title: Multigene mutational profiling of cholangiocarcinomas identifies actionable molecular subgroups.
abstract: 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-ß/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.
authors.affiliation: ARC-Net Research Centre, University and Hospital Trust of Verona, Verona, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Simbolo
authors.forename: Matteo
authors.initials: M
authors.lastname: Fassan
authors.forename: Andrea
authors.initials: A
authors.lastname: Ruzzenente
authors.forename: Andrea
authors.initials: A
authors.lastname: Mafficini
authors.forename: Laura D
authors.initials: LD
authors.lastname: Wood
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Corbo
authors.forename: Davide
authors.initials: D
authors.lastname: Melisi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Malleo
authors.forename: Caterina
authors.initials: C
authors.lastname: Vicentini
authors.forename: Giorgio
authors.initials: G
authors.lastname: Malpeli
authors.forename: Davide
authors.initials: D
authors.lastname: Antonello
authors.forename: Nicola
authors.initials: N
authors.lastname: Sperandio
authors.forename: Paola
authors.initials: P
authors.lastname: Capelli
authors.forename: Anna
authors.initials: A
authors.lastname: Tomezzoli
authors.forename: Calogero
authors.initials: C
authors.lastname: Iacono
authors.forename: Rita T
authors.initials: RT
authors.lastname: Lawlor
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.forename: Ralph H
authors.initials: RH
authors.lastname: Hruban
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guglielmi
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Tortora
authors.forename: Filippo
authors.initials: F
authors.lastname: de Braud
authors.forename: Aldo
authors.initials: A
authors.lastname: Scarpa
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D017734:Bile Ducts, Extrahepatic / Q000378:metabolism* / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism* / Q000473:pathology; D014408:Biomarkers, Tumor / Q000235:genetics* / Q000378:metabolism; D018281:Cholangiocarcinoma / Q000145:classification* / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D007124:Immunoenzyme Techniques; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor