Molecular Genetic Landscape of Sclerosing Pneumocytomas

Jennifer M. Boland, Hee Eun Lee, Emily G. Barr Fritcher, Jesse S. Voss, Erik Jessen, Jaime I. Davila, Benjamin R. Kipp, Rondell P. Graham, Joseph J. Maleszewski, Joanne E.S. Yi

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: Sclerosing pneumocytomas are rare pulmonary neoplasms that are typically benign. However, rare patients experience progressive disease, and therapy targeting specific genetic underpinnings could be an attractive therapeutic option. Recent studies have found recurrent AKT 1 mutations in sclerosing pneumocytoma, but little is known about whether oncogenic fusion genes may also be present. METHODS: To better understand the genetic background, 10 sclerosing pneumocytomas were subjected to next-generation sequencing cancer mutation panel testing (n = 9) and/or RNA sequencing (n = 3). The patients were all women (average age, 47 years; range, 17-74 years). RESULTS: Eight patients had solitary sclerosing pneumocytomas, while one had two tumors, and one had many bilateral tumors. Recurrent mutations were noted in genes involved in the mTOR pathway, including AKT1, PIK3R1, and PTEN. AKT1 alterations were particularly common, present in 78%. No recurrent genetic fusions were identified. The patient in our study with multiple bilateral lesions was treated with the mammalian target of rapamycin (mTOR) inhibitor everolimus, with no objective radiographic evidence of treatment response after 4 months. CONCLUSIONS: Our data further support that abnormal activation of the mTOR pathway is a consistent genetic event in sclerosing pneumocytoma. This warrants further exploration to determine if mTOR pathway inhibitors may be effective in patients with metastatic or recurrent disease.

Original languageEnglish (US)
Pages (from-to)397-404
Number of pages8
JournalAmerican journal of clinical pathology
Volume155
Issue number3
DOIs
StatePublished - Feb 11 2021

Keywords

  • Fusion
  • mTOR
  • Mutation
  • Sclerosing pneumocytoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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