Genomic Sub-Classification of Ovarian Clear Cell Carcinoma Revealed by Distinct Mutational Signatures

• Published in: Cancers Vol. 13; no. 20; p. 5242
• Main Authors: Oliveira, Douglas V N P, Schnack, Tine H, Poulsen, Tim S, Christiansen, Anne P, Høgdall, Claus K, Høgdall, Estrid V
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 19.10.2021; MDPI
• Subjects: Aging; Chemoresistance; Chemotherapy; Classification; Data analysis; Genomes; Genomic instability; Medical prognosis; Microsatellite instability; Mutation; Ovarian cancer; Denmark; United States > US; translational medicine; clear cell carcinoma; ovarian cancer; patient stratification; NGS; genomic instability; mutational signature
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13205242

Ovarian clear cell carcinoma (OCCC) is characterized by dismal prognosis, partially due to its low sensitivity to standard chemotherapy regimen. It is also well-known for presenting unique molecular features in comparison to other epithelial ovarian cancer subtypes. Here, we aim to identify potential subgroups of patients in order to (1) determine their molecular features and (2) characterize their mutational signature. Furthermore, we sought to perform the investigation based on a potentially clinically relevant setting. To that end, we assessed the mutational profile and genomic instability of 55 patients extracted from the Gynecologic Cancer Database (DGCD) by using a panel comprised of 409 cancer-associated genes and a microsatellite assay, respectively; both are currently used in our routine environment. In accordance with previous findings, and were the most prevalent mutations, present in 49.1% and 41.8%, respectively. From those, the co-occurrence of and mutations was observed in 36.1% of subjects, indicating that this association might be a common feature of OCCC. The microsatellite instability frequency was low across samples. An unbiased assessment of signatures identified the presence of three subgroups, where "PIK3CA" and "Double hit" (with and double mutation) subgroups exhibited unique signatures, whilst "ARID1A" and "Undetermined" (no mutations on nor ) subgroups showed similar profiles. Those differences were further indicated by COSMIC signatures. Taken together, the current findings suggest that OCCC presents distinct mutational landscapes within its group, which may indicate different therapeutic approaches according to its subgroup. Although encouraging, it is noteworthy that the current results are limited by sample size, and further investigation on a larger group would be crucial to better elucidate them.