scholarly journals Plasmacytoid Variant of Urothelial Carcinoma: Poor Prognostic Variant with High Expression of CDH1 Mutation

Uro ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 23-29
Author(s):  
Alisa Erck ◽  
Wenping Li ◽  
Saeid Movahedi-Lankarani ◽  
Simon Chung ◽  
Jeanny B. Aragon-Ching
Keyword(s):  
Urothelial Carcinoma ◽  
Poor Prognosis ◽  
Initial Response ◽  
Review Of The Literature ◽  
Early Relapse ◽  
Radical Cystoprostatectomy ◽  
Mutational Burden ◽  
Tumor Mutational Burden ◽  
Cdh1 Mutation ◽  
Response To Neoadjuvant Chemotherapy

Plasmacytoid variant of urothelial carcinoma is a rare subtype of urothelial carcinoma that has poor prognosis. We describe two cases of patients with the plasmacytoid variant of urothelial carcinoma (PVUC) who had initial response to neoadjuvant chemotherapy followed by radical cystoprostatectomy and lymph node dissection but presented with early relapse and disease progression manifesting with intestinal obstruction and peritoneal carcinomatosis. Tumor genomic sequencing revealed mutations and alterations in ARID1A, CDH1, PIK3CA, RB1 loss, and TERT promoter, as well as tumor mutational burden of 10 Muts/Mb treated with pembrolizumab with a minimal response. A further review of the literature regarding this rare variant is discussed here.

scholarly journals Exploration of Key Genes Combining with Immune Infiltration Level and Tumor Mutational Burden in Hepatocellular Carcinoma

2021 ◽  
Author(s):  
Jing Chen ◽  
shuzhen wu ◽  
sijia ge ◽  
ran Ji ◽  
Yuyan Chen ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Poor Prognosis ◽  
R Package ◽  
Immune Microenvironment ◽  
Chi Square ◽  
Term Survival ◽  
Immune Infiltration ◽  
Mutational Burden ◽  
Tumor Mutational Burden ◽  
And Function

Abstract Background: Hepatocellular carcinoma (HCC) is still a lethal malignancy because of its heterogenicity and aggressive behavior, with unsatisfactory early diagnosis and poor prognosis. Recently, few somatic mutations have been reported to associated with HCC carcinogenesis and function in predicting HCC progression. Interactions of tumor cells with surrounding immune microenvironment in HCC participate in orchestrating the onset and development. Herein, our aim is to investigate the associations of tumor mutational burden (TMB) with immune microenvironment in HCC. Then we will seek for differential expression genes (DEGs) in terms of immune and TMB scores and discuss whether their latent functions affect HCC prognosis and progression.Methods: The expression, clinical and mutational data were downloaded from TCGA database, then calculated the immune infiltration of these HCC samples by R package “ssGSEA”, “CIBERSORT” and “ESTIMATE”. Then the samples were clarified to 2 groups according to the immune levels. TMB was also calculated and differential expressional genes (DEGs) in the low and high TMB group were intersected and the different immune level groups. Then the cox analyses and prognostic model were performed and tested by R package “glmnet”. Then the selected genes BCL10 and TRAF3 were tested their expression by qrt-PCR and IHC and tested their clinical correlation by chi-square analyses and their biological processes enriched by GSEA, and their immune infiltration by “ssGSEA” individualy. Last, pearson algorithm was employed to judge the relevance of BCL10 and TRAF3.Results: Upregulated degrees of immune infiltration correlated with TMB, they synergistically predicted poor prognosis in HCC. DEGs enriched in immune-related pathways could serve as an indicator of therapeutic effect of HCC immunotherapy. Among these DEGs, BCL10 and TRAF3 were highly expressed in HCC tissues, especially in TP53 mutation group. BCL10 and TRAF3 corporately exhibited immunological function, thereby affecting HCC progression and prognosis.Conclusions: We identified that BCL10 and TRAF3 exhibited good prognostic value in predicting the clinical outcome of HCC patients, which may influence TMB and tumor microenvironment (TME) and help us moving towards immune-based therapies with HCC patients, ultimately improving their long-term survival.

scholarly journals Complete Response To Tislelizumab In A Muscle-Invasive Urothelial Carcinoma After Surgery Associated With Tumor Mutational Burden High: A Case Report

2022 ◽  
Author(s):  
Jing Jin ◽  
Qidong Yang ◽  
Yangyang Yu ◽  
Lin Chen ◽  
Shouhua Pan
Keyword(s):  
Urothelial Carcinoma ◽  
Adjuvant Treatment ◽  
Muscularis Propria ◽  
Progression Free Survival ◽  
Complete Response ◽  
Regional Lymph Nodes ◽  
Metastatic Recurrence ◽  
Mutational Burden ◽  
Tumor Mutational Burden ◽  
Muscle Invasive

