Skip to main content

Advertisement

Log in

Molecular spectrum of c-KIT and PDGFRA gene mutations in gastro intestinal stromal tumor: determination of frequency, distribution pattern and identification of novel mutations in Indian patients

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

KIT and PDGFRA gene mutations are the major genetic alterations seen in gastrointestinal stromal tumors (GISTs) and are being used clinically for predicting response to imatinib therapy. In the current study, we set out to explore the frequency and distribution pattern of c-KIT (exons 9, 11 and 13) and PDGFRA (exons 12 and 18) by direct sequencing in a series of 70 Indian GIST cases. Overall, 27 (38.5 %) and 4 (5.7 %) of the cases had c-KIT and PDGFRA mutations, respectively. Majority of KIT mutations involved exon 11 (85.7 %), followed by exon 9 (14.3 %), while none showed exon 13 mutation. Most exon 9 mutations showed Ala503-Tyr504 duplication, while one had novel point mutation at codon 476 (S476G). In contrast to exon 9 mutations, most exon 11 mutations were in-frame deletions (79 %, 19/24), predominantly at codons 550-560, while remaining exon 11 mutant cases were point mutations at codons 559, 560, 568, 573 and 575. Interestingly, P573T, Q556_V560delinsH, Q575H and Q575_P577 were novel variations observed in exon 11. The PDGFRA mutations were seen mostly in exon 18, which showed point mutation at codon 842 (D842V), while exon 12 showed a novel indel variation (V561_H570delinsT). No significant correlation between c-KIT/PDGFRA mutations and clinicopathological data was observed. In conclusion, this study highlights the frequency and distribution pattern of c-KIT/PDGFRA mutation in Indian cohort. The current study identified novel variations that added new insights into the genetic heterogeneity of GIST patients. Furthermore, this is the first study to report the presence of PDGFRA mutation from Indian subcontinent.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sarlomo-Rokala M, Kovatich AJ, Barusevicius A, Miettinen M. CD117: a sensitive marker for gastrointestinal stromal tumors that is more specific than CD34. Mod Pathol. 1998;11:728–38.

    Google Scholar 

  2. Corless CL, Fletcher JA, Heinrich MC. Biology of gastrointestinal stromal tumors. J Clin Oncol. 2004;22:3813–25.

    Article  CAS  PubMed  Google Scholar 

  3. Heinrich MC, Rubin BP, Longley BJ, Fletcher JA. Biology and genetic aspects of gastrointestinal stromal tumors: KIT activation and cytogenetic alterations. Hum Pathol. 2002;33:484–95.

    Article  CAS  PubMed  Google Scholar 

  4. Corless CL, Heinrich MC. Molecular pathobiology of gastrointestinal stromal sarcomas. Annu Rev Pathol. 2008;3:557–86.

    Article  CAS  PubMed  Google Scholar 

  5. Miettinen M, Lasota J. Gastrointestinal stromal tumors review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med. 2006;130:1466–78.

    CAS  PubMed  Google Scholar 

  6. Battochio A, Mohammed S, Winthrop D, Lefresne S, Mulder K, Chu Q, et al. Detection of c-KIT and PDGFRA gene mutations in gastrointestinal stromal tumors: comparison of DHPLC and DNA sequencing methods using a single population-based cohort. Am J Clin Pathol. 2010;133:149–55.

    Article  CAS  PubMed  Google Scholar 

  7. Lasota J, Miettinen M. Clinical significance of oncogenic KIT and PDGFRA mutations in gastrointestinal stromal tumours. Histopathology. 2008;53:245–66.

    Article  CAS  PubMed  Google Scholar 

  8. Heinrich MC, Corless CL, Duensing A, McGreevey L, Chen CJ, Joseph N, et al. PDGFRA activating mutations in gastrointestinal stromal tumors. Science. 2003;279:708–10.

    Article  Google Scholar 

  9. Tuveson DA, Willis NA, Jacks T, Griffin JD, Singer S, Fletcher CD, et al. STI571 inactivation of the gastrointestinal stromal tumor c-KIT oncoprotein: biological and clinical implications. Oncogene. 2001;20:5054–8.

    Article  CAS  PubMed  Google Scholar 

  10. Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med. 2002;347:472–80.

