The online version of this article (https://doi.org/10.1186/s12885-018-4789-4) contains supplementary material, which is available to authorized users.
We report on a female patient who underwent primary radical resection for a stage 2B Her-2-positive Barrett’s-type esophageal adenocarcinoma (EAC). Despite Her-2 targeted therapy, her disease recurred and required repeated metastectomies.
Digital cell sorting and targeted sequencing of cancer sub-clones from EAC and metastases revealed a completely mutated TP53, whereas the sorted stromal cells were wild-type. Her-2 amplification was significantly lower in the metastases when the patient became therapy-resistant.
The mechanism of therapy resistance illustrated by this case could only be detected through accurate analysis of tumor sub-populations.
Investigating tumor sub-populations of recurrent disease is important for adjusting therapy in recurrent EAC.
Additional file 1: Supplementary methods and metarials. (DOCX 79 kb)12885_2018_4789_MOESM1_ESM.docx
Additional file 2: Figure S1. Plots of Copy Number Analysis and phylogenetic tree using WES data. A 18 Mb region on chromosome 6 (q21-22.33) is indicated (red box), where CNV analysis identified a copy gain in PT (A) and M1 (B), as reported in Additional file 1: Table S2. (C) In the second chest metastasis (M2) a focal amplification was detected in the 6q22.33 region, spanning RNF146 and ECHDC1 genes (black arrowhead). (D) SNPhylo analysis results, showing the genetic distance between the three tumor samples. Numbers indicate the branch length from central node. The distance between two tumors is equal to the sum of their branch length. Analysis was performed according to [ 6]. (PDF 137 kb)
Secrier M, Li X, De Silva N, Eldridge MD, Contino G, Bornschein J, et al. Mutational signatures in esophageal adenocarcinoma define etiologically distinct subgroups with therapeutic relevance. Nature. 2016;48:1131–41.
Cancer Genome Atlas Research Network. Integrated genomic characterization of oesophageal carcinoma. Nature. 2017;542:169–75. CrossRef
Taylor NJ, Nikolaishvili-Feinberg N, Midkiff BR, Conway K, Millikan RC, Geradts J. Rational manual and automated scoring thresholds for the immuhistochemical detection of TP53 missense mutations in human breast carcinomas. Immunohistochem Mol Morphol. 2016;24:398–404. CrossRef
Dietal M, Ellis IO, Hofler H, Kreipe H, Moch H, Dankof A, et al. Comparison of automated silver enhanced in situ hybridisation (SISH) and fluorescence ISH (FISH) for the validation of HER2 gene status in breast carcinoma according to the guidelines of the American Society of Clinical Oncology and the College of American Pathologists. Virchows Arch. 2007;451:19–25. CrossRef
APROC (ClinicalTrials.gov Identifier:NCT02999893).
Rexer BN, Arteaga CL. Intrinsic and acquired resistence to HER2-targeted therapies in HER2 gene-amplified breast cancer: mechanisms and clinical implications. Crit Rev Oncol. 2012;17:1–16. CrossRef
Asai S, Miura N, Sawada Y, Noda T, Kikugawa T, Tanji N, et al. Silencing of ECHDC1 inhibits growth of gemcitabine-resistant bladder cancer cells. Oncol Let. 2018;15(1):522–7.
- Genomic profiles of primary and metastatic esophageal adenocarcinoma identified via digital sorting of pure cell populations: results from a case report
Kausilia K. Krishnadath
- BioMed Central
Neu im Fachgebiet Onkologie
Histological appearance of the primary EAC/© Isidori et al., Mail Icon II