Abstract

BackgroundColorectal cancer with metastases limited to the liver (liver-limited mCRC) is a distinct clinical subset characterized by possible cure with surgery. We performed high-depth sequencing of over 750 cancer-associated genes and copy number profiling in matched primary, metastasis and normal tissues to characterize genomic progression in 18 patients with liver-limited mCRC.ResultsHigh depth Illumina sequencing and use of three different variant callers enable comprehensive and accurate identification of somatic variants down to 2.5% variant allele frequency. We identify a median of 11 somatic single nucleotide variants (SNVs) per tumor. Across patients, a median of 79.3% of somatic SNVs present in the primary are present in the metastasis and 81.7% of all alterations present in the metastasis are present in the primary. Private alterations are found at lower allele frequencies; a different mutational signature characterized shared and private variants, suggesting distinct mutational processes. Using B-allele frequencies of heterozygous germline SNPs and copy number profiling, we find that broad regions of allelic imbalance and focal copy number changes, respectively, are generally shared between the primary tumor and metastasis.ConclusionsOur analyses point to high genomic concordance of primary tumor and metastasis, with a thick common trunk and smaller genomic branches in general support of the linear progression model in most patients with liver-limited mCRC. More extensive studies are warranted to further characterize genomic progression in this important clinical population.Electronic supplementary materialThe online version of this article (doi:10.1186/s13059-015-0589-1) contains supplementary material, which is available to authorized users.

Highlights

  • Colorectal cancer with metastases limited to the liver is a distinct clinical subset characterized by possible cure with surgery

  • Single nucleotide variants (SNVs), broad regions of allelic imbalance and focal copy number alterations were generally similar in the primary and metastasis, supporting linear progression in the majority of our patients with liver-limited metastatic colorectal cancer (mCRC), we found evidence of a different mutational signature/context amongst ‘shared’ truncal variants present in both the primary and metastasis and ‘private’ branch alterations unique to the primary or the metastasis

  • From Genomic DNA extracted from 24 frozen tissue specimens from an initial 8 patients with liver-limited mCRC (Table 1), we performed library construction, target enrichment and Illimuina next generation sequencing (NGS)

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Summary

Introduction

Colorectal cancer with metastases limited to the liver (liver-limited mCRC) is a distinct clinical subset characterized by possible cure with surgery. In a subset of patients with liver-limited mCRC, surgical resection of all visible disease, often accompanied by peri-operative chemotherapy, can lead to long-term disease control, remission and possible cure [3,4,5] This striking natural history, which has motivated aggressive treatment strategies in the clinic, raises questions about the evolving genetic determinants contributing to disease progression in this distinct subset of patients with liver-limited mCRC. Given that liver-limited metastatic colorectal cancer represents a unique clinical phenotype where the natural history of the disease makes long-term disease control and cure possible, we performed a comparative genomic study to understand the genomic determinants of cancer progression in this distinct clinical subset

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