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Spinelli M, Du Parcq P, Gupta N, Khorashad J, Viola P. Coexistence of two missense mutations in the KRAS gene in adenocarcinoma of the lung: a possible indicator of poor prognosis. Pathologica 2022; 114:221-227. [PMID: 35775708 PMCID: PMC9248237 DOI: 10.32074/1591-951x-334] [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: 07/26/2021] [Accepted: 09/20/2021] [Indexed: 12/04/2022] Open
Abstract
Background KRAS mutations are present in up to 30% of patients with lung adenocarcinoma. The two most common KRAS mutations in non-small cell lung cancer (NSCLC) are G12C (~40%) and G12V (~22%). We describe the case of a 63-year-old Asian male patient with a very aggressive lung adenocarcinoma harbouring two coexisting missense mutations in the same exon. Methods The patient presented with a 6 cm spiculated lung mass and bilateral mediastinal lymphadenopathy on imaging. A cytology sample was obtained from EBUS-TBNA of mediastinal lymph nodes, and mutation screening was performed by next-generation sequencing using the Ion Torrent Cancer Hotspot panel. Results Cytological examination and immunocytochemistry confirmed the presence of metastatic lung adenocarcinoma. The molecular analysis revealed the coexistence of two missense mutations: c.34G > T; p.(Gly12Cys) and c.38G > T; A; p.(Gly13Asp) in exon 2 of the KRAS gene. The two independent variants were confirmed on Integrative Genomic Viewer (IGV), suggesting molecularly independent clones. The patient was treated with palliative care and died within two months of the diagnosis. Conclusions The present case showed aggressive clinical behaviour. It is questionable whether this aggressive course was due to the coexistence of multiple mutations or to a specific single mutation. Data in the literature regarding the outcome of polyclonal KRAS polyclonal lung adenocarcinomas are scarce, but some evidence seems to indicate that specific mutations may have prognostic value, possibly depending on the disease setting.
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Affiliation(s)
- Manuela Spinelli
- Histopathology, Lincoln County Hospital, Greetwell Rd, Lincoln, UK
| | | | - Nandita Gupta
- Cellular Pathology Department, Charing Cross Hospital, London, UK
| | | | - Patrizia Viola
- Cellular Pathology Department, Charing Cross Hospital, London, UK
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2
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Vaclova T, Chakraborty A, Sherwood J, Ross S, Carroll D, Barrett JC, Downward J, de Bruin EC. Concomitant KRAS mutations attenuate sensitivity of non-small cell lung cancer cells to KRAS G12C inhibition. Sci Rep 2022; 12:2699. [PMID: 35177674 PMCID: PMC8854729 DOI: 10.1038/s41598-022-06369-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/17/2022] [Indexed: 12/17/2022] Open
Abstract
The development of covalent inhibitors against KRAS G12C represents a major milestone in treatment of RAS-driven cancers, especially in non-small cell lung cancer (NSCLC), where KRAS G12C is one of the most common oncogenic driver. Here we investigated if additional KRAS mutations co-occur with KRAS G12C (c.34G>T) in NSCLC tumours and if such mutation co-occurrence affects cellular response to G12C-specific inhibitors. Analysis of a large cohort of NSCLC patients whose tumours harboured KRAS mutations revealed co-occurring KRAS mutations in up to 8% of tumours with the KRAS c.34G>T mutation. KRAS c.35G>T was the most frequently co-occurring mutation, and could occur on the same allele (in cis) translating to a single mutant KRAS G12F protein, or on the other allele (in trans), translating to separate G12C and G12V mutant proteins. Introducing KRAS c.35G>T in trans in the KRAS G12C lung cancer model NCI-H358, as well as the co-occurrence in cis in the KRAS G12F lung cancer model NCI-H2291 led to cellular resistance to the G12C-specific inhibitor AZ’8037 due to continuing active MAPK and PI3K cascades in the presence of the inhibitor. Overall, our study provides a comprehensive assessment of co-occurring KRAS mutations in NSCLC and in vitro evidence of the negative impact of co-occurring KRAS mutations on cellular response to G12C inhibitors, highlighting the need for a comprehensive KRAS tumour genotyping for optimal patient selection for treatment with a KRAS G12C inhibitor.
