype, may be significant for patients with CRC and has possible therapeutic implications. However, rare KRAS concomitant mutations in CRC patients suggest that each individual may present distinct therapeutic responses. KRAS testing alongside the identification of other affected genes in the same patient will make the treatments even more personalized by contributing more accurately to the clinical decision process. Overall, early diagnosis using novel molecular techniques may improve the management of CRC by providing the most efficient therapies for Moroccan patients.
Collapse
Affiliation(s)
- Sara El Zaitouni
- Laboratory of Biology of Human Pathologies, Genomic Center of Human Pathologies, Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
- Laboratory of Research and Biosafety P3, Mohammed V Military Teaching Hospital of Rabat, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Abdelilah Laraqui
- Royal School of Military Health Service, Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious, and Tropical Diseases, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Meriem Ghaouti
- Department of Pathology, Nations-Unites Pathology Center, Rabat, Morocco
| | - Asmae Benzekri
- Department of Pathology, Nations-Unites Pathology Center, Rabat, Morocco
| | - Fouad Kettani
- Department of Pathology, Nations-Unites Pathology Center, Rabat, Morocco
| | - Tahar Bajjou
- Laboratory of Research and Biosafety P3, Mohammed V Military Teaching Hospital of Rabat, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Yassine Sekhsokh
- Laboratory of Research and Biosafety P3, Mohammed V Military Teaching Hospital of Rabat, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Soukaina Benmokhtar
- Laboratory of Biology of Human Pathologies, Genomic Center of Human Pathologies, Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
- Laboratory of Research and Biosafety P3, Mohammed V Military Teaching Hospital of Rabat, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Meryem Jafari
- Laboratory of Biology of Human Pathologies, Genomic Center of Human Pathologies, Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
- Laboratory of Research and Biosafety P3, Mohammed V Military Teaching Hospital of Rabat, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Walid Baba
- Laboratory of Biology of Human Pathologies, Genomic Center of Human Pathologies, Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
- Laboratory of Research and Biosafety P3, Mohammed V Military Teaching Hospital of Rabat, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohamed Oukabli
- Department of Pathology, Mohammed V Military Teaching Hospital of Rabat, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Hicham El Annaz
- Royal School of Military Health Service, Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious, and Tropical Diseases, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Rachid Abi
- Royal School of Military Health Service, Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious, and Tropical Diseases, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohamed Rida Tagajdid
- Royal School of Military Health Service, Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious, and Tropical Diseases, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Safae El Kochri
- Royal School of Military Health Service, Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious, and Tropical Diseases, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Idriss Amine Lahlou
- Royal School of Military Health Service, Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious, and Tropical Diseases, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Rabii Ameziane El Hassani
- Laboratory of Biology of Human Pathologies, Genomic Center of Human Pathologies, Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
| | - Khalid Ennibi
- Royal School of Military Health Service, Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious, and Tropical Diseases, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| |
Collapse
|
6
|
Kasi PM, Afable MG, Herting C, Lukanowski M, Jin Z. Anti-EGFR Antibodies in the Management of Advanced Colorectal Cancer. Oncologist 2023; 28:1034-1048. [PMID: 37774394 PMCID: PMC11025386 DOI: 10.1093/oncolo/oyad262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/25/2023] [Indexed: 10/01/2023] Open
Abstract
Colorectal cancer is the third most common cancer worldwide, and incidence is rising in younger individuals. Anti-EGFR antibodies, including cetuximab and panitumumab, have been incorporated into standard-of-care practice for patients with advanced disease. Herein, we review the molecular characteristics of these agents and the trials that lead to their approvals. Further, we discuss clinical implications of data regarding biomarkers that dictate treatment selection, different dosing strategies, and side effect management. Finally, we look towards the future and describe contexts in which these agents are currently being investigated clinically with a focus on combinations with MAPK-targeted therapies and immunotherapy. Overall, this review provides historical context, current clinical usage, and future directions for anti-EGFR antibodies in advanced colorectal cancer.
Collapse
Affiliation(s)
- Pashtoon Murtaza Kasi
- Department of Oncology/Hematology, Division of Internal Medicine, Weill Cornell Medicine, Meyer Cancer Center, Englander Institute of Precision Medicine, New York, NY, USA
| | | | - Cameron Herting
- Medical Affairs, Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Zhaohui Jin
- Department of Oncology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
7
|
Jurado M, Zorzano A, Castaño O. Cooperativity and oscillations: Regulatory mechanisms of K-Ras nanoclusters. Comput Biol Med 2023; 166:107455. [PMID: 37742420 DOI: 10.1016/j.compbiomed.2023.107455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 08/07/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
K-Ras nanoclusters (NCs) concentrate all required molecules belonging to the extracellular signal-regulated kinase (ERK) mitogen-activated protein kinase (MAPK) pathway in a small area where signaling events take place, increasing efficiency and specificity of signaling. Such nanostructures are characterized by controlled sizes and lifetimes distributions, but there is a poor understanding of the mechanisms involved in their dynamics of growth/decay. Here, a minimum computational model is presented to analyze the behavior of K-Ras NCs as cooperative dynamic structures that self-regulate their growth and decay according to their size. Indeed, the proposed model reveals that the growth and the local production of a K-Ras nanocluster depend positively on its actual size, whilst its lifetime is inversely proportional to the root of its size. The cooperative binding between the structural constituents of the NC (K-Ras proteins) induces oscillations in the size distributions of K-Ras NCs allowing them to range within controlled values, regulating the growth/decay dynamics of these NCs. Thereby, the size of a K-Ras NC is proposed as a key factor to regulate cell signaling, opening a range of possibilities to develop strategies for use in chronic diseases and cancer.
