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Identification of Clonal Hematopoiesis Mutations in Solid Tumor Patients Undergoing Unpaired Next-Generation Sequencing Assays

Title: Identification of Clonal Hematopoiesis Mutations in Solid Tumor Patients Undergoing Unpaired Next-Generation Sequencing Assays
Authors: Coombs, Catherine C; Gillis, Nancy K; Tan, Xianming; Berg, Jonathan S; Ball, Markus; Balasis, Maria E; Montgomery, Nathan D; Bolton, Kelly L; Parker, Joel S; Mesa, Tania E; Yoder, Sean J; Hayward, Michele C; Patel, Nirali M; Richards, Kristy L; Walko, Christine M; Knepper, Todd C; Soper, John T; Weiss, Jared; Grilley-Olson, Juneko E; Kim, William Y; Earp, H Shelton; Levine, Ross L; Papaemmanuil, Elli; Zehir, Ahmet; Hayes, D Neil; Padron, Eric
Source: Clinical Cancer Research, vol 24, iss 23
Publisher Information: eScholarship, University of California
Publication Year: 2018
Collection: University of California: eScholarship
Subject Terms: 32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); 3211 Oncology and Carcinogenesis (for-2020); Hematology (rcdc); Genetics (rcdc); Precision Medicine (rcdc); Human Genome (rcdc); Clinical Research (rcdc); Biotechnology (rcdc); Cancer (rcdc); Rare Diseases (rcdc); Cancer Genomics (rcdc); Cancer (hrcs-hc); 3 Good Health and Well Being (sdg); Adult (mesh); Aged (mesh); Biomarkers (mesh); Clonal Evolution (mesh); Computational Biology (mesh); Female (mesh); Genome-Wide Association Study (mesh); Hematopoiesis (mesh); High-Throughput Nucleotide Sequencing (mesh); Humans (mesh); Male (mesh); Middle Aged (mesh); Mutation (mesh); Neoplasms (mesh)
Time: 5918 - 5924
Description: PURPOSE: In this era of precision-based medicine, for optimal patient care, results reported from commercial next-generation sequencing (NGS) assays should adequately reflect the burden of somatic mutations in the tumor being sequenced. Here, we sought to determine the prevalence of clonal hematopoiesis leading to possible misattribution of tumor mutation calls on unpaired Foundation Medicine NGS assays. EXPERIMENTAL DESIGN: This was a retrospective cohort study of individuals undergoing NGS of solid tumors from two large cancer centers. We identified and quantified mutations in genes known to be frequently altered in clonal hematopoiesis (DNMT3A, TET2, ASXL1, TP53, ATM, CHEK2, SF3B1, CBL, JAK2) that were returned to physicians on clinical Foundation Medicine reports. For a subset of patients, we explored the frequency of true clonal hematopoiesis by comparing mutations on Foundation Medicine reports with matched blood sequencing. RESULTS: Mutations in genes that are frequently altered in clonal hematopoiesis were identified in 65% (1,139/1,757) of patients undergoing NGS. When excluding TP53, which is often mutated in solid tumors, these events were still seen in 35% (619/1,757) of patients. Utilizing paired blood specimens, we were able to confirm that 8% (18/226) of mutations reported in these genes were true clonal hematopoiesis events. The majority of DNMT3A mutations (64%, 7/11) and minority of TP53 mutations (4%, 2/50) were clonal hematopoiesis. CONCLUSIONS: Clonal hematopoiesis mutations are commonly reported on unpaired NGS testing. It is important to recognize clonal hematopoiesis as a possible cause of misattribution of mutation origin when applying NGS findings to a patient's care.See related commentary by Pollyea, p. 5790.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: qt26d445jx; https://escholarship.org/uc/item/26d445jx; https://escholarship.org/content/qt26d445jx/qt26d445jx.pdf
DOI: 10.1158/1078-0432.ccr-18-1201
Availability: https://escholarship.org/uc/item/26d445jx; https://escholarship.org/content/qt26d445jx/qt26d445jx.pdf; https://doi.org/10.1158/1078-0432.ccr-18-1201
Rights: public
Accession Number: edsbas.754CC32F
Database: BASE