t(12;15)(p13;q25) ETV6/NTRK3 in Hematological malignancies

2019-11-01   Jean-Loup Huret  

1.jean-loup.huret@atlasgeneticsoncology.org

Abstract

Review on t(12;15)(p13;q25), with data on clinics, and the genes involved.

Clinics and Pathology

Disease

Myeloid leukemias and acute lymphoblastic leukemia (ALL).

Phenotype stem cell origin

Chronic eosinophilic leukemia (one case), acute myeloblastic leukemia with maturation (FAB type M2) (one case), acute myeloblastic leukemia with minimal differentiation (FAB type M0) (one case), and B-lineage acute lymphoblastic leukemia (three cases).

Epidemiology

A chronic eosinophilic leukemia was diagnosed in a 82-year old female patient with a previous history of breast and pancreatic carcinomas (Forghieri et al., 2011). A M2-AML was diagnosed in a 52-yr old female patient. The patient died 5 months after the onset of the leukaemia (Eguchi et al., 1999). A M0-AML was found in a 55-yr old male patient who died after a short period of supportive care (Kralik et al., 2011). Three cases of B-cell ALL were diagnosed. There was an adolescent boy and a 26-yr old male patient (Roberts et al., 2014; Gu et al., 2016; Reshmi et al., 2017).

Cytogenetics

There was a monosomy 7 in two of the three documented cases (Forghieri et al., 2011; Kralik et al., 2011), and a trisomy 8 in 2 cases as well (Eguchi et al., 1999; Forghieri et al., 2011). The lymphoid cases were not documented.

Genes Involved and Proteins

Gene name
ETV6 (ets variant 6)
Location
12p13.2
Protein description
ETV6 is a strong transcriptional repressor. ETV6 is a 452 amino acid member of the ETS family (signal-dependent transcriptional regulators, mediating cell proliferation, differentiation and tumorigenesis. The ETV6 protein contains two major domains, the HLH (helix-loop-helix) and ETS domains. The N-term HLH domain, also referred to as the pointed or sterile alpha motif domain, is responsible for hetero- and homodimerization. The C-term ETS domain is responsible for sequence specific DNA-binding and protein-protein interaction. A central domain, called internal domain, is involved in the recruitment of a repression complex includingNCOR1, NCOR2, and SIN3A (Braekeleer et al., 2014 http://atlasgeneticsoncology.org//Genes/ETV6ID38.html ).
Gene name
NTRK3 (neurotrophic tyrosine kinase, receptor, type 3)
Location
15q25.3
Protein description
NTRK3 is a transmembrane receptor tyrosine kinase which triggers PI3K/AKT, RAS/RAF/MAPK, and PLCG pathways. NTRK3 is a 839 amino acid protein with a N-term extra-cellular ligand binding domain, a transmembrane domain, and a C-term intracellular tyrosine kinase domain. Ligand for NTRK3 is NTF3 (neurotrophin 3) (Knezevich 2004 http://atlasgeneticsoncology.org/Genes/NTRK3ID433.html ).

Result of the Chromosomal Anomaly

Description

In most cases, ETV6 exon 5 was fused to NTRK3 exon 15 (Forghieri et al., 2011; Roberts et al., 2014). In one case ETV6 exon 4 was fused to NTRK3 exon 15 (Eguchi: et al., 1999), and in another case, fusion transcripts contain ETV6 exons 1 through 5 fused to NTRK3 exons 13b and 14b or NTRK3 exons 13 through 18 (Kralik et al., 2011).
In solid tumors, ETV6 exon 5 - NTRK3 exon 15 fusion is the most frequent:
The fusion was exon 4 - exon 14 in most papillary thyroid carcinoma ceases, but one exon 5 - exon 14 fusion case (Leeman-Neill et al., 2014), and exon 5 - exon 15 in: secretory ductal breast carcinoma (Tognon et al., 2002), congenital mesoblastic nephroma (Knezevich et al., 1998; Rubin et al., 1998; Argani et al., 2000; Ramachandran et al., 2001; Watanabe et al., 2002; Henno et al., 2003; Anderson et al., 2006; Bayindir et al., 2009), secretory carcinoma of salivary glands (mammary analogue) (Skálová et al., 2010; Skálová et al., 2014), atypical Spitz tumors (Yeh et al., 2016), and also in a case of colon adenocarcinoma (Seshagiri et al., 2012). The classical exon 5 - exon 15 fusion is also found in congenital/infantile fibrosarcoma (Knezevich et al., 1998; Rubin et al., 1998; Bourgeois et al., 2000; Punnett et al., 2000; Argani et al., 2001; Dubus et al., 2001; Sheng et al., 2001; Miura et al., 2002; McCahon et al., 2003; Ramphal et al., 2003; Nonaka and Sun, 2004; Himori et al., 2005), but, also, a fusion NTRK3 exon 14 - ETV6 exon 6 was found in one case (Dubus et al., 2001).
Atlas Image

Description

The SAM-PNT (sterile alpha motif- pointed) domain of ETV6 is fused to the PTK (Protein Tyrosine Kinase domain) of NTRK3.