Collapse
Affiliation(s)
- Manuel Jurado
- Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
| | - Antonio Zorzano
- Institute for Research in Biomedicine (IRB), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain; CIBER of Diabetes and Associated Metabolic Diseases, Barcelona, Spain; Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain.
| | - Oscar Castaño
- Electronics and Biomedical Engineering, Universitat de Barcelona (UB), Barcelona, Spain; Nanobioengineering and Biomaterials, Institute of Nanoscience and Nanotechnology of the University of Barcelona, Barcelona, Spain
| |
Collapse
|
8
|
Ding M, Yan J, Chao G, Zhang S. Application of artificial intelligence in colorectal cancer screening by colonoscopy: Future prospects (Review). Oncol Rep 2023; 50:199. [PMID: 37772392 DOI: 10.3892/or.2023.8636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/07/2023] [Indexed: 09/30/2023] Open
Abstract
Colorectal cancer (CRC) has become a severe global health concern, with the third‑high incidence and second‑high mortality rate of all cancers. The burden of CRC is expected to surge to 60% by 2030. Fortunately, effective early evidence‑based screening could significantly reduce the incidence and mortality of CRC. Colonoscopy is the core screening method for CRC with high popularity and accuracy. Yet, the accuracy of colonoscopy in CRC screening is related to the experience and state of operating physicians. It is challenging to maintain the high CRC diagnostic rate of colonoscopy. Artificial intelligence (AI)‑assisted colonoscopy will compensate for the above shortcomings and improve the accuracy, efficiency, and quality of colonoscopy screening. The unique advantages of AI, such as the continuous advancement of high‑performance computing capabilities and innovative deep‑learning architectures, which hugely impact the control of colorectal cancer morbidity and mortality expectancy, highlight its role in colonoscopy screening.
Collapse
Affiliation(s)
- Menglu Ding
- The Second Affiliated Hospital of Zhejiang Chinese Medical University (The Xin Hua Hospital of Zhejiang Province), Hangzhou, Zhejiang 310000, P.R. China
| | - Junbin Yan
- The Second Affiliated Hospital of Zhejiang Chinese Medical University (The Xin Hua Hospital of Zhejiang Province), Hangzhou, Zhejiang 310000, P.R. China
| | - Guanqun Chao
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Shuo Zhang
- The Second Affiliated Hospital of Zhejiang Chinese Medical University (The Xin Hua Hospital of Zhejiang Province), Hangzhou, Zhejiang 310000, P.R. China
| |
Collapse
|
9
|
Zeng J, Fan W, Li J, Wu G, Wu H. KRAS/NRAS Mutations Associated with Distant Metastasis and BRAF/PIK3CA Mutations Associated with Poor Tumor Differentiation in Colorectal Cancer. Int J Gen Med 2023; 16:4109-4120. [PMID: 37720173 PMCID: PMC10503567 DOI: 10.2147/ijgm.s428580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023] Open
Abstract
Background The occurrence, progression, and prognosis of colorectal cancer (CRC) are regulated by EGFR-mediated signaling pathways. However, the relationship between the core genes (KRAS/NRAS/BRAF/PIK3CA) status in the signaling pathways and clinicopathological characteristics of CRC patients in Hakka population remains controversial. Methods Patients were genotyped for KRAS (codons 12, 13, 61, 117, and 146), NRAS (codons 12, 61, 117, and 146), BRAF (codons 600), and PIK3CA (codons 542, 545 and 1047) mutations. Clinical records were collected, and clinicopathological characteristic associations were analyzed together with mutations of studied genes. Results Four hundred and eight patients (256 men and 152 women) were included in the analysis. At least one mutation in the four genes was detected in 216 (52.9%) patients, while none was detected in 192 (47.1%) patients. KRAS, NRAS, BRAF, and PIK3CA mutation status were detected in 190 (46.6%), 11 (2.7%), 10 (2.5%), 34 (8.3%) samples, respectively. KRAS exon 2 had the highest proportion (62.5%). Age, tumor site, tumor size, lymphovascular invasion, and perineural invasion were not associated with gene mutations. KRAS mutations (adjusted OR 1.675, 95% CI 1.017-2.760, P=0.043) and NRAS mutations (adjusted OR 5.183, 95% CI 1.239-21.687, P=0.024) appeared more frequently in patients with distant metastasis. BRAF mutations (adjusted OR 7.224, 95% CI 1.356-38.488, P=0.021) and PIK3CA mutations (adjusted OR 3.811, 95% CI 1.268-11.455, P=0.017) associated with poorly differentiated tumor. Conclusion KRAS/NRAS mutations are associated with distant metastasis and BRAF/PIK3CA mutations are associated with poor tumor differentiation in CRC. And the results provided a better understanding between clinicopathological characteristics and gene mutations in CRC patients.
