Mutations in the DNA methylation pathway and number of driver mutations predict response to azacitidine in myelodysplastic syndromes.
Oncotarget
; 8(63): 106948-106961, 2017 Dec 05.
Article
em En
| MEDLINE
| ID: mdl-29291002
ABSTRACT
We evaluated the association of mutations in 34 candidate genes and response to azacitidine in 84 patients with myelodysplastic syndrome (MDS), with 217 somatic mutations identified by next-generation sequencing. Most patients (93%) had ≥1 mutation (mean=2.6/patient). The overall response rate to azacitidine was 42%. No clinical characteristic was associated with response to azacitidine. However, total number of mutations/patient was negatively associated with overall drug response (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.33-0.94; p=0.028), and a positive association was found for having ≥1 mutation in a DNA methylation-related gene TET2, DNMT3A, IDH1 and/or IDH2 (OR 4.76, 95%CI 1.31-17.27; p=0.017). Mutations in TP53 (hazard ratio [HR] 3.88; 95%CI 1.94-7.75) and EZH2 (HR 2.50; 95%CI 1.23-5.09) were associated with shorter overall survival. Meta-analysis of 6 studies plus present data (n=815 patients) allowed assessment of the association of drug response with mutations in 9 candidate genes ASXL1, CBL, EZH2, SF3B1, SRSF2, TET2, DNMT3A, IDH1/2 and TP53. TET2 mutations predicted a more favorable drug response compared with 'wild-type' peers (pooled OR 1.67, 95%CI 1.14-2.44; p=0.01). In conclusion, mutations in the DNA methylation pathway, especially TET2 mutations, and low number of total mutations are associated with a better response to azacitidine.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Oncotarget
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Espanha