Genomic assessment distinguishes intrapulmonary metastases from synchronous primary lung cancers

Erin M. Corsini, Jinliang Wang, Chia Chin Wu, Junya Fujimoto, Marcelo V. Negrao, Runzhe Chen, Kelly Quek, Kyle G. Mitchell, Chi Wan B. Chow, Latasha Little, Curtis Gumbs, Xingzhi Song, Carmen Behrens, Arlene M. Correa, Mara B. Antonoff, Stephen G. Swisher, John V. Heymach, Jianhua Zhang, Ignacio I. Wistuba, P. Andrew FutrealBoris Sepesi, Jianjun Zhang

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: Multiple synchronous lung tumors (MSLT), particularly within a single lobe, represent a diagnostic and treatment challenge. While histologic assessment was once the only method to possibly distinguish multiple primary lung cancers, there is a growing interest in identifying unique genomic features or mutations to best characterize these processes. Methods: In order to differentiate multiple primary lung malignancies from intrapulmonary metastases in patients with MSLT, we performed whole exome sequencing (WES) on 10 tumor samples from 4 patients with MSLT. Results: Shared mutations between tumors from the same patient varied from 0-91%. Patient 3 shared no common mutations; however, in Patients 2 and 4, identical mutations were identified among all tumors from each patient, suggesting that the three tumors identified in Patient 3 represent separate primary lung cancers, while those of Patients 1, 2 and 4 signify hematogenous and lymphatic spread. Conclusions: A high proportion of shared mutations between different lung tumors is likely indicative of intrapulmonary metastatic disease, while tumors with distinct genomic profiles likely represent multiple primary malignancies driven by distinct molecular events. Application of genomic profiling in the clinical setting may prove to be important to precise management of patients with MSLT.

Original languageEnglish (US)
Pages (from-to)1952-1959
Number of pages8
JournalJournal of Thoracic Disease
Volume12
Issue number5
DOIs
StatePublished - May 1 2020

Keywords

  • Gene sequencing
  • Genomic heterogeneity
  • Multiple synchronous lung cancers
  • Non-small cell lung cancer

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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