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Mutational Signatures Driven by Epigenetic Determinants Enable the Stratification of Patients with Gastric Cancer for Therapeutic Intervention.

Title: Mutational Signatures Driven by Epigenetic Determinants Enable the Stratification of Patients with Gastric Cancer for Therapeutic Intervention.
Authors: Buttura, JR; Provisor Santos, MN; Valieris, R; Drummond, RD; Defelicibus, A; Lima, JP; Calsavara, VF; Freitas, HC; Cordeiro de Lima, VC; Fernanda Bartelli, T; Wiedner, M; Rosales, R; Gollob, KJ; Loizou, J; Dias-Neto, E; Nunes, DN; da Silva, IT
Contributors: Loizou, Joanna
Publisher Information: MDPI
Publication Year: 2026
Collection: The Institute of Cancer Research (ICR): Publications Repository
Subject Terms: DNA mismatch repair; gastric cancer; mutational signature; prognosis
Subject Geographic: Switzerland
Description: DNA mismatch repair deficiency (dMMR) is associated with the microsatellite instability (MSI) phenotype and leads to increased mutation load, which in turn may impact anti-tumor immune responses and treatment effectiveness. Various mutational signatures directly linked to dMMR have been described for primary cancers. To investigate which mutational signatures are associated with prognosis in gastric cancer, we performed a de novo extraction of mutational signatures in a cohort of 787 patients. We detected three dMMR-related signatures, one of which clearly discriminates tumors with MLH1 gene silencing caused by promoter hypermethylation (area under the curve = 98%). We then demonstrated that samples with the highest exposure of this signature share features related to better prognosis, encompassing clinical and molecular aspects and altered immune infiltrate composition. Overall, the assessment of the prognostic value and of the impact of modifications in MMR-related genes on shaping specific dMMR mutational signatures provides evidence that classification based on mutational signature exposure enables prognosis stratification.
Document Type: article in journal/newspaper
File Description: Electronic; application/pdf
Language: English
ISSN: 2072-6694
Relation: ARTN 490; cancers13030490; Cancers, 2021, 13 (3), pp. 490 -; https://repository.icr.ac.uk/handle/internal/7596
DOI: 10.3390/cancers13030490
Availability: https://doi.org/10.3390/cancers13030490; https://repository.icr.ac.uk/handle/internal/7596
Rights: http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.EBA5C3AC
Database: BASE