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Genomic landscape of metastatic lung adenocarcinomas from large-scale clinical sequencing

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机构: [a]Department of Thoracic Surgery, Kunming Yan’an Hospital, Yunnan Provincial Key Laboratory of Cancer Immune Prevention and Control, Yan’an Affiliated Hospital of Kunming Medical University, Kunming 650051, China [b]Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, China [c]Cancer Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China [d]Nanjing Geneseeq Technology Inc., Nanjing 210032, China [e]School of Public Health, Nanjing Medical University, Nanjing 211166, China [f]Department of Thoracic Surgery, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China. [g]Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China.
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关键词: Genomic profiling NSCLC Metastasis Therapeutic target

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Background: Metastases are responsible for over 70% of deaths from lung adenocarcinomas. Previous large-scale studies of LUAD mainly focused on primary diseases. We aimed to comprehensively analyze the genomic landscape of metastatic LUADs and elucidate its clinical implications in the context of precision medicine. Methods: We performed retrospective analyses on targeted sequencing data of 3,743 primary tumors and 934 metastases from 4,480 patients with lung adenocarcinomas, and PD-L1 immunohistochemical data of 1,336 primary tumors and 252 metastases from 1,588 LUAD patients. Results: Metastases generally manifested significantly higher mutational burdens and chromosomal instability than primary lung adenocarcinomas. Clinically actionable alterations, including ALK mutations, ALK and ROS1 fusions, and MET copy number gains, were enriched in metastases, particularly metastases to some specific organs/tissues, such as lymph nodes, liver, and brain. PD-L1 expression decreased as the approximate metastatic distance increased. Additional data of paired primary tumors and metastases to lymph nodes and brain validated patterns of actionable alterations and candidates for metastatic drivers. Two evolutionary modes of metastatic dissemination, common origins and distinct origins, were identified in both types of primary-metastasis pairs. Conclusions: Our study showed heterogenous patterns of clinically actionable alterations, PD-L1 expressions, metastatic driver candidates, and evolutionary patterns among multiple types of metastases of lung adenocarcinomas, which may advise the planning of treatments and the identification of novel therapeutic targets.

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出版当年[2022]版:
大类 | 2 区 医学
小类 | 2 区 肿瘤学
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 肿瘤学
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Q2 ONCOLOGY
最新[2023]版:
Q1 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [a]Department of Thoracic Surgery, Kunming Yan’an Hospital, Yunnan Provincial Key Laboratory of Cancer Immune Prevention and Control, Yan’an Affiliated Hospital of Kunming Medical University, Kunming 650051, China
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通讯机构: [c]Cancer Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China [f]Department of Thoracic Surgery, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China. [g]Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China. [*1]295 Xichang Road, Kunming 650032, Yunnan, China. [*2]Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 17 Panjiayuannanli, Chaoyang District, Beijing 100021, China. [*3]Cancer Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, 32 West Section Two of Yihuan Road, Chengdu 610072, Sichuan, China.
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