Oncogenesis

It leads to dimerization, and induction of CCND1 (cyclin D1) and increased cell cycle progression. ETV6/NTRK3 also leads to constitutive activation of the PI3K/AKT, RAS/RAF/MAPK, and PLCG pathways (Lannon and Sorensen, 2005).

Highly cited references

Pubmed IDYearTitleCitations
351587432022Recent Advances on Immunohistochemistry and Molecular Biology for the Diagnosis of Adnexal Sweat Gland Tumors.171
376865222023The Impact of ETV6-NTRK3 Oncogenic Gene Fusions on Molecular and Signaling Pathway Alterations.121
351068562022Fusion-associated carcinomas of the breast: Diagnostic, prognostic, and therapeutic significance.117
367530242023Translocations and Gene Fusions in Sinonasal Malignancies.111
364673502022Advancement of secretory breast carcinoma: a narrative review.94
330243042021Problematic breast tumors reassessed in light of novel molecular data.91
324662022020NTRK Fusions, from the Diagnostic Algorithm to Innovative Treatment in the Era of Precision Medicine.73
365344212022Paediatric-type diffuse high-grade gliomas in the 5th CNS WHO Classification.65
180686312007ETV6-NTRK3 fusion oncogene initiates breast cancer from committed mammary progenitors via activation of AP1 complex.56
274773202016NTRK3 kinase fusions in Spitz tumours.46
336601472021Secretory Carcinoma of the Oral Cavity: A Retrospective Case Series with Review of Literature.45
304460162018Secretory carcinoma: the eastern Canadian experience and literature review.45
243273982014ETV6-NTRK3 is a common chromosomal rearrangement in radiation-associated thyroid cancer.42
373836772023Andrographis paniculata methanol extract suppresses the phosphorylation of ETV6‑NTRK3.42
329681852021Fusion partners of NTRK3 affect subcellular localization of the fusion kinase and cytomorphology of melanocytes.42
237986772013Mutation of the salt bridge-forming residues in the ETV6-SAM domain interface blocks ETV6-NTRK3-induced cellular transformation.42
351563432022Cytological and molecular characterization of secretory breast carcinoma.42
380240172023Paediatric and Adolescent Breast Cancer: A Narrative Review.41
384387312024Adaptive Darwinian off-target resistance mechanisms to selective RET inhibition in RET driven cancer.40
386125182024ETV6::NTRK3 Fusion-Positive Wild-Type Gastrointestinal Stromal Tumor (GIST) with Abundant Lymphoid Infiltration (TILs and Tertiary Lymphoid Structures): A Report on a New Case with Therapeutic Implications and a Literature Review.38
329579842020Clinicopathological findings of pediatric NTRK fusion mesenchymal tumors.38
389256162024Prevalence of neurotrophic tropomyosin receptor kinase (NTRK) fusion gene positivity in patients with solid tumors in Japan.35
281254512017Clinical and Morphologic Features of ETV6-NTRK3 Translocated Papillary Thyroid Carcinoma in an Adult Population Without Radiation Exposure.31
344293032021Mechanisms of targeted therapy resistance in a pediatric glioma driven by ETV6-NTRK3 fusion.30
296233062017Successful Targeted Therapy of Refractory Pediatric ETV6-NTRK3 Fusion-Positive Secretory Breast Carcinoma.28
364484412023A Pediatric Case of High-Grade Secretory Carcinoma of the Maxillary Sinus With ETV6::NTRK3 Gene Fusion, Therapeutic Implications, and Review of the Literature.26
341762002021Locally Recurrent Secretory Carcinoma of the Breast with NTRK3 Gene Fusion.26
329238922020Regression of ETV6-NTRK3 Infantile Glioblastoma After First-Line Treatment With Larotrectinib.25
298806142018ETV6-NTRK3 induces aggressive acute lymphoblastic leukemia highly sensitive to selective TRK inhibition.23
371881792023Case Report: Identification of a novel NTRK3-AJUBA fusion co-existing with ETV6-NTRK3 fusion in papillary thyroid carcinoma.22
346094372021ETV6-NTRK3-positive parotid mammary analogue secretory carcinoma: a case report.22
214019662011Characterization of a newly identified ETV6-NTRK3 fusion transcript in acute myeloid leukemia.17
