Genome-wide association study using whole-genome sequencing to identify a novel locus associated with cardiomyopathy risk in adult survivors of childhood cancer: Utility of a two-stage analytic approach.

Authors

null

Yadav Sapkota

St. Jude Children’s Research Hospital, Memphis, TN

Yadav Sapkota , Qi Liu , Kyla C. Shelton , Xuexia Wang , Carmen Louise Wilson , Zhaoming Wang , Daniel A. Mulrooney , John L Jefferies , Kevin C. Oeffinger , Lindsay M. Morton , Jinghui Zhang , Gregory T. Armstrong , Smita Bhatia , Melissa M. Hudson , Leslie L. Robison , Yutaka Yasui

Organizations

St. Jude Children’s Research Hospital, Memphis, TN, University of Alberta, Edmonton, AB, Canada, St. Jude Children's Research Hospital, Memphis, TN, University of North Texas, Denton, TX, The University of Tennessee Heath Science Center, Memphis, TN, Duke University, Durham, NC, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, University of Alabama at Birmingham, Birmingham, AL

Research Funding

Other
The Leukemia and Lymphoma Society and the American Lebanese Syrian Associated Charities, Memphis, Tennessee

Background: Survivors of childhood cancer are at increased risk of treatment-related cardiomyopathy, found to be modified by genetic factors. To further investigate genetic risks of cardiomyopathy, we utilized whole-genome sequencing (WGS) in a clinically phenotyped cohort of long-term survivors of pediatric cancer. Methods: Utilizing a novel 2-stage analytic approach, we first performed association analysis for ejection fraction (EF) using WGS data in European-descent childhood cancer survivors from the St. Jude Lifetime Cohort (SJLIFE). EF was analyzed as a continuous variable to increase statistical power for genetic discovery. Common variants (minor allele frequency (MAF) > 0.05) were analyzed using linear regression, adjusting for age at diagnosis, sex, age at follow-up, doses of anthracycline and average radiation dose to the heart, and eigenvectors. Rare/low-frequency variants were aggregated by different functional annotations and agnostic 4-kb sliding windows, testing jointly using Burden/SKAT test. In the second stage, only the variant showing genome-wide significance with EF was tested for its association with cardiomyopathy risk. Results: Among the 2,015 SJLIFE survivors with WGS data, a locus on 6p21.2 near KCNK17achieved genome-wide significance with EF (rs2815063; MAF = 0.13; per allele beta = -0.016; P = 2.10´10-8), which replicated in 320 SJLIFE African survivors (MAF = 0.48; beta = -0.015; P = 0.004). In SJLIFE Europeans, 282 had a CTCAE Grade 2-5 cardiomyopathy. rs2815063 was significantly associated with increased risk of cardiomyopathy [per allele odds ratio (OR) = 1.38; P = 0.02], which replicated in 3,957 European survivors from the Childhood Cancer Survivor Study (163 CTCAE Grade 3-5 self-reported cases; per allele OR = 1.39; P = 0.038). rs2815063 alters DNA binding motif of EWSR1-FLI1, whose expression was found to lead to cardiomyopathy and death due to chronic cardiac failure in mice. Conclusions: Using a 2-stage approach, we report a novel locus for cardiomyopathy in childhood cancer survivors, which warrants additional work to gain mechanistic insights.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Cancer Prevention, Hereditary Genetics, and Epidemiology

Track

Prevention, Risk Reduction, and Genetics

Sub Track

Etiology/Epidemiology

Citation

J Clin Oncol 37, 2019 (suppl; abstr 1516)

DOI

10.1200/JCO.2019.37.15_suppl.1516

Abstract #

1516

Poster Bd #

10

Abstract Disclosures