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Genomic features of renal cell carcinoma with venous tumor thrombus.

Gregor WarsowDaniel HübschmannKortine KleinheinzCathleen NientiedtMartina HellerLaura Van CoileYanis TolstovLukas TrennheuserKathrin WieczorekCarine PecqueuxClaudia GaschTimur KuruJoanne Nyarangi-DixGencay HatibogluDogu TeberSven PernerAlbrecht StenzingerWilfried RothBoris HadaschikSascha PahernikDirk JägerCarsten GrüllichAnette U DuensingRoland EilsMatthias SchlesnerHolger SültmannMarkus HohenfellnerStefan Duensing
Published in: Scientific reports (2018)
A venous tumor thrombus (VTT) is a potentially lethal complication of renal cell carcinoma (RCC) but virtually nothing is known about the underlying natural history. Based on our observation that venous thrombi contain significant numbers of viable tumor cells, we applied multiregion whole exome sequencing to a total of 37 primary tumor and VTT samples including normal tissue specimens from five consecutive patients. Our findings demonstrate mutational heterogeneity between primary tumor and VTT with 106 of 483 genes (22%) harboring functional SNVs and/or indels altered in either primary tumor or thrombus. Reconstruction of the clonal phylogeny showed clustering of tumor samples and VTT samples, respectively, in the majority of tumors. However, no new subclones were detected suggesting that pre-existing subclones of the primary tumor drive VTT formation. Importantly, we found several lines of evidence for "BRCAness" in a subset of tumors. These included mutations in genes that confer "BRCAness", a mutational signature and an increase of small indels. Re-analysis of SNV calls from the TCGA KIRC-US cohort confirmed a high frequency of the "BRCAness" mutational signature AC3 in clear cell RCC. Our findings warrant further pre-clinical experiments and may lead to novel personalized therapies for RCC patients.
Keyphrases
  • renal cell carcinoma
  • end stage renal disease
  • chronic kidney disease
  • ejection fraction
  • peritoneal dialysis
  • genome wide
  • rna seq
  • fine needle aspiration