The clinical heterogeneity of round cell sarcomas with EWSR1/FUS gene fusions: Impact of gene fusion type on clinical features and outcome.


Journal

Genes, chromosomes & cancer
ISSN: 1098-2264
Titre abrégé: Genes Chromosomes Cancer
Pays: United States
ID NLM: 9007329

Informations de publication

Date de publication:
09 2020
Historique:
received: 25 03 2020
revised: 16 04 2020
accepted: 20 04 2020
pubmed: 4 5 2020
medline: 7 7 2021
entrez: 4 5 2020
Statut: ppublish

Résumé

The genetic hallmark of classic Ewing sarcoma is a recurrent fusion between EWSR1 and FUS gene with a member of the ETS transcription factor family. In contrast, tumors with non-ETS gene partners have been designated until recently "Ewing-like sarcoma," as a provisional molecular entity, as their clinical and pathologic features were still evolving. However, this group was reclassified as "round cell sarcoma with EWSR1-non-ETS fusions" in the latest 2020 WHO classification. Moreover, round cell sarcomas with either CIC or BCOR gene abnormalities, initially classified under Ewing family of tumors, are now regarded as stand-alone pathologic entities based on their distinct features. In this study we investigated the clinical characteristics of 226 confirmed Ewing sarcoma patients (EWSR1-FLI1 [n = 176], EWSR1/FUS-ERG [n = 35], EWSR1/FUS-FEV [n = 12], and EWSR1-ETV1/4 [n = 3]) and 14 round cell sarcoma patients with EWSR1-non-ETS fusion (EWSR1/FUS-NFATC2 [n = 10], EWSR1-PATZ1 [n = 3], and EWSR1-VEZF1 [n = 1]). The impact on overall survival (OS) was assessed in 90 patients with available follow-up, treated between 2011 and 2018. Patients with fusions involving FEV and NFATC2 genes showed an older median age at diagnosis, compared to those with EWSR1-FLI1 (P = .005), while extraskeletal location was more common in tumors with noncanonical EWSR1-FLI1 fusions (P = .001). Axial and pelvic primary sites were more common in patients with EWSR1-FLI1 (72%), while tumors with NFATC2 fusions were more frequent in the limb (78%, P = .006). The 3-year OS in patients with EWSR1-FLI1 was 91%, compared to only 60% in patients with alternative fusions (P = .037); the latter group showing a higher rate of metastases at presentation. However, this OS difference was not significant in patients with localized tumor (P = .585). Our study demonstrates significant correlations between fusion subtype and age at presentation, primary tumor sites, and OS, in both conventional Ewing sarcoma and round cell sarcoma with EWSR1-non ETS fusions patients. Larger studies are needed to determine survival differences in localized tumors.

Identifiants

pubmed: 32362012
doi: 10.1002/gcc.22857
pmc: PMC7372700
mid: NIHMS1601067
doi:

Substances chimiques

Biomarkers, Tumor 0
EWSR1 protein, human 0
FUS protein, human 0
Oncogene Proteins, Fusion 0
RNA-Binding Protein EWS 0
RNA-Binding Protein FUS 0

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

525-534

Subventions

Organisme : NCI NIH HHS
ID : P50 CA217694
Pays : United States
Organisme : NCI NIH HHS
ID : P50 CA140146
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States

Informations de copyright

© 2020 Wiley Periodicals, Inc.

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Auteurs

Yusuke Tsuda (Y)

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Lei Zhang (L)

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Paul Meyers (P)

Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

William D Tap (WD)

Department of Medicine and Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

John H Healey (JH)

Department of Orthopedic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Cristina R Antonescu (CR)

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

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Classifications MeSH