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Clinical Impact of Tumor Mutational Burden in Neuroblastoma.


ABSTRACT:

Background

Neuroblastoma is the most common pediatric extracranial solid tumor. Within conventional risk groups, there is considerable heterogeneity in outcomes, indicating the need for improved risk stratification.

Methods

In this study we analyzed the somatic mutational burden of 515 primary, untreated neuroblastoma tumors from three independent cohorts. Mutations in coding regions were determined by whole-exome/genome sequencing of tumor samples compared to matched blood leukocytes. Survival data for 459 patients were available for analysis of 5-year overall survival using the Kaplan-Meier method and log-rank test. All statistical tests were two-sided.

Results

Despite a low overall somatic mutational burden (mean = 3, range = 0-56), 107 patients were considered to have high mutational burden (>3 mutations). Unfavorable histology and age 18?months and older were associated with high mutational burden. Patients with high mutational burden had inferior 5-year overall survival (29.0%, 95% confidence interval [CI] = 17.2 to 41.8%) vs those with three or fewer somatic mutations (76.2%, 95% CI = 71.5 to 80.3%) (log-rank P?ConclusionsThis study demonstrates that mutational burden of primary neuroblastoma may be useful in combination with conventional risk factors to optimize risk stratification and guide treatment decisions, pending prospective validation.

SUBMITTER: Hwang WL 

PROVIDER: S-EPMC6624164 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Clinical Impact of Tumor Mutational Burden in Neuroblastoma.

Hwang William L WL   Wolfson Rachel L RL   Niemierko Andrzej A   Marcus Karen J KJ   DuBois Steven G SG   Haas-Kogan Daphne D  

Journal of the National Cancer Institute 20190701 7


<h4>Background</h4>Neuroblastoma is the most common pediatric extracranial solid tumor. Within conventional risk groups, there is considerable heterogeneity in outcomes, indicating the need for improved risk stratification.<h4>Methods</h4>In this study we analyzed the somatic mutational burden of 515 primary, untreated neuroblastoma tumors from three independent cohorts. Mutations in coding regions were determined by whole-exome/genome sequencing of tumor samples compared to matched blood leukoc  ...[more]

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