Abstract PD14-03: Genetic and epigenetic basis of invasive lobular carcinomas lacking CDH1-alterations
Fatemeh DerakhshanHiginio DopesoArnaud Da Cruz PaulaPier SelenicaAntonio MarraEdaise M. da SilvaAndrea GazzoShirin Issa BhalooDara S. RossAnne GrabenstetterSarat ChandarlapatyPedram RazaviHannah Y. WenHong ZhangEdi BrogiBritta WeigeltFresia ParejaJorge S. Reis‐Filho
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Abstract Introduction: Invasive lobular carcinoma (ILC) is the most prevalent histologic special type of breast cancer, representing ~15% of invasive breast cancers. ILCs are mostly hormone receptor-positive and diagnosed histologically based on their distinctive discohesive growth pattern, dispersed single cells or line of cells invading the stroma. ILCs commonly show biallelic inactivation of a CDH1 (~65%), a tumor suppressor gene that is mapped to 16q22.1 and encodes for E-cadherin, a critical component of the epithelial adhesion complex. Massively parallel sequencing and pathologic studies have shown that a subset of ILCs (up to 15%) may lack CDH1 loss-of-function (LOF) mutations/deletions and retain E-cadherin expression, despite their distinctive lobular phenotype. The genetic and epigenetic underpinning of ILCs lacking CDH1 alterations has yet to be defined. Here we sought to define the mechanistic basis of the lobular phenotype in ILCs lacking CDH1 LOF genetic alterations or CDH1 gene promoter methylation and to determine the repertoire of epigenetic and genetic alterations of CDH1-wildtype ILCs. Materials and methods: Reanalysis of the CDH1 gene status in 364 primary ILCs, previously subjected to clinical massively parallel sequencing, was performed to identify all primary ILCs lacking bi-allelic CDH1 alterations. The hematoxylin and eosin stained slides of all identified ILCs lacking bi-allelic CDH1 alterations were reviewed by two pathologists and primary pure ILCs lacking bi-allelic CDH1 alterations were curated. We evaluated the presence of genetic alterations in genes playing essential roles in epithelial adhesion included in the clinical sequencing panel of up to 505 genes. The presence of CDH1 promoter methylation in 18 ILCs lacking bi-allelic CDH1 alterations with available formalin-fixed, paraffin-embedded (FFPE) material was assessed using methylation-specific PCR (MSP) and bisulfite sequencing. Results: We identified 23/364 (6.3%) primary ILCs lacking bi-allelic CDH1 alterations, of which 65.3% and 34.7% were classic and pleomorphic lobular variants, respectively. In 18 cases with available FFPE material, our analyses revealed that 67% (12/18) of ILCs lacking bi-allelic CDH1 alterations displayed biallelic CDH1 inactivation via promoter methylation and 16q loss. Furthermore, we observed that 1/23 ILC lacking bi-allelic CDH1 alterations had bi-allelic inactivation of AXIN2. We then extended our query to all invasive breast carcinomas subjected to clinical sequencing, including the ones initially categorized as invasive breast carcinoma “type unknown”, and observed that the three additional cases with pathogenic LOF AXIN2 alterations were ILCs lacking bi-allelic CDH1 alterations. Conclusions: The lobular phenotype in ILCs can be due to CDH1 promoter methylation or genetic alterations affecting other genes related to epithelial cell adhesion, such as AXIN2 LOF mutations. Whole-genome sequencing analyses of ILCs whose molecular basis has not been identified by targeted sequencing are warranted. Citation Format: Fatemeh Derakhshan, Higinio Dopeso, Arnaud Da Cruz Paula, Pier Selenica, Antonio Marra, Edaise M da Silva, Andrea Gazzo, Shirin Issa Bhaloo, Dara S Ross, Anne Grabenstetter, Sarat Chandarlapaty, Pedram Razavi, Hannah Y. Wen, Hong Zhang, Edi Brogi, Britta Weigelt, Fresia Pareja, Jorge S. Reis-Filho. Genetic and epigenetic basis of invasive lobular carcinomas lacking CDH1-alterations [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr PD14-03.Keywords:
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Abstract Recent studies uncovered critical roles of the adhesion protein E‐cadherin in health and disease. Global inactivation of Cdh1 , the gene encoding E‐cadherin in mice, results in early embryonic lethality due to an inability to form the trophectodermal epithelium. To unravel E‐cadherin's functions beyond development, numerous mouse lines with tissue‐specific disruption of Cdh1 have been generated. The consequences of E‐cadherin loss showed great variability depending on the tissue in question, ranging from nearly undetectable changes to a complete loss of tissue structure and function. This review focuses on these studies and discusses how they provided important insights into E‐cadherin's role in cell adhesion, proliferation and differentiation, and its consequences for biological processes as epithelial‐to‐mesenchymal transition, vascularization, and carcinogenesis. Lastly, we present some perspectives and possible approaches for future research.
