[HTML][HTML] Molecular stratification of endometrioid ovarian carcinoma predicts clinical outcome

RL Hollis, JP Thomson, B Stanley… - Nature …, 2020 - nature.com
RL Hollis, JP Thomson, B Stanley, M Churchman, AM Meynert, T Rye, C Bartos, Y Iida…
Nature communications, 2020nature.com
Endometrioid ovarian carcinoma (EnOC) demonstrates substantial clinical and molecular
heterogeneity. Here, we report whole exome sequencing of 112 EnOC cases following
rigorous pathological assessment. We detect a high frequency of mutation in CTNNB1
(43%), PIK3CA (43%), ARID1A (36%), PTEN (29%), KRAS (26%), TP53 (26%) and SOX8
(19%), a recurrently-mutated gene previously unreported in EnOC. POLE and mismatch
repair protein-encoding genes were mutated at lower frequency (6%, 18%) with significant …
Abstract
Endometrioid ovarian carcinoma (EnOC) demonstrates substantial clinical and molecular heterogeneity. Here, we report whole exome sequencing of 112 EnOC cases following rigorous pathological assessment. We detect a high frequency of mutation in CTNNB1 (43%), PIK3CA (43%), ARID1A (36%), PTEN (29%), KRAS (26%), TP53 (26%) and SOX8 (19%), a recurrently-mutated gene previously unreported in EnOC. POLE and mismatch repair protein-encoding genes were mutated at lower frequency (6%, 18%) with significant co-occurrence. A molecular taxonomy is constructed, identifying clinically distinct EnOC subtypes: cases with TP53 mutation demonstrate greater genomic complexity, are commonly FIGO stage III/IV at diagnosis (48%), are frequently incompletely debulked (44%) and demonstrate inferior survival; conversely, cases with CTNNB1 mutation, which is mutually exclusive with TP53 mutation, demonstrate low genomic complexity and excellent clinical outcome, and are predominantly stage I/II at diagnosis (89%) and completely resected (87%). Moreover, we identify the WNT, MAPK/RAS and PI3K pathways as good candidate targets for molecular therapeutics in EnOC.
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