Cited by 800Lung Cancer Treatments and MutationsCancer Genomics and DiagnosticsCancer Mechanisms and Therapy

Activation of MET via Diverse Exon 14 Splicing Alterations Occurs in Multiple Tumor Types and Confers Clinical Sensitivity to MET Inhibitors

Frampton, Garrett M., Ali, Siraj M., Rosenzweig, Mark, Chmielecki, Juliann, Lu, Xinyuan, Bauer, Todd M., Akimov, Mikhail, Bufill, Jose A. +30 more·2015·Cancer Discovery

Published version of a preprint

Abstract

Focal amplification and activating point mutation of the MET gene are well-characterized oncogenic drivers that confer susceptibility to targeted MET inhibitors. Recurrent somatic splice site alterations at MET exon 14 (METex14) that result in exon skipping and MET activation have been characterized, but their full diversity and prevalence across tumor types are unknown. Here, we report analysis of tumor genomic profiles from 38,028 patients to identify 221 cases with METex14 mutations (0.6%), including 126 distinct sequence variants. METex14 mutations are detected most frequently in lung adenocarcinoma (3%), but also frequently in other lung neoplasms (2.3%), brain glioma (0.4%), and tumors of unknown primary origin (0.4%). Further in vitro studies demonstrate sensitivity to MET inhibitors in cells harboring METex14 alterations. We also report three new patient cases with METex14 alterations in lung or histiocytic sarcoma tumors that showed durable response to two different MET-targeted therapies. The diversity of METex14 mutations indicates that diagnostic testing via comprehensive genomic profiling is necessary for detection in a clinical setting. Significance: Here we report the identification of diverse exon 14 splice site alterations in MET that result in constitutive activity of this receptor and oncogenic transformation in vitro. Patients whose tumors harbored these alterations derived meaningful clinical benefit from MET inhibitors. Collectively, these data support the role of METex14 alterations as drivers of tumorigenesis, and identify a unique subset of patients likely to derive benefit from MET inhibitors. Cancer Discov; 5(8); 850–9. ©2015 AACR. See related commentary by Ma, p. 802. See related article by Paik et al., p. 842. This article is highlighted in the In This Issue feature, p. 783

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Crossref · 10.1158/2159-8290.cd-15-0285

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  • Large-scale profiling studies in NSCLC have revealed multiple non-random patterns of co-occurring or mutually exclusive mutations, which typically vary depending on the particular oncogenic driver mutation.

    “Importantly, large-scale profiling studies utilizing either whole exome sequencing or broad targeted sequencing panels in NSCLC tumors have revealed multiple non-random patterns of co-occurring or mutually exclusive mutations, which typically vary depending on the particular oncogenic driver mutation15, 34, 58–62.”
  • Landmark large scale sequencing studies have established a census of major KRAS co-mutations in both early-stage and advanced LUAD.

    “Landmark large scale sequencing studies have established a census of major KRAS co-mutations in both early-stage and advanced LUAD15, 34, 59, 62.”
  • The overwhelming majority of EGFR-mutant lung tumors harbor one or more co-mutations, even when analysis is limited to pre-defined sets of cancer-relevant genes within established panels.

    “Although EGFR –mutant tumors represent the prototypical oncogene-addicted LUAD subgroup that spearheaded adoption of the single-driver model, the overwhelming majority of EGFR-mutant lung tumors harbor one or more co-mutations, even when the analysis is limited to pre-defined sets of cancer-relevant genes within established panels (FoundationOne, Guardant360, MSK-IMPACT)15, 59, 72, 73.”
  • EGFR-mutant LUAD show significant enrichment of NKX2-1 amplification.

    “NKX2–1 amplification is significantly enriched in EGFR-mutant LUAD”
  • WNT signaling has a central role in LUAD metastasis.

    “earlier studies that identified a central role for WNT signaling in LUAD metastasis”

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Authors
Frampton, G. M., Ali, S. M., Rosenzweig, M., Chmielecki, J., Lu, X., Bauer, T. M., Akimov, M., Bufill, J. A., Lee, C., Jentz, D., Hoover, R., Ou, S.-H. I., Salgia, R., Brennan, T., Chalmers, Z. R., Jaeger, S., Huang, A., Elvin, J. A., Erlich, R., Fichtenholtz, A., Gowen, K. A., Greenbowe, J., Johnson, A., Khaira, D., McMahon, C., Sanford, E. M., Roels, S., White, J., Greshock, J., Schlegel, R., Lipson, D., Yelensky, R., Morosini, D., Ross, J. S., Collisson, E., Peters, M., Stephens, P. J., & Miller, V. A.
Affiliations
  • Foundation Medicine (United States) (US)
  • University of California, San Francisco (US)
  • Tennessee Oncology (US)
  • Novartis (Switzerland) (CH)
  • 5Michiana Hematology-Oncology, PC, Mishawaka, Indiana.
  • University of North Carolina at Chapel Hill (US)
  • South Bend Medical Foundation (US)
  • University of California, Irvine (US)
  • University of Chicago (US)
  • 1Foundation Medicine Inc., Cambridge, Massachusetts.
Corresponding author
Frampton, Garrett M.
Venue
Cancer Discovery
Published
2015-08-01
Volume
5
Issue
8
Pages
850-859
ISSN
  • 2159-8274 (ISSN-L)
  • 2159-8290
OpenAlex
W2160212814
Cited by
796
References
41
Citations by year
2026: 26 · 2025: 47 · 2024: 69 · 2023: 83 · 2022: 73 · 2021: 97 · 2020: 91 · 2019: 71 · 2018: 71 · 2017: 86 · 2016: 65 · 2015: 13 · 2014: 1 · 2013: 1
FWCI
62.31
Type
journal article
Language
en
Open access
closed
Locations
  • Cancer Discovery (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Cancer Institute (P30CA016086)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Cancer Mechanisms and Therapy
Keywords
MET activation, MET inhibitors, exon skipping, lung adenocarcinoma, glioma, histiocytic sarcoma, targeted therapy sensitivity, oncogenic transformation, comprehensive genomic profiling, tumor genomic profiles
MeSH terms
Aged, Aged, 80 and over, Antineoplastic Agents, Exons, Female, Humans, Immunohistochemistry, Male, Mutation, Neoplasm Staging, Neoplasms, Tomography, X-Ray Computed, Cluster Analysis, Alternative Splicing, Drug Resistance, Neoplasm, Proto-Oncogene Proteins c-met, Gene Expression Profiling, Genomics, Protein Kinase Inhibitors

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