Integrated genomic characterization of endometrial carcinoma
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SummaryWe performed an integrated genomic, transcriptomic, and proteomic characterization of 373 endometrial carcinomas using array- and sequencing-based technologies. Uterine serous tumors and ~25% of high-grade endometrioid tumors have extensive copy number alterations, few DNA methylation changes, low ER/PR levels, and frequent TP53 mutations. Most endometrioid tumors have few copy number alterations or TP53 mutations but frequent mutations in PTEN, CTNNB1, PIK3CA, ARID1A, KRAS and novel mutations in the SWI/SNF gene ARID5B. A subset of endometrioid tumors we identified had a dramatically increased transversion mutation frequency, and newly identified hotspot mutations in POLE. Our results classified endometrial cancers into four categories: POLE ultramutated, microsatellite instability hypermutated, copy number low, and copy number high. Uterine serous carcinomas share genomic features with ovarian serous and basal-like breast carcinomas. We demonstrated that the genomic features of endometrial carcinomas permit a reclassification that may impact post-surgical adjuvant treatment for women with aggressive tumors.
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Androgen receptor is upregulated in 9.8% of grade 3 endometrial adenocarcinoma samples.
“AR is up-regulated in 9.8% of endometrial adenocarcinoma grade 3 samples [63, 90].”
From Role of aldo-keto reductase family 1 (AKR1) enzymes in human steroid metabolism (2014) · cites this paper as [90]
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Research works printed but not linked: 1
- Martin L. Ferguson 69 , John A. Demchok 67 , Liming Yang 67 ; National Human Genome Research Institute Mark S. Guyer 70 , Bradley A. Ozenberger 70 , Heidi J. Sofia 70 Writing committee: Cyriac Kandoth 2 , Nikolaus Schultz 24 , Andrew D. Cherniack 1 , Rehan Akbani 33 , Yuexin Liu 30,31 , Hui Shen 22 , A. Gordon Robertson 3 , Itai Pashtan 1,4,5 , Ronglai Shen 27 , Christopher C. Benz 29 , Christina Yau 29 , Peter W. Laird 22 , Li Ding 2 , Wei Zhang 30,31 , Gordon B. Mills 34 , Raju Kucherlapati 9 , Elaine R. Mardis 2 & Douglas A. Levine 51 1 The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology and Harvard University Cambridge, Massachusetts 02142, USA.
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“In contrast to tubo-ovarian HGSC, however, some p53abn endometrial carcinomas have recurrent mutations in PIK3CA, FBXW7, and PPP2R1A46; they are less likely to have mutations in BRCA1 or BRCA2 than is tubo-ovarian HGSC.46,67 HER2 amplification occurs in ~20% of this molecular subtype, and a proportion have homologous…”
BackgroundInfluentialIncreased somatic mutation burdens in normal human cells due to defective DNA polymerases
Robinson, P. S., Coorens, T. H. H., Palles, C., Mitchell, E., Abascal, F., Olafsson, S., Lee, B. C. H., Lawson, A. R. J., Lee-Six, H., Moore, L., et al. (2021) · Nature Genetics · doi:10.1038/s41588-021-00930-y · Cited by 173 · see citing works
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“8 The Cancer Genome Atlas (TCGA)(9) identified a novel subgroup of ECs with mutations in DNA polymerase epsilon (POLE) that are responsible for DNA replication and lead to exceedingly high somatic mutation frequencies (“ultramutated”: >100 mutations per megabase).(9) It is now recognized that approximately 5% to 10% o…”
BackgroundEfficient Use of Patient-Derived Organoids as a Preclinical Model for Gynecologic Tumors
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“POLE ultra-mutated tumors account for 7% to 12% of all endometrial carcinomas (1, 2, 5, 6) and occur secondary to mutations in the exonuclease domain of POLE, a nuclear DNA polymerase endowed with intrinsic proofreading activity (5).”
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“Thus, in order to validate our method of summarizing Illumina 450k DNAm data at the gene-level, we decided to apply the EpiMod and FEM algorithms to an independent endometrial normal/cancer Infinium 450k set generated as part of the TCGA (Methods) (Kandoth et al., 2013).”
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Endometrial carcinoma: molecular subtypes, precursors and the role of pathology in early diagnosis
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“In 2013, The Cancer Genome Atlas (TCGA) identified four molecular subtypes of EC based on genomic features [10].”
BackgroundOncogenic mutations in histologically normal endometrium: the new normal?
Lac, V., Nazeran, T. M., Tessier‐Cloutier, B., Aguirre-Hernández, R., Albert, A., Lum, A. M., Khattra, J. S., Praetorius, T., Mason, M., Chiu, D. S., et al. (2019) · The Journal of Pathology · doi:10.1002/path.5314 · Cited by 139 · see citing works
“Comparing our data to the TCGA endometrial cancer dataset reveals that the prevalence of driver mutations is higher across age in endometrial cancer (or comparably as uncommon) in all genes except for KRAS.”
