Mutations In AXIN2 Research Articles

Recapitulating the adenoma-carcinoma sequence by selection of four spontaneous oncogenic mutations in mismatch-repair-deficient human colon organoids.

Carcinogenesis results from the sequential acquisition of oncogenic mutations that convert normal cells into invasive, metastasizing cancer cells. Colorectal cancer exemplifies this process through its well-described adenoma-carcinoma sequence, modeled previously using clustered regularly interspaced short palindromic repeats (CRISPR) to induce four consecutive mutations in wild-type human gut organoids. Here, we demonstrate that long-term culture of mismatch-repair-deficient organoids allows the selection of spontaneous oncogenic mutations through the sequential withdrawal of Wnt agonists, epidermal growth factor (EGF) agonists and the bone morphogenetic protein (BMP) antagonist Noggin, while TP53 mutations were selected through the addition of Nutlin-3. Thus, organoids sequentially acquired mutations in AXIN1 and AXIN2 (Wnt pathway), TP53, ACVR2A and BMPR2 (BMP pathway) and NRAS (EGF pathway), gaining complete independence from stem cell niche factors. Quadruple-pathway (Wnt, EGF receptor, p53 and BMP) mutant organoids formed solid tumors upon xenotransplantation. This demonstrates that carcinogenesis can be recapitulated in a DNA repair-mutant background through in vitro selection that targets four consecutive cancer pathways.

Reply to Importance of Identifying Physical Manifestations That Are Associated With Hereditary Cancer Predisposition: AXIN2 Mutation in an African-American Patient.

Reply to Importance of Identifying Physical Manifestations That Are Associated With Hereditary Cancer Predisposition: AXIN2 Mutation in an African-American Patient.

AXIN1 mutations in nonsyndromic craniosynostosis.

Occurring once in every 2000 live births, craniosynostosis (CS) is the most frequent cranial birth defect. Although the genetic etiologies of syndromic CS cases are well defined, the genetic cause of most nonsyndromic cases remains unknown. The authors analyzed exome or RNA sequencing data from 876 children with nonsyndromic CS, including 291 case-parent trios and 585 additional probands. The authors also utilized the GeneMatcher platform and the Gabriella Miller Kids First genome sequencing project to identify additional CS patients with AXIN1 mutations. The authors describe 11 patients with nonsyndromic CS harboring rare, damaging mutations in AXIN1, an inhibitor of Wnt signaling. AXIN1 regulates signaling upstream of key mediators of osteoblast differentiation. Three of the 6 mutations identified in trios occurred de novo in the proband, while 3 were transmitted from unaffected parents. Patients with nonsyndromic CS were highly enriched for mutations in AXIN1 compared to both expectation (p = 0.0008) and exome sequencing data from > 76,000 healthy controls (p = 2.3 × 10-6), surpassing the thresholds for genome-wide significance. These findings describe the first phenotype associated with mutations in AXIN1, with mutations identified in approximately 1% of nonsyndromic CS cases. The results strengthen the existing link between Wnt signaling and maintenance of cranial suture patency and have implications for genetic testing in families with CS.

Association of chr11q13 amplification with survival and recurrence in patients with surgically treated hepatocellular carcinoma.