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Affiliation(s)
- Tereza Vaclova
- Translational Medicine, Oncology, AstraZeneca, Cambridge, CB4 0WG, UK
| | | | - James Sherwood
- Precision Medicine and Biosamples, BioPharmaceutical, AstraZeneca, Cambridge, CB4 0WG, UK
| | - Sarah Ross
- Bioscience, Oncology, AstraZeneca, Cambridge, CB2 0RE, UK
| | - Danielle Carroll
- Translational Medicine, Oncology, AstraZeneca, Cambridge, CB4 0WG, UK
| | - J Carl Barrett
- Translational Medicine, Oncology, AstraZeneca, Waltham, MA, 02451, USA
| | - Julian Downward
- Oncogene Biology, Francis Crick Institute, London, NW1 1AT, UK
| | - Elza C de Bruin
- Translational Medicine, Oncology, AstraZeneca, Cambridge, CB4 0WG, UK.
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3
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Li JH, Sun SS, Li N, Lv P, Xie SY, Wang PY. MiR-205 as a promising biomarker in the diagnosis and prognosis of lung cancer. Oncotarget 2017; 8:91938-91949. [PMID: 29190887 PMCID: PMC5696153 DOI: 10.18632/oncotarget.20262] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 07/13/2017] [Indexed: 01/09/2023] Open
Abstract
MicroRNA-205 (miR-205) was revealed as a novel diagnostic and prognostic biomarker for lung cancer, but the results in the published papers were inconsistent. This meta-analysis aimed to investigate the diagnostic and prognostic roles of miR-205 in patients with lung cancer. Totally, 16 eligible articles were included, among which 10 articles investigated the diagnostic value of miR-205, 5 articles examined its prognostic values, and 1 article studied both diagnostic and prognostic values. For the diagnostic meta-analysis, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the overall area under the curve of miR-205 for patients with lung cancer were 0.88 (95% CI = 0.78 – 0.94), 0.78 (95% CI = 0.66 – 0.86), 4.00 (95% CI = 2.47 – 6.49), 0.16 (95% CI = 0.08 – 0.30), 25.86 (95% CI = 9.29 – 71.95), and 0.90 (95% CI = 0.87 – 0.92), respectively, indicating that miR-205 is a useful biomarker for diagnostic of lung cancer. The subgroup analysis further demonstrated that miR-205 had an excellent overall accuracy for detection with tissue samples compare with blood samples. For the prognostic meta-analysis, the pooled outcome of the disease-free survival and recurrence-free survival analyses revealed that increased miR-205 levels had a protective role in the prognosis of patients with lung cancer (pooled HR = 0.86, 95% CI: 0.78-0.96, z = 2.83, P = 0.005). In conclusion, miR-205 may be a promising biomarker for detection, predicting the recurrence of patients with lung cancer.
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Affiliation(s)
- Jing-Hua Li
- Department of Epidemiology, Binzhou Medical University, YanTai, ShanDong 264003, P.R. China.,Key Laboratory of Tumor Molecular Biology in Binzhou Medical University, Department of Biochemistry and Molecular Biology, Binzhou Medical University, YanTai, ShanDong 264003, P.R. China
| | - Shan-Shan Sun
- Department of Epidemiology, Binzhou Medical University, YanTai, ShanDong 264003, P.R. China
| | - Ning Li
- Department of Epidemiology, Binzhou Medical University, YanTai, ShanDong 264003, P.R. China
| | - Peng Lv
- Department of Epidemiology, Binzhou Medical University, YanTai, ShanDong 264003, P.R. China
| | - Shu-Yang Xie
- Key Laboratory of Tumor Molecular Biology in Binzhou Medical University, Department of Biochemistry and Molecular Biology, Binzhou Medical University, YanTai, ShanDong 264003, P.R. China
| | - Ping-Yu Wang
- Department of Epidemiology, Binzhou Medical University, YanTai, ShanDong 264003, P.R. China.,Key Laboratory of Tumor Molecular Biology in Binzhou Medical University, Department of Biochemistry and Molecular Biology, Binzhou Medical University, YanTai, ShanDong 264003, P.R. China
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Charkiewicz R, Niklinski J, Claesen J, Sulewska A, Kozlowski M, Michalska-Falkowska A, Reszec J, Moniuszko M, Naumnik W, Niklinska W. Gene Expression Signature Differentiates Histology But Not Progression Status of Early-Stage NSCLC. Transl Oncol 2017; 10:450-458. [PMID: 28456114 PMCID: PMC5408153 DOI: 10.1016/j.tranon.2017.01.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/25/2017] [Accepted: 01/31/2017] [Indexed: 01/10/2023] Open
Abstract
Advances in molecular analyses based on high-throughput technologies can contribute to a more accurate classification of non-small cell lung cancer (NSCLC), as well as a better prediction of both the disease course and the efficacy of targeted therapies. Here we set out to analyze whether global gene expression profiling performed in a group of early-stage NSCLC patients can contribute to classifying tumor subtypes and predicting the disease prognosis. Gene expression profiling was performed with the use of the microarray technology in a training set of 108 NSCLC samples. Subsequently, the recorded findings were validated further in an independent cohort of 44 samples. We demonstrated that the specific gene patterns differed significantly between lung adenocarcinoma (AC) and squamous cell lung carcinoma (SCC) samples. Furthermore, we developed and validated a novel 53-gene signature distinguishing SCC from AC with 93% accuracy. Evaluation of the classifier performance in the validation set showed that our predictor classified the AC patients with 100% sensitivity and 88% specificity. We revealed that gene expression patterns observed in the early stages of NSCLC may help elucidate the histological distinctions of tumors through identification of different gene-mediated biological processes involved in the pathogenesis of histologically distinct tumors. However, we showed here that the gene expression profiles did not provide additional value in predicting the progression status of the early-stage NSCLC. Nevertheless, the gene expression signature analysis enabled us to perform a reliable subclassification of NSCLC tumors, and it can therefore become a useful diagnostic tool for a more accurate selection of patients for targeted therapies.
