1. Personalized oncogenomics in the management of gastrointestinal carcinomas--early experiences from a pilot study.
- Author
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Sheffield, B. S., Tessier-Cloutier, B., Li-Chang, H., Shen, Y., Pleasance, E., Kasaian, K., Li, Y., Jones, S. J. M., J. Lim, H., Renouf, D. J., Huntsman, D. G., Yip, S., Laskin, J., Marra, M., and Schaeffer, D. F.
- Subjects
GENOMICS ,CHOLANGIOCARCINOMA ,ADENOCARCINOMA ,TARGETED drug delivery ,INDIVIDUALIZED medicine ,BEVACIZUMAB - Abstract
Background Gastrointestinal carcinomas are genomically complex cancers that are lethal in the metastatic setting. Whole-genome and transcriptome sequencing allow for the simultaneous characterization of multiple oncogenic pathways. Methods We report 3 cases of metastatic gastrointestinal carcinoma in patients enrolled in the Personalized Onco-Genomics program at the BC Cancer Agency. Real-time genomic profiling was combined with clinical expertise to diagnose a carcinoma of unknown primary, to explore treatment response to bevacizumab in a colorectal cancer, and to characterize an appendiceal adenocarcinoma. Results In the first case, genomic profiling revealed an IDH1 somatic mutation, supporting the diagnosis of cholangiocarcinoma in a malignancy of unknown origin, and further guided therapy by identifying epidermal growth factor receptor amplification. In the second case, a BRAF V600E mutation and wild-type KRAS profile justified the use of targeted therapies to treat a colonic adenocarcinoma. The third case was an appendiceal adenocarcinoma defined by a p53 inactivation; RAS/RAF/MEK, AKT/MTOR, Wnt, and NOTCH pathway activation; and overexpression of RET, ERBB2 (HER2), ERBB3, MET, and cell cycle regulators. Summary We show that whole-genome and transcriptome sequencing can be achieved within clinically effective timelines, yielding clinically useful and actionable information. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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