e16253 Background: Hepatocellular carcinoma (HCC) is a highly lethal and aggressive malignant tumor characterized by high rates of recurrence and metastasis, and low survival outcomes. The current treatments available for HCC have shown limited success, and the prevalence of genomic characterization and their association with survival and recurrence in HCC patients are largely unknown. Methods: The investigation enrolled 1,221 Chinese individuals diagnosed with primary HCC. This study collected samples including tumor and paired tumor-free tissues and clinical characteristics. Among them, 348 patients' clinical outcome data, including overall survival (OS) and recurrence-free survival (RFS) were gathered. Genomic analysis was conducted through panel sequencing by OrigiMed. Hazard ratios were calculated employing both univariate and multivariate Cox proportional hazards regression models. The log-rank test and Kaplan-Meier plots were used to assess comparison of clinical outcomes by various prognostic factors. For other statistical analyses, a two-tailed unpaired t-test and Fisher's exact test were applied. Results: With a median age of 54, 87% of the cases were male. Pertaining to risk factors, 74% cases had HBV infection and 62% cases were cirrhosis. Meanwhile, serum AFP levels greater (or less) than 400 ng/mL were present in 299 cases (or 485 cases). Panel sequencing identified the most prevalent mutations ( > 10%, excluding copy number variations) in TP53 (60%), TERT (40%), CTNNB1 (21%), AXIN1 (14%), LRP1B (14%), ARID1A (13%), RB1 (12%) and TSC2 (11%). The most frequently amplified genes were located at chr11q13, including CCND1 (9%), FGF19 (9%), FGF4 (7%) and FGF3 (7%). Survival analysis indicated that patients with Chr11q13 amp had significantly shorter OS and RFS. Further studies revealed a higher incidence of Chr11q13 amp in patients at advanced stages III/IV (64/564, 11%) compared to early-stage I/II (38/523, 7%), and in patients with vascular invasion (31/220, 14%) versus those without (44/599, 7%). No significant differences were observed in tumor mutational burden and HLA-I evolutionary divergence between patients with various Chr11q13 amp statuses. Furthermore, multivariate Cox proportional hazards regression models were utilized to examine the relationship between Chr11q13 amp status, characteristics and outcomes. Among the 248 patients with comprehensive clinical characteristics and available OS and RFS data, analyses indicated significant negative correlations between Chr11q13 amp and embolus with both OS and RFS. Conclusions: Our study elucidates that the presence of Chr11q13 amp was significantly associated with worse survival and increased risk of recurrence among a large cohort of Chinese patients with HCC. This discovery yields important insights into the understanding of HCC and has the potential to benefit personalized therapy.

Genomic and epigenomic basis of breast invasive lobular carcinomas lacking CDH1 genetic alterations

CDH1 (E-cadherin) bi-allelic inactivation is the hallmark alteration of breast invasive lobular carcinoma (ILC), resulting in its discohesive phenotype. A subset of ILCs, however, lack CDH1 genetic/epigenetic inactivation, and their genetic underpinning is unknown. Through clinical targeted sequencing data reanalysis of 364 primary ILCs, we identified 25 ILCs lacking CDH1 bi-allelic genetic alterations. CDH1 promoter methylation was frequent (63%) in these cases. Targeted sequencing reanalysis revealed 3 ILCs harboring AXIN2 deleterious fusions (n = 2) or loss-of-function mutation (n = 1). Whole-genome sequencing of 3 cases lacking bi-allelic CDH1 genetic/epigenetic inactivation confirmed the AXIN2 mutation and no other cell-cell adhesion genetic alterations but revealed a new CTNND1 (p120) deleterious fusion. AXIN2 knock-out in MCF7 cells resulted in lobular-like features, including increased cellular migration and resistance to anoikis. Taken together, ILCs lacking CDH1 genetic/epigenetic alterations are driven by inactivating alterations in other cell adhesion genes (CTNND1 or AXIN2), endorsing a convergent phenotype in ILC.

Investigating the association of WNT pathway dysregulation and young-onset colorectal cancer.

217 Background: Colorectal cancer (CRC) is the third most common cancer in the United States with studies showing increasing incidence of Young-Onset CRC, defined as cases occurring in individuals 50 years old or younger. Separately, the WNT Signaling Pathway and its subsequent mutation can result in sustained activation and, therefore, unregulated cell proliferation which has been well described in colorectal cancers. Loss of function in APC, AXIN1, AXIN2, GKS3B, and RNF43 can each act to dysregulate WNT signaling, contributing to cancer development. In this study, we aimed to conduct a comprehensive, molecular evaluation of the WNT signaling pathway in colorectal cancer within age-specific cohorts with onset of CRC at 50 years old or less versus greater than 50 years old. Methods: We used published individual patient-level data of 6286 patients with colorectal cancer (CRC) from the 16 CRC datasets included in the cbioportal database. The WNT pathway alterations, including APC, AXIN1, AXIN2, GKS3B and RNF43 mutations were considered to define the WNT mutant CRC cohort. The presence of WNT alterations according to the age (50 years old or younger vs. over 50 years) were evaluated using Chi-square tests. The association between primary tumor distribution (colon vs. rectal) and age were evaluated across patients with and without WNT pathway alterations. The effect of WNT pathway alterations on the overall survival and survival after the metastatic stage was evaluated with Kaplan-Meier survival curves. A type-I error level of 5% (p<0.05) was considered the threshold limit for statistical significance. Results: A total of 2,630 individuals were identified with relevant clinical and molecular information. When comparing WNT alteration patterns between young-onset CRC (< 50 years old) and CRC in cohort >50 years old, there was no statistically significant difference (p-value .215). Analysis of common individual mutations in APC, AXIN1, AXIN2, GKS3B and RNF43 also showed similar incidences across age groups. However, we identified WNT alterations were significantly more common in rectal cancers compared to colon cancer, being found in 75.9% of rectal cancer cases, regardless of age groups (p-value <0.00001). Additionally, individuals identified to have WNT alterations were found to have improved survival with a median overall survival of of 58.19 months versus a median of 41.72 months in those without. Conclusions: Overall, no significant differences were found in WNT alteration expression between Young-onset CRC versus CRC in individuals over the age of 50. However, across all age groups, WNT alterations were frequently found in rectal cancers. Furthermore, these WNT alterations were associated with better outcomes.

