Abstract
The majority of patients with neuroblastoma have tumors that initially respond to chemotherapy, but a large proportion will experience therapy-resistant relapses. The molecular basis of this aggressive phenotype is unknown. Whole-genome sequencing of 23 paired diagnostic and relapse neuroblastomas showed clonal evolution from the diagnostic tumor, with a median of 29 somatic mutations unique to the relapse sample. Eighteen of the 23 relapse tumors (78%) showed mutations predicted to activate the RAS-MAPK pathway. Seven of these events were detected only in the relapse tumor, whereas the others showed clonal enrichment. In neuroblastoma cell lines, we also detected a high frequency of activating mutations in the RAS-MAPK pathway (11/18; 61%), and these lesions predicted sensitivity to MEK inhibition in vitro and in vivo. Our findings provide a rationale for genetic characterization of relapse neuroblastomas and show that RAS-MAPK pathway mutations may function as a biomarker for new therapeutic approaches to refractory disease.
Original language | English |
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Pages (from-to) | 864-71 |
Number of pages | 8 |
Journal | Nature Genetics |
Volume | 47 |
Issue number | 8 |
DOIs | |
Publication status | Published - Aug 2015 |
Keywords
- Anaplastic Lymphoma Kinase
- Animals
- Benzimidazoles/pharmacology
- Blotting, Western
- Cell Line, Tumor
- Child
- Child, Preschool
- Chromosome Aberrations
- Cyclin-Dependent Kinase Inhibitor p16/genetics
- Female
- Gene Expression Regulation, Neoplastic
- HEK293 Cells
- Humans
- Infant
- MAP Kinase Signaling System/genetics
- Male
- Mice, SCID
- Mitogen-Activated Protein Kinases/genetics
- Mutation
- Neoplasm Recurrence, Local/genetics
- Neuroblastoma/drug therapy
- Phosphorylation/drug effects
- Receptor Protein-Tyrosine Kinases/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Xenograft Model Antitumor Assays
- ras Proteins/genetics