Genetic Characteristics of Colorectal Neuroendocrine Carcinoma: More Similar to Colorectal Adenocarcinoma

Clin Colorectal Cancer. 2021 Jun;20(2):177-185.e13. doi: 10.1016/j.clcc.2020.09.001. Epub 2020 Sep 9.

Abstract

Background: Despite the increasing incidence rate of colorectal neuroendocrine carcinoma (CR-NEC), there are still few sequencing data to depict the genomic characteristics of CR-NEC.

Patients and methods: Next-generation sequencing data of CR-NEC, colorectal adenocarcinoma (COREAD), lung neuroendocrine carcinoma (lung NEC), and gastrointestinal neuroendocrine tumor (GI-NET) were retrieved from the American Association of Cancer Research Project Genomics, Evidence, Neoplasia, Information, Exchange (GENIE) database platform. Overall survival data of patients were obtained from cBioPortal.

Results: The median tumor mutation burden (TMB) was 5.18 per megabase. TP53 (65.5%), APC (59.5%), KRAS (36.9%), BRAF (20.2%), and RB1 (16.7%) were the most common genes harboring somatic mutations. Nearly all of the BRAF mutations (88.2%) caused V600E. The most common copy number alterations were gain of MYC (12.3%), loss of RB1 (10.7%), and loss of PTEN (5.4%). Compared to lung NEC and GI-NET, the genetic characteristics of CR-NEC were more similar to that of COREAD. CR-NEC had a higher rate of potentially targetable gene alterations compared to lung NEC and GI-NET, and BRAFV600E might be a promising treatment target. Survival analysis indicated that patients with high TMB had significantly worse survival than patients with low TMB (P < .001). In addition, KRAS and RB1 alteration were found to be correlated with worse survival (both P = .023).

Conclusion: CR-NEC has genetic alterations that are more similar to COREAD than other entities. A substantial group of CR-NEC harboring potentially targetable alterations (BRAFV600E) deserves to be tested in clinical practice.

Keywords: BRAF; Copy number alteration; Genomics; Survival; Targetable alteration.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenocarcinoma / genetics
  • Adenocarcinoma / secondary*
  • Biomarkers, Tumor / metabolism*
  • Carcinoma, Neuroendocrine / genetics
  • Carcinoma, Neuroendocrine / secondary*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / pathology*
  • Genotype
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Mutation
  • Prognosis

Substances

  • Biomarkers, Tumor