337384522021The experience of successful treatment of ETV6-NTRK3-positive infant glioblastoma with entrectinib.7
376018392023An ETV6::NTRK3 fusion transcript in a core-binding factor acute myeloid leukemia.1
334054002021Molecular Pathology of Salivary Gland Neoplasms: Diagnostic, Prognostic, and Predictive Perspective.0
301711972019Molecular characterization of cancers with NTRK gene fusions.0
158268362005ETV6-NTRK3: a chimeric protein tyrosine kinase with transformation activity in multiple cell lineages.0
360872742022Atypical/unbalanced ETV6/NTRK3 rearrangement in salivary secretory carcinoma with a focus on the incidence, the patterns, and the clinical implications.0
333017512021Pan-tropomyosin receptor kinase immunoreactivity, ETV6-NTRK3 fusion subtypes, and RET rearrangement in salivary secretory carcinoma.0
124507872002ETV6-NTRK3--Trk-ing the primary event in human secretory breast cancer.0
266068802016Transcriptome sequencing identifies ETV6-NTRK3 as a gene fusion involved in GIST.0
357879222022Therapeutic targeting of RBPJ, an upstream regulator of ETV6 gene, abrogates ETV6-NTRK3 fusion gene transformations in glioblastoma.0
107027992000The ETV6-NTRK3 gene fusion encodes a chimeric protein tyrosine kinase that transforms NIH3T3 cells.0
362743302022Myxoid spindle cell sarcoma with ETV6-NTRK3 fusion.0
264921822016Mammary Analogue Secretory Carcinoma of Salivary Glands: Molecular Analysis of 25 ETV6 Gene Rearranged Tumors With Lack of Detection of Classical ETV6-NTRK3 Fusion Transcript by Standard RT-PCR: Report of 4 Cases Harboring ETV6-X Gene Fusion.0
298942792018Acute myeloid leukemia carrying ETV6 mutations: biologic and clinical features.0
292865632018ETV6-NTRK3 in congenital mesoblastic nephroma: A report of the SIOP/GPOH nephroblastoma study.0
370707392023Salivary Gland Secretory Carcinoma: Clinicopathologic and Genetic Characteristics of 215 Cases and Proposal for a Grading System.0
275752692016Mammary Analogue Secretory Carcinoma.0
280603652017Newly described salivary gland tumors.0
314235582020Pan-Trk immunohistochemistry reliably identifies ETV6-NTRK3 fusion in secretory carcinoma of the salivary gland.0
386292452024RAF1 gene fusions are recurrent driver events in infantile fibrosarcoma-like mesenchymal tumors.0
344865432022Secretory Carcinoma of the Salivary Gland: A Rarity in Children.0
331837282020Pediatric Renal Tumors: Updates in the Molecular Era.0
375058082023Sweat Gland Tumors Arising on Acral Sites: A Molecular Survey.0
94627531998A novel ETV6-NTRK3 gene fusion in congenital fibrosarcoma.0
117514162001The chimeric protein tyrosine kinase ETV6-NTRK3 requires both Ras-Erk1/2 and PI3-kinase-Akt signaling for fibroblast transformation.0
358563622022A novel ETV6-NTRK3 gene fusion in primary renal fibrosarcoma.0
290463242018ETV6-NTRK3 and STRN-ALK kinase fusions are recurrent events in papillary thyroid cancer of adult population.0
274272382016"Wild type" GIST: Clinicopathological features and clinical practice.0
349585032022Mesenchymal neoplasms with NTRK and other kinase gene alterations.0
294275542018Sporadic pediatric papillary thyroid carcinoma harboring the ETV6/NTRK3 fusion oncogene in a 7-year-old Japanese girl: a case report and review of literature.0
343730982021Molecular Pathology of Thyroid Tumors: Old Problems and New Concepts.0
388216462024Molecular Pathology of Thyroid Tumors: Old Problems and New Concepts.0
356708542022Low-grade tracheal adenocarcinoma with ETV6::NTRK3 fusion: unique morphology akin to subsets of sinonasal low-grade non-intestinal-type adenocarcinoma.0
286835892018Infantile NTRK-associated Mesenchymal Tumors.0
392599282024Secretory Carcinoma of the Breast: Radiologic-Pathologic Correlation.0
338483862021High-grade salivary gland carcinoma with the ETV6-NTRK3 gene fusion: A case report and literature review of secretory carcinoma with high-grade transformation.0
382063842024ETV6::NTRK3-associated papillary adenocarcinoma: let us play it by ear.0
