Whole-exome sequencing identifies NF1 mutations in tumors of melanoma patients exhibiting resistance to vemurafenib. Whole-exome sequencing identifies.

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Presentation transcript:

Whole-exome sequencing identifies NF1 mutations in tumors of melanoma patients exhibiting resistance to vemurafenib. Whole-exome sequencing identifies NF1 mutations in tumors of melanoma patients exhibiting resistance to vemurafenib. A, patients with melanoma who progressed on treatment with vemurafenib were biopsied pre- and posttreatment. Whole-exome sequencing was conducted and NF1 alterations assessed. The NF1 mutations are listed alongside the functional impact on the expressed protein. Silent mutations were assessed for their potential effects on splicing sites using the human splicing finder. The splicing motif affected by the mutation (in red) is indicated and “site broken” indicates potentially damaging effects on splice site function. B, PFS data were extrapolated from Chapman and colleagues (2), and the number of patients who progressed per month is shown in blue, the cumulative number of progressing patients is in gray. NF1 mutations observed in our cohort of patients are overlaid at their respective PFS times. Patients with a PFS of less than 3 months were nominated for de novo resistance, whereas those with a PFS of 3 months or more showed acquired resistance. Three NF1 alterations were observed in pretreatment BRAF–mutant melanoma patient samples, and all 3 patients showed de novo resistance. A fourth patient with a PFS of 5 months exhibited acquired resistance. C, Integrative Genomics Viewer (48) plot showing an NF1 silent mutation observed in the post-relapse biopsy sample only (c.4023G>A) in a patient with a PFS of 5 months. Steven R. Whittaker et al. Cancer Discovery 2013;3:350-362 ©2013 by American Association for Cancer Research