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Genetic aberrations of gastrointestinal stromal tumors
Author(s) -
Yang Jilong,
Du Xiaoling,
Lazar Alexander J. F.,
Pollock Raphael,
Hunt Kelly,
Chen Kexin,
Hao Xishan,
Trent Jonathan,
Zhang Wei
Publication year - 2008
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23778
Subject(s) - pdgfra , cancer research , loss of heterozygosity , biology , imatinib , gist , receptor tyrosine kinase , carcinogenesis , tyrosine kinase , tyrosine kinase inhibitor , pathology , stromal cell , medicine , cancer , kinase , signal transduction , genetics , gene , allele , myeloid leukemia
Abstract Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm in the gastrointestinal tract and is associated with mutations of the KIT or PDGFRA gene. In addition, other genetic events are believed to be involved in GIST tumorigenesis. Cytogenetic aberrations associated with these tumors thus far described include loss of 1p, 13q, 14q, or 15q, loss of heterozygosity of 22q, numeric chromosomal imbalances, and nuclear/mitochondrial microsatellite instability. Molecular genetic aberrations include loss of heterozygosity of p16(INK4A ) and p14(ARF ), methylation of p15(INK4B ), homozygous loss of the Hox11L1 gene, and amplification of C ‐ MYC , MDM2 , EGFR1 , and CCND1 . GISTs in patients with neurofibromatosis type 1 appear to lack the KIT and PDGFRA mutations characteristic of GISTs and may have a different pathogenetic mechanism. Gene mutations of KIT or PDGFRA are critical in GISTs, because the aberrant versions not only are correlated with the specific cell morphology, histologic phenotype, metastasis, and prognosis, but also are the targets of therapy with imatinib and other agents. Furthermore, specific mutations in KIT and PDGFR appear to lead to differential drug sensitivity and may in the future guide selection of tyrosine kinase inhibitors. Activation of the receptor tyrosine kinases involves a signal transduction pathway whose components (mitogen‐activated protein kinase, AKT, phosphoinositide 3‐kinase, mammalian target of rapamycin, and RAS) are also possible targets of inhibition. A new paradigm of classification, integrating the standard clinical and pathological criteria with molecular aberrations, may permit personalized prognosis and treatment. Cancer 2008. © 2008 American Cancer Society.