Journal
ONCOTARGET
Volume 5, Issue 9, Pages 2839-2852Publisher
IMPACT JOURNALS LLC
DOI: 10.18632/oncotarget.1943
Keywords
cholangiocarcinoma; next-generation sequencing; molecular subclassification; target therapy; multigene mutational panels
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Funding
- GlaxoSmithKline [WEUSKOP5847]
- AIRC [12182, 11930, 6421]
- National Cancer Institutes (USA) [CA62924]
- FP7 EU project CAM-PaC [602783]
- Italian Cancer Genome Project grant from the Italian Ministry of Research [FIRB - RBAP10AHJB]
- FIMP-Ministry of Health [CUP_ J33G13000210001]
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One-hundred-fifty-three biliary cancers, including 70 intrahepatic cholangiocarcinomas (ICC), 57 extrahepatic cholangiocarcinomas (ECC) and 26 gallbladder carcinomas (GBC) were assessed for mutations in 56 genes using multigene next-generation sequencing. Expression of EGFR and mTOR pathway genes was investigated by immunohistochemistry. At least one mutated gene was observed in 118/153 (77%) cancers. The genes most frequently involved were KRAS (28%), TP53 (18%), ARID1A (12%), IDH1/2 (9%), PBRM1 (9%), BAP1 (7%), and PIK3CA (7%). IDH1/2 (p = 0.0005) and BAP1 (p = 0.0097) mutations were characteristic of ICC, while KRAS (p = 0.0019) and TP53 (p = 0.0019) were more frequent in ECC and GBC. Multivariate analysis identified tumour stage and TP53 mutations as independent predictors of survival. Alterations in chromatin remodeling genes (ARID1A, BAP1, PBRM1, SMARCB1) were seen in 31% of cases. Potentially actionable mutations were seen in 104/153 (68%) cancers: i) KRAS/NRAS/BRAF mutations were found in 34% of cancers; ii) mTOR pathway activation was documented by immunohistochemistry in 51% of cases and by mutations in mTOR pathway genes in 19% of cancers; iii) TGF-beta/Smad signaling was altered in 10.5% cancers; iv) mutations in tyrosine kinase receptors were found in 9% cases. Our study identified molecular subgroups of cholangiocarcinomas that can be explored for specific drug targeting in clinical trials.
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