There has been little improvement in the prognosis for adolescent and young adult (AYA) tumor patients. Hence, there is an urgent need to understand the etiology of tumor development and identify actionable gene aberrations to improve prevention and therapy. Here, 76 sporadic tumors (48 breast, 22 ovarian, and six uterine) from 76 AYA females (age range, 25-39 years) were subjected to whole exome and RNA sequencing to determine their mutational signatures and actionable gene profiles. Two individuals with breast cancer (4.2% of cases) and one with ovarian cancer (5.3% of cases) carried germlineBRCA2mutations. The two cases with breast tumors also each carried an additional deleterious germline mutation: one inTP53and the other inCHEK2. Mutational signature analysis of the 76 tumors indicated that spontaneous deamination of 5-methylcytosine and activity of the APOBEC cytidine deaminase protein family are major causes of mutagenesis. In addition, 18 breast or ovarian tumors (18/70, 26%), including the three cases with germlineBRCA2mutations, exhibited a predominant "BRCAness" mutational signature, an indicator of functionalBRCA1/BRCA2deficiency. Actionable aberrations and high tumor mutation burdens were detected in 24 breast (50%), 17 ovarian (77%), and five uterine (83%) tumor cases. Thus, mutational processes and aberrant genes in AYA tumors are largely shared with those identified in non-AYA tumors. The efficacy of molecular targeting and immune checkpoint inhibitory therapies should be explored for both AYA and non-AYA patients.
Kanke, Y., Shimomura, A., Saito, M., Honda, T., Shiraishi, K., Shimada, Y., … Kohno, T. (2017). Gene aberration profile of tumors of adolescent and young adult females. Oncotarget, 9(5). https://doi.org/10.18632/oncotarget.23765