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2017 ; 171
(5
): 1042-1056.e10
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Comprehensive Analysis of Hypermutation in Human Cancer
#MMPMID29056344
Campbell BB
; Light N
; Fabrizio D
; Zatzman M
; Fuligni F
; de Borja R
; Davidson S
; Edwards M
; Elvin JA
; Hodel KP
; Zahurancik WJ
; Suo Z
; Lipman T
; Wimmer K
; Kratz CP
; Bowers DC
; Laetsch TW
; Dunn GP
; Johanns TM
; Grimmer MR
; Smirnov IV
; Larouche V
; Samuel D
; Bronsema A
; Osborn M
; Stearns D
; Raman P
; Cole KA
; Storm PB
; Yalon M
; Opocher E
; Mason G
; Thomas GA
; Sabel M
; George B
; Ziegler DS
; Lindhorst S
; Issai VM
; Constantini S
; Toledano H
; Elhasid R
; Farah R
; Dvir R
; Dirks P
; Huang A
; Galati MA
; Chung J
; Ramaswamy V
; Irwin MS
; Aronson M
; Durno C
; Taylor MD
; Rechavi G
; Maris JM
; Bouffet E
; Hawkins C
; Costello JF
; Meyn MS
; Pursell ZF
; Malkin D
; Tabori U
; Shlien A
Cell
2017[Nov]; 171
(5
): 1042-1056.e10
PMID29056344
show ga
We present an extensive assessment of mutation burden through sequencing analysis
of >81,000 tumors from pediatric and adult patients, including tumors with
hypermutation caused by chemotherapy, carcinogens, or germline alterations.
Hypermutation was detected in tumor types not previously associated with high
mutation burden. Replication repair deficiency was a major contributing factor.
We uncovered new driver mutations in the replication-repair-associated DNA
polymerases and a distinct impact of microsatellite instability and replication
repair deficiency on the scale of mutation load. Unbiased clustering, based on
mutational context, revealed clinically relevant subgroups regardless of the
tumors' tissue of origin, highlighting similarities in evolutionary dynamics
leading to hypermutation. Mutagens, such as UV light, were implicated in
unexpected cancers, including sarcomas and lung tumors. The order of mutational
signatures identified previous treatment and germline replication repair
deficiency, which improved management of patients and families. These data will
inform tumor classification, genetic testing, and clinical trial design.