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  • Review Article
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The 'omics' of adrenocortical tumours for personalized medicine

Nature Reviews Endocrinology volume 10, pages 215–228 (2014)Cite this article

Subjects

Key Points

  • The available genomic data on adrenocortical tumours come from transcriptome (mRNA expression), miRNome (microRNA expression) and methylome (DNA methylation) analyses, as well as from comparative genomic hybridization and single nucleotide polymorphisms arrays

  • Genomic studies performed to date indicate that malignant and benign adrenocortical tumours can be discriminated using molecular tools, including profiling of mRNA expression, microRNA expression or of chromosomal alterations

  • Using transcriptome or methylome data, classification algorithms can identify subtypes of adrenocortical tumours that are associated with different outcomes; thus, these molecular features can help to determine prognosis

  • Large-scale clinical studies are needed to determine the part that molecular analyses should play in clinical practice; international collaborative research networks should enable recruitment of adequate cohorts in the near future

  • To improve personalization of prognostication and therapy, a detailed molecular classification of adrenocortical tumours should be developed through integration of data from wide-ranging and complementary 'omics' studies, particularly exome and whole-genome sequencing

Abstract

Pan-genomic analyses of genetic and epigenetic alterations and gene expression profiles are providing important new insights into the pathogenesis and molecular classification of cancers. The technologies and methods used for these studies are rapidly diversifying and improving. The use of such methodologies for the analysis of adrenocortical tumours has revealed clear transcriptomic (mRNA and microRNA expression profiles), epigenomic (DNA methylation profiles) and genomic (DNA mutations and chromosomal alterations) differences between benign and malignant tumours. Interestingly, genomic studies of adrenal cancers have also identified subtypes of malignant tumours, which demonstrate distinct patterns of molecular alterations and are associated with different clinical outcomes. These discoveries have created the opportunity for classifying adrenocortical tumours on the basis of molecular analyses. Following these genomic studies, efforts to develop new molecular tools that improve diagnosis and prognostication of patients with adrenocortical tumours have also been made. This Review describes the progress that has been made towards classification of adrenocortical tumours to date based on key genomic approaches. In addition, the potential for the development and use of various molecular tools to personalize the management of patients with adrenocortical tumours is discussed.

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Figure 1: Summary of the genomic and transcriptomic analyses performed in adrenocortical carcinomas.
Figure 2: Prediction of recurrence of adrenocortical tumours (adrenocortical carcinoma and adrenocortical adenoma).
Figure 3: Prediction of overall survival in adrenocortical carcinoma based on gene expression profiling.
Figure 4: Prediction of overall survival in patients with adrenocortical carcinomas based on analysis of chromosomal alterations.
Figure 5: Prediction of overall survival based on DNA methylation profiles in adrenocortical carcinomas.
Figure 6: Prediction of overall survival of patients with adrenocortical tumour based on miRNA expression.
Figure 7: Molecular classification of adrenocortical tumours according to the genomic information.

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Acknowledgements

J. Bertherat's research on adrenal cancer is supported in part by the COMETE Network (Programme Hospitalier de Recherche Clinique; grant AOM95201), the INCa Recherche Translationelle (grant 2009-RT-02), and ENSAT-CANCER Health (FP7 program grant F2-2010-259735).

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  1. Department of Endocrinology, Referral Centre for Rare Adrenal Diseases, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Cochin, 27 rue du Fg-St-Jacques, Paris, 75014, France

    Guillaume Assié & Jérôme Bertherat

  2. INSERM U1016, CNRS UMR 8104, Paris Descartes University, Institut Cochin, Paris, 75014, France

    Guillaume Assié, Anne Jouinot & Jérôme Bertherat

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  1. Guillaume Assié
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All authors contributed equally to researching the data and to writing the article. J. Bertherat and G. Assié discussed the content and reviewed and/or edited the article before submission.

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Key genomic studies in adrenocortical carcinoma published to date (XLS 61 kb)

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Assié, G., Jouinot, A. & Bertherat, J. The 'omics' of adrenocortical tumours for personalized medicine. Nat Rev Endocrinol 10, 215–228 (2014). https://doi.org/10.1038/nrendo.2013.272

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