Genome-Wide Association Studies of Endometrial Cancer: Latest Developments and Future Directions

Endometrial cancer, the most commonly diagnosed cancer of the female reproductive tract in developed countries, has a heritable component. To date, 16 genetic risk regions have been robustly discovered by genome-wide association studies (GWAS) of endometrial cancer. Post-GWAS analyses including expression quantitative trait loci analysis and laboratory-based functional studies have been successful in identifying genes and pathways involved in endometrial carcinogenesis. Mendelian randomization analysis studies have confirmed factors causal for endometrial cancer risk, including increased body mass index and early onset of menarche. In this review, we summarize findings from GWAS and post-GWAS analyses of endometrial cancer. We discuss clinical implications of these findings, current knowledge gaps, and future directions for the study of endometrial cancer genetics.

[1]  G. Davey Smith,et al.  Mendelian randomization: genetic anchors for causal inference in epidemiological studies , 2014, Human molecular genetics.

[2]  Marcin Imielinski,et al.  Identification of focally amplified lineage-specific super-enhancers in human epithelial cancers , 2015, Nature Genetics.

[3]  Harvey Risch,et al.  GWAS meta-analysis of 16 852 women identifies new susceptibility locus for endometrial cancer. , 2016, Human molecular genetics.

[4]  Peter H. L. Krijger,et al.  Regulation of disease-associated gene expression in the 3D genome , 2016, Nature Reviews Molecular Cell Biology.

[5]  Peter Kraft,et al.  Identification of nine new susceptibility loci for endometrial cancer , 2018, Nature Communications.

[6]  Hui Zhao,et al.  Five endometrial cancer risk loci identified through genome-wide association analysis , 2016, Nature Genetics.

[7]  P. Visscher,et al.  Integration of summary data from GWAS and eQTL studies predicts complex trait gene targets , 2016, Nature Genetics.

[8]  A. Spurdle,et al.  Endometrial cancer gene panels: clinical diagnostic vs research germline DNA testing , 2017, Modern Pathology.

[9]  Orli G. Bahcall,et al.  iCOGS collection provides a collaborative model , 2013, Nature Genetics.

[10]  W. Chung,et al.  Evaluation of Polygenic Risk Scores for Breast and Ovarian Cancer Risk Prediction in BRCA1 and BRCA2 Mutation Carriers , 2017, Journal of the National Cancer Institute.

[11]  A. Chen-Plotkin,et al.  The Post-GWAS Era: From Association to Function. , 2018, American journal of human genetics.

[12]  M. García-Closas,et al.  Two Estrogen-Related Variants in CYP19A1 and Endometrial Cancer Risk: A Pooled Analysis in the Epidemiology of Endometrial Cancer Consortium , 2009, Cancer Epidemiology Biomarkers & Prevention.

[13]  Antonia A. Dominguez,et al.  Transcriptional regulation of hepatic lipogenesis , 2015, Nature Reviews Molecular Cell Biology.

[14]  M. Daly,et al.  LD Score regression distinguishes confounding from polygenicity in genome-wide association studies , 2014, Nature Genetics.

[15]  P. Webb Environmental (nongenetic) factors in gynecological cancers: update and future perspectives. , 2015, Future oncology.

[16]  G. Parmigiani,et al.  Familial Risk and Heritability of Cancer Among Twins in Nordic Countries. , 2016, JAMA.

[17]  A. Spurdle,et al.  Most common 'sporadic' cancers have a significant germline genetic component. , 2014, Human molecular genetics.

[18]  N. Cox,et al.  Trait-Associated SNPs Are More Likely to Be eQTLs: Annotation to Enhance Discovery from GWAS , 2010, PLoS genetics.

[19]  R. Kaaks,et al.  Obesity , Endogenous Hormones , and Endometrial Cancer Risk : A Synthetic Review 1 , 2002 .

