Key Points
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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
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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
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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
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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
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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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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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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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DOI: https://doi.org/10.1038/nrendo.2013.272
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