Genomic Evolution of Breast Cancer Metastasis and Relapse

A partir de 299 échantillons de tumeurs primitives et de métastases prélevés sur 170 patientes atteintes d'un cancer du sein métastatique ou localement récidivant, cette étude montre notamment que la plupart des métastases distantes présentent des mutations oncogéniques nouvelles par rapport aux tumeurs primitives

Résumé en anglais

Patterns of genomic evolution between primary and metastatic breast cancer have not been studied in large numbers, despite patients with metastatic breast cancer having dismal survival. We sequenced whole genomes or a panel of 365 genes on 299 samples from 170 patients with locally relapsed or metastatic breast cancer. Several lines of analysis indicate that clones seeding metastasis or relapse disseminate late from primary tumors, but continue to acquire mutations, mostly accessing the same mutational processes active in the primary tumor. Most distant metastases acquired driver mutations not seen in the primary tumor, drawing from a wider repertoire of cancer genes than early drivers. These include a number of clinically actionable alterations and mutations inactivating SWI-SNF and JAK2-STAT3 pathways.