若年発症肺腺がんの一部にBRCA2やTP53遺伝子の遺伝的要因が関与することを解明~日本人の若年発症肺腺がんを対象とした初の大規模ゲノム解析の成果~

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2025-07-09 国立がん研究センター

この研究は、日本人若年発症肺腺がんにおいて、BRCA2やTP53といったがん抑制遺伝子の生殖細胞系列病的バリアントが高頻度に存在することを明らかにし、さらにDNA修復異常(相同組み換え修復機構破綻)を伴う症例ではPARP阻害剤の治療的効果が期待されることを示しました。また、DNA修復関連のALKBH2遺伝子バリアントも新たなリスク因子として同定しており、遺伝性腫瘍を踏まえた診療体制構築の重要性が示唆されています。

若年発症肺腺がんの一部にBRCA2やTP53遺伝子の遺伝的要因が関与することを解明~日本人の若年発症肺腺がんを対象とした初の大規模ゲノム解析の成果~
図1.がん登録情報に基づく2015年における年齢別肺がん発症数

<関連情報>

早期発症肺腺がんリスクに関連する病原性および中程度の遺伝的確率の生殖細胞系列変異のゲノムプロファイル Genomic profiles of pathogenic and moderate-penetrance germline variants associated with risk of early-onset lung adenocarcinoma

Hourin Cho MD, PhD , Kouya Shiraishi PhD , Kuniko Sunami MD, PhD , Yukihide Momozawa PhD , Tatsuya Yoshida MD, PhD , Shingo Matsumoto MD, PhD , Koichi Matsuda MD, PhD , Motonobu Saito MD, PhD , Akiteru Goto MD, PhD , Takayuki Honda MD, PhD , Akifumi Mochizuki MD , Masahiro Torasawa MD , Yataro Daigo MD, PhD , Kimihiro Shimizu MD, PhD , Hideo Kunitoh MD, PhD , Yukihiro Yoshida MD, PhD , Makoto Hirata MD, PhD , Yoko Shimada MS , Michiko Ueki MD , Hanako Ono PhD …Takahshi Kohno PhD
Journal of Thoracic Oncology  Available onlin:e 15 June 2025
DOI:https://doi.org/10.1016/j.jtho.2025.06.005

Abstract

Introduction

Up to 54% of all lung adenocarcinoma (LADC) cases in Asian populations occur in never-smoking women, suggesting that the impact of smoking and other environmental factors on the risk of early-onset LADC is minimal. Genetic factors may play a crucial role in disease development.

Methods

The prevalence of germline pathogenic variants (GPVs) of 454 hereditary cancer and DNA repair genes was examined by whole-exome and whole-genome sequencing of 350 early-onset LADC (aged < 40 years) and 1,441 later-onset LADC (aged ≥ 41 years) cases. A case-control study comprising 10,672 LADC cases and 7,898 healthy controls was performed to identify moderate-risk genetic factors for the disease. Analysis of somatic mutations in 1,280 LADC patients, including 31 patients with GPVs, was also performed.

Results

The frequency of GPVs of TP53 and BRCA2 was significantly higher in those with early-onset LADC than in those with later-onset LADC. The detection rates for TP53 and BRCA2 GPVs were 2.9% and 1.7%, respectively, in patients with early-onset LADC, and 0.14% and 0.21%, respectively, in patients with later-onset LADC. Patients with BRCA1 GPVs showed a high incidence of concurrent TP53 somatic mutations. Patients with BRCA2 GPVs showed deficient homologous recombination in tumors via loss of the wild-type allele. A germline ALKBH2 variant, p.Glu35Alafs*54, was associated with the risk of early-onset LADC, and patients with a deleterious variant showed a correlation between SBS4-related somatic mutations and the Brinkman index.

Conclusions

TP53 and BRCA2 GPVs and the ALKBH2 novel variant are associated with early-onset LADC in Asians.

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