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Mutations in the RAS/MAPK Pathway Drive Replication Repair-Deficient Hypermutated Tumors and Confer Sensitivity to MEK Inhibition.

Authors :
Campbell BB
Galati MA
Stone SC
Riemenschneider AN
Edwards M
Sudhaman S
Siddaway R
Komosa M
Nunes NM
Nobre L
Morrissy AS
Zatzman M
Zapotocky M
Joksimovic L
Kalimuthu SN
Samuel D
Mason G
Bouffet E
Morgenstern DA
Aronson M
Durno C
Malkin D
Maris JM
Taylor MD
Shlien A
Pugh TJ
Ohashi PS
Hawkins CE
Tabori U
Source :
Cancer discovery [Cancer Discov] 2021 Jun; Vol. 11 (6), pp. 1454-1467. Date of Electronic Publication: 2021 Feb 09.
Publication Year :
2021

Abstract

The RAS/MAPK pathway is an emerging targeted pathway across a spectrum of both adult and pediatric cancers. Typically, this is associated with a single, well-characterized point mutation in an oncogene. Hypermutant tumors that harbor many somatic mutations may obscure the interpretation of such targetable genomic events. We find that replication repair-deficient (RRD) cancers, which are universally hypermutant and affect children born with RRD cancer predisposition, are enriched for RAS/MAPK mutations ( P = 10 <superscript>-8</superscript> ). These mutations are not random, exist in subclones, and increase in allelic frequency over time. The RAS/MAPK pathway is activated both transcriptionally and at the protein level in patient-derived RRD tumors, and these tumors responded to MEK inhibition in vitro and in vivo . Treatment of patients with RAS/MAPK hypermutant gliomas reveals durable responses to MEK inhibition. Our observations suggest that hypermutant tumors may be addicted to oncogenic pathways, resulting in favorable response to targeted therapies. SIGNIFICANCE: Tumors harboring a single RAS/MAPK driver mutation are targeted individually for therapeutic purposes. We find that in RRD hypermutant cancers, mutations in the RAS/MAPK pathway are enriched, highly expressed, and result in sensitivity to MEK inhibitors. Targeting an oncogenic pathway may provide therapeutic options for these hypermutant polyclonal cancers. This article is highlighted in the In This Issue feature, p. 1307 .<br /> (©2021 American Association for Cancer Research.)

Details

Language :
English
ISSN :
2159-8290
Volume :
11
Issue :
6
Database :
MEDLINE
Journal :
Cancer discovery
Publication Type :
Academic Journal
Accession number :
33563663
Full Text :
https://doi.org/10.1158/2159-8290.CD-20-1050