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Stable intraepithelial adhesion complexes are essential for the maintenance of epithelial integrity. Alterations in these complexes are key events in the development and progression of many diseases. One of the major proteins involved in maintaining epithelial cell-cell adhesion is the cell-adhesion junction protein E-cadherin, a member of the cadherin family of transmembrane adhesion proteins. E-cadherin is involved in many cellular processes including morphogenesis, adhesion, recognition, communication and oncogenesis. Inactivation of its adhesive properties is often a key step in tumour progression and metastasis, leading to its recent description as a tumour suppressor gene. Mutations of the E-cadherin gene CDH1 in gastric and mammary cancers have been well documented and reports of transcriptional repression during tumour progression are increasing. This review examines the role of posttranslational truncation of E-cadherin in cancer cells focusing on implications for tumour progression. The various proteins involved in the directed cleavage of E-cadherin and consequences of these truncations are discussed.
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Loss of E-cadherin expression due to mutation of the CDH1 gene is a characteristic feature of invasive lobular breast cancer (ILBC). Beta-catenin, which binds to the cytoplasmic domain of E-cadherin, is simultaneously downregulated, reflecting disassembly of adherens junctions (AJs) and loss of cell adhesion. E-cadherin to P-cadherin expression switching can rescue AJs and cell adhesion. However, P-cadherin has not been implicated in ILBC, so far. We aimed to characterize 13 ILBCs with exceptional histomorphology, which we termed ILBCs with tubular elements. The CDH1 mutational status was determined by next generation sequencing and whole-genome copy number (CN) profiling. Expression of cadherins was assessed by immunohistochemistry. ILBCs with tubular elements were ER-positive (13/13) and HER2-negative (13/13) and harbored deleterious CDH1 mutations (11/13) accompanied by loss of heterozygosity due to deletion of chromosome 16q22.1 (9/11). E-cadherin expression was lost or reduced in noncohesive tumor cells and in admixed tubular elements (13/13). Beta-catenin expression was lost in noncohesive tumor cells, but was retained in tubular elements (11/13), indicating focal rescue of AJ formation. N-cadherin and R-cadherin were always negative (0/13). Strikingly, P-cadherin was commonly positive (12/13) and immunoreactivity was accentuated in tubular elements. Adjacent lobular carcinoma in situ (LCIS) was always P-cadherin-negative (0/7). In a reference cohort of LCIS specimens, P-cadherin was constantly not expressed (0/25). In a reference cohort of invasive mammary carcinomas, P-cadherin-positive cases (36/268, 13%) were associated with triple-negative nonlobular breast cancer (P < 0.001). Compared with ILBCs from the reference cohort, P-cadherin expression was more common in ILBCs with tubular elements (12/13 versus 7/84, P < 0.001). In summary, E-cadherin to P-cadherin switching occurs in a subset of ILBCs. P-cadherin is the molecular determinant of a mixed-appearing histomorphology in ILBCs with tubular elements.
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Adherens junction
Lobular carcinoma
Beta-catenin
Invasive lobular carcinoma
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Protocadherin
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Review on CDH1 (cadherin 1, type 1, E-cadherin (epithelial)), with data on DNA, on the protein encoded, and where the gene is implicated.
