Abstract

Although colorectal cancer is one of the most lethal cancer types in the world, its metastasis to the ovary is rare, compared to metastasis to other organs. Consequently, the genomic basis for colon-to-ovary metastasis remains unstudied, due to limited available patients, and thus there have been no attempts to construct individual-specific networks. Due to its rarity, the small sample size makes common mutations difficult to find. To overcome this problem, we herein attempted to apply a biological connectivity map called a sample-specific network (SSN), to reveal common biological functions in three samples. Our three samples were compared to a clinical dataset contained in The Cancer Genome Atlas (TCGA) Colorectal Adenocarcinoma (COAD), showing different mutational spectra, compared to matched samples based on age, gender, microsatellite instability (MSI) status, and tumor, node, metastasis (TNM) stage. The SSNs for the three samples revealed significant correlations of the mutation statuses of several apoptosis genes, in contrast to the TCGA-matched samples. Further analysis of a targeted-gene panel sequencing dataset for colon-to-ovary metastasis of primary tumor samples also confirmed significant correlations of the mutational statuses among apoptosis genes. In summary, using SSN, we successfully identified a common function (apoptosis) among our three patients having colon-to-ovary metastasis, despite no common mutations in the three patients. Such computational analyses could facilitate productive study of rare cancers and other diseases.

Highlights

  • Colorectal cancer is one of the most lethal cancer types in the world, its metastasis to the ovary is rare, compared to metastasis to other organs

  • We studied the mutational landscape of three patient samples of rare ovarian colorectal (CRC) metastases, as compared to their primary Colorectal cancer (CRC) tumors

  • All three patients had TP53 mutations, which were present in only 60% of the The Cancer Genome Atlas (TCGA)-matched and non-hypermutated patient samples

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Summary

Introduction

Colorectal cancer is one of the most lethal cancer types in the world, its metastasis to the ovary is rare, compared to metastasis to other organs. Clinicians have witnessed remarkable progress in the treatment of metastatic colon cancer, especially upon understanding its molecular basis, leading to effective combinations of chemotherapy regimens of oxaliplatin, irinotecan, cetuximab, and bevacizumab[2] These novel agents have yielded both higher tumor response rates and prolonged overall survival. The frequency of ovarian metastasis from a primary CRC is low, at approximately 3.4% of women diagnosed with a malignant colorectal cancer[8], compared to higher occurring metastases to the liver and the lung[9] Due to this rarity, limited sample sizes (and low statistical power) represent a major hurdle for genomic analyses of Patient # 5. It is important to apply a proper strategy to analyze mutational phenomena, using a systematic view, by comparing mutational occurrences

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