Tumor xenograft modeling identifies an association between TCF4 loss and breast cancer chemoresistance

Understanding the mechanisms of cancer therapeutic resistance is fundamental to improving cancer care. There is clear benefit from chemotherapy in different breast cancer settings; however, knowledge of the mutations and genes that mediate resistance is incomplete. In this study, by modeling chemoresistance in patientderived xenografts (PDXs), we show that adaptation to therapy is genetically complex and identify that loss of transcription factor 4 (TCF4; also known as ITF2) is associated with this process. A triple-negative BRCA1-mutaied PDX was used to study the genetics of chemoresistance. The PDX was treated in parallel with four chemotherapies for five iterative cycles. Exome sequencing identified few genes with de novo or enriched mutations in common among the different therapies, whereas many common depleted mutations/ genes were observed. Analysis of somatic mutations from The Cancer Genome Atlas (TCGA) supported the prognostic relevance of the identified genes. A mutation in TCF4 was found de novo in all treatments, and analysis of drug sensitivity profiles across cancer cell lines supported the link to chemoresistance. Loss of TCF4 conferred chemoresistance in breast cancer cell models, possibly by altering cell cycle regulation. Targeted sequencing in chemoresistant tumors identified an intronic variant of TCF4 that may represent an expression quantitative trait locus associated with relapse outcome in TCGA. Immunohistochemical studies suggest a common loss of nuclear TCF4 expression post-chemotherapy. Together, these results from tumor xenograft modeling depict a link between altered TCF4 expression and breast cancer chemoresistance

Exploring the Role of Mutations in Fanconi Anemia Genes in Hereditary Cancer Patients

Fanconi anemia (FA) is caused by biallelic mutations in FA genes. Monoallelic mutations in five of these genes (BRCA1, BRCA2, PALB2, BRIP1 and RAD51C) increase the susceptibility to breast/ovarian cancer and are used in clinical diagnostics as bona-fide hereditary cancer genes. Increasing evidence suggests that monoallelic mutations in other FA genes could predispose to tumor development, especially breast cancer. The objective of this study is to assess the mutational spectrum of 14 additional FA genes (FANCA, FANCB, FANCC, FANCD2, FANCE, FANCF, FANCG, FANCI, FANCL, FANCM, FANCP, FANCQ, FANCR and FANCU) in a cohort of hereditary cancer patients, to compare with local cancer-free controls as well as GnomAD. A total of 1021 hereditary cancer patients and 194 controls were analyzed using our next generation custom sequencing panel. We identified 35 pathogenic variants in eight genes. A significant association with the risk of breast cancer/breast and ovarian cancer was found for carriers of FANCA mutations (odds ratio (OR) = 3.14 95% confidence interval (CI) 1.4-6.17, p = 0.003). Two patients with early-onset cancer showed a pathogenic FA variant in addition to another germline mutation, suggesting a modifier role for FA variants. Our results encourage a comprehensive analysis of FA genes in larger studies to better assess their role in cancer risk

Highly sensitive MLH1 methylation analysis in blood identifies a cancer patient with low-level mosaic MLH1 epimutation

Constitutional MLH1 methylation (epimutation) is a rare cause of Lynch syndrome. Low-level methylation (<= 10%) has occasionally been described. This study aimed to identify low-level constitutional MLH1 epimutations and determine its causal role in patients with MLH1-hypermethylated colorectal cancer. Eighteen patients with MLH1-hypermethylated colorectal tumors in whom MLH1 methylation was previously undetected in blood by methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) were screened for MLH1 methylation using highly sensitive MS-melting curve analysis (MS-MCA). Constitutional methylation was characterized by different approaches. MS-MCA identified one patient (5.6%) with low-level MLH1 methylation ( 1%) in blood and other normal tissues, which was confirmed by clonal bisulfite sequencing in blood. The patient had developed three clonally related gastrointestinal MLH1-methylated tumor lesions at 22, 24, and 25 years of age. The methylated region in normal tissues overlapped with that reported for other carriers of constitutional MLH1 epimutations. Low-level MLH1 methylation and reduced allelic expression were linked to the same genetic haplotype, whereas the opposite allele was lost in patient's tumors. Mutation screening of MLH1 and other hereditary cancer genes was negative. Herein, a highly sensitive MS-MCA-based approach has demonstrated its utility for the identification of low-level constitutional MLH1 epigenetic mosaicism. The eventual identification and characterization of additional cases will be critical to ascertain the cancer risks associated with constitutional MLH1 epigenetic mosaicism