    Article  CAS  PubMed  Google Scholar 

  11. Heinrich MC, Corless CL, Blanke CD, Demetri GD, Joensuu H, Roberts PJ, et al. Molecular correlates of imatinib resistance in gastrointestinal stromal tumors. J Clin Oncol. 2006;24:4764–74.

    Article  CAS  PubMed  Google Scholar 

  12. Heinrich MC, Corless CL, Demetri GD, Blanke CD, von Mehren M, Joensuu H, et al. Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol. 2003;21:4342–9.

    Article  CAS  PubMed  Google Scholar 

  13. Haller F, Happel N, Schulten HJ, von Heydebreck A, Schwager S, Armbrust T, et al. Site-dependent differential KIT and PDGFRA expression in gastric and intestinal gastrointestinal stromal tumors. Mod Pathol. 2007;20:1103–11.

    Article  CAS  PubMed  Google Scholar 

  14. Wozniak A, Rutkowski P, Piskorz A, Ciwoniuk M, Osuch C, Bylina E, et al. Prognostic value of KIT/PDGFRA mutations in gastrointestinal stromal tumours (GIST): polish clinical GIST registry experience. Ann Oncol. 2012;23:353–60.

    Article  CAS  PubMed  Google Scholar 

  15. Koh Y, Lee HE, Oh DY, Kim JH, Lee SH, Kim SH, et al. The lack of CD34 expression in gastrointestinal stromal tumors is related to cystic degeneration following imatinib use. Jpn J Clin Oncol. 2012;42:1020–7.

    Article  PubMed  Google Scholar 

  16. Ma YY, Yu S, He XJ, Xu Y, Wu F, Xia YJ, et al. Involvement of c-KIT mutation in the development of gastrointestinal stromal tumors through proliferation promotion and apoptosis inhibition. Onco Targets Ther. 2014;7:637–43.

    CAS  PubMed Central  PubMed  Google Scholar 

  17. Cyriac S, Rajendranath R, Sagar TG. Gastrointestinal stromal tumor: analysis of outcome and correlation with c-kit status in Indian population. Indian J Cancer. 2014;51:35–9.

    Article  CAS  PubMed  Google Scholar 

  18. Penzel R, Aulmann S, Moock M, Schwarzbach M, Rieker RJ, Mechtersheimer G. The location of KIT and PDGFRA gene mutations in gastrointestinal stromal tumours is site and phenotype associated. J Clin Pathol. 2005;58:634–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279:577–80.

    Article  CAS  PubMed  Google Scholar 

  20. Wasag B, Debiec-Rychter M, Pauwels P, Stul M, Vranckx H, Oosterom AV, et al. Differential expression of KIT/PDGFRA mutant isoforms in epithelioid and mixed variants of gastrointestinal stromal tumors depends predominantly on the tumor site. Mod Pathol. 2004;17:889–94.

    Article  CAS  PubMed  Google Scholar 

  21. Martín J, Poveda A, Llombart-Bosch A, Ramos R, López-Guerrero JA, del Muro JG, et al. Deletions affecting codons 557-558 of the c-KIT gene indicate a poor prognosis in patients with completely resected gastrointestinal stromal tumors: a study by the Spanish Group for Sarcoma Research (GEIS). J Clin Oncol. 2005;23:6190–8.

    Article  PubMed  Google Scholar 

  22. Agaram NP, Baren A, Arkun K, Dematteo RP, Besmer P, Antonescu CR, et al. Comparative ultrastructural analysis and KIT/PDGFRA genotype in 125 gastrointestinal stromal tumors. Ultrastruct Pathol. 2006;30:443–52.

    Article  PubMed  Google Scholar 

  23. Steigen SE, Eide TJ, Wasag B, Lasota J, Miettinen M. Mutations in gastrointestinal stromal tumors—a population-based study from northern Norway. APMIS. 2007;115:289–98.

    Article  CAS  PubMed  Google Scholar 

  24. Gomes AL, Bardales RH, Milanezi F, Reis RM, Schmitt F. Molecular analysis of c-Kit and PDGFRA in GISTs diagnosed by EUS. Am J Clin Pathol. 2007;127:89–96.

