Urachal carcinoma shares genomic alterations with colorectal carcinoma and may respond to epidermal growth factor inhibition Journal Article

Authors: Collazo-Lorduy, A.; Castillo-Martin, M.; Wang, L.; Patel, V.; Iyer, G.; Jordan, E.; Al-Ahmadie, H.; Leonard, I.; Oh, W. K.; Zhu, J.; McBride, R. B.; Cordon-Cardo, C.; Solit, D. B.; Sfakianos, J. P.; Galsky, M. D.
Article Title: Urachal carcinoma shares genomic alterations with colorectal carcinoma and may respond to epidermal growth factor inhibition
Abstract: Metastatic urachal carcinoma is a rare, understudied, and aggressive malignancy with limited treatment options. Histologically, urachal carcinomas resemble enteric adenocarcinomas and anecdotally respond to systemic therapies utilized in colorectal cancer. Targeted exome sequencing of archival primary tumor tissue from a patient with metastatic urachal cancer revealed EGFR amplification and wild-type KRAS. The patient was treated with cetuximab, a monoclonal antibody directed against EGFR, as a single agent, and achieved a response lasting more than 8 mo. Subsequent whole-exome sequencing revealed no additional alterations likely to be associated with cetuximab sensitivity. Formalin-fixed, paraffin-embedded tumor specimens from nine additional urachal cancers were subjected to targeted exome sequencing. Mitogen-activated protein kinase (MAPK) pathway mutations were found in four of the nine samples, but no EGFR amplification was detected. Importantly, APC mutations were detected in two of the nine patients. To our knowledge, this is the first report of a response to single-agent cetuximab in a patient with metastatic urachal cancer and of molecular analysis to probe the basis for sensitivity. On the basis of these findings and the histologic, and now genomic, similarities with colorectal cancer, monoclonal antibodies directed at EGFR could be used in the treatment of metastatic urachal cancer. Patient summary Urachal cancers are morphologically and genomically similar to colon adenocarcinomas and may respond to drugs targeting the epidermal growth factor receptor. © 2016 European Association of Urology
Keywords: urachal carcinoma; inhibition; genomic alterations; epidermal growth-factor
Journal Title: European Urology
Volume: 70
Issue: 5
ISSN: 0302-2838
Publisher: Elsevier Science, Inc.  
Date Published: 2016-11-01
Start Page: 771
End Page: 775
Language: English
DOI: 10.1016/j.eururo.2016.04.037
PROVIDER: scopus
PUBMED: 27178450
PMCID: PMC5489411
Notes: Article -- Export Date: 3 January 2017 -- Source: Scopus
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MSK Authors
  1. David Solit
    420 Solit
  2. Gopakumar Vasudeva Iyer
    121 Iyer
  3. Emmet John Jordan
    27 Jordan