Collapse
Affiliation(s)
- Juanzi Zeng
- Department of Medical Oncology, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Center for Precision Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Wenwei Fan
- Department of Gastroenterology, Dongguan Eighth People’s Hospital, Dongguan, People’s Republic of China
| | - Jiaquan Li
- Department of Medical Oncology, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Center for Precision Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Guowu Wu
- Department of Medical Oncology, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Center for Precision Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Heming Wu
- Center for Precision Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| |
Collapse
|
10
|
Dane A, van Leeuwen R, Hoedemakers M, van der Kuy H, Sleijfer S. Combatting the rising costs of cancer drugs; interventions from a university hospital's perspective. Front Pharmacol 2023; 14:1264951. [PMID: 37701038 PMCID: PMC10493871 DOI: 10.3389/fphar.2023.1264951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/16/2023] [Indexed: 09/14/2023] Open
Abstract
Rapid increase in cost continues to have negative impact on patients' accessibility to life-changing anticancer medications. Moreover, the rising cost does not equate to similar increase in medication effectiveness. We recognise our responsibility as a university hospital to tackle this imbalance and strive to provide high quality, sustainable, affordable and accessible care. An active approach in cost containment of expensive and innovative cancer drugs was adopted in our organisation to safeguard accessibility and improve quality of life for patients. In this article, we described four inverventions: 1) identify right patient and minimise overtreatment, 2) in-house medicine production for selected indications, 3) minimise medicine spillages and 4) effective procurement strategies. We call on other hospitals to take action and, favourably, to collaborate on a European level. Together, we will safeguard the current and future care of our patients.
Collapse
Affiliation(s)
- Aniek Dane
- Department of Hospital Pharmacy, Erasmus MC, Rotterdam, Netherlands
| | | | - Maaike Hoedemakers
- Department of Market Strategy and Healthcare Financing, Erasmus MC, Rotterdam, Netherlands
| | - Hugo van der Kuy
- Department of Hospital Pharmacy, Erasmus MC, Rotterdam, Netherlands
| | | |
Collapse
|
11
|
Radanova M, Mihaylova G, Stoyanov GS, Draganova V, Zlatarov A, Kolev N, Dimitrova E, Conev N, Ivanova D. KRAS Mutation Status in Bulgarian Patients with Advanced and Metastatic Colorectal Cancer. Int J Mol Sci 2023; 24:12753. [PMID: 37628934 PMCID: PMC10454445 DOI: 10.3390/ijms241612753] [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: 07/04/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
RAS somatic variants are predictors of resistance to anti-EGFR therapy for colorectal cancer (CRC) and affect the outcome of the disease. Our study aimed to evaluate the frequency of RAS, with a focus on KRAS variants, and their association with tumor location and some clinicopathological characteristics in Bulgarian CRC patients. We prospectively investigated 236 patients with advanced and metastatic CRC. Genomic DNA was extracted from FFPE tumor tissue samples, and commercially available kits were used to detect RAS gene somatic mutations via real-time PCR. A total of 115 (48.73%) patients tested positive for RAS mutations, with 106 (44.92%) testing positive for KRAS mutations. The most common mutation in exon 2 was c.35G>T p.Gly12Val (32.56%). We did not find a significant difference in KRAS mutation frequency according to tumor location. However, patients with a mutation in exon 4 of KRAS were 3.23 times more likely to have a tumor in the rectum than in other locations (95% CI: 1.19-8.72, p = 0.021). Studying the link between tumor location and KRAS mutations in exon 4 is crucial for better characterizing CRC patients. Further research with larger cohorts, especially in rectal cancer patients, could provide valuable insights for patient follow-up and treatment selection.
Collapse
Affiliation(s)
- Maria Radanova
- Department of Biochemistry, Molecular Medicine and Nutrigenomics, Medical University of Varna, 9000 Varna, Bulgaria; (G.M.); (D.I.)
| | - Galya Mihaylova
- Department of Biochemistry, Molecular Medicine and Nutrigenomics, Medical University of Varna, 9000 Varna, Bulgaria; (G.M.); (D.I.)
| | - George St. Stoyanov
- Department of Clinical Pathology, Complex Oncology Center—Shumen, 9700 Shumen, Bulgaria;
- Department of Surgery Diseases, Medical University of Varna, 9000 Varna, Bulgaria;
| | - Vyara Draganova
- Department of Surgery Diseases, Medical University of Varna, 9000 Varna, Bulgaria;
- Second Clinic of Surgery, UMHAT “St. Marina”, 9000 Varna, Bulgaria
| | - Aleksandar Zlatarov
- Department of General and Operative Surgery, Medical University of Varna, 9000 Varna, Bulgaria; (A.Z.); (N.K.)