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瞄准：在胃的癌的原子核或膜 / 细胞质调查 beta-catenin 的分发房间，在 E-cadherin 基因甲基化之间的关系和它的表示，和象在预言肿瘤渗入的潜在的分子的标记的 beta-catenin 和 E-cadherin 的角色。方法：胃的癌的 29 个案例，分类同样弥漫、肠的变体，为学习被选择。原子、细胞质的蛋白质被净化， beta-catenin 内容被 ELISA 检测。E-cadherin/CDH1 基因倡导者的 DNA 甲基化被 methylation 特定的 PCR 和 compaired 学习， E-cadherin 表示由免疫组织化学检测了。结果：在胃的癌的 27 种情况中，在原子核和膜 / 细胞质之间的 beta-catenin 内容的比率与 T 分类被相关(r = 0.392， P = 0.043 ) 。意义在 T2 和 T3 组之间是在场的。没有关联以他们的 beta-catenin 分发在弥漫、肠的变体之间被检测。在胃的癌的弥漫的变体的 21 种情况中，在在 CDH1 基因甲醇化物组和甲醇化物得非的组之间的 E-cadherin 表示有差别(29 % 对 71 % ， P = 0.027 ) 。在 CDH1 基因甲基化和 T 分类之间的关联都没被发现，也不是在 E-cadherin 表示之间的意义，肿瘤渗入分级。结论：比较分析原子并且 membrane/cytoplasmic beta-catenin 能预言本地肿瘤渗入。E-cadherin/CDH1 基因甲基化是为它在弥漫的变体的基因沉默的一个重要原因胃的癌。当 E-cadherin 不在时的 CDH1 基因的甲基化是在胃的致癌作用的一个早事件。
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Inactivation of CDH1, encoding E-cadherin, promotes cancer initiation and progression. According to a newly proposed molecular mechanism, loss of E-cadherin triggers an upregulation of the anti-apoptotic oncoprotein BCL2. Conversely, reconstitution of E-cadherin counteracts overexpression of BCL2. This reciprocal regulation is thought to be critical for early tumor development. We determined the relevance of this new concept in human infiltrating lobular breast cancer (ILBC), the prime tumor entity associated with CDH1 inactivation. BCL2 expression was examined in human ILBC cell lines (IPH-926, MDA-MB-134, SUM-44) harboring deleterious CDH1 mutations. To test for an intact regulatory axis between E-cadherin and BCL2, wild-type E-cadherin was reconstituted in ILBC cells by ectopic expression. Moreover, BCL2 and E-cadherin were evaluated in primary invasive breast cancers and in synchronous lobular carcinomas in situ (LCIS). MDA-MB-134 and IPH-926 showed little or no BCL2 expression, while SUM-44 ILBC cells were BCL2-positive. Reconstitution of E-cadherin failed to impact on BCL2 expression in all cell lines tested. Primary ILBCs were almost uniformly E-cadherin-negative (97%) and were frequently BCL2-negative (46%). When compared with an appropriate control group, ILBCs showed a trend towards an increased frequency of BCL2-negative cases (P = 0.064). In terminal duct-lobular units affected by LCIS, the E-cadherin-negative neoplastic component showed a similar or a reduced BCL2-immunoreactivity, when compared with the adjacent epithelium. In conclusion, upregulation of BCL2 is not involved in lobular breast carcinogenesis and is unlikely to represent an important determinant of tumor development driven by CDH1 inactivation.
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We review the role of cadherins and cadherin-related proteins in human cancer. Cellular and animal models for human cancer are also dealt with whenever appropriate. E-cadherin is the prototype of the large cadherin superfamily and is renowned for its potent malignancy suppressing activity. Different mechanisms for inactivating E-cadherin/CDH1 have been identified in human cancers: inherited and somatic mutations, aberrant protein processing, increased promoter methylation, and induction of transcriptional repressors such as Snail and ZEB family members. The latter induce epithelial mesenchymal transition, which is also associated with induction of "mesenchymal" cadherins, a hallmark of tumor progression. VE-cadherin/CDH5 plays a role in tumor-associated angiogenesis. The atypical T-cadherin/CDH13 is often silenced in cancer cells but up-regulated in tumor vasculature. The review also covers the status of protocadherins and several other cadherin-related molecules in human cancer. Perspectives for emerging cadherin-related anticancer therapies are given.
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Transgenerational epigenetics, the study of non-genetic transfer of information from one generation to the next, has gained much attention in the past few decades due to the fact that, in many instances, epigenetic processes outweigh direct genetic processes in the manifestation of aberrant phenotypes across several generations. Maternal effects, or the influences of maternal environment, phenotype, and/or genotype on offsprings' phenotypes, independently of the offsprings' genotypes, are a subcategory of transgenerational epigenetics. Due to the intimate role of the mother during early development in animals, there is much interest in investigating the means by which maternal effects can shape the individual. Maternal effects are responsible for cellular organization, determination of the body axis, initiation and maturation of organ systems, and physiological performance of a wide variety of species and biological systems. The cardiovascular system is the first to become functional and can significantly influence the development of other organ systems. Thus, it is important to elucidate the role of maternal effects in cardiovascular development, and to understand its impact on adult cardiovascular health. Topics to be addressed include: (1) how and when do maternal effects change the developmental trajectory of the cardiovascular system to permanently alter the adult's cardiovascular phenotype, (2) what molecular mechanisms have been associated with maternally induced cardiovascular phenotypes, and (3) what are the evolutionary implications of maternally mediated changes in cardiovascular phenotype?
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Abstract The outcome of epigenetic responses to stress depends strictly on genetic background, suggesting that altered phenotypes, when induced, are created by a combination of induced epigenetic factors and pre‐existing allelic ones. When individuals with altered phenotypes are selected and subjected to successive breeding, alleles that potentiate epigenetic responses could accumulate in offspring populations. It is reasonable to suppose that many, if not all, of these allelic genes could also be involved in creating new phenotypes under nonstressful conditions. In this review, I discuss the possibility that the accumulation of such alleles in selected individuals with an epigenetic phenotype could give rise to individuals that exhibit the same phenotype even in the absence of stress.
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