Genomic and Epigenomic Heterogeneity of Hepatocellular Carcinoma

TLDR

Intratumoral heterogeneity in hepatocellular carcinoma informs personalized therapy and biomarker discovery. The study aimed to resolve the genetic architecture of subclonal diversification in HCC by applying whole‑exome sequencing to 69 samples from 11 patients. Whole‑exome sequencing of 69 samples from 11 patients was performed to map subclonal diversification. All 11 HCC cases showed spatial genomic diversity, with 29 % of driver mutations heterogeneous, while TP53 mutations were trunk‑shared; drug‑target variants (KIT, SYK, PIK3CA) were clonal, early mutagenic signatures from aristolochic acid and aflatoxin dominated, and extensive intratumoral epigenetic heterogeneity was also observed, underscoring widespread genomic and epigenomic heterogeneity in HCC. Published in Cancer Research 77(9):2255–65; ©2017 AACR.

Abstract

Abstract Understanding the intratumoral heterogeneity of hepatocellular carcinoma is instructive for developing personalized therapy and identifying molecular biomarkers. Here we applied whole-exome sequencing to 69 samples from 11 patients to resolve the genetic architecture of subclonal diversification. Spatial genomic diversity was found in all 11 hepatocellular carcinoma cases, with 29% of driver mutations being heterogeneous, including TERT, ARID1A, NOTCH2, and STAG2. Similar with other cancer types, TP53 mutations were always shared between all tumor regions, that is, located on the “trunk” of the evolutionary tree. In addition, we found that variants within several drug targets such as KIT, SYK, and PIK3CA were mutated in a fully clonal manner, indicating their therapeutic potentials for hepatocellular carcinoma. Temporal dissection of mutational signatures suggested that mutagenic processes associated with exposure to aristolochic acid and aflatoxin might play a more important role in early, as opposed to late, stages of hepatocellular carcinoma development. Moreover, we observed extensive intratumoral epigenetic heterogeneity in hepatocellular carcinoma based on multiple independent analytical methods and showed that intratumoral methylation heterogeneity might play important roles in the biology of hepatocellular carcinoma cells. Our results also demonstrated prominent heterogeneity of intratumoral methylation even in a stable hepatocellular carcinoma genome. Together, these findings highlight widespread intratumoral heterogeneity at both the genomic and epigenomic levels in hepatocellular carcinoma and provide an important molecular foundation for better understanding the pathogenesis of this malignancy. Cancer Res; 77(9); 2255–65. ©2017 AACR.