Hereditary breast and ovarian cancer: assessment of \ud point mutations and copy number variations in \ud Brazilian patients

Background \ud Germ line mutations in BRCA1 and BRCA2 (BRCA1/2) and other susceptibility genes have \ud been identified as genetic causes of hereditary breast and ovarian cancer (HBOC). To identify \ud the disease-causing mutations in a cohort of 120 Brazilian women fulfilling criteria for \ud HBOC, we carried out a comprehensive screening of BRCA1/2, TP53 R337H, CHEK2 \ud 1100delC, followed by an analysis of copy number variations in 14 additional breast cancer \ud susceptibility genes (PTEN, ATM, NBN, RAD50, RAD51, BRIP1, PALB2, MLH1, MSH2, \ud MSH6, TP53, CDKN2A, CDH1 and CTNNB1). \ud Methods \ud Capillary sequencing and multiplex ligation-dependent probe amplification (MLPA) were \ud used for detecting point mutations and copy number variations (CNVs), respectively, for the \ud BRCA1 and BRCA2 genes; capillary sequencing was used for point mutation for both variants \ud TP53 R337H and CHEK2 1100delC, and finally array comparative genomic hybridization \ud (array-CGH) was used for identifying CNVs in the 14 additional genes. \ud Results \ud The positive detection rate in our series was 26%. BRCA1 pathogenic mutations were found \ud in 20 cases, including two cases with CNVs, whereas BRCA2 mutations were found in 7 \ud cases. We also found three patients with the TP53 R337H mutation and one patient with the \ud CHEK2 1100delC mutation. Seven (25%) pathogenic mutations in BRCA1/2 were firstly \ud described, including a splice-site BRCA1 mutation for which pathogenicity was confirmed by \ud the presence of an aberrant transcript showing the loss of the last 62 bp of exon 7. \ud Microdeletions of exon 4 in ATM and exon 2 in PTEN were identified in BRCA2-mutated and \ud BRCA1/2-negative patients, respectively. \ud Conclusions \ud In summary, our results showed a high frequency of BRCA1/2 mutations and a higher \ud prevalence of BRCA1 (64.5%) gene. Moreover, the detection of the TP53 R337H variant in \ud our series and the fact that this variant has a founder effect in our population prompted us to \ud suggest that all female breast cancer patients with clinical criteria for HBOC and negative for \ud BRCA1/2 genes should be tested for the TP53 R337H variant. Furthermore, the presence of \ud genomic structural rearrangement resulting in CNVs in other genes that predispose breast \ud cancer in conjunction with BRCA2 point mutations demonstrated a highly complex genetic \ud etiology in Brazilian breast cancer families.Fundação de Amparo à Pesquisa do Estado de São Paulo (2008/57887- 9).Conselho Nacional de Desenvolvimento Científico e Tecnológico (408833/2006-8

Genomics and epidemiology for gastric adenocarcinomas (GE4GAC): a Brazilian initiative to study gastric cancer

Abstract Gastric cancer (GC) is the fifth most common type of cancer worldwide with high incidences in Asia, Central, and South American countries. This patchy distribution means that GC studies are neglected by large research centers from developed countries. The need for further understanding of this complex disease, including the local importance of epidemiological factors and the rich ancestral admixture found in Brazil, stimulated the implementation of the GE4GAC project. GE4GAC aims to embrace epidemiological, clinical, molecular and microbiological data from Brazilian controls and patients with malignant and pre-malignant gastric disease. In this letter, we summarize the main goals of the project, including subject and sample accrual and current findings

Mutation Detection in Tumor-Derived Cell Free DNA Anticipates Progression in a Patient With Metastatic Colorectal Cancer

Background: The observation of tumor-derived cell-free DNA (ctDNA) in plasma brought new expectations to monitor treatment response in cancer patients.Case presentation: In an exploratory case of a 57-year-old man diagnosed with metastatic sigmoid adenocarcinoma, we used a hotspot panel of cancer-associated gene mutations to identify tumor-specific mutations in the primary tumor and metastasis. Results: Five mutations were detected (KRAS, p.Gly12Val; TP53, p.Arg175His; RB1, p.Ile680Thr; ALK, p.Gly1184Glu; and ERBB2, p.Lys860Lys), of which three were detected in both tissue types (primary tumor and metastasis). All five mutations were monitored in the ctDNA of six serial plasma samples. Only KRAS and TP53 mutations were detected at a high frequency in the first plasma sample. After 1 month of chemotherapy the allele frequencies of both mutations fell below the detection limit. From the third month of systemic treatment onward, the allele frequencies of both mutations were detectable in plasma, displaying a continual increase thereafter. The remaining three mutations were not detected in plasma samples. Signs of disease progression in ctDNA during the treatment period were evident while computed tomography (CT) measurements suggested stable metastatic lesions throughout the treatment.Conclusions: Liquid biopsies revealed tumor heterogeneity and predicted tumor progression, demonstrating the potential of ctDNA analysis to be a sensitive and specific tool for monitoring treatment responsivity and for early identification of treatment resistance

Complex Landscape of Germline Variants in Brazilian Patients With Hereditary and Early Onset Breast Cancer

Pathogenic variants in known breast cancer (BC) predisposing genes explain only about 30% of Hereditary Breast Cancer (HBC) cases, whereas the underlying genetic factors for most families remain unknown. Here, we used whole-exome sequencing (WES) to identify genetic variants associated to HBC in 17 patients of Brazil with familial BC and negative for causal variants in major BC risk genes (BRCA1/2, TP53, and CHEK2 c.1100delC). First, we searched for rare variants in 27 known HBC genes and identified two patients harboring truncating pathogenic variants in ATM and BARD1. For the remaining 15 negative patients, we found a substantial vast number of rare genetic variants. Thus, for selecting the most promising variants we used functional-based variant prioritization, followed by NGS validation, analysis in a control group, cosegregation analysis in one family and comparison with previous WES studies, shrinking our list to 23 novel BC candidate genes, which were evaluated in an independent cohort of 42 high-risk BC patients. Rare and possibly damaging variants were identified in 12 candidate genes in this cohort, including variants in DNA repair genes (ERCC1 and SXL4) and other cancer-related genes (NOTCH2, ERBB2, MST1R, and RAF1). Overall, this is the first WES study applied for identifying novel genes associated to HBC in Brazilian patients, in which we provide a set of putative BC predisposing genes. We also underpin the value of using WES for assessing the complex landscape of HBC susceptibility, especially in less characterized populations

Recurrent somatic mutation in DROSHA induces microRNA profile changes in Wilms tumour

Wilms tumour (WT) is an embryonal kidney neoplasia for which very few driver genes have been identified. Here we identify DROSHA mutations in 12% of WT samples (26/222) using whole-exome sequencing and targeted sequencing of 10 microRNA (miRNA)-processing genes. A recurrent mutation (E1147K) affecting a metal-binding residue of the RNase IIIb domain is detected in 81% of the DROSHA-mutated tumours. In addition, we identify non-recurrent mutations in other genes of this pathway (DGCR8, DICER1, XPO5 and TARBP2). By assessing the miRNA expression pattern of the DROSHA-E1147K-mutated tumours and cell lines expressing this mutation, we determine that this variant leads to a predominant downregulation of a subset of miRNAs. We confirm that the downregulation occurs exclusively in mature miRNAs and not in primary miRNA transcripts, suggesting that the DROSHA E1147K mutation affects processing of primary miRNAs. Our data underscore the pivotal role of the miRNA biogenesis pathway in WT tumorigenesis, particularly the major miRNA-processing gene DROSHA