1. Genomic profiling of idiopathic peri-hilar cholangiocarcinoma reveals new targets and mutational pathways.
- Author
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Quinn LM, Haldenby S, Antzcak P, Fowler A, Bullock K, Kenny J, Gilbert T, Andrews T, Diaz-Nieto R, Fenwick S, Jones R, Costello-Goldring E, Poston G, Greenhalf W, Palmer D, Malik H, and Goldring C
- Subjects
- Humans, Bile Ducts, Intrahepatic pathology, Mutation, Genomics, DNA Mutational Analysis, MAP Kinase Kinase Kinases genetics, Klatskin Tumor pathology, Bile Duct Neoplasms pathology, Cholangiocarcinoma pathology
- Abstract
Peri-hilar cholangiocarcinoma (pCCA) is chemorefractory and limited genomic analyses have been undertaken in Western idiopathic disease. We undertook comprehensive genomic analyses of a U.K. idiopathic pCCA cohort to characterize its mutational profile and identify new targets. Whole exome and targeted DNA sequencing was performed on forty-two resected pCCA tumors and normal bile ducts, with Gene Set Enrichment Analysis (GSEA) using one-tailed testing to generate false discovery rates (FDR). 60% of patients harbored one cancer-associated mutation, with two mutations in 20%. High frequency somatic mutations in genes not typically associated with cholangiocarcinoma included mTOR, ABL1 and NOTCH1. We identified non-synonymous mutation (p.Glu38del) in MAP3K9 in ten tumors, associated with increased peri-vascular invasion (Fisher's exact, pā<ā0.018). Mutation-enriched pathways were primarily immunological, including innate Dectin-2 (FDR 0.001) and adaptive T-cell receptor pathways including PD-1 (FDR 0.007), CD4 phosphorylation (FDR 0.009) and ZAP70 translocation (FDR 0.009), with overlapping HLA genes. We observed cancer-associated mutations in over half of our patients. Many of these mutations are not typically associated with cholangiocarcinoma yet may increase eligibility for contemporary targeted trials. We also identified a targetable MAP3K9 mutation, in addition to oncogenic and immunological pathways hitherto not described in any cholangiocarcinoma subtype., (© 2023. The Author(s).)
- Published
- 2023
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