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Whole-genome landscape of pancreatic neuroendocrine tumours
Abstract
The diagnosis of pancreatic neuroendocrine tumours (PanNETs) is increasing owing to more sensitive detection methods, and this increase is creating challenges for clinical management. We performed whole-genome sequencing of 102 primary PanNETs and defined the genomic events that characterize their pathogenesis. Here we describe the mutational signatures they harbour, including a deficiency in G:C > T:A base excision repair due to inactivation of MUTYH, which encodes a DNA glycosylase. Clinically sporadic PanNETs contain a larger-than-expected proportion of germline mutations, including previously unreported mutations in the DNA repair genes MUTYH, CHEK2 and BRCA2. Together with mutations in MEN1 and VHL, these mutations occur in 17% of patients. Somatic mutations, including point mutations and gene fusions, were commonly found in genes involved in four main pathways: chromatin remodelling, DNA damage repair, activation of mTOR signalling (including previously undescribed EWSR1 gene fusions), and telomere maintenance. In addition, our gene expression analyses identified a subgroup of tumours associated with hypoxia and HIF signalling.
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“substitution signatures were dominated by C>A transversions in NpCpA or NpCpT contexts (Figures 2 and 3) previously associated with inactivation of the BER gene MUTYH [11].”
From Whole-genome sequencing reveals clinically relevant insights into the aetiology of familial breast cancers (2019) · cites this paper as [11]
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“Other (kidney, spleen, adrenal, adnexa, peritoneum) 5 (6)”
Pituitary neuroendocrine tumors: a model for neuroendocrine tumor classification
Asa, S. L., Mete, Ö., Cusimano, M. D., McCutcheon, I. E., Perry, A., Yamada, S., Nishioka, H., Casar‐Borota, O., Uccella, S., Rosa, S. L., et al. (2021) · Modern Pathology · doi:10.1038/s41379-021-00820-y · Cited by 90
Combination Strategies to Improve Targeted Radionuclide Therapy
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“In recent years, TRT has rapidly grown in popularity, with agents such as [ 177 Lu-DOTA 0 ,Tyr 3 ]octreotate ( 177 Lu-DOTATATE), 131 I-metaiodobenzylguanidine ( 131 I-MIBG), Bexxar ® and Zevalin ® now clinically approved for the treatment of low-grade neuroendocrine tumours (NETs), neuroblastoma and non-Hodgkin’s lymp…”
BackgroundInfluentialThe landscape of molecular alterations in pancreatic and small intestinal neuroendocrine tumours
Scarpa, A. (2019) · Annales d Endocrinologie · doi:10.1016/j.ando.2019.04.010 · Cited by 88
Self-citationUccella, S., Rosa, S. L., Metović, J., Marchiori, D., Scoazec, J., Volante, M., Mete, Ö., & Papotti, M. G. (2021) · Endocrine Pathology · doi:10.1007/s12022-020-09660-z · Cited by 90
Diagnostic and Prognostic Biomarkers of Adrenal Cortical Carcinoma
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“The recently suggested category of NET G3 in the gastrointestinal tract [6, 27], which has been now introduced in the 2017 WHO classification of endocrine tumours [28], may well represent secondary NETs arising from pre-existing G1/G2 NETs.”
Self-citationWang, H., Bender, A. S., Wang, P., Karaköse, E., Inabnet, W. B., Libutti, S. K., Arnold, A., Lambertini, L., Stang, M., Chen, H., et al. (2017) · Nature Communications · doi:10.1038/s41467-017-00992-9 · Cited by 83
The neuroendocrine phenotype, genomic profile and therapeutic sensitivity of GEPNET cell lines
Hofving, T., Arvidsson, Y., Almobarak, B., Inge, L., Pfragner, R., Persson, M., Stenman, G., Kristiansson, E., Johanson, V., & Nilsson, O. (2018) · Endocrine Related Cancer · doi:10.1530/erc-17-0445 · Cited by 86
Mutational signatures are markers of drug sensitivity of cancer cells
Levatić, J., Salvadores, M., Fuster‐Tormo, F., & Supek, F. (2022) · Nature Communications · doi:10.1038/s41467-022-30582-3 · Cited by 79
“This exceeds the number of drug associations replicated in PRISM involving driver mutations (37), copy-number changes (55), or DNA methylation (64) in the same test.”
BackgroundBodei, L., Schöder, H. M., Baum, R. P., Herrmann, K., Strosberg, J., Caplin, M. E., Öberg, K., & Modlin, I. M. (2020) · The Lancet Oncology · doi:10.1016/s1470-2045(20)30323-5 · Cited by 79
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A MUTYH germline mutation is associated with small intestinal neuroendocrine tumors
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“This matter deserves follow-up studies for both SI-NETs and PAN-NETs.”