272590072016ETV6-NTRK3 Is Expressed in a Subset of ALK-Negative Inflammatory Myofibroblastic Tumors.0
108958162000Molecular detection of the ETV6-NTRK3 gene fusion differentiates congenital fibrosarcoma from other childhood spindle cell tumors.0
286142092017Newly Described Entities in Salivary Gland Pathology.0
307886032019Relationship between genetic alterations and clinicopathological characteristics of papillary thyroid carcinoma.0
305364872018Successful treatment of ETV6-NTRK3 fusion gene-negative infantile fibrosarcoma with metastatic lesion resistant to VAC chemotherapy.0
338997882021Pan-TRK Immunohistochemistry Is Highly Correlated With NTRK3 Gene Rearrangements in Salivary Gland Tumors.0
370361642023Targeted therapy using larotrectinib and venetoclax for the relapsed/refractory T-cell acute lymphoblastic leukemia harboring a cryptic ETV6-NTRK3 fusion.0
174094272007Cellular transformation and activation of the phosphoinositide-3-kinase-Akt cascade by the ETV6-NTRK3 chimeric tyrosine kinase requires c-Src.0
381136522024ETV6::NTRK3 gene fusion in a patient with metastatic lung atypical carcinoid successfully treated with repotrectinib: A case report.0
373387652023Development of a Cell Line Containing the Chimeric ETV6-NTRK3 Gene. The Search for Mutations of the Tyrosine Kinase Chimeric Domain That Cause Resistance to Larotrectinib.0
263070212015Are we really at the dawn of understanding sporadic pediatric thyroid carcinoma?0
352670842022The evolving role of molecular pathology in the diagnosis of salivary gland tumours with potential pitfalls.0
151010492004A fluorescence in situ hybridization study of ETV6-NTRK3 fusion gene in secretory breast carcinoma.0
379450132023Secretory Carcinoma with ETV6-NTRK3 Gene Fusion and Lymph Node Metastasis in Maxillary Gingiva: A Case Report with Pathological and Molecular Correlative Studies.0
218046052012A tripartite complex composed of ETV6-NTRK3, IRS1 and IGF1R is required for ETV6-NTRK3-mediated membrane localization and transformation.0
379246572023Utility of MUC4 in the diagnosis of secretory carcinoma of salivary glands.0
291193872018A new ETV6-NTRK3 cell line model reveals MALAT1 as a novel therapeutic target - a short report.0
367481822023Primary inflammatory myofibroblastic tumour of the liver: a clinicopathological and genetic study including a subset with ETV6::NTRK3 fusion.0
338956802021ETV6-NTRK3 translocation-associated low-grade mucinous bronchial adenocarcinoma: A novel bronchial salivary gland-type non-small cell lung cancer subtype.0
211484872011ETV6-NTRK3-mediated breast epithelial cell transformation is blocked by targeting the IGF1R signaling pathway.0
124507922002Expression of the ETV6-NTRK3 gene fusion as a primary event in human secretory breast carcinoma.0
362078122023Diagnostic accuracy of pan-TRK immunohistochemistry in differentiating secretory carcinoma from acinic cell carcinoma of salivary gland-A systematic review.0
259903692016Molecular signature of salivary gland tumors: potential use as diagnostic and prognostic marker.0
230600672012Morphologic features of carcinomas with recurrent gene fusions.0
293916022018Novel identification of STAT1 as a crucial mediator of ETV6-NTRK3-induced tumorigenesis.0
351581212022Genomic landscape of secretory carcinoma of the breast with axillary lymph node metastasis.0
174255052006Recurrent fusion oncogenes in carcinomas.0
308195302019Paraneoplastic disorders associated with miscellaneous neoplasms with focus on selected soft tissue and Undifferentiated/ rhabdoid malignancies.0
129730472003Recent advances in pediatric renal neoplasia.0
146683422004A highly conserved NTRK3 C-terminal sequence in the ETV6-NTRK3 oncoprotein binds the phosphotyrosine binding domain of insulin receptor substrate-1: an essential interaction for transformation.0
98233071998ETV6-NTRK3 gene fusions and trisomy 11 establish a histogenetic link between mesoblastic nephroma and congenital fibrosarcoma.0

