Changes in colorectal carcinoma genomes under anti-EGFR therapy identified by whole-genome plasma DNA sequencing.

Monoclonal antibodies targeting the Epidermal Growth Factor Receptor (EGFR), such as cetuximab and panitumumab, have evolved to important therapeutic options in metastatic colorectal cancer (CRC). However, almost all patients with clinical response to anti-EGFR therapies show disease progression wit...

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Main Authors: Sumitra Mohan, Ellen Heitzer, Peter Ulz, Ingrid Lafer, Sigurd Lax, Martina Auer, Martin Pichler, Armin Gerger, Florian Eisner, Gerald Hoefler, Thomas Bauernhofer, Jochen B Geigl, Michael R Speicher
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-03-01
Series:PLoS Genetics
Online Access:https://journals.plos.org/plosgenetics/article/file?id=10.1371/journal.pgen.1004271&type=printable
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author Sumitra Mohan
Ellen Heitzer
Peter Ulz
Ingrid Lafer
Sigurd Lax
Martina Auer
Martin Pichler
Armin Gerger
Florian Eisner
Gerald Hoefler
Thomas Bauernhofer
Jochen B Geigl
Michael R Speicher
author_facet Sumitra Mohan
Ellen Heitzer
Peter Ulz
Ingrid Lafer
Sigurd Lax
Martina Auer
Martin Pichler
Armin Gerger
Florian Eisner
Gerald Hoefler
Thomas Bauernhofer
Jochen B Geigl
Michael R Speicher
author_sort Sumitra Mohan
collection DOAJ
description Monoclonal antibodies targeting the Epidermal Growth Factor Receptor (EGFR), such as cetuximab and panitumumab, have evolved to important therapeutic options in metastatic colorectal cancer (CRC). However, almost all patients with clinical response to anti-EGFR therapies show disease progression within a few months and little is known about mechanism and timing of resistance evolution. Here we analyzed plasma DNA from ten patients treated with anti-EGFR therapy by whole genome sequencing (plasma-Seq) and ultra-sensitive deep sequencing of genes associated with resistance to anti-EGFR treatment such as KRAS, BRAF, PIK3CA, and EGFR. Surprisingly, we observed that the development of resistance to anti-EGFR therapies was associated with acquired gains of KRAS in four patients (40%), which occurred either as novel focal amplifications (n = 3) or as high level polysomy of 12p (n = 1). In addition, we observed focal amplifications of other genes recently shown to be involved in acquired resistance to anti-EGFR therapies, such as MET (n = 2) and ERBB2 (n = 1). Overrepresentation of the EGFR gene was associated with a good initial anti-EGFR efficacy. Overall, we identified predictive biomarkers associated with anti-EGFR efficacy in seven patients (70%), which correlated well with treatment response. In contrast, ultra-sensitive deep sequencing of KRAS, BRAF, PIK3CA, and EGFR did not reveal the occurrence of novel, acquired mutations. Thus, plasma-Seq enables the identification of novel mutant clones and may therefore facilitate early adjustments of therapies that may delay or prevent disease progression.
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spelling doaj-art-ca1ee54617a7403a9ad5c1ba8a23efa62025-08-20T02:34:07ZengPublic Library of Science (PLoS)PLoS Genetics1553-73901553-74042014-03-01103e100427110.1371/journal.pgen.1004271Changes in colorectal carcinoma genomes under anti-EGFR therapy identified by whole-genome plasma DNA sequencing.Sumitra MohanEllen HeitzerPeter UlzIngrid LaferSigurd LaxMartina AuerMartin PichlerArmin GergerFlorian EisnerGerald HoeflerThomas BauernhoferJochen B GeiglMichael R SpeicherMonoclonal antibodies targeting the Epidermal Growth Factor Receptor (EGFR), such as cetuximab and panitumumab, have evolved to important therapeutic options in metastatic colorectal cancer (CRC). However, almost all patients with clinical response to anti-EGFR therapies show disease progression within a few months and little is known about mechanism and timing of resistance evolution. Here we analyzed plasma DNA from ten patients treated with anti-EGFR therapy by whole genome sequencing (plasma-Seq) and ultra-sensitive deep sequencing of genes associated with resistance to anti-EGFR treatment such as KRAS, BRAF, PIK3CA, and EGFR. Surprisingly, we observed that the development of resistance to anti-EGFR therapies was associated with acquired gains of KRAS in four patients (40%), which occurred either as novel focal amplifications (n = 3) or as high level polysomy of 12p (n = 1). In addition, we observed focal amplifications of other genes recently shown to be involved in acquired resistance to anti-EGFR therapies, such as MET (n = 2) and ERBB2 (n = 1). Overrepresentation of the EGFR gene was associated with a good initial anti-EGFR efficacy. Overall, we identified predictive biomarkers associated with anti-EGFR efficacy in seven patients (70%), which correlated well with treatment response. In contrast, ultra-sensitive deep sequencing of KRAS, BRAF, PIK3CA, and EGFR did not reveal the occurrence of novel, acquired mutations. Thus, plasma-Seq enables the identification of novel mutant clones and may therefore facilitate early adjustments of therapies that may delay or prevent disease progression.https://journals.plos.org/plosgenetics/article/file?id=10.1371/journal.pgen.1004271&type=printable
spellingShingle Sumitra Mohan
Ellen Heitzer
Peter Ulz
Ingrid Lafer
Sigurd Lax
Martina Auer
Martin Pichler
Armin Gerger
Florian Eisner
Gerald Hoefler
Thomas Bauernhofer
Jochen B Geigl
Michael R Speicher
Changes in colorectal carcinoma genomes under anti-EGFR therapy identified by whole-genome plasma DNA sequencing.
PLoS Genetics
title Changes in colorectal carcinoma genomes under anti-EGFR therapy identified by whole-genome plasma DNA sequencing.
title_full Changes in colorectal carcinoma genomes under anti-EGFR therapy identified by whole-genome plasma DNA sequencing.
title_fullStr Changes in colorectal carcinoma genomes under anti-EGFR therapy identified by whole-genome plasma DNA sequencing.
title_full_unstemmed Changes in colorectal carcinoma genomes under anti-EGFR therapy identified by whole-genome plasma DNA sequencing.
title_short Changes in colorectal carcinoma genomes under anti-EGFR therapy identified by whole-genome plasma DNA sequencing.
title_sort changes in colorectal carcinoma genomes under anti egfr therapy identified by whole genome plasma dna sequencing
url https://journals.plos.org/plosgenetics/article/file?id=10.1371/journal.pgen.1004271&type=printable
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