Identification of BRCA1/2 mutation female carriers using circulating microRNA profiles
Kevin M. Elias, Urszula Smyczyńska, Konrad Stawiski, Zuzanna Nowicka, James W. Webber, Jakub Kaplan, Charles N. Landen, Jan Lubiński, Asima Mukhopadhyay, Dona Chakraborty, Denise C. Connolly, Heather Symecko, Susan M. Domchek, Judy E. Garber, Panagiotis A. Konstantinopoulos, Wojciech Fendler, Dipanjan Chowdhury
Abstract
Identifying germline BRCA1/2 mutation carriers is vital for reducing their risk of breast and ovarian cancer. To derive a serum miRNA-based diagnostic test we used samples from 653 healthy women from six international cohorts, including 350 (53.6%) with BRCA1/2 mutations and 303 (46.4%) BRCA1/2 wild-type. All individuals were cancer-free before and at least 12 months after sampling. RNA-sequencing followed by differential expression analysis identified 19 miRNAs significantly associated with BRCA mutations, 10 of which were ultimately used for classification: hsa-miR-20b-5p, hsa-miR-19b-3p, hsa-let-7b-5p, hsa-miR-320b, hsa-miR-139-3p, hsa-miR-30d-5p, hsa-miR-17-5p, hsa-miR-182-5p, hsa-miR-421, hsa-miR-375-3p. The final logistic regression model achieved area under the receiver operating characteristic curve 0.89 (95% CI: 0.87-0.93), 93.88% sensitivity and 80.72% specificity in an independent validation cohort. Mutated gene, menopausal status or having preemptive oophorectomy did not affect classification performance. Circulating microRNAs may be used to identify BRCA1/2 mutations in patients of high risk of cancer, offering an opportunity to reduce screening costs.