- First Clinic of Surgery, UMHAT “St. Marina”, 9000 Varna, Bulgaria
| | - Nikola Kolev
- Department of General and Operative Surgery, Medical University of Varna, 9000 Varna, Bulgaria; (A.Z.); (N.K.)
- First Clinic of Surgery, UMHAT “St. Marina”, 9000 Varna, Bulgaria
| | - Eleonora Dimitrova
- Department of Oncology, Medical University of Varna, 9000 Varna, Bulgaria; (E.D.); (N.C.)
- Clinic of Medical Oncology, UMHAT “St. Marina”, 9000 Varna, Bulgaria
| | - Nikolay Conev
- Department of Oncology, Medical University of Varna, 9000 Varna, Bulgaria; (E.D.); (N.C.)
- Clinic of Medical Oncology, UMHAT “St. Marina”, 9000 Varna, Bulgaria
| | - Diana Ivanova
- Department of Biochemistry, Molecular Medicine and Nutrigenomics, Medical University of Varna, 9000 Varna, Bulgaria; (G.M.); (D.I.)
| |
Collapse
|
12
|
Hasbullah HH, Sulong S, Che Jalil NA, Abdul Aziz AA, Musa N, Musa M. KRAS Mutational Profiles among Colorectal Cancer Patients in the East Coast of Peninsular Malaysia. Diagnostics (Basel) 2023; 13:diagnostics13050822. [PMID: 36899966 PMCID: PMC10001354 DOI: 10.3390/diagnostics13050822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND KRAS is a key driver gene in colorectal carcinogenesis. Despite this, there are still limited data on the mutational status of KRAS amongst colorectal cancer (CRC) patients in Malaysia. In the present study, we aimed to analyze the KRAS mutational profiles on codons 12 and 13 amongst CRC patients in Hospital Universiti Sains Malaysia, Kelantan, located on the East Coast of Peninsular Malaysia. METHODS DNA were extracted from formalin-fixed, paraffin-embedded tissues obtained from 33 CRC patients diagnosed between 2018 and 2019. Amplifications of codons 12 and 13 of KRAS were conducted using conventional polymerase chain reaction (PCR) followed by Sanger sequencing. RESULTS Mutations were identified in 36.4% (12/33) of patients, with G12D (50%) being the most frequent single-point mutation observed, followed by G12V (25%), G13D (16.7%), and G12S (8.3%). No correlation was found between mutant KRAS and location of the tumor, staging, and initial carcinoembryonic antigen (CEA) level. CONCLUSION Current analyses revealed that a significant proportion of CRC patients in the East Coast of Peninsular Malaysia have KRAS mutations, where this frequency is higher compared to those in the West Coast. The findings of this study would serve as a precursor for further research that explores KRAS mutational status and the profiling of other candidate genes among Malaysian CRC patients.
Collapse
Affiliation(s)
| | - Sarina Sulong
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
| | - Nur Asyilla Che Jalil
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
| | - Ahmad Aizat Abdul Aziz
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
| | - Nurfadhlina Musa
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
| | - Marahaini Musa
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
- Correspondence: ; Tel.: +609-7676794
| |
Collapse
|
13
|
Yin Z, Yao C, Zhang L, Qi S. Application of artificial intelligence in diagnosis and treatment of colorectal cancer: A novel Prospect. Front Med (Lausanne) 2023; 10:1128084. [PMID: 36968824 PMCID: PMC10030915 DOI: 10.3389/fmed.2023.1128084] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/13/2023] [Indexed: 03/29/2023] Open
Abstract
In the past few decades, according to the rapid development of information technology, artificial intelligence (AI) has also made significant progress in the medical field. Colorectal cancer (CRC) is the third most diagnosed cancer worldwide, and its incidence and mortality rates are increasing yearly, especially in developing countries. This article reviews the latest progress in AI in diagnosing and treating CRC based on a systematic collection of previous literature. Most CRCs transform from polyp mutations. The computer-aided detection systems can significantly improve the polyp and adenoma detection rate by early colonoscopy screening, thereby lowering the possibility of mutating into CRC. Machine learning and bioinformatics analysis can help screen and identify more CRC biomarkers to provide the basis for non-invasive screening. The Convolutional neural networks can assist in reading histopathologic tissue images, reducing the experience difference among doctors. Various studies have shown that AI-based high-level auxiliary diagnostic systems can significantly improve the readability of medical images and help clinicians make more accurate diagnostic and therapeutic decisions. Moreover, Robotic surgery systems such as da Vinci have been more and more commonly used to treat CRC patients, according to their precise operating performance. The application of AI in neoadjuvant chemoradiotherapy has further improved the treatment and efficacy evaluation of CRC. In addition, AI represented by deep learning in gene sequencing research offers a new treatment option. All of these things have seen that AI has a promising prospect in the era of precision medicine.
