Synapse - TERT copy number alterations, promoter mutations and rearrangements in adrenocortical carcinomas

TERT copy number alterations, promoter mutations and rearrangements in adrenocortical carcinomas Journal Article

Authors:	Gupta, S.; Won, H.; Chadalavada, K.; Nanjangud, G. J.; Chen, Y. B.; Al-Ahmadie, H. A.; Fine, S. W.; Sirintrapun, S. J.; Strong, V. E.; Raj, N.; Lagunes, D. R.; Vanderbilt, C. M.; Berger, M. F.; Ladanyi, M.; Dogan, S.; Tickoo, S. K.; Reuter, V. E.; Gopalan, A.
Article Title:	TERT copy number alterations, promoter mutations and rearrangements in adrenocortical carcinomas
Abstract:	Molecular characterization of adrenocortical carcinomas (ACC) by The Cancer Genome Atlas (TCGA) has highlighted a high prevalence of TERT alterations, which are associated with disease progression. Herein, 78 ACC were profiled using a combination of next generation sequencing (n = 76) and FISH (n = 9) to assess for TERT alterations. This data was combined with TCGA dataset (n = 91). A subset of borderline adrenocortical tumors (n = 5) and adrenocortical adenomas (n = 7) were also evaluated. The most common alteration involving the TERT gene involved gains/amplifications, seen in 22.2% (37/167) of cases. In contrast, “hotspot” promoter mutations (C > T promoter mutation at position -124, 7/167 cases, 4.2%) and promoter rearrangements (2/165, 1.2%) were rare. Recurrent co-alterations included 22q copy number losses seen in 24% (9/38) of cases. Although no significant differences were identified in cases with and without TERT alterations pertaining to age at presentation, tumor size, weight, laterality, mitotic index and Ki67 labeling, cases with TERT alterations showed worse outcomes. Metastatic behavior was seen in 70% (28/40) of cases with TERT alterations compared to 51.2% (65/127, p = 0.04) of cases that lacked these alterations. Two (of 5) borderline tumors showed amplifications and no TERT alterations were identified in 7 adenomas. In the borderline group, 0 (of 4) patients with available follow up had adverse outcomes. We found that TERT alterations in ACC predominantly involve gene amplifications, with a smaller subset harboring “hotspot” promoter mutations and rearrangements, and 70% of TERT-altered tumors are associated with metastases. Prospective studies are needed to validate the prognostic impact of these findings. © 2021, The Author(s).
Keywords:	adrenocortical carcinoma; tcga; adrenocortical adenoma; tert
Journal Title:	Endocrine Pathology
Volume:	33
Issue:	2
ISSN:	1046-3976
Publisher:	Springer Nature
Date Published:	2022-06-01
Start Page:	304
End Page:	314
Language:	English
DOI:	10.1007/s12022-021-09691-0
PUBMED:	34549366
PROVIDER:	scopus
PMCID:	PMC9135779
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85115270261&doi=10.1007%2fs12022-021-09691-0&partnerID=40&md5=ce77fd43c56d4a5f0d955322568e7060
Notes:	Article -- Export Date: 1 July 2022 -- Source: Scopus