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Genes frequently altered in pancreatic neuroendocrine tumors

a neuroendocrine tumor and pancreatic gene technology, applied in the field of pancreatic neuroendocrine tumors, can solve the problems of insufficient information about this tumor and relatively ineffective medical therapies

Inactive Publication Date: 2019-02-21
THE JOHN HOPKINS UNIV SCHOOL OF MEDICINE
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

This patent provides methods for diagnosing and predicting outcomes of pancreatic neuroendocrine tumors through testing tumor tissue, cells, or nucleic acid for mutations in genes such as Rheb, AMPK, mTOR, TSC2, IRS1, PI3KCA, AKT, PTEN, ERK1 / 2, p38MAPK, MK2, LKB1, GSK3β, RPS6KB1, and 4E-BP1. These mutations can be used to identify the tumor and aid in treatment decisions. The patent also provides genetic markers that can be used for diagnosis or monitoring of the disease. Additionally, the patent describes a method for distinguishing between pancreatic neuroendocrine and pancreatic ductal adenocarcinoma based on mutations in specific genes. Overall, this patent provides important tools for better care of pancreatic tumor patients.

Problems solved by technology

Surgical resection is the treatment of choice, but many patients present with unresectable tumors or extensive metastatic disease, and medical therapies are relatively ineffective.
There is currently insufficient information about this tumor to either predict prognosis of patients diagnosed with PanNETs or to develop companion diagnostics and personalized treatments to improve disease management.

Method used

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  • Genes frequently altered in pancreatic neuroendocrine tumors
  • Genes frequently altered in pancreatic neuroendocrine tumors
  • Genes frequently altered in pancreatic neuroendocrine tumors

Examples

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Effect test

example 1

lection, Preparation, and Decoding

[0032]To gain insights into the genetic basis of this tumor type, we determined the exomic sequence of 18,000 protein-coding genes in a Discovery set of ten well-characterized sporadic PanNETs. A clinically homogeneous set of tumors of high neoplastic cellularity is essential for the successful identification of genes and pathways involved in any tumor type. Thus, we excluded small cell and large neuroendocrine carcinomas and studied only samples that were not part of a familial syndrome. We macrodisected them to achieve a neoplastic cellularity of >80%. DNA from the enriched neoplastic samples and from matched non-neoplastic tissue from ten patients was used to prepare fragment libraries suitable for massively parallel sequencing. The coding sequences were enriched by capture with the SureSelect Enrichment System and sequenced using an Illumina GAIIx platform (10). The average coverage of each base in the targeted regions was 101-fold and 94.8% of ...

example 2

Analysis in Discovery Set

[0033]We identified 157 somatic mutations in 158 genes among the ten tumors used in the Discovery set. The mutations per tumor ranged from 8 to 23, with a mean of 16 (table S2). There were some obvious differences between the genetic landscapes of PanNETs and those of pancreatic ductal adenocarcinomas (PDAC, ref 11). First, there were 60% fewer genes mutated per tumor in PanNETs than in PDACs. Second, the genes most commonly affected by mutation in PDACs (KRAS, TGF-β pathway, CDKN2A, TP53) were rarely altered in PanNETs and vice versa (table S3). Third, the spectrum of mutations in PDAC and PanNET were different, with C to T transitions more common in PDACs than in PanNETs, and C to G transversions more common in PanNETs than in PDACs (table S4). This suggests that PanNETs are exposed to different environmental carcinogens or that they harbor different repair pathways than PDACs.

example 3

Analysis in Validation Set

[0034]Four genes were mutated in at least two tumors in the Discovery set: MEN1 in five, DAXX in three, PTEN in two, and TSC2 in two. Somatic mutations in each of these genes were confirmed by Sanger sequencing. The sequences of these genes were then determined by Sanger sequencing in a Validation set consisting of 58 additional PanNETs and their corresponding normal tissues (FIG. 1a,b). Although ATRX was mutated in only one sample in the Discovery set, it was included in the list of genes for further evaluation in the Validation set because its product forms a heterodimer with DAXX and therefore is part of the same pathway. Similarly, PIK3CA was included because it is considered to be part of the mTOR pathway that includes PTEN and TSC2 (12-14). In total, somatic mutations in MEN1, DAXX, ATRX, PTEN, TSC2, and PIK3CA were identified in 44.1%, 25%, 17.6%, 7.3%, 8.8%, and 1.4% PanNETs, respectively (Table 1).

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Abstract

Pancreatic Neuroendocrine Tumors (PanNETs) are a rare but clinically important form of pancreatic neoplasia. To explore the genetic basis of PanNETs, we determined the exomic sequences of ten non-familial PanNETs and then screened the most commonly mutated genes in 58 additional PanNETs. Remarkably, the most frequently mutated genes specify proteins implicated in chromatin remodeling: 44% of the tumors had somatic inactivating mutations in MEN-1, which encodes menin, a component of a histone methyltransferase complex; and 43% had mutations in genes encoding either of the two subunits of a transcription / chromatin remodeling complex consisting of DAXX (death-domain associated protein) and ATRX (alpha thalassemia / mental retardation syndrome X-linked). Clinically, mutations in the MEN1 and DAXX / ATRX genes were associated with better prognosis. We also found mutations in genes in the mTOR (mammalian target of rapamycin) pathway in 14% of the tumors, a finding that could potentially be used to stratify patients for treatment with mTOR inhibitors.

Description

[0001]This application is a divisional of U.S. application Ser. No. 13 / 977,810, filed Oct. 24, 2013, which is a national stage application, filed under 35 U.S.C. § 371 of International Application No. PCT / US2012 / 020199, filed Jan. 4, 2012, which claims priority to U.S. Provisional Application No. 61 / 429,666, filed Jan. 4, 2011, the contents of each of which are hereby incorporated by reference in their entireties.[0002]This invention was made with government support under CA 57345, CA 62924, and CA 121113 awarded by National Institutes of Health. The government has certain rights in the invention.TECHNICAL FIELD OF THE INVENTION[0003]This invention is related to the area of identifying, treating, and predicting outcome for pancreatic tumors. In particular, it relates to pancreatic neuroendocrine tumors.BACKGROUND OF THE INVENTION[0004]Pancreatic Neuroendocrine Tumors (PanNETs) are the second most common malignancy of the pancreas. The ten-year survival rate is only 40% (1-3). They a...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): C12Q1/6886G01N33/574
CPCC12Q2600/106C12Q2600/112C12Q1/6886G01N2800/52G01N33/57438C12Q2600/118C12Q2600/156
Inventor VOGELSTEIN, BERTKINZLER, KENNETH W.VELCULESCU, VICTORDIAZ, LUISPAPADOPOULOS, NICKOLASJIAO, YUCHENHRUBAN, RALPH
Owner THE JOHN HOPKINS UNIV SCHOOL OF MEDICINE
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