Amplification of KRAS and its heterogeneity in non-Asian gastric adenocarcinomas
Abstract Background Gastric cancer is one of the deadliest cancer entities worldwide. While surgery is the only curative treatment option in early tumors, for locally advanced and metastatic patients further therapeutic targets are needed. Several studies not only reported mutations but also amplifi...
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doaj-30c88af3d4424d22aaa1c39d94f4e49a2020-11-25T03:31:52ZengBMCBMC Cancer1471-24072020-06-012011810.1186/s12885-020-06996-xAmplification of KRAS and its heterogeneity in non-Asian gastric adenocarcinomasJan Rehkaemper0Michael Korenkov1Alexander Quaas2Josef Rueschoff3Aylin Pamuk4Thomas Zander5Axel M. Hillmer6Reinhard Buettner7Arnulf Heinrich Hoelscher8Christiane Josephine Bruns9Heike Loeser10Hakan Alakus11Birgid Schoemig-Markiefka12Institute of Pathology, University Hospital CologneDepartment of General, Visceral and Cancer Surgery, University Hospital CologneInstitute of Pathology, University Hospital CologneInstitute of Pathology, Nordhessen and Targos Molecular Pathology GmbHDepartment of General, Visceral and Cancer Surgery, University Hospital CologneDepartment of Internal Medicine I, University Hospital CologneInstitute of Pathology, University Hospital CologneInstitute of Pathology, University Hospital CologneCenter for Esophageal and Gastric Surgery, AGAPLESION Markus KrankenhausDepartment of General, Visceral and Cancer Surgery, University Hospital CologneInstitute of Pathology, University Hospital CologneDepartment of General, Visceral and Cancer Surgery, University Hospital CologneInstitute of Pathology, University Hospital CologneAbstract Background Gastric cancer is one of the deadliest cancer entities worldwide. While surgery is the only curative treatment option in early tumors, for locally advanced and metastatic patients further therapeutic targets are needed. Several studies not only reported mutations but also amplifications of the KRAS locus in different cancer entities. More recently, KRAS amplification was discussed as a new therapeutic target. Little is known about the (prognostic) relevance and (heterogenic) distribution of KRAS amplification in gastric adenocarcinomas, especially in Non-Asian patients. Methods Amplification of the KRAS locus and corresponding protein expression was analyzed in 582 gastric adenocarcinomas employing fluorescence in-situ hybridization (FISH) and immunohistochemistry. Amplification status was correlated with clinico-pathological features, clinical outcome and molecular tumor data including a correlation to the TCGA subtypes of gastric carcinoma. Results KRAS amplification was detected in 27 out of 470 analysable tumors (5.7%) and correlated with protein expression of KRAS in all amplified tumors. Within the KRAS amplified gastric tumors 14/27 (51.9%) showed a heterogeneous distribution with also KRAS non-amplified tumor parts. According to TCGA 24 tumors (88.8%) were related to chromosomal instable tumors (CIN). The survival analysis of the entire patient cohort did not show any difference in overall survival in dependence on the KRAS status. However, a significant survival difference with a worse outcome for patients with KRAS amplified tumors was identified when analysing patients without neoadjuvant pre-treatment. Conclusions We confirm the unfavorable prognosis of KRAS amplified tumors reported by other studies in (Asian) patient groups, at least in patients without neoadjuvant pre-treatment. Within KRAS amplified tumors we revealed intratumoral heterogeneity that may define a (more aggressive) tumor cell population which is more frequently observed in patients with lymph node metastases. Despite the heterogeneous distribution of KRAS amplified tumor clones, KRAS amplified locally advanced or metastasized gastric adenocarcinomas represent a therapeutically highly relevant tumor subgroup.http://link.springer.com/article/10.1186/s12885-020-06996-xKRAS amplificationGastric adenocarcinomaPrognosisFluorescence-in-situ-hybridization (FISH)Heterogeneity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jan Rehkaemper Michael Korenkov Alexander Quaas Josef Rueschoff Aylin Pamuk Thomas Zander Axel M. Hillmer Reinhard Buettner Arnulf Heinrich Hoelscher Christiane Josephine Bruns Heike Loeser Hakan Alakus Birgid Schoemig-Markiefka |