Elucidating the molecular basis of Lynch-Like syndrome

ANTECEDENTES: La deficiencia de reparación de bases desapareadas es una característica de los tumores de pacientes con síndrome de Lynch (SL) con mutaciones germinales en genes reparadores (MMR). En una proporción significativa de pacientes con sospecha de SL no se detecta mutación germinal en MMR, ellos se conocen como pacientes con síndrome “Lynch-like” (LLS). HIPÓTESIS: En pacientes con sospecha de SL podría haber otra causa responsable de la deficiencia reparadora, como (epi)mutaciones germinales en genes MMR o en otros asociados a cáncer colorectal (CCR). OBJETIVO: Elucidar la base molecular de la deficiencia MMR en pacientes con sospecha de SL sin mutación germinal identificada en genes MMR. OBJETIVOS ESPECÍFICOS: Refinar el análisis de genes MMR incluyendo regiones promotoras. Estudiar la contribución de mutaciones en MUTYH a LLS. Estudiar la contribución relativa de mutaciones germinales y somáticas en otros genes asociados a CCR. PACIENTES Y MÉTODOS: Hemos analizado una serie de 260 pacientes con sospecha de SL, 34 tenían tumores MLH1 metilados y 226 eran LLS (BRAF wildtype, sin metilación en MLH1 y MMR wildtype). La secuenciación del promotor en genes MMR se hizo por Sanger. Los análisis de metilación por múltiples técnicas incluyendo análisis de curvas de disociación (MCA) específica de metilación, MLPA específico de metilación, secuenciación con bisulfito o pirosecuenciación. Las VSDs en MSH2 se estudiaron por análisis multifactoriales y de cDNA. Las variantes patogénicas Españolas de MUTYH se analizaron por Sanger o MCA y otros genes asociados a CCR se estudiaron por secuenciación masiva con un panel del subexoma. RESULTADOS Y CONCLUSIONES: En LLS el estudio de metilación somática en tumores MSH2- y/o MSH6- no ayuda a descartar pacientes con SL. Epimutaciones constitucionales en MLH1 representan alrededor del 2% del SL. La evaluación de la patogenicidad de las VUS en MSH2 permitió su re-clasificación en la mayoría (90%). Mutaciones bialélicas germinales en MUTYH son responsables de ~3% de LLS. Mutaciones en FAN1 podrían ser responsables de un 10% del LLS. La combinación del análisis germinal y somático de mutaciones asociadas a CCR por medio de paneles de subexomas es útil para elucidar la base molecular del LLS.BACKGROUND: MMR deficiency is a hallmark of tumors from Lynch syndrome LS) patients, who harbor germline mutations in MMR genes. No germline alterations are detected in a significant proportion of suspected LS now known as Lynch-like syndrome (LLS) cases. HYPOTHESIS: In LS-suspected patients there may be other responsible causes for the MMR-deficiency in tumors, such as unidentified germline mutations or epimutations in MMR genes, or mutations in other CRC-associated genes (germline or somatic). AIMS: To elucidate the molecular basis of MMR deficiency in LS-suspected cases without identified germline MMR mutation. SPECIFIC AIMS: To refine and complete the analysis of MMR gene including the promoter regions. To study the contribution of MUTYH mutations to LLS. To study the relative contribution of germline and somatic mutations in other CRC-associated genes. PATIENTS AND METHODS: We have analyzed a series of 260 LS-suspected patients, thirty-four harboring MLH1-methylated tumors and 226 classified as LLS (BRAF negative, MLH1 methylation negative and MMR wildtype). Promoter sequencing of MMR genes was performed by Sanger. Methylation analyses were analyzed by multiple techniques including MS-MLPA, MS-Melting Curve Analysis (MCA), bisulfite sequencing or pyrosequencing. Pathogenicity assessment of MSH2 VUS was performed by multifactorial models and cDNA analysis. MUTYH Spanish variants were analyzed by Sanger or MCA and other CRC-associated genes by a customized subexome panel. MAIN RESULTS AND CONCLUSIONS: In LLS somatic methylation in MSH2 and MSH6-deficient tumors is absent and does not of help in ruling out LS. MLH1 constitutional epimutations account for about 2% of suspected LS cases. Pathogenicity assessment of MSH2 variants allows the reclassification of the majority of them (90%). Germline biallelic MUTYH mutations are responsible for up to 3% of LLS. FAN1 probable pathogenic variants may account for 10% of LLS. The combined germline and somatic assessment of the mutational status of CRC-associated genes by means of a subexome panel is useful to elucidate the molecular basis of a relevant number of LLS

