1. Genomic landscape of metastatic breast cancer identifies preferentially dysregulated pathways and targets
- Author
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Aaron Solomon, Noah Goodman, Dhruv K. Pant, Michael Feldman, Kara N. Maxwell, Matt R. Paul, S. William Stavropoulos, Tien-chi Pan, Yan Chen, Natalie N. C. Shih, George K. Belka, Danielle Soucier-Ernst, Kyra L. Harvey, Lewis A. Chodosh, Candace Clark, Angela DeMichele, David B. Lieberman, and Jennifer J.D. Morrissette
- Subjects
0301 basic medicine ,Breast Neoplasms ,Biology ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,CDKN2A ,Progesterone receptor ,medicine ,Humans ,Neoplasm Metastasis ,Wnt Signaling Pathway ,PI3K/AKT/mTOR pathway ,Wnt signaling pathway ,MYLK ,General Medicine ,medicine.disease ,Metastatic breast cancer ,Neoplasm Proteins ,Gene Expression Regulation, Neoplastic ,030104 developmental biology ,030220 oncology & carcinogenesis ,Mutation ,Cancer research ,Female ,Estrogen receptor alpha ,Research Article - Abstract
Nearly all breast cancer deaths result from metastatic disease. Despite this, the genomic events that drive metastatic recurrence are poorly understood. We performed whole-exome and shallow whole-genome sequencing to identify genes and pathways preferentially mutated or copy-number altered in metastases compared with the paired primary tumors from which they arose. Seven genes were preferentially mutated in metastases — MYLK, PEAK1, SLC2A4RG, EVC2, XIRP2, PALB2, and ESR1 — 5 of which are not significantly mutated in any type of human primary cancer. Four regions were preferentially copy-number altered: loss of STK11 and CDKN2A/B, as well as gain of PTK6 and the membrane-bound progesterone receptor, PAQR8. PAQR8 gain was mutually exclusive with mutations in the nuclear estrogen and progesterone receptors, suggesting a role in treatment resistance. Several pathways were preferentially mutated or altered in metastases, including mTOR, CDK/RB, cAMP/PKA, WNT, HKMT, and focal adhesion. Immunohistochemical analyses revealed that metastases preferentially inactivate pRB, upregulate the mTORC1 and WNT signaling pathways, and exhibit nuclear localization of activated PKA. Our findings identify multiple therapeutic targets in metastatic recurrence that are not significantly mutated in primary cancers, implicate membrane progesterone signaling and nuclear PKA in metastatic recurrence, and provide genomic bases for the efficacy of mTORC1, CDK4/6, and PARP inhibitors in metastatic breast cancer.
- Published
- 2020
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