spellingShingle |
Jan Rehkaemper Michael Korenkov Alexander Quaas Josef Rueschoff Aylin Pamuk Thomas Zander Axel M. Hillmer Reinhard Buettner Arnulf Heinrich Hoelscher Christiane Josephine Bruns Heike Loeser Hakan Alakus Birgid Schoemig-Markiefka Amplification of KRAS and its heterogeneity in non-Asian gastric adenocarcinomas BMC Cancer KRAS amplification Gastric adenocarcinoma Prognosis Fluorescence-in-situ-hybridization (FISH) Heterogeneity |
author_facet |
Jan Rehkaemper Michael Korenkov Alexander Quaas Josef Rueschoff Aylin Pamuk Thomas Zander Axel M. Hillmer Reinhard Buettner Arnulf Heinrich Hoelscher Christiane Josephine Bruns Heike Loeser Hakan Alakus Birgid Schoemig-Markiefka |
author_sort |
Jan Rehkaemper |
title |
Amplification of KRAS and its heterogeneity in non-Asian gastric adenocarcinomas |
title_short |
Amplification of KRAS and its heterogeneity in non-Asian gastric adenocarcinomas |
title_full |
Amplification of KRAS and its heterogeneity in non-Asian gastric adenocarcinomas |
title_fullStr |
Amplification of KRAS and its heterogeneity in non-Asian gastric adenocarcinomas |
title_full_unstemmed |
Amplification of KRAS and its heterogeneity in non-Asian gastric adenocarcinomas |
title_sort |
amplification of kras and its heterogeneity in non-asian gastric adenocarcinomas |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2020-06-01 |
description |
Abstract Background Gastric cancer is one of the deadliest cancer entities worldwide. While surgery is the only curative treatment option in early tumors, for locally advanced and metastatic patients further therapeutic targets are needed. Several studies not only reported mutations but also amplifications of the KRAS locus in different cancer entities. More recently, KRAS amplification was discussed as a new therapeutic target. Little is known about the (prognostic) relevance and (heterogenic) distribution of KRAS amplification in gastric adenocarcinomas, especially in Non-Asian patients. Methods Amplification of the KRAS locus and corresponding protein expression was analyzed in 582 gastric adenocarcinomas employing fluorescence in-situ hybridization (FISH) and immunohistochemistry. Amplification status was correlated with clinico-pathological features, clinical outcome and molecular tumor data including a correlation to the TCGA subtypes of gastric carcinoma. Results KRAS amplification was detected in 27 out of 470 analysable tumors (5.7%) and correlated with protein expression of KRAS in all amplified tumors. Within the KRAS amplified gastric tumors 14/27 (51.9%) showed a heterogeneous distribution with also KRAS non-amplified tumor parts. According to TCGA 24 tumors (88.8%) were related to chromosomal instable tumors (CIN). The survival analysis of the entire patient cohort did not show any difference in overall survival in dependence on the KRAS status. However, a significant survival difference with a worse outcome for patients with KRAS amplified tumors was identified when analysing patients without neoadjuvant pre-treatment. Conclusions We confirm the unfavorable prognosis of KRAS amplified tumors reported by other studies in (Asian) patient groups, at least in patients without neoadjuvant pre-treatment. Within KRAS amplified tumors we revealed intratumoral heterogeneity that may define a (more aggressive) tumor cell population which is more frequently observed in patients with lymph node metastases. Despite the heterogeneous distribution of KRAS amplified tumor clones, KRAS amplified locally advanced or metastasized gastric adenocarcinomas represent a therapeutically highly relevant tumor subgroup. |
topic |
KRAS amplification Gastric adenocarcinoma Prognosis Fluorescence-in-situ-hybridization (FISH) Heterogeneity |
url |
http://link.springer.com/article/10.1186/s12885-020-06996-x |
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