Abstract

High-grade serous ovarian carcinoma (HGSOC) remains the deadliest form of epithelial ovarian cancer and despite major efforts little improvement in overall survival has been achieved. Identification of recurring “driver” genetic lesions has the potential to enable design of novel therapies for cancer. Here, we report on a study to find such new therapeutic targets for HGSOC using exome-capture sequencing approach targeting all kinase genes in 127 patient samples. Consistent with previous reports, the most frequently mutated gene was TP53 (97% mutation frequency) followed by BRCA1 (10% mutation frequency). The average mutation frequency of the kinase genes mutated from our panel was 1.5%. Intriguingly, after BRCA1, JAK3 was the most frequently mutated gene (4% mutation frequency). We tested the transforming properties of JAK3 mutants using the Ba/F3 cell-based in vitro functional assay and identified a novel gain-of-function mutation in the kinase domain of JAK3 (p.T1022I). Importantly, p.T1022I JAK3 mutants displayed higher sensitivity to the JAK3-selective inhibitor Tofacitinib compared to controls. For independent validation, we re-sequenced the entire JAK3 coding sequence using tagged amplicon sequencing (TAm-Seq) in 463 HGSOCs resulting in an overall somatic mutation frequency of 1%. TAm-Seq screening of CDK12 in the same population revealed a 7% mutation frequency.Our data confirms that the frequency of mutations in kinase genes in HGSOC is low and provides accurate estimates for the frequency of JAK3 and CDK12 mutations in a large well characterized cohort. Although p.T1022I JAK3 mutations are rare, our functional validation shows that if detected they should be considered as potentially actionable for therapy. The observation of CDK12 mutations in 7% of HGSOC cases provides a strong rationale for routine somatic testing, although more functional and clinical characterization is required to understand which nonsynonymous mutations alterations are associated with homologous recombination deficiency.

Highlights

  • Epithelial ovarian cancer is the most deadly gynecological cancer in western countries accounting for almost two-thirds of ovarian cancer deaths [1,2]

  • Around 96% of the target interval had at least a 30-fold coverage and 50% had more than 150x fold coverage, which provides a high degree of sensitivity for detecting variants (S1 Fig)

  • In addition to the kinase genes, we screened 48 bona-fide cancer-related genes, which could play a role in the pathogenesis of ovarian cancer as well

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Summary

Introduction

Epithelial ovarian cancer is the most deadly gynecological cancer in western countries accounting for almost two-thirds of ovarian cancer deaths [1,2]. The cancer is usually diagnosed at an advanced stage because of early metastatic spread from the fallopian tube [3]. High-grade serous ovarian carcinoma (HGSOC) represents 60%-80% of epithelial ovarian cancers and most deaths are associated with this subtype. HGSOC is associated with initial chemotherapy responsiveness, most cancers relapse and become increasingly chemotherapy resistant, with an overall 5-year survival probability of approximately 30% [4,5]. The lack of successful treatment strategies led researchers in recent years to identify genetic abnormalities in HGSOC samples with the aim to exploit these as therapeutic targets. Several studies have addressed this issue using a comprehensive genomic approach [2,4,6,7,8,9]

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