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Vettore AL, Ramnarayanan K, Poore G, Lim K, Ong CK, Huang KK, Leong HS, Chong FT, Lim TKH, Lim WK, Cutcutache I, Mcpherson JR, Suzuki Y, Zhang S, Skanthakumar T, Wang W, Tan DSW, Cho BC, Teh BT, Rozen S, Tan P, Iyer NG. Mutational landscapes of tongue carcinoma reveal recurrent mutations in genes of therapeutic and prognostic relevance. Genome Med 2015; 7:98. [PMID: 26395002 PMCID: PMC4580363 DOI: 10.1186/s13073-015-0219-2] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 08/25/2015] [Indexed: 12/19/2022] Open
Abstract
Background Carcinoma of the oral tongue (OTSCC) is the most common malignancy of the oral cavity, characterized by frequent recurrence and poor survival. The last three decades has witnessed a change in the OTSCC epidemiological profile, with increasing incidence in younger patients, females and never-smokers. Here, we sought to characterize the OTSCC genomic landscape and to determine factors that may delineate the genetic basis of this disease, inform prognosis and identify targets for therapeutic intervention. Methods Seventy-eight cases were subjected to whole-exome (n = 18) and targeted deep sequencing (n = 60). Results While the most common mutation was in TP53, the OTSCC genetic landscape differed from previously described cohorts of patients with head and neck tumors: OTSCCs demonstrated frequent mutations in DST and RNF213, while alterations in CDKN2A and NOTCH1 were significantly less frequent. Despite a lack of previously reported NOTCH1 mutations, integrated analysis showed enrichments of alterations affecting Notch signaling in OTSCC. Importantly, these Notch pathway alterations were prognostic on multivariate analyses. A high proportion of OTSCCs also presented with alterations in drug targetable and chromatin remodeling genes. Patients harboring mutations in actionable pathways were more likely to succumb from recurrent disease compared with those who did not, suggesting that the former should be considered for treatment with targeted compounds in future trials. Conclusions Our study defines the Asian OTSCC mutational landscape, highlighting the key role of Notch signaling in oral tongue tumorigenesis. We also observed somatic mutations in multiple therapeutically relevant genes, which may represent candidate drug targets in this highly lethal tumor type. Electronic supplementary material The online version of this article (doi:10.1186/s13073-015-0219-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andre Luiz Vettore
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore. .,Laboratory of Cancer Molecular Biology, Department of Biological Sciences, Federal University of São Paulo, Rua Pedro de Toledo 669, São Paulo, 04039-032, Brazil.
| | - Kalpana Ramnarayanan
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore.
| | - Gregory Poore
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore.
| | - Kevin Lim
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore.
| | - Choon Kiat Ong
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore. .,Laboratory of Cancer Molecular Biology, Department of Biological Sciences, Federal University of São Paulo, Rua Pedro de Toledo 669, São Paulo, 04039-032, Brazil.
| | - Kie Kyon Huang
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore.
| | - Hui Sun Leong
- Cancer Therapeutics Research Laboratory, National Cancer Centre, 11 Hospital Drive, Singapore, 169610, Singapore.
| | - Fui Teen Chong
- Cancer Therapeutics Research Laboratory, National Cancer Centre, 11 Hospital Drive, Singapore, 169610, Singapore.
| | - Tony Kiat-Hon Lim
- Department of Pathology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
| | - Weng Khong Lim
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore. .,Laboratory of Cancer Epigenome, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore.
| | - Ioana Cutcutache
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore.
| | - John R Mcpherson
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore.
| | - Yuka Suzuki
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore.
| | - Shenli Zhang
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore.
| | - Thakshayeni Skanthakumar
- Department of Surgical Oncology, National Cancer Centre, 11 Hospital Drive, Singapore, 169610, Singapore.
| | - Weining Wang
- Department of Surgical Oncology, National Cancer Centre, 11 Hospital Drive, Singapore, 169610, Singapore.
| | - Daniel S W Tan
- Cancer Therapeutics Research Laboratory, National Cancer Centre, 11 Hospital Drive, Singapore, 169610, Singapore.
| | - Byoung Chul Cho
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore. .,Division of Medical Oncology, Yonsei Cancer Center, Yonsei Unversity College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, South Korea.