Collapse
Affiliation(s)
- Zugang Yin
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Chenhui Yao
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Chenhui Yao,
| | - Limin Zhang
- Department of Respiratory, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shaohua Qi
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing, China
| |
Collapse
|
14
|
Vital M, Carusso F, Vergara C, Neffa F, Della Valle A, Esperón P. Genetic and epigenetic characteristics of patients with colorectal cancer from Uruguay. Pathol Res Pract 2023; 241:154264. [PMID: 36495761 DOI: 10.1016/j.prp.2022.154264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
Colorectal cancer (CRC), the 3rd most frequent cancer worldwide, affects both men and women. This pathology arises from the progressive accumulation of genetic and epigenetic alterations. In this study, KRAS, NRAS, PIK3CA, and BRAF gene mutations, mismatch repair (MMR) genes methylation profile, microsatellite instability (MSI) and CpG Island Methylator Phenotype (CIMP) status were assessed. The associations of these molecular features with clinicopathological data were also investigated. A hundred and eight unselected CRC samples and their histological and clinical data, were gathered between 2017 and 2020. The prevalence of KRAS, NRAS and BRAF gene mutations was similar to that described in other populations. 28.7% of tumors were KRAS-mutated, mostly in men, distal location, with a CIMP-negative status. BRAFV600E frequency was 6.5% and associated with MSI (p = 0.048), MLH1-methylated (p < 0.001) and CIMP-High (p < 0.001) status. We also confirmed that BRAFV600E tumors were more prevalent in older women and proximal location. A striking different result was the lack of most common variants in the PIK3CA gene. A complete absence of PIK3CA-mutated tumors in a population has not been previously reported. Among MMR genes, the only with an aberrant methylation pattern was MLH1 gene. Its frequency was 9.25%, lower than previously reported. Methylated tumors were most frequent in patients older than 70 years old and proximal tumor location. Finally, CIMP-High status was mainly observed in moderately differentiated tumors with a rate of 15.7%. Our findings were consistent with previous reports in other populations, but also showed some features unique to our cohort. This study is the first to report the analysis of a large number molecular biomarkers of CRC in Uruguay and one of the few performed in Latin-America.
Collapse
Affiliation(s)
- Marcelo Vital
- Molecular Genetic Unit, School of Chemistry, Universidad de la República, General Flores 2124, CP1800 Montevideo, Uruguay.
| | - Florencia Carusso
- Uruguayan Collaborative Group, Dirección Nacional de Sanidad de las Fuerzas Armadas, 8 de Octubre 3020, CP1600 Montevideo, Uruguay.
| | - Carolina Vergara
- Uruguayan Collaborative Group, Dirección Nacional de Sanidad de las Fuerzas Armadas, 8 de Octubre 3020, CP1600 Montevideo, Uruguay.
| | - Florencia Neffa
- Uruguayan Collaborative Group, Dirección Nacional de Sanidad de las Fuerzas Armadas, 8 de Octubre 3020, CP1600 Montevideo, Uruguay.
| | - Adriana Della Valle
- Uruguayan Collaborative Group, Dirección Nacional de Sanidad de las Fuerzas Armadas, 8 de Octubre 3020, CP1600 Montevideo, Uruguay.
| | - Patricia Esperón
- Molecular Genetic Unit, School of Chemistry, Universidad de la República, General Flores 2124, CP1800 Montevideo, Uruguay; Uruguayan Collaborative Group, Dirección Nacional de Sanidad de las Fuerzas Armadas, 8 de Octubre 3020, CP1600 Montevideo, Uruguay; Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Madrid, Spain.