    Article  CAS  PubMed  Google Scholar 

  25. Zamò A, Bertolaso A, Franceschetti I, Weirich G, Capelli P, Pecori S, et al. Microfluidic deletion/insertion analysis for rapid screening of KIT and PDGFRA mutations in CD117-positive gastrointestinal stromal tumors. J Mol Diagn. 2007;9:151–7.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Liegl B, Kepten I, Le C, Zhu M, Demetri GD, Heinrich MC, et al. Heterogeneity of kinase inhibitor resistance mechanisms in GIST. J Pathol. 2008;216:64–74.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  27. Braggio E, de Braggio DA, Small IA, Lopes LF, Valadão M, Gouveia ME, et al. Prognostic relevance of KIT and PDGFRA mutations in gastrointestinal stromal tumors. Anticancer Res. 2010;30:2407–14.

    CAS  PubMed  Google Scholar 

  28. Barreca A, Fornari A, Bonello L, Tondat F, Chiusa L, Lista P, et al. KIT and PDGFRA mutations and PDGFRA immunostaining in gastrointestinal stromal tumors. Mol Med Rep. 2011;4:3–8.

    CAS  PubMed  Google Scholar 

  29. Kern A, Görgens H, Dittert DD, Krüger S, Richter KK, Schackert HK, et al. Mutational status of KIT and PDGFRA and expression of PDGFRA are not associated with prognosis after curative resection of primary gastrointestinal stromal tumors (GISTs). J Surg Oncol. 2011;104:59–65.

    Article  CAS  PubMed  Google Scholar 

  30. Emile JF, Brahimi S, Coindre JM, Bringuier PP, Monges G, Samb P, et al. Frequencies of KIT and PDGFRA mutations in the MolecGIST prospective population-based study differ from those of advanced GISTs. Med Oncol. 2012;29:1765–72.

    Article  CAS  PubMed  Google Scholar 

  31. Minárik G, Plank L, Lasabová Z, Szemes T, Burjanivová T, Szépe P, et al. Spectrum of mutations in gastrointestinal stromal tumor patients—a population-based study from Slovakia. APMIS. 2013;121:539–48.

    Article  PubMed  Google Scholar 

  32. Baker G, Babb C, Schnugh D, Nayler S, Louw M, Goedhals J, et al. Molecular characterisation of gastrointestinal stromal tumours in a South African population. Oncol Lett. 2013;5:155–60.

    CAS  PubMed Central  PubMed  Google Scholar 

  33. Chen J, Gundara JS, Haddad R, Schiavone V, Meldrum C, Samra J, et al. Clinicopathological and molecular aspects of foregut gastrointestinal stromal tumours. ANZ J Surg. 2014;84:52–8.

    Article  PubMed  Google Scholar 

  34. Kang HJ, Nam SW, Kim H, Rhee H, Kim NG, Kim H, et al. Correlation of KIT and platelet-derived growth factor receptor alpha mutations with gene activation and expression profiles in gastrointestinal stromal tumors. Oncogene. 2005;24:1066–74.

    Article  CAS  PubMed  Google Scholar 

  35. Teong YT, Teo ST, Tan LP, Wu BQ, Peh SC. An immunohistochemical and molecular study of gastrointestinal stromal tumours. Med J Malaya. 2006;61:526–33.

    CAS  PubMed  Google Scholar 

  36. Yeh CN, Chen TW, Wu TJ, Hsueh S, Jan YY. Treatment of patients with advanced gastrointestinal stromal tumor of small bowel: implications of imatinib mesylate. World J Gastroenterol. 2006;12:3760–5.

    CAS  PubMed Central  PubMed  Google Scholar 

  37. Imamura M, Yamamoto H, Nakamura N, Oda Y, Yao T, Kakeji Y, et al. Prognostic significance of angiogenesis in gastrointestinal stromal tumor. Mod Pathol. 2007;20:529–37.

    Article  CAS  PubMed  Google Scholar 

  38. Du CY, Shi YQ, Zhou Y, Fu H, Zhao G. The analysis of status and clinical implication of KIT and PDGFRA mutations in gastrointestinal stromal tumor (GIST). J Surg Oncol. 2008;98:175–8.

