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Activating mutations in ERBB3 (human epidermal growth factor receptor 3) occur in 5.4% of small bowel adenocarcinomas. These ERBB3 mutations are targetable with anti-HER2 therapies and often co-occur with ERBB2 mutations.

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Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • Activating mutations in ERBB3 (human epidermal growth factor receptor 3) can drive cancer through the ErbB signaling pathway.
  • Anti-HER2 therapies show clinical activity in cancers with ERBB3 mutations.
  • Small bowel adenocarcinoma (SBA) is a rare cancer with a previously reported 12% rate of ERBB2 mutations.

Purpose of the Study:

  • To determine the frequency of activating ERBB3 mutations in small bowel adenocarcinoma (SBA).
  • To investigate the association between ERBB3 mutations and ERBB2 mutations in SBA.
  • To explore the potential for targeted therapies in ERBB3-mutated SBAs.

Main Methods:

  • Sequencing of key ERBB3 exons (3, 6, 7, 8, 23) in DNA from 74 SBAs.
  • Orthogonal validation using targeted next-generation sequencing.
  • Analysis of associations between ERBB3 mutations, ERBB2 mutations, and microsatellite instability.

Main Results:

  • Activating ERBB3 mutations were identified in 5.4% (4/74) of SBAs.
  • The identified mutations were p.V104M in exon 3 and p.E928G in exon 23.
  • ERBB3 mutations were significantly associated with microsatellite instability (P = .002) and the presence of ERBB2 mutations (P = .002).
  • Co-occurring ERBB2 and ERBB3 mutations suggested they originated from the same tumor clone.

Conclusions:

  • Small bowel adenocarcinomas exhibit a notable frequency of activating ERBB3 mutations.
  • These ERBB3 mutations are potentially targetable with existing anti-HER2 therapies.
  • Frequent co-mutation of ERBB2 and ERBB3 suggests a strong dependence on the HER2 pathway in a subset of SBAs.