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Affiliation(s)
- Radoslaw Charkiewicz
- Department of Clinical Molecular Biology, Medical University of Bialystok, Waszyngtona 13, Bialystok 15-269, Poland
| | - Jacek Niklinski
- Department of Clinical Molecular Biology, Medical University of Bialystok, Waszyngtona 13, Bialystok 15-269, Poland
| | - Jürgen Claesen
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Diepenbeek 3590, Belgium
| | - Anetta Sulewska
- Department of Clinical Molecular Biology, Medical University of Bialystok, Waszyngtona 13, Bialystok 15-269, Poland
| | - Miroslaw Kozlowski
- Department of Thoracic Surgery, Medical University of Bialystok, Marii Sklodowskiej-Curie 24a, Bialystok 15-276, Poland
| | - Anna Michalska-Falkowska
- Department of Clinical Molecular Biology, Medical University of Bialystok, Waszyngtona 13, Bialystok 15-269, Poland
| | - Joanna Reszec
- Department of Medical Pathomorphology, Medical University of Bialystok, Waszyngtona 13, Bialystok 15-269, Poland
| | - Marcin Moniuszko
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Waszyngtona 13, Bialystok, 15-269, Poland
| | - Wojciech Naumnik
- Department of Clinical Molecular Biology, Medical University of Bialystok, Waszyngtona 13, Bialystok 15-269, Poland; First Department of Lung Diseases, Medical University of Bialystok, Zurawia 14, Bialystok 15-540, Poland
| | - Wieslawa Niklinska
- Department of Histology and Embryology, Medical University of Bialystok, Waszyngtona 13, Bialystok 15-269, Poland.
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ANGPTL2/LILRB2 signaling promotes the propagation of lung cancer cells. Oncotarget 2016; 6:21004-15. [PMID: 26056041 PMCID: PMC4673246 DOI: 10.18632/oncotarget.4217] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 05/10/2015] [Indexed: 12/29/2022] Open
Abstract
Immune inhibitory receptors expressed on various types of immune cells deliver inhibitory signals that maintain the homeostasis of the immune system. Recently we demonstrated that leukocyte immunoglobulin-like receptor subfamily B member 2 (LILRB2) and its murine homolog, paired immunoglobulin-like receptor B (PIRB), are expressed on hematopoietic stem cells and acute myeloid leukemia stem cells and function in maintenance of stemness. Herein, we determined that both LILRB2 and its soluble ligand ANGPTL2 are highly expressed in non-small cell lung cancer (NSCLC) samples, and levels are adversely related to patient prognosis. Inhibition of LILRB2 expression in NSCLC cell lines, such as A549 cells, resulted in a dramatic decrease in proliferation, colony formation, and migration. Mechanistic analyses indicated that ANGPTL2 binds LILRB2 to support the growth of lung cancer cells and that the SHP2/CaMK1/CREB axis controls the proliferation of lung cancer cell lines. Our results suggest that signaling involving ANGPTL2 and LILRB2 is important for lung cancer development and represents a novel target for treatment of this type of cancer.