InfluentialScoazec, J., & Couvelard, A. (2017) · Annales de Pathologie · doi:10.1016/j.annpat.2017.10.003 · Cited by 78
Current and emerging therapies for PNETs in patients with or without MEN1
Frost, M., Lines, K. E., & Thakker, R. V. (2018) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2018.3 · Cited by 77
Pancreatic Neuroendocrine Tumors: Molecular Mechanisms and Therapeutic Targets
Maharjan, C. K., Ear, P. H., Tran, C. G., Howe, J. R., Chandrasekharan, C., & Quelle, D. E. (2021) · Cancers · doi:10.3390/cancers13205117 · Cited by 73
“One of the major conclusions has been that pNETs, unlike PDACs, have a low mutational burden [23,24].”
BackgroundResultInfluentialHistopathological, immunohistochemical, genetic and molecular markers of neuroendocrine neoplasms
Kyriakopoulos, G., Mavroeidi, V., Chatzellis, E., Kaltsas, G., & Alexandraki, K. (2018) · Annals of Translational Medicine · doi:10.21037/atm.2018.06.27 · Cited by 78
“Moreover, biallelic inactivation of ATRX or DAXX through loss of heterozygosity (LOH) was strongly associated with an increase in telomere length as quantified by whole-genome sequencing data (95) while their mutations promoted alternative lengthening of telomeres (ALT) and chromosomal instability (96,97).”
BackgroundXue, Y., Reid, M. D., Pehlivanoğlu, B., Obeng, R. C., Jiang, H., Memiş, B., Lui, S. K., Sarmiento, J. M., Kooby, D. A., Maithel, S. K., et al. (2020) · Endocrine Pathology · doi:10.1007/s12022-020-09628-z · Cited by 75
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Twenty years of menin: emerging opportunities for restoration of transcriptional regulation in MEN1
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“Mutations in genes associated with DNArepair have been described in pancreatic neuroendocrine tumours [22].”
BackgroundMolecular Events in the Natural History of Pancreatic Cancer
Oldfield, L. E., Connor, A. A., & Gallinger, S. (2017) · Trends in cancer · doi:10.1016/j.trecan.2017.04.005 · Cited by 65
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“Age, yrs, median (range) 57 (19–85) 59 (27–83) 55 (19–85) Sex, n (%) Female 321 (51) 116 (51) 205 (51) Male 311 (49) 110 (49) 201 (49) Functional, n (%) No 540 (85) 215 (95) 325 (80) Yes 90 (14) 11 (5) 79 (19) Unknown 2 (1) 0 (0) 2 (1) Multifocal, n (%) No 618 (98) 216 (96) 402 (99) Yes 14 (2) 10 (4) 5 (1) Primary pan…”
Self-citationScott, A. T., Weitz, M., Breheny, P. J., Ear, P. H., Darbro, B. W., Brown, B. J., Braun, T. A., Li, G., Umesalma, S., Kaemmer, C. A., et al. (2020) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-19-2884 · Cited by 62
“Other commonly mutated genes include DAXX or ATRX, genes in the mTOR pathway, genes involved in DNA damage repair such as MUTHY, and genes involved in chromatin modification.(17,18) Although mutations in the mTOR pathway are seen in only 12-15% of PNETs, expression and activity level analyses have revealed alterations…”
BackgroundNeuroendocrine neoplasia of the gastrointestinal tract revisited: towards precision medicine
Rindi, G., & Wiedenmann, B. (2020) · Nature Reviews Endocrinology · doi:10.1038/s41574-020-0391-3 · Cited by 66
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Self-citation
Metadata
- Authors
- Initiative, A. P. C. G., Scarpa, A., Chang, D. K., Nones, K., Corbo, V., Patch, A.-M., Bailey, P., Lawlor, R. T., Johns, A. L., Miller, D. K., Mafficini, A., Rusev, B., Scardoni, M., Antonello, D., Barbi, S., Sikora, K. O., Cingarlini, S., Vicentini, C., McKay, S., Quinn, M. C. J., Bruxner, T. J. C., Christ, A. N., Harliwong, I., Idrisoglu, S., McLean, S., Nourse, C., Nourbakhsh, E., Wilson, P. J., Anderson, M. J., Fink, J. L., Newell, F., Waddell, N., Holmes, O., Kazakoff, S. H., Leonard, C., Wood, S., Xu, Q., Nagaraj, S. H., Amato, E., Dalai, I., Bersani, S., Cataldo, I., Dei Tos, A. P., Capelli, P., Davì, M. V., Landoni, L., Malpaga, A., Miotto, M., Whitehall, V. L. J., Leggett, B. A., Harris, J. L., Harris, J., Jones, M. D., Humphris, J., Chantrill, L. A., Chin, V., Nagrial, A. M., Pajic, M., Scarlett, C. J., Pinho, A., Rooman, I., Toon, C., Wu, J., Pinese, M., Cowley, M., Barbour, A., Mawson, A., Humphrey, E. S., Colvin, E. K., Chou, A., Lovell, J. A., Jamieson, N. B., Duthie, F., Gingras, M.-C., Fisher, W. E., Dagg, R. A., Lau, L. M. S., Lee, M., Pickett, H. A., Reddel, R. R., Samra, J. S., Kench, J. G., Merrett, N. D., Epari, K., Nguyen, N. Q., Zeps, N., Falconi, M., Simbolo, M., Butturini, G., Van Buren, G., Partelli, S., Fassan, M., Khanna, K. K., Gill, A. J., Wheeler, D. A., Gibbs, R. A., Musgrove, E. A., Bassi, C., Tortora, G., Pederzoli, P., Pearson, J. V., Waddell, N., Biankin, A. V., & Grimmond, S. M.
