RESUMO
PURPOSE: This study aimed to investigate factors, which influence the content of circulating tumor DNA (ctDNA). METHODS: 398 serial plasma samples were collected within 1-7 consecutive days from patients with EGFR-mutated lung cancer (n = 13), RAS/RAF-mutated colorectal cancer (n = 54) and BRAF-mutated melanoma (n = 17), who presented with measurable tumor disease. The amount of ctDNA was determined by ddPCR. RESULTS: Among 82 patients, who donated 2-6 serial plasma samples, 42 subjects were classified as ctDNA-positive; only 22% cases were mutation-positive across all consecutive tests, while 24/82 (29%) patients showed presence of mutated ctDNA in some but not all blood draws. Subjects with progressing tumors had higher probability of being detected ctDNA-positive as compared to patients, who responded to therapy or had stable disease (39/55 (71%) vs. 4/24 (17%); p = 0.0001). Our study failed to reveal the impact of the time of the day, recent meal or prior physical exercise on the results of ctDNA testing. CONCLUSIONS: Presence of ctDNA in plasma is particularly characteristic for patients, who experience clinical progression of tumor disease. Consecutive plasma tests may occasionally provide discordant data; thus, the repetition of analysis may be advised in certain cases in order to ensure the validity of negative ctDNA result.
Assuntos
DNA Tumoral Circulante/sangue , Exercício Físico/fisiologia , Carga Tumoral , Idoso , Idoso de 80 Anos ou mais , DNA Tumoral Circulante/genética , Análise Mutacional de DNA , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação/genética , Probabilidade , Reprodutibilidade dos Testes , Fatores de TempoRESUMO
PURPOSE: Germline variants in known breast cancer (BC) predisposing genes explain less than half of hereditary BC cases. This study aimed to identify missing genetic determinants of BC. METHODS: Whole exome sequencing (WES) of lymphocyte DNA was performed for 49 Russian patients with clinical signs of genetic BC predisposition, who lacked Slavic founder mutations in BRCA1, BRCA2, CHEK2, and NBS1 genes. RESULTS: Bioinformatic analysis of WES data was allowed to compile a list of 229 candidate mutations. 79 of these mutations were subjected to a three-stage case-control analysis. The initial two stages, which involved up to 797 high-risk BC patients, 1504 consecutive BC cases, and 1081 healthy women, indicated a potentially BC-predisposing role for 6 candidates, i.e., USP39 c.*208G > C, PZP p.Arg680Ter, LEPREL1 p.Pro636Ser, SLIT3 p.Arg154Cys, CREB3 p.Lys157Glu, and ING1 p.Pro319Leu. USP39 c.*208G > C was strongly associated with triple-negative breast tumors (p = 0.0001). In the third replication stage, we genotyped the truncating variant of PZP (rs145240281) and the potential splice variant of USP39 (rs112653307) in three independent cohorts of Russian, Byelorussian, and German ancestry, comprising a total of 3216 cases and 2525 controls. The data obtained for USP39 rs112653307 supported the association identified in the initial stages (the combined OR 1.72, p = 0.035). CONCLUSIONS: This study suggests the role of a rare splicing variant in BC susceptibility. USP39 encodes an ubiquitin-specific peptidase that regulates cancer-relevant tumor suppressors including CHEK2. Further epidemiological and functional studies involving these gene variants are warranted.
Assuntos
Neoplasias da Mama/genética , Sequenciamento do Exoma , Predisposição Genética para Doença , Proteases Específicas de Ubiquitina/genética , Alelos , Processamento Alternativo , Biomarcadores Tumorais , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etiologia , Biologia Computacional , Feminino , Estudos de Associação Genética , Genótipo , Mutação em Linhagem Germinativa , Humanos , Razão de Chances , Reprodutibilidade dos Testes , Federação RussaRESUMO
Exomes of 27 Russian subjects were analyzed for the presence of medically relevant alleles, such as protein-truncating variants (PTVs) in known recessive disease-associated genes and pathogenic missense mutations included in the ClinVar database. 36 variants (24 PTVs and 12 amino acid substitutions) were identified and then subjected to the analysis in 897 population controls. 9/36 mutations were novel, however only two of them (POLH c.490delG associated with xeroderma pigmentosum variant (XPV) and CATSPER1 c.859_860delCA responsible for spermatogenic failure) were shown to be recurrent. 27 out of 36 pathogenic alleles were already described in prior genetic studies; seven of them occurred only in the index cases, while 20 demonstrated evidence for persistence in Russian population. In particular, non-random occurrence was revealed for SERPINA1 c.1096Gâ¯>â¯A (alpha-1 antitrypsin deficiency), C8B c.1282Câ¯>â¯T and c.1653Gâ¯>â¯A (complement component 8B deficiency), ATP7B c.3207Câ¯>â¯A (Wilson disease), PROP1 c.301_302delAG (combined pituitary hormone deficiency), CYP21A2 c.844Gâ¯>â¯T (non-classical form of adrenogenital syndrome), EYS c.1155Tâ¯>â¯A (retinitis pigmentosa), HADHA c.1528Gâ¯>â¯C (LCHAD deficiency), SCO2 c.418Gâ¯>â¯A (cytochrome c oxidase deficiency), OTOA c.2359Gâ¯>â¯T (sensorineural deafness), C2 c.839_866del (complement component 2 deficiency), ACADVL c.848Tâ¯>â¯C (VLCAD deficiency), TGM5 c.337Gâ¯>â¯T (acral peeling skin syndrome) and VWF c.2561â¯Gâ¯>â¯A (von Willebrand disease, type 2N). These data deserve to be considered in future medical genetic activities.