Clonal evolution of chemotherapy-resistant urothelial carcinoma.

TitleClonal evolution of chemotherapy-resistant urothelial carcinoma.
Publication TypeJournal Article
Year of Publication2016
AuthorsFaltas BM, Prandi D, Tagawa ST, Molina AM, Nanus DM, Sternberg C, Rosenberg J, Mosquera JMiguel, Robinson B, Elemento O, Sboner A, Beltran H, Demichelis F, Rubin MA
JournalNat Genet
Volume48
Issue12
Pagination1490-1499
Date Published2016 12
ISSN1546-1718
KeywordsAntineoplastic Agents, APOBEC-1 Deaminase, Carcinoma, Transitional Cell, Clonal Evolution, Clone Cells, Drug Resistance, Neoplasm, Exome, High-Throughput Nucleotide Sequencing, Humans, Mutagenesis, Mutation, Neural Cell Adhesion Molecule L1, Prospective Studies, Urinary Bladder Neoplasms
Abstract

Chemotherapy-resistant urothelial carcinoma has no uniformly curative therapy. Understanding how selective pressure from chemotherapy directs the evolution of urothelial carcinoma and shapes its clonal architecture is a central biological question with clinical implications. To address this question, we performed whole-exome sequencing and clonality analysis of 72 urothelial carcinoma samples, including 16 matched sets of primary and advanced tumors prospectively collected before and after chemotherapy. Our analysis provided several insights: (i) chemotherapy-treated urothelial carcinoma is characterized by intra-patient mutational heterogeneity, and the majority of mutations are not shared; (ii) both branching evolution and metastatic spread are very early events in the natural history of urothelial carcinoma; (iii) chemotherapy-treated urothelial carcinoma is enriched with clonal mutations involving L1 cell adhesion molecule (L1CAM) and integrin signaling pathways; and (iv) APOBEC-induced mutagenesis is clonally enriched in chemotherapy-treated urothelial carcinoma and continues to shape the evolution of urothelial carcinoma throughout its lifetime.

DOI10.1038/ng.3692
Alternate JournalNat. Genet.
PubMed ID27749842
PubMed Central IDPMC5549141
Grant ListP30 CA008748 / CA / NCI NIH HHS / United States
KL2 TR000458 / TR / NCATS NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States
KL2 TR002385 / TR / NCATS NIH HHS / United States
648670 / / European Research Council / International
U01 CA111275 / CA / NCI NIH HHS / United States