Abstract

Synovial sarcoma is the most common pediatric non-rhabdomyosarcoma soft tissue sarcoma and accounts for about 8–10% of all soft tissue sarcoma in childhood and adolescence. The presence of a chromosomal translocation-associated SS18-SSX-fusion gene is causally linked to development of primary synovial sarcoma. Metastases occur in approximately 50–70% of synovial sarcoma cases with yet unknown mechanisms, which led to about 70–80% mortality rate in five years. To explore the possibilities to investigate metastatic mechanisms of synovial sarcoma, we carried out the first genome-wide search for potential genetic biomarkers and drivers associated with metastasis by comparative mutational profiling of 18 synovial sarcoma samples isolated from four patients carrying the primary tumors and another four patients carrying the metastatic tumors through whole exome sequencing. Selected from the candidates yielded from this effort, we examined the effect of the multiple missense mutations of ADAM17, which were identified solely in metastatic synovial sarcoma. The mutant alleles as well as the wild-type control were expressed in the mammalian cells harboring the SS18-SSX1 fusion gene. The ADAM17-P729H mutation was shown to enhance cell migration, a phenotype associated with metastasis. Therefore, like ADAM17-P729H, other mutations we identified solely in metastatic synovial sarcoma may also have the potential to serve as an entry point for unraveling the metastatic mechanisms of synovial sarcoma.

Highlights

  • Synovial sarcoma (SS) is a highly aggressive and distinct soft tissue sarcoma and the most common nonrhabdomyosarcoma soft tissue sarcoma in childhood and adolescence [1, 2]

  • To explore the possibilities to investigate metastatic mechanisms of synovial sarcoma, we carried out the first genome-wide search for potential genetic biomarkers and drivers associated with metastasis by comparative mutational profiling of 18 synovial sarcoma samples isolated from four patients carrying the primary tumors and another four patients carrying the metastatic tumors through whole exome sequencing

  • Selected from the candidates yielded from this effort, we examined the effect of the multiple missense mutations of ADAM17, which were identified solely in metastatic synovial sarcoma

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Summary

Introduction

Synovial sarcoma (SS) is a highly aggressive and distinct soft tissue sarcoma and the most common nonrhabdomyosarcoma soft tissue sarcoma in childhood and adolescence [1, 2]. Primary SS is associated with translocations between human chromosome 18 and X, t(X;18) (p11.2;q11.2), which may result in fusions between exon 10 of SS18 and exon 6 of SSX. 90–95% of SS carry chromosomal translocation-associated SS18-SSX1 or SS18-SSX2 fusion gene [1]. Treatment of SS includes surgical resection with or without radiotherapy for primary disease. SS is associated with local recurrence and distant metastases which occurs in approximately 50–70% of cases with yet unknown mechanisms [9]. The current five-year overall survival after metastasis is about 20–30% and few patients survive beyond 3 years in cases with multiple foci of metastatic disease [6]. The prognosis of metastatic SS remains dismal and the vast majority of mortality is the result of metastatic disease and not the local recurrence. There is an urgent need to identify genetic causes driving metastasis of this tumor type

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