Clonal evolution of chemotherapy-resistant urothelial carcinoma

Nat Genet. 2016 Dec;48(12):1490-1499. doi: 10.1038/ng.3692. Epub 2016 Oct 17.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • APOBEC-1 Deaminase / genetics*
  • Antineoplastic Agents / pharmacology
  • Carcinoma, Transitional Cell / drug therapy
  • Carcinoma, Transitional Cell / genetics*
  • Carcinoma, Transitional Cell / secondary
  • Clonal Evolution / genetics*
  • Clone Cells / metabolism
  • Clone Cells / pathology
  • Drug Resistance, Neoplasm / genetics*
  • Exome
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Mutagenesis / genetics*
  • Mutation / genetics*
  • Neural Cell Adhesion Molecule L1 / genetics*
  • Prospective Studies
  • Urinary Bladder Neoplasms / drug therapy
  • Urinary Bladder Neoplasms / genetics*
  • Urinary Bladder Neoplasms / pathology

Substances

  • Antineoplastic Agents
  • Neural Cell Adhesion Molecule L1
  • APOBEC-1 Deaminase