Mutational signature profiling classifies subtypes of clinically different mismatch-repair-deficient tumours with a differential immunogenic response potential.

Abstract

Mismatch repair (MMR) deficiency is the hallmark of tumours from Lynch syndrome (LS), sporadic MLH1 hypermethylated and Lynch-like syndrome (LLS), but there is a lack of understanding of the variability in their mutational profiles based on clinical phenotypes. The aim of this study was to perform a molecular characterisation to identify novel features that can impact tumour behaviour and clinical management.

We tested 105 MMR-deficient colorectal cancer tumours (25 LS, 35 LLS and 45 sporadic) for global exome microsatellite instability, cancer mutational signatures, mutational spectrum and neoepitope load.

Fifty-three percent of tumours showed high contribution of MMR-deficient mutational signatures, high level of global exome microsatellite instability, loss of MLH1/PMS2 protein expression and included sporadic tumours. Thirty-one percent of tumours showed weaker features of MMR deficiency, 62% lost MSH2/MSH6 expression and included 60% of LS and 44% of LLS tumours. Remarkably, 9% of all tumours lacked global exome microsatellite instability. Lastly, HLA-B07:02 could be triggering the neoantigen presentation in tumours that show the strongest contribution of MMR-deficient tumours.

Next-generation sequencing approaches allow for a granular molecular characterisation of MMR-deficient tumours, which can be essential to properly diagnose and treat patients with these tumours in the setting of personalised medicine.

EDRN PI Authors
Medline Author List
  • Alenda C
  • Alustiza-Fernandez M
  • Carrillo-Palau M
  • Cecchini M
  • De Leon S
  • Ellis NA
  • Fehlmann TD
  • Gibson J
  • Giner-Calabuig M
  • Herraiz M
  • Jover R
  • Llor X
  • Obrador-Hevia A
  • Ortega SP
  • Pico MD
  • Reyes J
  • Salces I
  • Stoffel E
  • Sweasy J
  • Syngal S
  • Ukaegbu C
  • Wang J
  • Xicola RM
PubMed ID
Appears In
Br J Cancer, 2022 Jun (issue 11)