Unraveling the impact of AXIN1 mutations on HCC development: Insights from CRISPR/Cas9 repaired AXIN1-mutant liver cancer cell lines.

Hepatocellular carcinoma (HCC) is a highly aggressive liver cancer with significant morbidity and mortality rates. AXIN1 is one of the top-mutated genes in HCC, but the mechanism by which AXIN1 mutations contribute to HCC development remains unclear. In this study, we utilized CRISPR/Cas9 genome editing to repair AXIN1-truncated mutations in five HCC cell lines. For each cell line we successfully obtained 2-4 correctly repaired clones, which all show reduced β-catenin signaling accompanied with reduced cell viability and colony formation. Although exposure of repaired clones to Wnt3A-conditioned medium restored β-catenin signaling, it did not or only partially recover their growth characteristics, indicating the involvement of additional mechanisms. Through RNA-sequencing analysis, we explored the gene expression patterns associated with repaired AXIN1 clones. Except for some highly-responsive β-catenin target genes, no consistent alteration in gene/pathway expression was observed. This observation also applies to the Notch and YAP/TAZ-Hippo signaling pathways, which have been associated with AXIN1-mutant HCCs previously. The AXIN1-repaired clones also cannot confirm a recent observation that AXIN1 is directly linked to YAP/TAZ protein stability and signaling. Our study provides insights into the effects of repairing AXIN1 mutations on β-catenin signaling, cell viability, and colony formation in HCC cell lines. However, further investigations are necessary to understand the complex mechanisms underlying HCC development associated with AXIN1 mutations.

Abstract C085: The somatic genomic landscape of hepatocellular carcinoma by race and ethnicity

Abstract Background: Hepatocellular carcinoma (HCC) has generally well-known causative agents; key genetic alterations are emerging form a heterogenous molecular landscape. Although the genomic landscape of hepatocellular carcinoma (HCC) has been well studied in recent years; however, previous genomic studies have disproportionately included non-Hispanic White (NHW) patients with limited inclusion of racial and ethnic minorities, particularly non-Hispanic Black (NHB) and Hispanic patients. We describe somatic mutation differences in a larger and more racially and ethnically representative HCC cohort than previously characterized. Methods: HCC mutational data was downloaded from The Cancer Genome Atlas (TCGA) project, an international data registry with 2.5 petabytes of genomic data, on cBioPortal. Non-Hispanic White, NHB and Hispanic (of any race), and Asian patients were analyzed. Median Fraction of Genes Altered (FGA) was calculated for all mutations. The primary objective was to compare the mutation frequencies between NHW and others with respect to fourteen genes of interest. Five genes (TERT, TP53, CTNNB1, AXIN1, ARID1A) are reported in literature as the most common HCC mutations, five other genes (ARID2, NFE2L2, KEAP1, RPS6KA3, JAK1) were identified as novel genes, and the remaining four (AJAP1, ADARB2, PTPRN2, SDK1) have been identified as part of potentially important epigenetic processes. Fisher’s Exact Test with a False Discovery Rate correction was used to calculate the statistical significance of the differences in mutation frequency between NHW and other patient groups. Results: Patients in the HCC cohort included 1,136 individuals (NHW N= 418, 50.7%; NHB N= 34, 4.1%; Hispanic N= 35, 4.2%; Asian N= 338, 41.0%). When compared to the NHW group, NHB patients had higher rates of TP53 mutations (69.7% vs 23.6%, p <0.00001, FDR <0.00004) while Hispanic patients had more SDK1 mutations (22.9% vs 4.3%, p= 0.0005, FDR= 0.005). Asian patients had higher frequency of TERT (38.1% vs 13.1%, p= 0.0051, FDR= 0.017), TP53 (36.2% vs 23.6%, p= 0.0002, FDR= 0.003), AXIN1 (9.8% vs 3.9%%, p= 0.0016, FDR= 0.007), and JAK1 (5.3% vs 1.2%, p= 0.0012, FDR= 0.008) mutations. All other comparisons between groups did not reach statistical significance. Median FGA for all patients was 0.24 with Asian patients presenting with higher rates as compared to NHW patients (0.28 vs 0.21, p <0.00001). Conclusions: The advances of cancer genomics has provided important insight into new therapeutics. Similarly, understanding the somatic genomic landscape of HCC in different patient populations is critical as we aim towards increased use of targeted therapies. In this study, TERT, TP53, AXIN1, JAK1, and SDK1 mutations were shown to occur at different frequencies in specific racial and ethnic groups. These differences in molecular landscape amongst racial and ethnic groups could contribute to precision medicine strategies used to address HCC. Citation Format: J. Alberto Maldonado, Tim F. Greten, Cecilia Monge. The somatic genomic landscape of hepatocellular carcinoma by race and ethnicity [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C085.