BackgroundResultInfluentialRole of POLE and POLD1 in familial cancer
Mur, P., García‐Mulero, S., Valle, J. D., Magraner-Pardo, L., Vidal, A., Pineda, M., Cinnirella, G., Martin, E. J., Pons, T., López‐Doriga, A., et al. (2020) · Genetics in Medicine · doi:10.1038/s41436-020-0922-2 · Cited by 140 · see citing works
Molecular stratification of endometrioid ovarian carcinoma predicts clinical outcome
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Overcoming Wnt–β-catenin dependent anticancer therapy resistance in leukaemia stem cells
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Selective Progesterone Receptor Modulators—Mechanisms and Therapeutic Utility
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Conditional Selection of Genomic Alterations Dictates Cancer Evolution and Oncogenic Dependencies
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“MMRd carcinomas rarely displayed aberrant p53 or L1CAM positivity, both considered molecular markers of aggressive EC [1, 27, 46, 47].”
BackgroundMethodInfluentialUnderstanding mutagenesis through delineation of mutational signatures in human cancer
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Solid Tumors Challenges and New Insights of CAR T Cell Engineering
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Moving pan-cancer studies from basic research toward the clinic
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Detection of endometrial cancer via molecular analysis of DNA collected with vaginal tampons.
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New perspectives on screening and early detection of endometrial cancer
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“Although the dualistic classification system remains the gold standard, a new classification system by The Cancer Genome Atlas (TCGA) Consortium based on molecular features is starting to be integrated into clinical practice.(9,10) In contrast to many common diseases that could be detected preclinically, but screening…”
BackgroundCochrane, D. R., Campbell, K. R., Greening, K., Ho, G. C., Hopkins, J., Bui, M., Douglas, J. M., Sharlandjieva, V., Munzur, A. D., Lai, D., et al. (2020) · The Journal of Pathology · doi:10.1002/path.5511 · Cited by 84 · see citing works
“The Cancer Genome Atlas (TCGA) demonstrated that endometrial carcinoma patients could be differentiated into four prognostically distinct subgroups [22].”
BackgroundNetwork Medicine in Pathobiology
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“Oncologic research is one of the leading areas in which PARADIGM or similar algorithms have been widely adopted to integrate multiplatform patient data.(90) One of these multi-omic cancer studies recently added a novel dimension of antitumor immunity profiles to guide personalized immunotherapy.”
BackgroundAlterations of DNA damage repair in cancer: from mechanisms to applications
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“Kandoth et al. identified the frequencies of MSI in DNA polymerase epsilon ( POLE ) mutations in endometrial and colorectal cancers to be 40% and 11%, respectively, and the mutation rates to be 7% and 3%, respectively (26).”
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Prognostic Integrated Image-Based Immune and Molecular Profiling in Early-Stage Endometrial Cancer
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Cancer-associated mutations in endometriosis: shedding light on the pathogenesis and pathophysiology
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“Given that previous studies have shown that the association of CTNNB1 mutated tumors with poor prognosis was dependent on molecular subgroup (9), we examined our stage IA exon 3 mutated tumors in the context of other significant molecular classifiers in TCGA classification system (6); almost 80% of tumors were TP53 an…”
MethodResultPhenotype of POLE-mutated endometrial cancer
Imboden, S., Nastic, D., Ghaderi, M., Rydberg, F., Rau, T. T., Mueller, M. D., Epstein, E., & Carlson, J. W. (2019) · PLoS ONE · doi:10.1371/journal.pone.0214318 · Cited by 87 · see citing works
Past, present, and future of hormonal therapy in recurrent endometrial cancer
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Molecular subtypes of endometrial cancer: Implications for adjuvant treatment strategies
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“15 The first group, hypermutated, had somatic inactivating mutations in the exonuclease domain of polymerase epsilon (POLE), resulting in a very high mutation rate and excellent prognosis (7%).”
BackgroundGenetic characteristics of gastric-type mucinous carcinoma of the uterine cervix
Park, E., Kim, S. W., Kim, S., Kim, H.-S., Lee, J., Kim, Y. T., & Cho, N. H. (2020) · Modern Pathology · doi:10.1038/s41379-020-0614-0 · Cited by 78 · see citing works
Epidemiology, pathogenesis, biology and evolving management of MSI-H/dMMR cancers
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Evidence of androgen action in endometrial and ovarian cancers
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Dysregulated FGF signalling in neoplastic disorders
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Reverse phase protein arrays in signaling pathways: a data integration perspective
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PD-L1 Expression in Endometrial Carcinoma Cells and Intratumoral Immune Cells
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Krämer, P., Talhouk, A., Brett, M. A., Chiu, D. S., Cairns, E. S., Scheunhage, D. A., Hammond, R. F. L., Farnell, D., Nazeran, T. M., Grube, M. P., et al. (2020) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-20-1268 · Cited by 67 · see citing works
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“About 7% to 12% of ECs demonstrate mutations in the exonuclease domain of POLE (11,14).”