Abstract Muscle-invasive urothelial carcinoma (MIUC) is a highly aggressive urothelial carcinoma. Radical cystectomy (RC) is standard of treatment, but still more than 50% patients with cancer invading the muscularis propria or involving the regional lymph nodes will have metastatic recurrence. In CheckMate274 study, programmed cell death-1 (PD-1) inhibitor nivolumab as adjuvant treatment has shown effective for patients with MIUC. Tislelizumab is an anti-human PD-1 monoclonal IgG4 antibody which was specifically engineered to minimize FcɣR macrophage binding to abrogate antibody-dependent phagocytosis. But there is no report of tislelizumab as adjuvant treatment in MIUC currently. Here, we report a case of MIUC in a patient with PD-L1-negative, microsatellite stable (MSS), high tumor mutational burden (TMB-H) obtained complete response (CR) receiving tislelizumab therapy after surgery. Progression-free survival (PFS) exceeded 6 months since tislelizumab treatment. To our knowledge, this is the first reported case of MIUC patient with PD-L1-negative, MSS and TMB-H who responded well to tislelizumab as adjuvant treatment. However, we still need more studies to assess the efficacy of tislelizumab as adjuvant treatment in MIUC and to confirm that TMB is a predicted biomarker of tislelizumab for efficacy.

scholarly journals NCMP-17. MISMATCH REPAIR MUTATIONS AND THE CENTRAL NERVOUS SYSTEM: A CASE SERIES OF GERMLINE MUTATIONS AND CNS MALIGNANCY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii126-ii126
Author(s):  
Amber Ruiz ◽  
Jerome Graber
Keyword(s):  
Treatment Response ◽  
Mismatch Repair ◽  
Case Series ◽  
Germline Mutations ◽  
Molecular Characteristics ◽  
Loss Of Function ◽  
Dna Mismatch ◽  
Mutational Burden ◽  
Increased Risk ◽  
Tumor Mutational Burden

Abstract Our understanding of genetic predispositions for malignancy is continually evolving. One family of germline mutations well described in the literature is that of the DNA mismatch repair mechanism (MMR). Lynch syndrome (LS) is due to a loss of function mutation of several MMR genes- MSH2, MLH1, MSH6, and PMS2. Germline MMR mutations lead to microsatellite instability and loss of genomic integrity resulting in an increased risk for various cancers (colorectal, genitourinary, etc). LS may be as common as 1 in 400 people and some MMR mutations have been associated with gliomas. There is a paucity of information regarding frequency of glioma subtypes as well as tumor genetic and molecular characteristics which have important clinical implications. We describe a case series of 6 individuals with germline MMR mutations and brain tumors. Those with MSH2 and PMS2 mutations (n=3) developed glioblastomas at a mean age at diagnosis of 48 years. These tumors expressed MGMT hyper-methylation and high tumor mutational burden. Only one had IDH-1 mutation. Those with MLH1 mutations (n=3), did not develop gliomas. This raises the question of differential glioma subtype development based on MMR gene. It also highlights the possibility of Lynch-associated gliomas having more favorable treatment response due to MGMT methylation and potential response to immunotherapy based on high tumor mutational burden. Though the sample size is small, there appears to be a preponderance of women compared to men (5:1 respectively). Larger studies are needed to verify CNS involvement in germline MMR mutations. In doing so, we hope to identify factors that may influence clinical management and lead to a better understanding of treatment response and disease prognosis.

Comprehensive exploration of tumor mutational burden and immune infiltration in diffuse glioma

2021 ◽  
Vol 96 ◽  
pp. 107610
Author(s):  
Kai Kang ◽  
Fucun Xie ◽  
Yijun Wu ◽  
Zhile Wang ◽  
Li Wang ◽  
...  
Keyword(s):  
Diffuse Glioma ◽  
Immune Infiltration ◽  
Mutational Burden ◽  
Tumor Mutational Burden

scholarly journals Tumor mutational burden assessment in non-small-cell lung cancer samples: results from the TMB2 harmonization project comparing three NGS panels

2021 ◽  
Vol 9 (5) ◽  
pp. e001904
Author(s):  
Javier Ramos-Paradas ◽  
Susana Hernández-Prieto ◽  
David Lora ◽  
Elena Sanchez ◽  
Aranzazu Rosado ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Predictive Value ◽  
Predictive Biomarker ◽  
Small Cell ◽  
Small Cell Lung ◽  
Mutational Burden ◽  
Reproducibility Study ◽  
Tumor Mutational Burden

