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2016 ; 7
(42
): 68638-68649
Nephropedia Template TP
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English Wikipedia
The somatic POLE P286R mutation defines a unique subclass of colorectal cancer
featuring hypermutation, representing a potential genomic biomarker for
immunotherapy
#MMPMID27612425
Ahn SM
; Ansari AA
; Kim J
; Kim D
; Chun SM
; Kim J
; Kim TW
; Park I
; Yu CS
; Jang SJ
Oncotarget
2016[Oct]; 7
(42
): 68638-68649
PMID27612425
show ga
Early-onset colorectal cancers (EOCRCs) may have biological or genomic features
distinct from late-onset CRCs (LOCRCs). Previous studies have mostly focused on
the germline predisposition conditions of EOCRCs, but we hypothesized that EOCRCs
may have distinct somatic aberrations that accelerate cancer development. To
identify the somatic aberrations that accelerate cancer development at an early
age, we conducted whole exome sequencing for 28 polyposis-unrelated,
microsatellite stable (MSS) EOCRCs with no known germline predisposition
conditions. Surprisingly, we found two distinct groups in the context of
mutational burden: 6 hypermutated cases with 2325 to 10973 mutations and 22
nonhypermutated cases with 47 to 154 mutations. Further analysis revealed that
four of the six hypermutated cases had the same POLE P286R mutation. We validated
this finding in 83 MSS EOCRCs and 27 MSS LOCRCs, which revealed that 7.2% of
EOCRCs (6/83) had the POLE P286R mutation, which was not found in LOCRCs.
Clinicopathologically, EOCRCs with POLE mutations occurred far more frequently in
the right colon than in the left colon, affecting men more frequently than women.
In summary, we have identified a unique subclass of colon cancer characterized by
a hypermutation associated with the POLE mutation. The acquisition of the POLE
mutation leading to hypermutation can accelerate cancer development. Clinically,
this subset with hypermutation may be susceptible to immune checkpoint blockade.