| |
Collapse
|
15
|
Jafari M, Laraqui A, Baba W, Benmokhtar S, Zaitouni SE, Ali AA, Bounaim A, Moujahid M, Tanz R, Mahfoud T, Sbitti Y, Annaz HE, Abi R, Tagajdid MR, Kochri SE, Lahlou IA, Hsaini HE, Belayachi L, Benjouad A, Ichou M, En-Nya A, Ennibi K. Prevalence and patterns of mutations in RAS/RAF/MEK/ERK/MAPK signaling pathway in colorectal cancer in North Africa. BMC Cancer 2022; 22:1142. [PMCID: PMC9639273 DOI: 10.1186/s12885-022-10235-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
Background Our review discuss (i) the findings from analyzed data that have examined KRAS, NRAS and BRAF mutations in patients with colorectal cancer (CRC) in North Africa and to compare its prevalence with that shown in other populations and (ii) the possible role of dietary and lifestyle factors with CRC risk. Methods Using electronic databases, a systematic literature search was performed for the KRAS, NRAS, and BRAF mutations in CRC patients from Morocco, Tunisia, Algeria and Lybia. Results Seventeen studies were identified through electronic searches with six studies conducted in Morocco, eight in Tunisia, two in Algeria, and one in Libya. A total of 1843 CRC patients were included 576 (31.3%) in Morocco, 641 (34.8%) in Tunisia, 592 (32.1%) in Algeria, and 34 (1.8%) in Libya. Overall, the average age of patients was 52.7 years old. Patients were predominantly male (56.6%). The mutation rates of KRAS, NRAS and BRAF were 46.4%, 3.2% and 3.5% of all patients, respectively. A broad range of reported KRAS mutation frequencies have been reported in North Africa countries. The KRAS mutation frequency was 23.9% to 51% in Morocco, 23.1% to 68.2% in Tunisia, 31.4% to 50% in Algeria, and 38.2% in Libya. The G12D was the most frequently identified KRAS exon 2 mutations (31.6%), followed by G12V (25.4%), G13D (15.5%), G12C (10.2%), G12A (6.9%), and G12S (6.4%). G12R, G13V, G13C and G13R are less than 5%. There are important differences among North Africa countries. In Morocco and Tunisia, there is a higher prevalence of G12D mutation in KRAS exon 2 (≈50%). The most frequently mutation type in KRAS exon 3 was Q61L (40%). A59T and Q61E mutations were also found. In KRAS exon 4, the most common mutation was A146T (50%), followed by K117N (33.3%), A146P (8.3%) and A146V (8.3%). Conclusion KRAS mutated CRC patients in North Africa have been identified with incidence closer to the European figures. Beside established anti-CRC treatment, better understanding of the causality of CRC can be established by combining epidemiology and genetic/epigenetic on CRC etiology. This approach may be able to significantly reduce the burden of CRC in North Africa.
Collapse
Affiliation(s)
- Meryem Jafari
- grid.31143.340000 0001 2168 4024Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco ,grid.31143.340000 0001 2168 4024Laboratory of Biology of Human Pathologies, Department of Biology, Faculty of Sciences, Genomic Center of Human Pathologies, Mohammed V University in Rabat, Rabat, Morocco
| | - Abdelilah Laraqui
- grid.31143.340000 0001 2168 4024Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Walid Baba
- grid.31143.340000 0001 2168 4024Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco ,grid.31143.340000 0001 2168 4024Laboratory of Biology of Human Pathologies, Department of Biology, Faculty of Sciences, Genomic Center of Human Pathologies, Mohammed V University in Rabat, Rabat, Morocco
| | - Soukaina Benmokhtar
- grid.31143.340000 0001 2168 4024Laboratory of Biology of Human Pathologies, Department of Biology, Faculty of Sciences, Genomic Center of Human Pathologies, Mohammed V University in Rabat, Rabat, Morocco
| | - Sara El Zaitouni
- grid.31143.340000 0001 2168 4024Laboratory of Biology of Human Pathologies, Department of Biology, Faculty of Sciences, Genomic Center of Human Pathologies, Mohammed V University in Rabat, Rabat, Morocco
| | - Abdelmounaim Ait Ali
- grid.31143.340000 0001 2168 4024Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Ahmed Bounaim
- grid.31143.340000 0001 2168 4024Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Mountassir Moujahid
- grid.31143.340000 0001 2168 4024Department of Digestive Surgery, Faculty of Medicine and Pharmacy, Mohammed V Military Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Rachid Tanz
- grid.31143.340000 0001 2168 4024Department of Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Tarik Mahfoud
- grid.31143.340000 0001 2168 4024Department of Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Yassir Sbitti
- grid.31143.340000 0001 2168 4024Department of Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Hicham El Annaz
- grid.31143.340000 0001 2168 4024Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Rachid Abi
- grid.31143.340000 0001 2168 4024Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohamed Rida Tagajdid
- grid.31143.340000 0001 2168 4024Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Safae El Kochri
- grid.31143.340000 0001 2168 4024Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Idriss Amine Lahlou
- grid.31143.340000 0001 2168 4024Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Houda El Hsaini
- grid.463678.80000 0004 5896 7337International Faculty of Dental Medicine, College of Health Sciences, International University in Rabat, Rabat, Morocco
| | - Lamiae Belayachi
- grid.463678.80000 0004 5896 7337International Faculty of Dental Medicine, College of Health Sciences, International University in Rabat, Rabat, Morocco
| | - Abdelaziz Benjouad
- grid.463678.80000 0004 5896 7337International Faculty of Dental Medicine, College of Health Sciences, International University in Rabat, Rabat, Morocco
| | - Mohammed Ichou
- grid.31143.340000 0001 2168 4024Department of Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Amina En-Nya
- grid.31143.340000 0001 2168 4024Laboratory of Biology of Human Pathologies, Department of Biology, Faculty of Sciences, Genomic Center of Human Pathologies, Mohammed V University in Rabat, Rabat, Morocco
| | - Khalid Ennibi
- grid.31143.340000 0001 2168 4024Sequencing Unit, Laboratory of Virology, Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco ,grid.31143.340000 0001 2168 4024Center of Virology, Infectious and Tropical Diseases, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Mohammed V University in Rabat, Rabat, Morocco
| |
Collapse
|
16
|