BackgroundMethodBrett, M. A., Atenafu, E. G., Singh, N., Ghatage, P., Clarke, B. A., Nelson, G. S., Bernardini, M. Q., & Köbel, M. (2020) · International Journal of Gynecological Pathology · doi:10.1097/pgp.0000000000000674 · Cited by 65 · see citing works
“A molecular subtype classification has been proposed for endometrial carcinoma following The Cancer Genome Atlas (TCGA) project (1).”
BackgroundResultInfluentialBrain high-throughput multi-omics data reveal molecular heterogeneity in Alzheimer’s disease
Eteleeb, A. M., Novotny, B. C., Tarraga, C. S., Sohn, C., Dhungel, E., Brase, L., Nallapu, A., Buss, J., Farias, F., Bergmann, K., et al. (2024) · PLOS Biology · doi:10.1371/journal.pbio.3002607 · Cited by 64 · see citing works
Molecular characterization of endometrial cancer and therapeutic implications
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Clear cell endometrial carcinoma and the TCGA classification
Travaglino, A., Raffone, A., Mascolo, M., Guida, M., Insabato, L., Zannoni, G. F., & Zullo, F. (2019) · Histopathology · doi:10.1111/his.13976 · Cited by 65 · see citing works
“Conversely, the CNH subgroup (also referred to as the ‘serous’ subgroup) is mainly composed of serous carcinomas and bears the worst prognosis among all TCGA subgroups.(1) Therefore, it might be hypothesized that some CCCs are biologically similar to endometrioid carcinoma and have a better prognosis, while some are s…”
BackgroundInfluentialYasin, H. K., Taylor, A. H., & Ayakannu, T. (2021) · Cancers · doi:10.3390/cancers13092149 · Cited by 63 · see citing works
“Copy number groups are defined by a differential profile of copy alterations (CNA), with the CNH group particularly presenting an elevated incidence of tumour suppressor p53 (TP53) mutations and worse prognosis when compared to the low copy number group [70].”
BackgroundMethodTime Interval Between Endometrial Biopsy and Surgical Staging for Type I Endometrial Cancer
Matsuo, K., Opper, N. R., Ciccone, M. A., et al. (2015) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000000636 · Cited by 62 · see citing works
- Authors
- The Cancer Genome Atlas Research Network, & Levine, D. A.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Levine, Douglas A.
- ORCID
- Levine, Douglas A.
- Venue
- Nature
- Published
- 2013-05-01
- Volume
- 497
- Issue
- 7447
- Pages
- 67-73
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- PMC
- PMC3704730
- OpenAlex
- W2041440766
- Cited by
- 5,784
- References
- 40
- Citations by year
- 2026: 467 · 2025: 580 · 2024: 559 · 2023: 595 · 2022: 591 · 2021: 572 · 2020: 455 · 2019: 384 · 2018: 320 · 2017: 328 · 2016: 313 · 2015: 285 · 2014: 231 · 2013: 96 · 2012: 5
- FWCI
- 345.78
- Type
- journal article
- Language
- en
- Update notices
- erratum (2013-06-12)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Nature (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- National Institutes of Health
- National Human Genome Research Institute (U54HG003067, U54HG003079, U54HG003273)
- National Cancer Institute (P50CA098258, U24CA143882, R01CA180006, U24CA143843, U24CA143840, U24CA143858, U24CA144025, U24CA143866, U24CA143883, U24CA143845, U24CA143867, U24CA143848, U24CA143799, U24CA143835, P30CA008748, P30CA016672, P30CA016056, P30CA016086)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Chromatin Remodeling and Cancer
- Keywords
- endometrial cancer, uterine serous carcinoma, endometrioid carcinoma, copy number alterations, TP53 mutation, POLE mutation, microsatellite instability, ARID5B, SWI/SNF chromatin remodeling, CTNNB1, PIK3CA, KRAS, PTEN, DNA methylation, oestrogen receptor, progesterone receptor, adjuvant therapy, genomic profiling
- MeSH terms
- Poly-ADP-Ribose Binding Proteins, Breast Neoplasms, Chromosome Aberrations, DNA Mutational Analysis, DNA Polymerase II, DNA-Binding Proteins, Female, Humans, Ovarian Neoplasms, Transcription Factors, Signal Transduction, Genome, Human, Gene Expression Regulation, Neoplastic, Endometrial Neoplasms, Genomics, DNA Copy Number Variations, Exome
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