[20]  Joan L. Walker,et al.  A phase II trial of anastrozole in advanced recurrent or persistent endometrial carcinoma: a Gynecologic Oncology Group study. , 2000, Gynecologic oncology.

[21]  Steven Gallinger,et al.  Cross-Cancer Genome-Wide Analysis of Lung, Ovary, Breast, Prostate, and Colorectal Cancer Reveals Novel Pleiotropic Associations. , 2016, Cancer research.

[22]  L. Kruglyak,et al.  The role of regulatory variation in complex traits and disease , 2015, Nature Reviews Genetics.

[23]  Jayne-Louise E. Pritchard,et al.  Enhancing the Promise of Drug Repositioning through Genetics , 2017, Front. Pharmacol..

[24]  Maristella,et al.  Genomic analyses identify hundreds of variants associated with age at menarche and 1 support a role for puberty timing in cancer risk 2 , 2017 .

[25]  J. Kaprio,et al.  Environmental and heritable factors in the causation of cancer--analyses of cohorts of twins from Sweden, Denmark, and Finland. , 2000, The New England journal of medicine.

[26]  C. Haiman,et al.  Genome-Wide Association Studies of Cancer in Diverse Populations , 2017, Cancer Epidemiology, Biomarkers & Prevention.

[27]  Aung Ko Win,et al.  Family History and Risk of Endometrial Cancer: A Systematic Review and Meta-analysis , 2015, Obstetrics and gynecology.

[28]  B. Charreau,et al.  The adaptor Lnk (SH2B3): an emerging regulator in vascular cells and a link between immune and inflammatory signaling. , 2011, Biochemical pharmacology.

[29]  A. Dunning,et al.  Beyond GWASs: illuminating the dark road from association to function. , 2013, American journal of human genetics.

[30]  M. Beckmann,et al.  Genome-wide association study identifies a common variant associated with risk of endometrial cancer , 2011, Nature Genetics.

[31]  James O J Davies,et al.  How best to identify chromosomal interactions: a comparison of approaches , 2017, Nature Methods.

[32]  A. Spurdle,et al.  Family history of cancer predicts endometrial cancer risk independently of Lynch Syndrome: Implications for genetic counselling. , 2017, Gynecologic oncology.

[33]  Peng-Hui Wang,et al.  Hormone therapy for younger patients with endometrial cancer. , 2012, Taiwanese journal of obstetrics & gynecology.

[34]  C. Friedenreich,et al.  Body Mass Index Genetic Risk Score and Endometrial Cancer Risk , 2015, PloS one.

[35]  Michael Q. Zhang,et al.  Identification of Tumor Suppressors and Oncogenes from Genomic and Epigenetic Features in Ovarian Cancer , 2011, PloS one.

[36]  C. Friedenreich,et al.  Genome-wide association study of endometrial cancer in E2C2 , 2013, Human Genetics.

[37]  Søren Brunak,et al.  Analysis of five chronic inflammatory diseases identifies 27 new associations and highlights disease-specific patterns at shared loci , 2016, Nature Genetics.

[38]  P. Pollock,et al.  A Common Variant at the 14q32 Endometrial Cancer Risk Locus Activates AKT1 through YY1 Binding. , 2016, American journal of human genetics.

[39]  P. Visscher,et al.  10 Years of GWAS Discovery: Biology, Function, and Translation. , 2017, American journal of human genetics.

[40]  A. Morris,et al.  Genetic overlap between endometriosis and endometrial cancer: evidence from cross‐disease genetic correlation and GWAS meta‐analyses , 2018, Cancer medicine.

[41]  Michael Q. Zhang,et al.  Integrative analysis of 111 reference human epigenomes , 2015, Nature.

[42]  B. Weber,et al.  Everolimus as second- or third-line treatment of advanced endometrial cancer: ENDORAD, a phase II trial of GINECO , 2013, British Journal of Cancer.

