Investigating the role of somatic sequencing platforms for phaeochromocytoma and paraganglioma in a large UK cohort.
S Lim, Eugenie
Carroll, Paul V
Whitelaw, Benjamin C
Clark, Graeme R
Clin Endocrinol (Oxf)
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Winzeler, B., Tufton, N., S Lim, E., Challis, B. G., Park, S., Izatt, L., Carroll, P. V., et al. (2021). Investigating the role of somatic sequencing platforms for phaeochromocytoma and paraganglioma in a large UK cohort.. Clin Endocrinol (Oxf) https://doi.org/10.1111/cen.14639
OBJECTIVES: Phaeochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumours with malignant potential and a hereditary basis in almost 40% of patients. Germline genetic testing has transformed the management of PPGL enabling stratification of surveillance approaches, earlier diagnosis and predictive testing of at-risk family members. Recent studies have identified somatic mutations in a further subset of patients, indicating that molecular drivers at either a germline or tumour level can be identified in up to 80% of PPGL cases. The aim of this study was to investigate the clinical utility of somatic sequencing in a large cohort of patients with PPGL in the United Kingdom. DESIGN AND PATIENTS: Prospectively collected matched germline and tumour samples (development cohort) and retrospectively collected tumour samples (validation cohort) of patients with PPGL were investigated. MEASUREMENTS: Clinical characteristics of patients were assessed and tumour and germline DNA was analysed using a next-generation sequencing strategy. A screen for variants within 'mutation hotspots' in 68 human cancer genes was performed. RESULTS: Of 141 included patients, 45 (32%) had a germline mutation. In 37 (26%) patients one or more driver somatic variants were identified including 26 likely pathogenic or pathogenic variants and 19 variants of uncertain significance. Pathogenic somatic variants, observed in 25 (18%) patients, were most commonly identified in the VHL, NF1, HRAS and RET genes. Pathogenic somatic variants were almost exclusively identified in patients without a germline mutation (all but one), suggesting that somatic sequencing is likely to be most informative for those patients with negative germline genetic test results. CONCLUSIONS: Somatic sequencing may further stratify surveillance approaches for patients without a germline genetic driver and may also inform targeted therapeutic strategies for patients with metastatic disease.
paraganglioma, phaeochromocytoma, somatic variant
External DOI: https://doi.org/10.1111/cen.14639
This record's URL: https://www.repository.cam.ac.uk/handle/1810/331602
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Licence URL: https://creativecommons.org/licenses/by-nc-nd/4.0/