| | - Bin Tean Teh
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore. .,Laboratory of Cancer Epigenome, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore. .,Cancer Science Institute of Singapore, National University of Singapore, 14 Medical Drive, #12-01, Singapore, 117599, Singapore.
| | - Steve Rozen
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore. .,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA.
| | - Patrick Tan
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore. .,Cancer Science Institute of Singapore, National University of Singapore, 14 Medical Drive, #12-01, Singapore, 117599, Singapore. .,Cancer Therapeutics and Stratified Oncology, Genome Institute of Singapore, 60 Biopolis Street, Genome #02-01, Singapore, 138672, Singapore.
| | - N Gopalakrishna Iyer
- Cancer Stem Cell Biology Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singaore. .,Cancer Therapeutics Research Laboratory, National Cancer Centre, 11 Hospital Drive, Singapore, 169610, Singapore. .,Department of Surgical Oncology, National Cancer Centre, 11 Hospital Drive, Singapore, 169610, Singapore.
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Tan DSW, Wang W, Leong HS, Sew PH, Lau DP, Chong FT, Krisna SS, Lim TKH, Iyer NG. Tongue carcinoma infrequently harbor common actionable genetic alterations. BMC Cancer 2014; 14:679. [PMID: 25234657 PMCID: PMC4177593 DOI: 10.1186/1471-2407-14-679] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 09/11/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral tongue squamous cell carcinomas (TSCC) are a unique subset of head and neck cancers with a distinct demographic profile, where up to half of the cases are never smokers. A small proportion of patients with OSCC are known to respond to EGFR TKI. We used a high-sensitivity mass spectrometry-based mutation profiling platform to determine the EGFR mutation status, as well as other actionable alterations in a series of Asian TSCC. METHODS 66 TSCC patients treated between 1998-2009 with complete clinico-pathologic data were included in this study. Somatic mutation profiling was performed using Sequenom LungCarta v1.0, and correlated with clinical parameters. RESULTS Mutations were identified in 20/66(30.3%) of samples and involved TP53, STK11, MET, PIK3CA, BRAF and NRF2. No activating EGFR mutations or KRAS mutations were discovered in our series, where just over a third were never smokers. The most common mutations were in p53 (10.6%; n = 7) and MET (10.6%, n = 11) followed by STK11 (9.1%, n = 6) and PIK3CA (4.5%, n = 3). BRAF and NRF2 mutations, which are novel in TSCC, were demonstrated in one sample each. There was no significant correlation between overall mutation status and smoking history (p = 0.967) or age (p = 0.360). Positive MET alteration was associated with poorer loco-regional recurrence free survival (LRFS) of 11 months [vs 90 months in MET-negative group (p = 0.008)]. None of the other mutations were significantly correlated with LRFS or overall survival. Four of these tumors were propagated as immortalized cell lines and demonstrated the same mutations as the original tumor. CONCLUSIONS Using the Sequenom multiplexed LungCarta panel, we identified mutations in 6 genes, TP53, STK11, MET, PIK3CA, BRAF and NRF2, with the notable absence of EGFR and HER2 mutations in our series of Asian OSCC. Primary cell line models recapitulated the mutation profiles of the original primary tumours and provide an invaluable resource for experimental cancer therapeutics.
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Affiliation(s)
- Daniel SW Tan
- />Cancer Therapeutics Research Laboratory, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 Singapore
- />Department of Medical Oncology, National Cancer Centre, 11 Hospital Drive, Singapore, 169610 Singapore
| | - Weining Wang
- />Department of Surgical Oncology, National Cancer Centre, 11 Hospital Drive, Singapore, 169610 Singapore
| | - Hui Sun Leong
- />Cancer Therapeutics Research Laboratory, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 Singapore
| | - Pui Hoon Sew
- />Cancer Therapeutics Research Laboratory, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 Singapore
| | - Dawn P Lau
- />Cancer Therapeutics Research Laboratory, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 Singapore
| | - Fui Teen Chong
- />Cancer Therapeutics Research Laboratory, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 Singapore
| | - Sai Sakktee Krisna
- />Cancer Therapeutics Research Laboratory, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 Singapore
| | - Tony KH Lim
- />Department of Pathology, Singapore General Hospital, Outram Road, Singapore, 169610 Singapore
| | - N Gopalakrishna Iyer
- />Cancer Therapeutics Research Laboratory, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610 Singapore
- />Department of Surgical Oncology, National Cancer Centre, 11 Hospital Drive, Singapore, 169610 Singapore
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