Identification of a genetically defined ultra-high-risk group in relapsed pediatric T-lymphoblastic leukemia

In the search for genes that define critical steps of relapse in pediatric T-cell acute lymphoblastic leukemia (T-ALL) and can serve as prognostic markers, we performed targeted sequencing of 313 leukemia-related genes in 214 patients: 67 samples collected at the time of relapse and 147 at initial diagnosis. As relapse-specific genetic events, we identified activating mutations in NT5C2 (P=0.0001, Fisher's exact test), inactivation of TP53 (P=0.0007, Fisher's exact test) and duplication of chr17:q11.2-24.3 (P=0.0068, Fisher's exact test) in 32/67 of T-ALL relapse samples. Alterations of TP53 were frequently homozygous events, which significantly correlated with higher rates of copy number alterations in other genes compared with wild-type TP53 (P=0.0004, Mann–Whitney's test). We subsequently focused on mutations with prognostic impact and identified genes governing DNA integrity (TP53, n=8; USP7, n=4; MSH6, n=4), having key roles in the RAS signaling pathway (KRAS, NRAS, n=8), as well as IL7R (n=4) and CNOT3 (n=4) to be exclusively mutated in fatal relapses. These markers recognize 24/49 patients with a second event. In 17 of these patients with mostly refractory relapse and dire need for efficient treatment, we identified candidate targets for personalized therapy with p53 reactivating compounds, MEK inhibitors or JAK/STAT-inhibitors that may be incorporated in future treatment strategies.

Invasion front-specific overexpression of tissue inhibitor of metalloproteinase-1 in liver metastases from colorectal cancer

BACKGROUND

Matrix metalloproteinases (MMPs) and their inhibitors, the tissue inhibitors of metalloproteinases (TIMPs), have been implicated in invasion and metastasis. The distribution of MMPs and TIMPs in the invasion front of liver metastases from colorectal cancer were investigated in order to understand their potential role in invasiveness.

MATERIALS AND METHODS

Freshly frozen material of colorectal metastases of the liver was microdissected into four separate compartments, namely pure liver, liver invasion, tumour invasion and pure tumour. RNA was isolated and analyzed on Affymetrix microarrays. Expression of TIMP-1 was confirmed by quantitative polymerase chain reaction in 10 colorectal liver metastases. Cellular localisation of TIMP-1 was examined by immunohistochemistry.

RESULTS

Affymetrix microarray data revealed that several MMP and TIMP genes including MMP-2, -3, -7, -9, -11, -12, -14, -15, -16, -19 and -24, and TIMP-1, -2 and -3 were generally up-regulated in both invasion front compartments. Among these genes, TIMP-1 showed the highest expression. The qPCR results indicated an average 15-fold upregulation of TIMP-1 in the liver invasive front and an average 13-fold up-regulation in the tumor invasive front, each compared to normal liver tissue. Immunohistochemistry revealed expression of TIMP-1 in tumour epithelia as well as in host tissue cells, including fibroblastic cells.

CONCLUSION

Our data indicate that tumour invasion in colorectal liver metastasis is associated with increased TIMP-1 RNA and protein levels in both tumour and host cells.