Article Bibliography

Pubmed IDLast YearTitleAuthors
166816922006Expression of ETV6-NTRK in classical, cellular and mixed subtypes of congenital mesoblastic nephroma.Anderson J et al
116849682001Reduced sensitivity of paraffin-based RT-PCR assays for ETV6-NTRK3 fusion transcripts in morphologically defined infantile fibrosarcoma.Argani P et al
196294652009Cellular mesoblastic nephroma (infantile renal fibrosarcoma): institutional review of the clinical, diagnostic imaging, and pathologic features of a distinctive neoplasm of infancy.Bayindir P et al
108958162000Molecular detection of the ETV6-NTRK3 gene fusion differentiates congenital fibrosarcoma from other childhood spindle cell tumors.Bourgeois JM et al
168889132003Secretory carcinoma of the breast: a genetically defined carcinoma entity.Diallo R et al
111695202001The detection of Tel-TrkC chimeric transcripts is more specific than TrkC immunoreactivity for the diagnosis of congenital fibrosarcoma.Dubus P et al
99491791999Fusion of ETV6 to neurotrophin-3 receptor TRKC in acute myeloid leukemia with t(12;15)(p13;q25).Eguchi M et al
212267632011Chronic eosinophilic leukaemia with ETV6-NTRK3 fusion transcript in an elderly patient affected with pancreatic carcinoma.Forghieri F et al
278240512016Genomic analyses identify recurrent MEF2D fusions in acute lymphoblastic leukaemia.Gu Z et al
126505162003Cellular mesoblastic nephroma: morphologic, cytogenetic and molecular links with congenital fibrosarcoma.Henno S et al
158016892005Infantile fibrosarcoma of thigh--a case report.Himori K et al
214019662011Characterization of a newly identified ETV6-NTRK3 fusion transcript in acute myeloid leukemia.Kralik JM et al
243273982014ETV6-NTRK3 is a common chromosomal rearrangement in radiation-associated thyroid cancer.Leeman-Neill RJ et al
126526162003Non-resectable congenital tumors with the ETV6-NTRK3 gene fusion are highly responsive to chemotherapy.McCahon E et al
124061912002Regression of congenital fibrosarcoma to hemangiomatous remnant with histological and genetic findings.Miura K et al
150220582004Congenital fibrosarcoma with metastasis in a fetus.Nonaka D et al
145780342003Retroperitoneal infantile fibrosarcoma: clinical, molecular, and therapeutic aspects of an unusual tumor.Ramphal R et al
284084642017Targetable kinase gene fusions in high-risk B-ALL: a study from the Children's Oncology Group.Reshmi SC et al
252077662014Targetable kinase-activating lesions in Ph-like acute lymphoblastic leukemia.Roberts KG et al
98113361998Congenital mesoblastic nephroma t(12;15) is associated with ETV6-NTRK3 gene fusion: cytogenetic and molecular relationship to congenital (infantile) fibrosarcoma.Rubin BP et al
228951932012Recurrent R-spondin fusions in colon cancer.Seshagiri S et al
112427902001Congenital-infantile fibrosarcoma. A clinicopathologic study of 10 cases and molecular detection of the ETV6-NTRK3 fusion transcripts using paraffin-embedded tissues.Sheng WQ et al
241456512014Mammary analogue secretory carcinoma of salivary glands with high-grade transformation: report of 3 cases with the ETV6-NTRK3 gene fusion and analysis of TP53, β-catenin, EGFR, and CCND1 genes.Skálová A et al
124507922002Expression of the ETV6-NTRK3 gene fusion as a primary event in human secretory breast carcinoma.Tognon C et al
121654452002Cryptic t(12;15)(p13;q26) producing the ETV6-NTRK3 fusion gene and no loss of IGF2 imprinting in congenital mesoblastic nephroma with trisomy 11: fluorescence in situ hybridization and IGF2 allelic expression analysis.Watanabe N et al
274773202016NTRK3 kinase fusions in Spitz tumours.Yeh I et al

Summary

Fusion gene

ETV6/NTRK3

Note

The t(12;15)(p13;q25) ETV6/NTRK3 is also found in: Secretory ductal breast carcinoma; Congenital mesoblastic nephroma; Congenital/infantile fibrosarcoma; Papillary thyroid carcinoma (PTC), especially so in radiation-associated PTCs; ALK-negative inflammatory myofibroblastic sarcoma; Secretory carcinoma of salivary glands (mammary analogue); atypical Spitz tumors, and rare other conditions.

Citation

Jean-Loup Huret

t(12;15)(p13;q25) ETV6/NTRK3 in Hematological malignancies

Atlas Genet Cytogenet Oncol Haematol. 2019-11-01

Online version: http://atlasgeneticsoncology.org/haematological/1347/t(12;15)(p13;q25)-etv6-ntrk3-in-hematological-malignancies

Historical Card

2008-01-01 t(12;15)(p13;q25) ETV6/NTRK3 in Hematological malignancies by  Jean-Loup Huret 

jean-loup.huret@atlasgeneticsoncology.org