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Updated: May 19, 2026

Spontaneous Murine Model of Anaplastic Thyroid Cancer
Published on: February 3, 2023
Somatic RAS mutations occur in a large proportion of sporadic RET-negative medullary thyroid carcinomas and extend to
A Boichard1, L Croux, A Al Ghuzlan
1Institut Gustave Roussy, Translational Research Laboratory, 114 Rue Édouard Vaillant, 94805 Villejuif, France.
Context:
Medullary thyroid carcinoma (MTC) is characterized by proto-oncogene RET mutations in almost all hereditary cases as well as in more than 40% of sporadic cases. Recently, a high prevalence of RAS mutations was reported in sporadic MTC, suggesting an alternative genetic event in sporadic MTC tumorigenesis.
Objective:
This study aimed to extend this observation by screening somatic mutational status of RET, BRAF, and the three RAS proto-oncogenes in a large series of patients with MTC.
Materials And Methods:
Direct sequencing of RET (exons 8, 10, 11, 13, 14, 15, 16), BRAF (exons 11 and 15), and KRAS, HRAS, and NRAS genes (exons 2, 3, and 4) was performed on DNA prepared from 50 MTC samples, including 30 sporadic cases.
Results:
Activating RET mutations were detected in the 20 hereditary cases (germline mutations) and in 14 sporadic cases (somatic mutations). Among the 16 sporadic MTC without any RET mutation, eight H-RAS mutations and five K-RAS mutations were found. Interestingly, nine RAS mutations correspond to mutation hot spots in exons 2 and 3, but the other four mutations were detected in exon 4. The RET and RAS mutations were mutually exclusive. No RAS gene mutation was found in hereditary MTC, and no BRAF or NRAS mutation was observed in any of the 50 samples.
Conclusions:
Our study confirms that RAS mutations are frequent events in sporadic MTC. Moreover, we showed that RAS mutation analysis should not be limited to the classical mutational hot spots of RAS genes and should include analysis of exon 4.
Insights
RAS mutations are common in sporadic medullary thyroid carcinoma (MTC), occurring independently of RET mutations. Analysis should include exon 4 of RAS genes, not just hot spots.
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- Medullary thyroid carcinoma (MTC) often involves RET proto-oncogene mutations.
- RAS mutations are increasingly recognized as significant in sporadic MTC tumorigenesis.
Purpose of the Study:
- To investigate the frequency and spectrum of RET, BRAF, and RAS mutations in MTC.
- To determine the role of RAS mutations in sporadic MTC lacking RET alterations.
Main Methods:
- Direct sequencing of RET, BRAF, KRAS, HRAS, and NRAS genes in 50 MTC samples.
- Analysis included exons 2, 3, and 4 for RAS genes, and specific exons for RET and BRAF.
Main Results:
- RET mutations were found in hereditary and sporadic MTC cases.
- RAS mutations (HRAS, KRAS) were identified in 13 of 16 sporadic MTCs without RET mutations.
- RAS and RET mutations were mutually exclusive; no BRAF or NRAS mutations were detected.
Conclusions:
- RAS mutations are frequent in sporadic MTC and represent an alternative oncogenic pathway.
- Comprehensive RAS mutation analysis, including exon 4, is crucial for sporadic MTC diagnosis.
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