Photoelectron spectroscopy for surface analysis: X-ray and UV excitation

Podeu consultar el llibre complet a: http://hdl.handle.net/2445/32166This article summarizes the basic principles of photoelectron spectroscopy for surface analysis, with examples of applications in material science that illustrate the capabilities of the related techniques

Does multilocus inherited neoplasia alleles syndrome have severe clinical expression?

Importance: Genetic testing of hereditary cancer using comprehensive gene panels can identify patients with more than one pathogenic mutation in high and/or moderate-risk-associated cancer genes. This phenomenon is known as multilocus inherited neoplasia alleles syndrome (MINAS), which has been potentially linked to more severe clinical manifestations. Objective: To determine the prevalence and clinical features of MINAS in a large cohort of adult patients with hereditary cancer homogeneously tested with the same gene panel. Patients and methods: A cohort of 1023 unrelated patients with suspicion of hereditary cancer was screened using a validated panel including up to 135 genes associated with hereditary cancer and phakomatoses. Results: Thirteen (1.37%) patients harbouring two pathogenic mutations in dominant cancer-predisposing genes were identified, representing 5.7% (13/226) of patients with pathogenic mutations. Most (10/13) of these cases presented clinical manifestations associated with only one of the mutations identified. One case showed mutations in MEN1 and MLH1 and developed tumours associated with both cancer syndromes. Interestingly, three of the double mutants had a young age of onset or severe breast cancer phenotype and carried mutations in moderate to low-risk DNA damage repair-associated genes; two of them presented biallelic inactivation of CHEK2. We included these two patients for the sake of their clinical interest although we are aware that they do not exactly fulfil the definition of MINAS since both mutations are in the same gene. Conclusions and relevance: Genetic analysis of a broad cancer gene panel identified the largest series of patients with MINAS described in a single study. Overall, our data do not support the existence of more severe manifestations in double mutants at the time of diagnosis although they do confirm previous evidence of severe phenotype in biallelic CHEK2 and other DNA repair cancer-predisposing genes

Tumor xenograft modeling identifies an association between TCF4 loss and breast cancer chemoresistance

Understanding the mechanisms of cancer therapeutic resistance is fundamental to improving cancer care. There is clear benefit from chemotherapy in different breast cancer settings; however, knowledge of the mutations and genes that mediate resistance is incomplete. In this study, by modeling chemoresistance in patientderived xenografts (PDXs), we show that adaptation to therapy is genetically complex and identify that loss of transcription factor 4 (TCF4; also known as ITF2) is associated with this process. A triple-negative BRCA1-mutaied PDX was used to study the genetics of chemoresistance. The PDX was treated in parallel with four chemotherapies for five iterative cycles. Exome sequencing identified few genes with de novo or enriched mutations in common among the different therapies, whereas many common depleted mutations/ genes were observed. Analysis of somatic mutations from The Cancer Genome Atlas (TCGA) supported the prognostic relevance of the identified genes. A mutation in TCF4 was found de novo in all treatments, and analysis of drug sensitivity profiles across cancer cell lines supported the link to chemoresistance. Loss of TCF4 conferred chemoresistance in breast cancer cell models, possibly by altering cell cycle regulation. Targeted sequencing in chemoresistant tumors identified an intronic variant of TCF4 that may represent an expression quantitative trait locus associated with relapse outcome in TCGA. Immunohistochemical studies suggest a common loss of nuclear TCF4 expression post-chemotherapy. Together, these results from tumor xenograft modeling depict a link between altered TCF4 expression and breast cancer chemoresistance