BackgroundTumor mutational burden (TMB) is a recently proposed predictive biomarker for immunotherapy in solid tumors, including non-small cell lung cancer (NSCLC). Available assays for TMB determination differ in horizontal coverage, gene content and algorithms, leading to discrepancies in results, impacting patient selection. A harmonization study of TMB assessment with available assays in a cohort of patients with NSCLC is urgently needed.MethodsWe evaluated the TMB assessment obtained with two marketed next generation sequencing panels: TruSight Oncology 500 (TSO500) and Oncomine Tumor Mutation Load (OTML) versus a reference assay (Foundation One, FO) in 96 NSCLC samples. Additionally, we studied the level of agreement among the three methods with respect to PD-L1 expression in tumors, checked the level of different immune infiltrates versus TMB, and performed an inter-laboratory reproducibility study. Finally, adjusted cut-off values were determined.ResultsBoth panels showed strong agreement with FO, with concordance correlation coefficients (CCC) of 0.933 (95% CI 0.908 to 0.959) for TSO500 and 0.881 (95% CI 0.840 to 0.922) for OTML. The corresponding CCCs were 0.951 (TSO500-FO) and 0.919 (OTML-FO) in tumors with <1% of cells expressing PD-L1 (PD-L1<1%; N=55), and 0.861 (TSO500-FO) and 0.722 (OTML-FO) in tumors with PD-L1≥1% (N=41). Inter-laboratory reproducibility analyses showed higher reproducibility with TSO500. No significant differences were found in terms of immune infiltration versus TMB. Adjusted cut-off values corresponding to 10 muts/Mb with FO needed to be lowered to 7.847 muts/Mb (TSO500) and 8.380 muts/Mb (OTML) to ensure a sensitivity >88%. With these cut-offs, the positive predictive value was 78.57% (95% CI 67.82 to 89.32) and the negative predictive value was 87.50% (95% CI 77.25 to 97.75) for TSO500, while for OTML they were 73.33% (95% CI 62.14 to 84.52) and 86.11% (95% CI 74.81 to 97.41), respectively.ConclusionsBoth panels exhibited robust analytical performances for TMB assessment, with stronger concordances in patients with negative PD-L1 expression. TSO500 showed a higher inter-laboratory reproducibility. The cut-offs for each assay were lowered to optimal overlap with FO.

scholarly journals Pancreatic Cancer Exposome Profile to Aid Early Detection and Inform Prevention Strategies

2021 ◽  
Vol 10 (8) ◽  
pp. 1665
Author(s):  
Maria J. Monroy-Iglesias ◽  
Saoirse Dolly ◽  
Debashis Sarker ◽  
Kiruthikah Thillai ◽  
Mieke Van Hemelrijck ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Early Detection ◽  
Immune Responses ◽  
Inflammatory Markers ◽  
Poor Prognosis ◽  
Associated Factors ◽  
Review Of The Literature ◽  
Prevention Strategies ◽  
Factors Influencing ◽  
Detection Strategies

Pancreatic cancer (PCa) is associated with a poor prognosis and high mortality rate. The causes of PCa are not fully elucidated yet, although certain exposome factors have been identified. The exposome is defined as the sum of all environmental factors influencing the occurrence of a disease during a life span. The development of an exposome approach for PCa has the potential to discover new disease-associated factors to better understand the carcinogenesis of PCa and help with early detection strategies. Our systematic review of the literature identified several exposome factors that have been associated with PCa alone and in combination with other exposures. A potential inflammatory signature has been observed among the interaction of several exposures (i.e., smoking, alcohol consumption, diabetes mellitus, obesity, and inflammatory markers) that further increases the incidence and progression of PCa. A large number of exposures have been identified such as genetic, hormonal, microorganism infections and immune responses that warrant further investigation. Future early detection strategies should utilize this information to assess individuals’ risk for PCa.

scholarly journals Identification and validation of a miRNA-related expression signature for tumor mutational burden in colorectal cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lijun Xu ◽  
Qing Zheng
Keyword(s):  
Colorectal Cancer ◽  
Immune Response ◽  
Validation Cohort ◽  
Expression Profiles ◽  
Functional Enrichment ◽  
Immune Checkpoints ◽  
Positive Correlation ◽  
Expression Signature ◽  
Mutational Burden ◽  
Tumor Mutational Burden

Abstract Background Tumor mutational burden (TMB) is a promising predictor, which could stratify colorectal cancer (CRC) patients based on the response to immune checkpoint inhibitors (ICIs). MicroRNAs (miRNAs) act as the key regulators of anti-cancer immune response. However, the relationship between TMB and miRNA expression profiles is not elucidated in CRC. Methods Differentially expressed miRNAs (DE miRNAs) between the TMBhigh group and the TMBlow group were identified for the CRC cohort of the TCGA database. In the training cohort, a miRNA-related expression signature for predicting TMB level was developed by the least absolute shrinkage and selection operator (LASSO) method and tested with reference to its discrimination, calibration, and decision curve analysis (DCA) in the validation cohort. Functional enrichment analysis of these TMB-related miRNAs was performed. The correlation between this miRNA-related expression signature and three immune checkpoints was analyzed. Results Twenty-one out of 43 DE miRNAs were identified as TMB-related miRNAs, which were used to develop a miRNA-related expression signature. This TMB-related miRNA signature demonstrated great discrimination (AUCtest set = 0.970), satisfactory calibration (P > 0.05), and clinical utility in the validation cohort. Functional enrichment results revealed that these TMB-related miRNAs were mainly involved in biological processes associated with immune response and signaling pathways related with cancer. This miRNA-related expression signature showed a median positive correlation with PD-L1 (R = 0.47, P < 0.05) and CTLA4 (R = 0.39, P < 0.05) and a low positive correlation with PD-1 (R = 0.16, P < 0.05). Conclusion This study presents a miRNA-related expression signature which could stratify CRC patients with different TMB levels.

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