    Article  PubMed  Google Scholar 

  39. Kucujodaci Z, Tezel GG, Simsek AH, Gedikoglu G, Baloglu H. KIT and PDGFRA mutation analysis of GIST. Turk J Cancer. 2009;39:11–7.

    Google Scholar 

  40. Wang C, Jin MS, Zou YB, Gao JN, Li XB, Peng F, et al. Diagnostic significance of DOG-1 and PKC-θ expression and c-Kit/PDGFRA mutations in gastrointestinal stromal tumours. Scand J Gastroenterol. 2013;48:1055–65.

    Article  CAS  PubMed  Google Scholar 

  41. Xu Z, Huo X, Tang C, Ye H, Nandakumar V, Lou F, et al. Frequent KIT mutations in human gastrointestinal stromal tumors. Sci Rep. 2014;4:5907.

    PubMed Central  PubMed  Google Scholar 

  42. Lasota J, Miettinen M. KIT and PDGFRA mutations in gastrointestinal stromal tumors (GISTs). Semin Diagn Pathol. 2006;23:91–102.

    Article  PubMed  Google Scholar 

  43. Wardelmann E, Hrychyk A, Merkelbach-Bruse S, Pauls K, Goldstein J, Hohenberger P, et al. Association of platelet-derived growth factor receptor a mutations with gastric primary site and epithelioid or mixed cell morphology in gastrointestinal stromal tumors. J Mol Diagn. 2004;6:197–204.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  44. Kim TW, Lee H, Kang YK, Choe MS, Ryu MH, Chang HM, et al. Prognostic significance of c-kit mutation in localized gastrointestinal stromal tumors. Clin Cancer Res. 2004;10:3076–81.

    Article  CAS  PubMed  Google Scholar 

  45. Rubin BP, Singer S, Tsao C, Duensing A, Lux ML, Ruiz R, et al. KIT activation is a ubiquitous feature of gastrointestinal stromal tumors. Cancer Res. 2001;61:8118–21.

    CAS  PubMed  Google Scholar 

  46. Gizem C, Yasemin B, İlhan Ö, Özğül S, Koray A, Hülya E, et al. The frequencies of c-kit proto-oncogene (KIT) mutations in gastrointestinal stromal tumours: a population based study from Aegean Region of Turkey. Turk J Biochem. 2013;38:5–12.

    Article  Google Scholar 

  47. Hou YY, Tan YS, Sun MH, Wei YK, Xu JF, Lu SH, et al. C-kit gene mutation in human gastrointestinal stromal tumors. World J Gastroenterol. 2004;10:1310–4.

    CAS  PubMed  Google Scholar 

  48. Andersson J, Bümming P, Meis-Kindblom JM, Sihto H, Nupponen N, Joensuu H, et al. Gastrointestinal stromal tumors with KIT exon 11 deletions are associated with poor prognosis. Gastroenterology. 2006;130:1573–81.

    Article  CAS  PubMed  Google Scholar 

  49. Sakurai S, Oguni S, Hironaka M, Fukayama M, Morinaga S, Saito K. Mutations in c-kit gene exons 9 and 13 in gastrointestinal stromal tumors among Japanese. Jpn J Cancer Res. 2001;92:494–8.

    Article  CAS  PubMed  Google Scholar 

  50. Debiec-Rychter M, Sciot R, Le Cesne A, Schlemmer M, Hohenberger P, van Oosterom AT, et al. KIT mutations and dose selection for imatinib in patients with advanced gastrointestinal stromal tumors. Eur J Cancer. 2006;42:1093–103.

    Article  CAS  PubMed  Google Scholar 

  51. Antonescu CR, Besmer P, Guo T, Arkun K, Hom G, Koryotowski B, et al. Acquired resistance to imatinib in gastrointestinal stromal tumors occurs through secondary gene mutation. Clin Cancer Res. 2005;11:4182–90.

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bibhu Ranjan Das.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ahmad, F., Lad, P., Bhatia, S. et al. Molecular spectrum of c-KIT and PDGFRA gene mutations in gastro intestinal stromal tumor: determination of frequency, distribution pattern and identification of novel mutations in Indian patients. Med Oncol 32, 424 (2015). https://doi.org/10.1007/s12032-014-0424-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-014-0424-7

Keywords

Navigation