The Genomic Landscape of Early-Stage Ovarian High-Grade Serous Carcinoma.

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PURPOSE: Ovarian high-grade serous carcinoma (HGSC) is usually diagnosed at late stage. We investigated whether late-stage HGSC has unique genomic characteristics consistent with acquisition of evolutionary advantage compared with early-stage tumors. EXPERIMENTAL DESIGN: We performed targeted next-generation sequencing and shallow whole-genome sequencing (sWGS) on pretreatment samples from 43 patients with FIGO stage I-IIA HGSC to investigate somatic mutations and copy-number (CN) alterations (SCNA). We compared results to pretreatment samples from 52 patients with stage IIIC/IV HGSC from the BriTROC-1 study. RESULTS: Age of diagnosis did not differ between early-stage and late-stage patients (median 61.3 years vs. 62.3 years, respectively). TP53 mutations were near-universal in both cohorts (89% early-stage, 100% late-stage), and there were no significant differences in the rates of other somatic mutations, including BRCA1 and BRCA2. We also did not observe cohort-specific focal SCNA that could explain biological behavior. However, ploidy was higher in late-stage (median, 3.0) than early-stage (median, 1.9) samples. CN signature exposures were significantly different between cohorts, with greater relative signature 3 exposure in early-stage and greater signature 4 in late-stage. Unsupervised clustering based on CN signatures identified three clusters that were prognostic. CONCLUSIONS: Early-stage and late-stage HGSCs have highly similar patterns of mutation and focal SCNA. However, CN signature analysis showed that late-stage disease has distinct signature exposures consistent with whole-genome duplication. Further analyses will be required to ascertain whether these differences reflect genuine biological differences between early-stage and late-stage or simply time-related markers of evolutionary fitness. See related commentary by Yang et al., p. 2730.

Carcinoma, Ovarian Epithelial, Female, Genomics, High-Throughput Nucleotide Sequencing, Humans, Middle Aged, Mutation, Ovarian Neoplasms
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Clin Cancer Res
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American Association for Cancer Research (AACR)
Cancer Research UK (CB4320)
Cancer Research UK (C14303/A17197)
Royal Society (WM170023)
European Commission Horizon 2020 (H2020) Marie Sk?odowska-Curie actions (766030)
Biotechnology and Biological Sciences Research Council (BB/R006563/1)
Innovate UK (74918)
Alan Turing Institute (TUR-000346)
Cancer Research UK (A22905)
Cancer Research UK (A15973)
Cancer Research UK (A11592)
Cancer Research UK (A15601)
Cancer Research UK (A19274)