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Charkiewicz R, Pilz L, Sulewska A, Kozlowski M, Niklinska W, Moniuszko M, Reszec J, Manegold C, Niklinski J. Validation for histology-driven diagnosis in non-small cell lung cancer using hsa-miR-205 and hsa-miR-21 expression by two different normalization strategies. Int J Cancer 2015; 138:689-97. [PMID: 26311306 DOI: 10.1002/ijc.29816] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/13/2015] [Accepted: 08/14/2015] [Indexed: 11/09/2022]
Abstract
Targeted therapy of non-small cell lung cancer (NSCLC) demands a more accurate tumor classification that is crucial for patient selection in personalized treatment. MicroRNAs constitute a promising class of biomarkers and a helpful tool for the distinction between lung adenocarcinoma (AC) and squamous cell lung carcinoma (SCC). The aim of this study was to evaluate the impact of two different normalization strategies, using U6 snRNA and hsa-miR-103 as reference genes, on hsa-miR-205 and hsa-miR-21 expression levels, in terms of the classification of subtypes of NSCLC. By means of a quantitative real-time polymerase chain reaction (qRT-PCR) microRNA expression levels were evaluated in a classification set of 98 surgically resected NSCLC fresh-frozen samples, and validated findings in an independent set of 42 NSCLC samples. The microRNA expression levels were exploited to develop a diagnostic test using two data normalization strategies. The performance of microRNA profiling in different normalization methods was compared. We revealed the microRNA-based qRT-PCR tests to be appropriate measures for distinguishing between AC and SCC (the concordance of histologic diagnoses and molecular methods greater than 88%). Performance evaluation of microRNA tests, based on the two normalization strategies, showed that the procedure using hsa-miR-103 as reference target has a slight advantage (sensitivity 83.33 and 100% in classification and validation set, respectively) compared to U6 snRNA. Molecular tests based on microRNA expression allow a reliable classification of subtypes for NSCLC and can constitute a useful diagnostic strategy in patient selection for targeted therapy.
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Affiliation(s)
- Radoslaw Charkiewicz
- Department of Clinical Molecular Biology, Medical University of Bialystok, Bialystok, Poland
| | - Lothar Pilz
- Department of Clinical Molecular Biology, Medical University of Bialystok, Bialystok, Poland.,Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anetta Sulewska
- Department of Clinical Molecular Biology, Medical University of Bialystok, Bialystok, Poland
| | - Miroslaw Kozlowski
- Department of Thoracic Surgery, Medical University of Bialystok, Bialystok, Poland
| | - Wieslawa Niklinska
- Department of Histology and Embryology, Medical University of Bialystok, Bialystok, Poland
| | - Marcin Moniuszko
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Reszec
- Department of Medical Pathomorphology, Medical University of Bialystok, Bialystok, Poland
| | - Christian Manegold
- Department of Clinical Molecular Biology, Medical University of Bialystok, Bialystok, Poland.,Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jacek Niklinski
- Department of Clinical Molecular Biology, Medical University of Bialystok, Bialystok, Poland
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Significance of EGFR signaling pathway genetic alterations in radically resected non-small cell lung cancers from a Polish cohort. One institutional study. Adv Med Sci 2015; 60:277-86. [PMID: 26118982 DOI: 10.1016/j.advms.2015.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 12/12/2022]
Abstract
PURPOSE We evaluated the distribution and clinical impact of EGFR, KRAS and HER2 copy number gains and EGFR, KRAS and BRAF activating mutations in resected non-small cell lung cancers (NSCLCs) from 151 Polish patients. MATERIALS AND METHODS Quantitative PCR and DNA sequencing were used for copy number evaluation and mutational analysis, respectively. RESULTS An increased EGFR CN was found in 21.2% of the tumors, more commonly of the non-squamous histology (P=0.029), larger in size (P=0.004) and those obtained from women (P=0.040). HER2 copy gain was observed in 21.8% of the patients, more frequently with lymph node metastases (P=0.048) and stage IIIA disease (P=0.061). KRAS gain was found in 29.3% of the tumors, and was not associated with patients' clinicopathological features. No BRAF mutations were found. EGFR and KRAS mutation frequency and associations with clinicopathological characteristics did not differ significantly from those previously described for the NSCLC patients of Caucasian ethnicity. Strong associations existed between most of the analyzed alterations. In the multivariate model, EGFR mutations constituted an independent prognostic factor of the disease recurrence in adenocarcinoma patients (HR 7.20; 95%CI 1.31-39.48; P=0.023), while an increased EGFR copy number tended to indicate a shorter overall survival (HR 4.85; 95%CI 0.92-25.58; P=0.062). CONCLUSIONS EGFR pathway genes alterations are frequent in NSCLCs from Polish patients and have a prognostic potential for patients' clinical outcome after a curative tumor resection. Gene CN evaluation by quantitative PCR provides comparable results and enables assay standardization, yet the optimal scoring system needs to be developed.
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