Tumor biology, immune infiltration and liver function define seven hepatocellular carcinoma subtypes linked to distinct drivers, survival and drug response

Background & aimsTumor heterogeneity is jointly determined by the components of the tumor ecosystem (TES) including tumor cells, immune cells, stromal cells, and non-cellular components. We aimed to identify subtypes using TES-related genes and determine subtype specific drivers and treatments for hepatocellular carcinoma (HCC). MethodsWe collected 68 genesets depicting tumor biology, immune infiltration, and liver function, totaling 2831 genes, and collected mRNA profiles and clinical data for over 6000 tumors from 65 datasets in the GEO, TCGA, ICGC, and several other databases. We designed a three-step clustering pipeline to identify subtypes. The microenvironment, genomic alteration, and drug response differences were systematically compared among subtypes. ResultsSeven subtypes (TES-1/2/3/4/5/6/7) were revealed in 159 tumors from the CHCC-HBV cohort. We constructed a single sample classifier using paired genes (sscpgsTES). TES subtypes were significantly associated with multiple clinical variables including etiology, and survival in 14 of 17 cohorts and the meta-cohort. TES-1 had the poorest prognosis and highest proliferation level. Both TES-2 and TES-7 were immune-enriched, however, TES-2 had a significantly worse prognosis, and hypoxic and immunosuppressive microenvironment. TES-4 had activated Wnt pathway, driven by CTNNB1 mutation. Good prognosis TES-6 exhibited the best differentiation. TES-5 and TES-3 were considered as novel subclasses by comparing with ten previous subtyping systems. TES-5 tumors had high AFP but good overall survival, and ∼45% of them harbored AXIN1 mutation. TES-3 was immune and stromal desert, may be driven by high copy number alteration burden, and had the poorest response to immune checkpoint inhibitor. TES-1 and TES-2 had significantly lower response to transarterial chemoembolization, but they showed significantly higher sensitivity to compound YM-155. ConclusionsTumor ecosystem subtypes expand existing HCC subtyping systems, have distinct drivers, prognosis, and treatment vulnerabilities.

The genetic basis of hypodontia in dental development.

Dental agenesis is one of the most common developmental anomalies in humans, characterised by the developmental absence of one or more teeth. It can present as an isolated condition (non-syndromic hypodontia) or associated with a syndrome (syndromic hypodontia). This paper aims to review the genetic basis of hypodontia with reference to aetiology, classification and the subsequent clinical features.Significant progress has been made to identify the developmental basis of tooth formation, though there is still a lack of knowledge within the literature of the aetiological basis of inherited tooth loss.Gene anomalies or mutations in WNT10A, MSX1, PAX9, AXIN2 and EDA appear to be most critical during tooth development, leading to various forms of tooth agenesis.

