Lab Invest. 2023 Nov 04. pii: S0023-6837(23)00226-X. [Epub ahead of print] 100283
Osteosarcoma is the most common primary bone malignancy. It is most often detected in children and adolescents and is commonly associated with TP53 alterations along with a high number of chromosomal rearrangements. However, osteosarcoma can affect patients of any age and some tumors display less genetic complexity. Besides TP53 variants, data on key driving mutations is lacking for many osteosarcomas, particularly those affecting adults. To detect osteosarcoma-specific alterations, we screened transcriptomic and genomic sequencing and copy number data from 150 bone tumors originally diagnosed as osteosarcoma. To increase the precision in gene fusion detection, we developed a bioinformatic tool denoted NAFuse, which extracts gene fusions that are verified at both the genomic and transcriptomic levels. Apart from the already reported genetic subgroups of osteosarcoma with TP53 structural variants, or MDM2 and/or CDK4 amplification, we did not identify any recurrent genetic driver that signifies the remaining cases. Among the plethora of mutations identified, we found genetic alterations characteristic for, or similar to, those of other bone and soft tissue tumors in eight cases. These mutations were found in tumors with relatively few other genetic alterations and/or affecting adults. Due to lack of clinical context and available tissue, we can question the diagnosis only on a genetic basis. Our findings, however, support the notion that osteosarcomas with few chromosomal alterations and/or affecting adults seem genetically distinct from conventional osteosarcomas of children and adolescents.
Keywords: NAFuse; bone tumor; gene fusion; osteosarcoma; sarcoma; soft tissue tumor