Cancer Discov:基于小鼠模型鉴定三阴性乳腺癌散发型致癌基因突变及治疗策略

2018-01-06 王帅 “医海拾贝微转化”微信号

三阴性乳腺癌(TNBC)常出现TP53突变,而其他常见癌基因的点突变出现频率较低,因而其对靶向治疗效果不佳。应用全外显子测序(WES)和RNA测序,本研究鉴定了小鼠TNBC模型在TP53突变(或合并Brca1缺失)情况下的的体细胞遗传学改变谱。约50%的肿瘤出现基因扩增或易位导致的癌蛋白升高(或癌蛋白融合),合并基因的框架移位突变。尽管TNBC体细胞遗传改变的频谱多样化,但是大多数改变都可激活MA

摘要:三阴性乳腺癌(TNBC)常出现TP53突变,而其他常见癌基因的点突变出现频率较低,因而其对靶向治疗效果不佳。应用全外显子测序(WES)和RNA测序,本研究鉴定了小鼠TNBC模型在TP53突变(或合并Brca1缺失)情况下的的体细胞遗传学改变谱。约50%的肿瘤出现基因扩增或易位导致的癌蛋白升高(或癌蛋白融合),合并基因的框架移位突变。尽管TNBC体细胞遗传改变的频谱多样化,但是大多数改变都可激活MAPK / PI3K通路。而靶向体细胞靶点突变的药物可以获得较好的抑瘤效果。

内容:TNBC多发生于年轻女性,局部复发及远处转移率较高,预后差。当前没有针对TNBC的有效靶向治疗药物,化疗仍然是标准治疗。而TNBC对化疗的反应并不均一,这可能与肿瘤异质性有关。最近的转录组学研究将TNBC分为不同亚群,每种亚群都有不同的表达谱和临床意义。大规模的WES和WGS进一步证实了TNBC异质性的分子基础,超过80%TNBC发生点突变或TP53位点缺失。康乃尔大学医学院的Lewis C. Cantley团队构建了遗传工程小鼠模型,该小鼠Tp53特异性缺失(或同时伴有Brca1缺失)。对这两种小鼠进行WES和RNA测序。通过测序鉴定出致癌基因的突变谱,包括染色体扩增和缺失,染色体易位,原癌基因过表达等。通过靶向受基因畸变影响的信号通路,单独应用抑制剂进行治疗或联合化疗可以使肿瘤达到完全根除。

研究表明,6号染色体Met和9号染色体Yap1位点的染色体扩增及Fgfr2和Egfr位点的扩增,Pten的双等位基因缺失等遗传变异会驱动肿瘤发生。染色体易位激活蛋白激酶也可能成为致癌因素。肿瘤会通过不同的进展途径发展为TNBC,但大多数肿瘤均通过增强MAPK和PI3K通路发生遗传学改变。通过查询TCGA数据库发现超过60%乳腺癌会发生至少一个这样的畸变,超过90%TNBC有这些遗传损伤,表明MAPK和PI3K通路对TNBC发生至关重要。

基于特定的致癌因子对特定肿瘤实施个体化治疗研究表明,匹配治疗药物和致癌基因突变状态非常重要。其中一个上游驱动事件是FGFR激活。诸多临床及前期研究表明FGFR抑制剂有望可以抑制肿瘤生长。cMET过表达和扩增与TNBC相关,Met过表达的小鼠肿瘤对MET抑制剂有效,联合应用MET、PARP抑制剂可以抑制奥拉帕尼耐药的TNBC肿瘤生长;另一个TNBC潜在的治疗靶点是YAP1,其与其它转录子如TEAD协同促进肿瘤发生和转移。体内和体外实验证实,Verteporfin可以用于抑制YAP1和TEAD相互作用从而抑制转录活性,其在TNBC小鼠模型中的有效性有待进一步研究。

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    2018-01-08 jambiya
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    2018-01-08 xlysu
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    2018-01-08 yankaienglish

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