Clinical Sequencing Defines the Genomic Landscape of Metastatic Colorectal Cancer.

Clinical Sequencing Defines the Genomic Landscape of Metastatic Colorectal Cancer.
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DOI:
10.1016/j.ccell.2017.12.004
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发表时间:
2018-01-08
期刊:
影响因子:
50.3
通讯作者:
Schultz N
Schultz N
中科院分区:
医学1区
文献类型:
--
作者:
Yaeger R;Chatila WK;Lipsyc MD;Hechtman JF;Cercek A;Sanchez-Vega F;Jayakumaran G;Middha S;Zehir A;Donoghue MTA;You D;Viale A;Kemeny N;Segal NH;Stadler ZK;Varghese AM;Kundra R;Gao J;Syed A;Hyman DM;Vakiani E;Rosen N;Taylor BS;Ladanyi M;Berger MF;Solit DB;Shia J;Saltz L;Schultz N

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Metastatic colorectal cancers (mCRCs) are clinically heterogeneous, but the genomic basis of this variability remains poorly understood. We performed prospective targeted sequencing of 1134 CRCs. We identified splice alterations in intronic regions of APC and large in-frame deletions in CTNNB1, increasing oncogenic WNT pathway alterations to 96% of CRCs. Right-sided primary site in microsatellite stable mCRC was associated with shorter survival, older age at diagnosis, increased mutations, and enrichment of oncogenic alterations in KRAS, BRAF, PIK3CA, AKT1, RNF43, and SMAD4 compared to left-sided primaries. Left-sided tumors frequently had no identifiable genetic alteration in mitogenic signaling, but exhibited higher mitogenic ligand expression. Our results suggest different pathways to tumorigenesis in right- and left-sided microsatellite stable CRC that may underlie clinical differences.
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