Inherited genes may cause more cancer than previously thought

A study into a rare type of pancreatic cancer reveals that we may inherit more than twice the number of ‘cancer genes’ than experts previously thought.

The research, which was led by AOUI Verona, Italy, with significant contributions from the University of Glasgow, was published in Nature.

Scientists looked at neuroendocrine tumours (NETs), specifically those which are found in the pancreas (PaNETs), the most common form of this rare cancer.

Researchers found that there were a significant number of inherited mutations in this type of cancer – 17% of PaNETs cases looked at were linked to inherited faulty genes. Previously it was thought only 5% of tumours were linked to hereditary genes.

Using international expertise the study also discovered how mutations affected different genes and their functions.

Four key cellular processes were affected by mutating genes including: the DNA repair systems; the systems that control cell growth; the systems that regulate the processes of cellular aging; the systems that regulate chromosomal structure.

NETs are relatively rare and represent less than 0.5% of all malignant tumours. They are low-incidence tumours, but with high prevalence, often because patients live for many years with the disease.

However, these tumours can also be fatal – Apple co-founder Steve Jobs died of a pancreatic neuroendocrine tumour after having the disease for several years.

The study was co-ordinated by the Veronese multicentre team of Arc-Net, led by Professor Aldo Scarpa, which brought together pancreatic cancer expertise from around the world.

Professor Scarpa said: “In this study we studied 160 PaNETs. By sequencing the genome of these tumours we have decrypted the landscape of genetic alterations of these tumours. This discovery will allow us to target the development of specific therapies that aim to counter the alterations identified.”

Professor Andrew Biankin, the University of Glasgow’s Regius Chair of Surgery and the Director the Translational Research Centre, said: “This study is a great example of International Team Science under the auspices of the International Cancer Genome Consortium. We managed to overcome all the societal hurdles of data and material sharing to make significant findings in an uncommon cancer type that can be difficult to treat. Glasgow is proud to make a substantial contribution to this project led by Aldo Scarpa in Verona, Italy.”

“One of the most provocative findings is that these cancers had a larger than expected inherited gene defect that likely contributed to their development, potentially raising challenges in the clinic and refocusing future studies in the area.”

The most common NETs are those that arise in the gastro-entro-pancreatic tract (70%), followed by those affecting the lungs (20%) and other body parts such as skin, thyroid, parathyroid and adrenal glands (10%).

Dr David Chang, one of the first authors on the paper, said: “This is the largest and most comprehensive study to date on pancreatic neuroendocrine tumour – a relatively rare pancreatic tumour type – using next generation-sequencing technology.

“We now have a deeper understanding of the molecular pathology of PanNET, including defining specific ways which these tumours can mutate. Importantly, we identified key biomarkers in tumours that could lead to better treatment options.”

AOUI Verona is a national and international reference for pancreatic diseases. Verona, thanks to the applied Arc-Net Research Centre, represents Italy in the International Cancer Genome Consortium (ICGC) with the support of the Ministry of 'Education, Universities and Research and relevant contributions from the Ministry of Health and AIRC, Italian Cancer Research Association.

The paper, Whole genome landscape of Pancreatic Neuroendocrine Tumours was published in Nature.

The study was funded by the Italian Ministry of Research; Associazione Italiana Ricerca Cancro, Fondazione Italiana Malattie Pancreas – Ministero Salute, Wellcome Trust, Cancer Research UK, Pancreatic Cancer UK, The Howat Foundation; University of Glasgow; National Health and Medical Research Council of Australia, Australian Cancer Research Foundation; Cancer Council NSW; Cancer Institute NSW.

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