Sorokin M, Zolotovskaia M, Nikitin D, Suntsova M, Poddubskaya E, Glusker A, Garazha A, Moisseev A, Li X, Sekacheva M, Naskhletashvili D, Seryakov A, Wang Y, Buzdin A. Personalized targeted therapy prescription in colorectal cancer using algorithmic analysis of RNA sequencing data. BMC Cancer 2022; 22:1113. [PMCID: PMC9623986 DOI: 10.1186/s12885-022-10177-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 09/26/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Overall survival of advanced colorectal cancer (CRC) patients remains poor, and gene expression analysis could potentially complement detection of clinically relevant mutations to personalize CRC treatments. Methods: We performed RNA sequencing of formalin-fixed, paraffin-embedded (FFPE) cancer tissue samples of 23 CRC patients and interpreted the data obtained using bioinformatic method Oncobox for expression-based rating of targeted therapeutics. Oncobox ranks cancer drugs according to the efficiency score calculated using target genes expression and molecular pathway activation data. The patients had primary and metastatic CRC with metastases in liver, peritoneum, brain, adrenal gland, lymph nodes and ovary. Two patients had mutations in NRAS, seven others had mutated KRAS gene. Patients were treated by aflibercept, bevacizumab, bortezomib, cabozantinib, cetuximab, crizotinib, denosumab, panitumumab and regorafenib as monotherapy or in combination with chemotherapy, and information on the success of totally 39 lines of therapy was collected. Results: Oncobox drug efficiency score was effective biomarker that could predict treatment outcomes in the experimental cohort (AUC 0.77 for all lines of therapy and 0.91 for the first line after tumor sampling). Separately for bevacizumab, it was effective in the experimental cohort (AUC 0.87) and in 3 independent literature CRC datasets, n = 107 (AUC 0.84–0.94). It also predicted progression-free survival in univariate (Hazard ratio 0.14) and multivariate (Hazard ratio 0.066) analyses. Difference in AUC scores evidences importance of using recent biosamples for the prediction quality. Conclusion: Our results suggest that RNA sequencing analysis of tumor FFPE materials may be helpful for personalizing prescriptions of targeted therapeutics in CRC. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-10177-3.
Collapse
Affiliation(s)
- Maxim Sorokin
- grid.448878.f0000 0001 2288 8774I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia ,grid.18763.3b0000000092721542Moscow Institute of Physics and Technology, 141701 Moscow Region, Russia ,OmicsWay Corp, 91789 Walnut, CA USA
| | - Marianna Zolotovskaia
- grid.18763.3b0000000092721542Moscow Institute of Physics and Technology, 141701 Moscow Region, Russia
| | - Daniil Nikitin
- OmicsWay Corp, 91789 Walnut, CA USA ,grid.418853.30000 0004 0440 1573Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, 117997 Moscow, Russia
| | - Maria Suntsova
- grid.448878.f0000 0001 2288 8774World-Class Research Center “Digital biodesign and personalized healthcare”, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Elena Poddubskaya
- grid.448878.f0000 0001 2288 8774I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia ,Clinical Center Vitamed, 121309 Moscow, Russia
| | - Alexander Glusker
- grid.448878.f0000 0001 2288 8774I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | | | - Alexey Moisseev
- grid.448878.f0000 0001 2288 8774I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Xinmin Li
- grid.19006.3e0000 0000 9632 6718Department of Pathology and Laboratory Medicine, University of California, 90095 Los Angeles, CA USA
| | - Marina Sekacheva
- grid.448878.f0000 0001 2288 8774World-Class Research Center “Digital biodesign and personalized healthcare”, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - David Naskhletashvili
- grid.466904.90000 0000 9092 133XN.N. Blokhin Russian Cancer Research Center, 115478 Moscow, Russia
| | | | - Ye Wang
- grid.410645.20000 0001 0455 0905Core Laboratory, The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao, China
| | - Anton Buzdin
- grid.18763.3b0000000092721542Moscow Institute of Physics and Technology, 141701 Moscow Region, Russia ,grid.418853.30000 0004 0440 1573Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, 117997 Moscow, Russia ,grid.448878.f0000 0001 2288 8774World-Class Research Center “Digital biodesign and personalized healthcare”, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| |
Collapse
|
17
|
Multivariate Risk Analysis of RAS, BRAF and EGFR Mutations Allelic Frequency and Coexistence as Colorectal Cancer Predictive Biomarkers. Cancers (Basel) 2022; 14:cancers14112792. [PMID: 35681771 PMCID: PMC9179415 DOI: 10.3390/cancers14112792] [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: 05/02/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary The colorectal cancer (CRC) stage and evolution should be described by biomarker profiles. In 60 CRC cases, KRAS, NRAS, BRAF, and EGFR mutations were analyzed by droplet digital PCR (ddPCR). KRAS G12/G13 mutation was present in all patients with variable allelic frequencies. KRAS Q61 mutation was correlated with tumor invasion beyond the subserosa and poor differentiation, both associated with worst prognosis. Tumors with NRAS and BRAF mutations were prevalently localized on the right segment colon. The discovery of the KRAS Q61 role in tumor phenotypes provides the foundation for new therapeutic strategies and perspectives on molecular subtypes classification of CRC. Abstract Background: Biomarker profiles should represent a coherent description of the colorectal cancer (CRC) stage and its predicted evolution. Methods: Using droplet digital PCR, we detected the allelic frequencies (AF) of KRAS, NRAS, BRAF, and EGFR mutations from 60 tumors. We employed a pair-wise association approach to estimate the risk involving AF mutations as outcome variables for clinical data and as predicting variables for tumor-staging. We evaluated correlations between mutations of AFs and also between the mutations and histopathology features (tumor staging, inflammation, differentiation, and invasiveness). Results: KRAS G12/G13 mutations were present in all patients. KRAS Q61 was significantly associated with poor differentiation, high desmoplastic reaction, invasiveness (ypT4), and metastasis (ypM1). NRAS and BRAF were associated with the right-side localization of tumors. Diabetic patients had a higher risk to exhibit NRAS G12/G13 mutations. BRAF and NRAS G12/G13 mutations co-existed in tumors with invasiveness limited to the submucosa. Conclusions: The associations we found and the mutational AF we reported may help to understand disease processes and may be considered as potential CCR biomarker candidates. In addition, we propose representative mutation panels associated with specific clinical and histopathological features of CRC, as a unique opportunity to refine the degree of personalization of CRC treatment.