S2602 AXIN2 Mutation: A Toothless Cause of Hereditary Colorectal Cancer

S2602 AXIN2 Mutation: A Toothless Cause of Hereditary Colorectal Cancer

A novel pathogenic frameshift variant in AXIN2 in a man with polyposis and hypodontia

BackgroundWNT signaling is pivotal in embryogenesis and tissue homeostasis. Aberrant WNT signaling, due to mutations in components of this pathway, contributes to the development and progression of human cancers, including colorectal cancer. AXIN2, encoded by the AXIN2 gene, is a key negative regulator and target of the canonical WNT signaling pathway. Germline mutations in AXIN2 are associated with absence of permanent teeth (hypo- and oligodontia) and predisposition to gastrointestinal polyps and cancer. The limited number of patients makes an accurate genotype–phenotype analysis currently challenging.Case presentationWe present the case of a 55-year-old male with colorectal polyposis and hypodontia. Genetic testing confirmed a novel frameshift germline mutation in exon 8 of the AXIN2 gene. In addition, we provide an updated overview of germline AXIN2 mutations reported in literature.ConclusionsAlthough the number of missing teeth is less severe in our patient than in some previously reported cases, our findings provide additional evidence that missing teeth and gastrointestinal neoplasia are associated with rare pathogenic AXIN2 germline mutations.

Intestinal Epithelial Axin1 Deficiency Protects Against Colitis via Altered Gut Microbiota

Intestinal homeostasis is maintained by specialized host cells and the gut microbiota. Wnt/β-catenin signaling is essential for gastrointestinal development and homeostasis, and its dysregulation has been implicated in inflammation and colorectal cancer. Axin1 negatively regulates activated Wnt/β-catenin signaling, but little is known regarding its role in regulating host–microbial interactions in health and disease. Here, we aim to demonstrate that intestinal Axin1 determines gut homeostasis and host response to inflammation. Axin1 expression was analyzed in human inflammatory bowel disease datasets. To explore the effects and mechanism of intestinal Axin1 in regulating intestinal homeostasis and colitis, we generated new mouse models with Axin1 conditional knockout in intestinal epithelial cell (IEC; Axin1ΔIEC) and Paneth cell (PC; Axin1ΔPC) to compare with control (Axin1LoxP; LoxP: locus of X-over, P1) mice. We found increased Axin1 expression in the colonic epithelium of human inflammatory bowel disease (IBD). Axin1ΔIEC mice exhibited altered goblet cell spatial distribution, PC morphology, reduced lysozyme expression, and enriched Akkermansia muciniphila (A. muciniphila). The absence of intestinal epithelial and PC Axin1 decreased susceptibility to dextran sulfate sodium (DSS)-induced colitis in vivo. Axin1ΔIEC and Axin1ΔPC mice became more susceptible to DSS-colitis after cohousing with control mice. Treatment with A. muciniphila reduced DSS-colitis severity. Antibiotic treatment did not change the IEC proliferation in the Axin1Loxp mice. However, the intestinal proliferative cells in Axin1ΔIEC mice with antibiotic treatment were reduced compared with those in Axin1ΔIEC mice without treatment. These data suggest non-colitogenic effects driven by the gut microbiome. In conclusion, we found that the loss of intestinal Axin1 protects against colitis, likely driven by epithelial Axin1 and Axin1-associated A. muciniphila. Our study demonstrates a novel role of Axin1 in mediating intestinal homeostasis and the microbiota. Further mechanistic studies using specific Axin1 mutations elucidating how Axin1 modulates the microbiome and host inflammatory response will provide new therapeutic strategies for human IBD.

Aggressive progression to EGFR tyrosine kinase inhibitors in advanced NSCLC patients: concomitant mutations, prognostic indicator and subsequent management.

EGFR tyrosine kinase (TKIs) are recommend as the first-line treatment for non-small cell lung cancer (NSCLC) patients with EGFR mutation. However, some patients experience aggressive progression withaprogression-free survival (PFS) less than6months on the first-line EGFR TKI therapy. Therefore, our study is to analyze the potential influencing factors including clinical features, biomarkers, concomitant mutations et al. METHODS: A total of 1073 NSCLC patients with EGFR mutation in a multi-center study from January 2019 to December 2021. The datum pathological and molecular characteristics were collected. The area under the receiver operating characteristic (ROC) curve was used to evaluate the predictive effect of Ki-67 on the first-line TKI. The curve of PFS was conducted by Kaplan-Meier method and tested by bilateral log-rank. Cox regression model was used to predict and evaluate PFS of different variables. Chi-square or Fisher analysis was used for correlation between groups. 55 patients who show aggressive progression(PFS ≤6 months) on the first-line TKI therapy were analyzed in this study, while 71 with slow progression (PFS > 6months). Concomitant mutations including AXIN2, P2CG and RAD51C mutations occurred only in the aggressively progressive group (P = 0.029). Correlation between Ki-67 index and the aggressive progression of the first-line TKI therapy was significant statistically different (P < 0.05). In the second-line therapy, the PFS of chemotherapy in combination with other treatments was better than single TKIs in the first ten months. NSCLC harbored EGFR and concomitant mutations (such as AXIN2, PLCG2 and RAD51C), and/or Ki-67 high expression may indicate the aggressive progression to the first-line EGFR-TKI.