[43]  Howard Y. Chang,et al.  Enhancer connectome in primary human cells identifies target genes of disease-associated DNA elements , 2017, Nature Genetics.

[44]  M. Beckmann,et al.  CYP19A1 fine-mapping and Mendelian randomization: estradiol is causal for endometrial cancer , 2015, Endocrine-related cancer.

[45]  Jacques Ferlay,et al.  International Patterns and Trends in Endometrial Cancer Incidence, 1978-2013. , 2018, Journal of the National Cancer Institute.

[46]  Andrew R. Bassett Editing the genome of hiPSC with CRISPR/Cas9: disease models , 2017, Mammalian Genome.

[47]  N. Risch,et al.  Evaluating genetic association among ovarian, breast, and endometrial cancer: evidence for a breast/ovarian cancer relationship. , 1989, American journal of human genetics.

[48]  T. Lehtimäki,et al.  Integrative approaches for large-scale transcriptome-wide association studies , 2015, Nature Genetics.

[49]  Kconfab Investigators,et al.  Identification of 12 new susceptibility loci for different histotypes of epithelial ovarian cancer , 2017 .

[50]  Steven J. M. Jones,et al.  Integrated genomic characterization of endometrial carcinoma , 2013, Nature.

[51]  Clement Adebamowo,et al.  Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context , 2018, Cell reports.

[52]  P. Koper,et al.  Survival after relapse in patients with endometrial cancer: results from a randomized trial. , 2003, Gynecologic oncology.

[53]  J. Perry,et al.  Evidence of a Causal Association Between Insulinemia and Endometrial Cancer: A Mendelian Randomization Analysis , 2015, Journal of the National Cancer Institute.

[54]  Chris S Haley,et al.  The genomic signature of trait-associated variants , 2013, BMC Genomics.

[55]  Mulin Jun Li,et al.  Nature Genetics Advance Online Publication a N a Ly S I S the Support of Human Genetic Evidence for Approved Drug Indications , 2022 .

[56]  A. Tee,et al.  Neurofibromatosis type 1: Fundamental insights into cell signalling and cancer. , 2016, Seminars in cell & developmental biology.

[57]  Peter Kraft,et al.  Genome-Wide Meta-Analyses of Breast, Ovarian, and Prostate Cancer Association Studies Identify Multiple New Susceptibility Loci Shared by at Least Two Cancer Types. , 2016, Cancer discovery.

[58]  Christopher P. Fischer,et al.  Genome-wide association study of colorectal cancer identifies six new susceptibility loci , 2015, Nature Communications.

[59]  Dennis J. Hazelett,et al.  The OncoArray Consortium: A Network for Understanding the Genetic Architecture of Common Cancers , 2016, Cancer Epidemiology, Biomarkers & Prevention.

[60]  M. Beckmann,et al.  Fine-mapping of the HNF1B multicancer locus identifies candidate variants that mediate endometrial cancer risk , 2014, Human molecular genetics.

[61]  Ellen T. Gelfand,et al.  The Genotype-Tissue Expression (GTEx) project , 2013, Nature Genetics.

[62]  M. Beckmann,et al.  Genome-Wide Association Study Identifies a Possible Susceptibility Locus for Endometrial Cancer , 2012, Cancer Epidemiology, Biomarkers & Prevention.

[63]  M. Beckmann,et al.  Genetic Risk Score Mendelian Randomization Shows that Obesity Measured as Body Mass Index, but not Waist:Hip Ratio, Is Causal for Endometrial Cancer , 2016, Cancer Epidemiology, Biomarkers & Prevention.

[64]  Joshua M. Stuart,et al.  The Cancer Genome Atlas Pan-Cancer analysis project , 2013, Nature Genetics.

[65]  Aung Ko Win,et al.  Meta-analysis of genome-wide association studies identifies common susceptibility polymorphisms for colorectal and endometrial cancer near SH2B3 and TSHZ1 , 2015, Scientific Reports.