Collapse
|
18
|
Uchida S, Kojima T, Sugino T. Frequency and Clinicopathological Characteristics of Patients With KRAS/BRAF Double-Mutant Colorectal Cancer: An In Silico Study. Pathol Oncol Res 2022; 28:1610206. [PMID: 35280113 PMCID: PMC8908457 DOI: 10.3389/pore.2022.1610206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/26/2022] [Indexed: 11/16/2022]
Abstract
KRAS and BRAF mutations are currently thought to be mutually exclusive as their co-occurrence is extremely rare. Therefore, clinicopathological and molecular characteristics of colorectal carcinoma with KRAS/BRAF double mutations are unclear. We aimed to investigate the frequency and clinicopathological characteristics of double-mutant colorectal carcinoma and its differences from KRAS/BRAF single-mutant colorectal carcinoma using bioinformatics tools. We estimated the KRAS/BRAF double mutation frequency in the whole exon and coding sequences via bioinformatic analyses of three datasets from cBioPortal. We compared the clinicopathological characteristics, microsatellite instability status, BRAF classification, and tumor mutation burden of patients harboring the double mutants with those of patients harboring KRAS or BRAF single mutations. We integrated three large datasets and found that the frequency of the KRAS/BRAF double mutation in the dataset was 1.2% (29/2347). The double mutation occurred more frequently in males, with a slightly higher occurrence in the right side of the colon. Sex, histological type, histological grade, microsatellite instability, and tumor mutation burden of the patients harboring KRAS-mutant, BRAF-mutant, and double-mutant colorectal carcinoma varied significantly. The frequency of double-mutant colorectal carcinoma was 60 times higher than that previously reported. Significantly fewer double-mutant colorectal carcinoma cases were classified as BRAF class 1 and more were classified as unknown. Our findings indicate that the biological characteristics of double-mutant tumors are different from those of single-mutant tumors.
Collapse
Affiliation(s)
- Shiro Uchida
- Division of Diagnostic Pathology, Kikuna Memorial Hospital, Yokohama, Japan.,Pathology Division, Shizuoka Cancer Center, Shizuoka, Japan.,Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan
| | - Takaaki Kojima
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Takashi Sugino
- Pathology Division, Shizuoka Cancer Center, Shizuoka, Japan
| |
Collapse
|
19
|
Colon Cancer Biomarkers: Implications for Personalized Medicine. J Pers Med 2020; 10:jpm10040167. [PMID: 33066312 PMCID: PMC7711712 DOI: 10.3390/jpm10040167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 12/14/2022] Open
Abstract
The heterogeneity of colon cancers and their reactions presents both a challenge and promise for personalized medicine. The challenge is to develop effective biologically personalized therapeutics guided by predictive and prognostic biomarkers. Presently, there are several classes of candidate biomarkers, including genomic probes, inhibitory RNAs, assays for immunity dysfunction and, not to be forgotten, specific histopathologic and histochemical features. To develop effective therapeutics, candidate biomarkers must be qualified and validated in comparable independent cohorts, no small undertaking. This process and subsequent deployment in clinical practice involves not only the strong association of the biomarker with the treatment but also careful attention to the prosaic aspects of representative tumor site selection, obtaining a fully adequate sample which is preserved and prepared to optimize high quality analysis. In the future, the clinical utility of biomarker analytical results will benefit from associated clinical and basic science data with the assistance of artificial intelligence techniques. By application of an individualized, selected suite of biomarkers, comprehensively interpreted, individualized, more effective and less toxic therapy for colon cancer will be enabled, thereby fulfilling the promise of personalized medicine.
Collapse
|