The higher body mass index is associated with a lower somatic mutation dependency in hepatocellular carcinoma

BackgroundReaching a certain somatic mutation threshold is a prerequisite of neoplastic initiation. High Body Mass Indexes (BMI) have been introduced as an independent risk factor for cancer development. However, there is evidence for lower mutational dependency in obese individuals in some types of cancers. In this study, we conducted a differential mutation analysis among patients with hepatocellular carcinoma (HCC) with different BMI. MethodsMutation annotation files of 158 normal-weights, 112 overweight and 76 obese HCC patients were retrieved from the TCGA-LIHC project using the TCGAbiolinks library [3]. The Ensembl Variant Effect Predictor (VEP) tool was used to further annotate the identified common and exclusive mutations in both BMI categories. The pathway enrichment of the characterized pathogenic mutations in different BMI categories was performed using the KEGG database. ResultHCC patients with normal BMIs showed a significantly higher frequency of pathogenic mutations compared with higher BMI groups. Pathogenic mutations in HCC-associated genes, namely TP53, CTTNB1, ARID2, ARID1A, AXIN1, and NFE2L2 were observed in the three BMI categories. However, they were more frequently targeted in normal-weights. Accordingly, a significantly larger number of mutated genes involved in cancer-associated signaling pathways, including Hepatocellular Carcinoma, PI3K-Akt, MAPK, and p53 were observed in patients with normal body weights compared with the higher BMI groups. In addition to the common targeted pathways among the three BMI groups, cAMP, Wnt, Hippo, and JAK-STAT signaling pathways were shared between normal-weight and overweight patients with HCC., Ras and mTOR signaling pathways were also exclusively targeted in the normal-weight group. ConclusionObese and overweight patients with HCC represent lower mutation dependency to develop HCC. More investigations considering central obesity measures will help to specify the molecular alterations caused by the presence of central fat that may promote tumor progression regardless of BMI.

Racial/Ethnic and Sex Differences in Somatic Cancer Gene Mutations among Patients with Early-Onset Colorectal Cancer.

NHBs, but not APIs, with early-onset nonhypermutated colorectal cancer had higher adjusted tumor mutation rates versus NHWs. Differences for FLT4, FBXW7, RNF43, LRP1B, APC, PIK3CA, and ATRX mutation rates between racial/ethnic groups and EP300, KRAS, AXIN2, WRN, BRAF, and LRP1B mutation rates by sex were observed in tumors of young patients. See related commentary by Shen et al., p. 530 . This article is highlighted in the In This Issue feature, p. 517.

The Profile of Articles on AXIN2 Mutations, Oligodontia, and Ethical Statements in Dental Research.

Editors often require ethical statements in research publications. This is particularly important with genetic data where discrimination may occur upon data disclosures. The purpose of this research is to determine if there was a positive trend of publishing ethical statements in dental genetic research. The study is limited to AXIN2 mutations which may be associated with oligodontia and cancer. A MEDLINE search of 2011-2021 articles concerning AXIN2, oligodontia, and ethical statements was conducted. Reviews, nonhuman subject research, abstracts, and articles not written nor translated into English were excluded. Forty-four studies were found; 10 excluded. There were 25 (75.8%) with ethical statements, and 25 (75.8%) with participant consent statements. There was no significant difference by year in ethical statements over the ten years (p = 0.094). There is a need to encourage more ethical statements in publications especially for genetically sensitive topics to reassure readers of ethical practices.