- Affiliations
- University of Verona (IT)
- Garvan Institute of Medical Research (AU)
- The University of Queensland (AU)
- Queensland University of Technology (AU)
- Glasgow Royal Infirmary (GB)
- Baylor College of Medicine (US)
- Children's Hospital at Westmead (AU)
- The University of Sydney (AU)
- Fremantle Hospital (AU)
- Royal Adelaide Hospital (AU)
- The University of Melbourne (AU)
- Corresponding author
- Scarpa, Aldo
- Biankin, Andrew V.
- Grimmond, Sean M.
- ORCID
- Scarpa, Aldo
- Chang, David K.
- Corbo, Vincenzo
- Patch, Ann-Marie
- Bailey, Peter
- Lawlor, Rita T.
- Johns, Amber L.
- Mafficini, Andrea
- Rusev, Borislav
- Antonello, Davide
- Barbi, Stefano
- Cingarlini, Sara
- Vicentini, Caterina
- Quinn, Michael C. J.
- Bruxner, Timothy J. C.
- Christ, Angelika N.
- Harliwong, Ivon
- Nourbakhsh, Ehsan
- Wilson, Peter J.
- Anderson, Matthew J.
- Fink, J. Lynn
- Newell, Felicity
- Holmes, Oliver
- Kazakoff, Stephen H.
- Leonard, Conrad
- Wood, Scott
- Nagaraj, Shivashankar Hiriyur
- Bersani, Samantha
- Cataldo, Ivana
- Davì, Maria Vittoria
- Landoni, Luca
- Malpaga, Anna
- Miotto, Marco
- Whitehall, Vicki L. J.
- Leggett, Barbara A.
- Harris, Jonathan
- Jones, Marc D.
- Chantrill, Lorraine A.
- Chin, Venessa
- Nagrial, Adnan M.
- Pajic, Marina
- Scarlett, Christopher J.
- Pinho, Andreia
- Rooman, Ilse
- Toon, Christopher
- Wu, Jianmin
- Pinese, Mark
- Cowley, Mark
- Barbour, Andrew
- Mawson, Amanda
- Colvin, Emily K.
- Chou, Angela
- Jamieson, Nigel B.
- Gingras, Marie-Claude
- Dagg, Rebecca A.
- Lau, Loretta M. S.
- Lee, Michael
- Pickett, Hilda A.
- Reddel, Roger R.
- Samra, Jaswinder S.
- Kench, James G.
- Merrett, Neil D.
- Nguyen, Nam Q.
- Zeps, Nikolajs
- Falconi, Massimo
- Simbolo, Michele
- Partelli, Stefano
- Fassan, Matteo
- Khanna, Kum Kum
- Gill, Anthony J.
- Wheeler, David A.
- Gibbs, Richard A.
- Bassi, Claudio
- Tortora, Giampaolo
- Pearson, John V.
- Waddell, Nicola
- Biankin, Andrew V.
- Grimmond, Sean M.
- Venue
- Nature
- Published
- 2017-02-15
- Volume
- 543
- Issue
- 7643
- Pages
- 65-71
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- OpenAlex
- W2589112207
- Cited by
- 999
- References
- 62
- Citations by year
- 2026: 65 · 2025: 101 · 2024: 103 · 2023: 110 · 2022: 126 · 2021: 108 · 2020: 131 · 2019: 89 · 2018: 103 · 2017: 52
- FWCI
- 81.15
- Type
- journal article
- Language
- en
- Update notices
- erratum (2017-09-27)
- Open access
- closed
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Funders
- Pancreatic Cancer UK (RIF2015_A06_Jamieson, FLF2015_04_GLASGOW)
- Wellcome Trust (103721/Z/14/Z)
- Cancer Research UK (23526, 17263, 22533)
- Academy of Medical Sciences (AMS-SGCL9-Jamieson)
- Medical Research Council (MR/N005813/1)
- Topics
- Health Sciences › Medicine › Oncology › Neuroendocrine Tumor Research Advances
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Keywords
- pancreatic neuroendocrine tumors, mutational signatures, MUTYH, germline mutations, CHEK2, BRCA2, MEN1, VHL, chromatin remodeling, DNA repair, mTOR signaling, telomere maintenance, hypoxia, carcinogenesis
- MeSH terms
- Base Sequence, Calmodulin-Binding Proteins, Chromosome Aberrations, DNA Mutational Analysis, DNA Repair, Female, Humans, Male, Pancreatic Neoplasms, Genome, Human, RNA-Binding Proteins, Telomere, Germ-Line Mutation, Carcinoma, Neuroendocrine, Genomics, RNA-Binding Protein EWS, Chromatin Assembly and Disassembly, DNA Glycosylases, DNA Copy Number Variations, TOR Serine-Threonine Kinases
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