PTCH1 and AXIN2 modulation of AR copy number effects on AR gene overexpression in metastatic castration resistant prostate cancer (mCRPC).

e17026 Background: Androgen receptor (AR) signaling is a critical pathway in prostate cancer progression. Reactivation of the AR pathway is a key driver in mCRPC. Patients with mCRPC often develop resistance to novel AR signaling inhibitors (ARSIs) such as enzalutamide. AR inhibitor resistance leads to shorter overall and progression-free survival and can be attributed to AR gene amplification with subsequent AR overexpression and androgen-sensitization in prostate tumors. Identifying novel modulators of AR amplification in patients progressing on ARSIs may lead towards potential targets in drug discovery. Methods: In this cross-sectional study, an in silico patient model was developed on prescribed drug therapies and failed therapies patient information, PSA measures, ̃100 mutation variables including somatic, germline, and gain/loss mutations, and ̃1K gene expressions data from 275 mCRPC patients obtained from the Tempus database using GNS Healthcare’s Causal artificial intelligence technology, REFS. A causal network model was reconstructed based on patient data with inferred effect estimates. The network model was topologically surveyed for biological interactions. Results: Causal analysis of this model uncovered two germline mutations, located in PTCH1 and AXIN2, which modify the effect of AR copy number gain ( ARgain+ : copy number 6, ARgain- : copy number &lt; 6) on AR gene expression. For PTCH1-mutant group, there was a 2-fold increase in AR gene expression in ARgain+ patients compared to ARgain- patients (p = 2.1e-12), while only 1.4 fold increase in AR gene expression from the PTCH1 non-mutant group (p = 6.3e-08). Similarly, there was a 2-fold increase in AR gene expression in ARgain+ patients compared to ARgain- patients (p = 7.2e-16) for the AXIN2-mutant group, while only one-fold increase in AR gene expression with the AXIN2 non-mutant group (p = 0.001). The C to T missense mutation in codon 3746 in PTCH1 and codon 148 in AXIN2 have higher prevalences, 55% and 72%, respectively in this mCRPC cohort compared to their population allele frequencies, 38% and 47%, respectively. Conclusions: PTCH1 and AXIN2 mutations from our analyses is consistent with a literature reported role for Hedgehog signaling and Wnt/-catenin signaling pathways, respectively, influencing the disease progression in castration-resistant prostate cancer. Our findings suggest that the missense germline mutations in PTCH1 and AXIN2 predicts response to enzalutamide and other ARSIs in CRPC setting, and propose potential targets for combination therapy to overcome ARSI drug resistance in hormone-refractory prostate cancer. [Table: see text]

Mutation Detection and Functional Analysis of MSX1, PAX9, AXIN2, and BMP in Nonsyndromic Congenital Missing Teeth Based on Intelligent Image Detection.

Due to the complexity of clinical manifestations and the lack of standardized diagnostic criteria, it is still difficult to distinguish the etiological types of congenital edentulousness corresponding to genetic defects. This paper studies the application of deep learning image processing and digital image processing in medical images in detail and analyzes the functions of congenital edentulous hotspot genes. The cases in the control group and the study group were collected, and the gene mutations of direct sequence MSX1, PAX9, AXIN2, and BMP were analyzed, and new pathogens were found. The experimental results suggest that PAX9 and MSX1 genes may have a synergistic effect in nonsyndromic congenital edentulous patients. In severely missing teeth, the role of PAX9 may be greater than that of MSX1. The experimental results will help us lay the foundation for further understanding of the disease in the future.

Novel mutation signatures in the prognosis of EGFR-TKIs targeted therapy for non-small cell lung cancer patients based on the 1000-gene panel sequencing.

The application of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) in non-small cell lung cancer (NSCLC) may be affected by somatic mutations. The purpose of this study was to explore the effect of mutations on the prognosis and tumor markers of NSCLC patients treated with EGFR-TKIs. 21 NSCLC patients treated with EGFR-TKIs were selected, and the targeted sequencing of the tumor tissues or whole blood samples with the 1000-gene panel was conducted to screen mutations. Afterward, functional enrichment analysis was performed based on mutant genes. Subsequently, the correlation between mutations and clinical indicators, prognosis, and tumor markers were analyzed. Finally, the prognosis after taking osimertinib was compared between NSCLC patients with EGFR p.T790M positive and negative mutations, and the EGFR p.T790M concomitant and uncommon mutations were screened. A total of 485 mutations in 251 genes were identified, in which MTOR, AXIN2, AR, EGFR, NOTCH1, and HRAS mutations were significantly correlated with PFS and/or tumor markers. There was no significant difference in PFS, therapeutic effect, and prognosis between EGFR p.T790M positive and negative patients who received osimertinib treatment. Besides, we also found 80 concomitant mutations and 54 uncommon mutations of EGFR p.T790M. AR, HRAS, EGFR, AXIN2, NOTCH1, and MTOR might be key genes to the prognosis of NSCLC treated with EGFR-TKIs. Osimertinib has certain efficacy in EGFR p.T790M negative NSCLC patients.