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• THE GENOMIC LANDSCAPE OF ACTINIC KERATOSIS

  Actinic keratoses (AK) are lesions of epidermal keratinocyte dysplasia and are precursors for invasive cutaneous squamous cell carcinoma (CSCC). Identifying the specific genomic alterations driving progression from normal skin-AK-invasive CSCC is challenging due to the massive ultraviolet radiation-induced mutational burden characteristic at all stages of this progression. Here, we report the largest AK whole exome sequencing study to date and perform mutational signature and candidate driver gene analysis on these lesions. We demonstrate in 37 AK, from both immunosuppressed and immunocompetent patients, that there are significant similarities to CSCC in terms of mutational burden, copy number alterations, mutational signatures and patterns of driver gene mutations. We identify 44 significantly mutated AK driver genes and confirm that these genes are similarly altered in CSCC. We identify the azathioprine mutational signature in all AK from patients exposed to the drug, providing further evidence for its role in keratinocyte carcinogenesis. CSCC differ from AK in having higher levels of intra-sample heterogeneity. Alterations in signaling pathways also differ, with immune-related signaling and TGF-β signaling significantly more mutated in CSCC. Integrating our findings with independent gene expression datasets confirms that dysregulated TGF-β signaling may represent an important event in AK-CSCC progression.

  Dataset EGAD00001006894

• Single Cell Genome Sequence for DLP+ library A118389B

  Single Cell Genome Sequence for Telomerase immortalized breast epithelium cell line 184-hTERT 85.14 p20 cell line AT135 on DLP+ library A118389B

  Dataset EGAD00001009433

• Single Cell Genome Sequence for DLP+ library A118782A

  Single Cell Genome Sequence for high grade serous ovarian carcinoma patient-derived xenograft SA1050B passage 1, patient-derived xenograft SA1050E passage 1 on DLP+ library A118782A

  Dataset EGAD00001009435

• Single Cell Genome Sequence for DLP+ library A118808A

  Single Cell Genome Sequence for high grade serous ovarian carcinoma patient-derived xenograft SA1096B passage 1 on DLP+ library A118808A

  Dataset EGAD00001009440

• Single Cell Genome Sequence for DLP+ library A118812B

  Single Cell Genome Sequence for high grade serous ovarian carcinoma patient-derived xenograft SA1180C passage 1 on DLP+ library A118812B

  Dataset EGAD00001009442

• Single Cell Genome Sequence for DLP+ library A118816A

  Single Cell Genome Sequence for high grade serous ovarian carcinoma patient-derived xenograft SA1180C passage 1 on DLP+ library A118816A

  Dataset EGAD00001009444

• Single Cell Genome Sequence for DLP+ library A118857B

  Single Cell Genome Sequence for high grade serous ovarian carcinoma patient-derived xenograft SA1184D passage 1 on DLP+ library A118857B

  Dataset EGAD00001009445

• Single Cell Genome Sequence for DLP+ library A95663A

  Single Cell Genome Sequence for high grade serous ovarian carcinoma patient-derived xenograft SA1053F passage 1 on DLP+ library A95663A

  Dataset EGAD00001009446

• Single Cell Genome Sequence for DLP+ library A95668A

  Single Cell Genome Sequence for high grade serous ovarian carcinoma patient SA1162SA on DLP+ library A95668A

  Dataset EGAD00001009447

• Single Cell Genome Sequence for DLP+ library A95670A

  Single Cell Genome Sequence for triple negative breast cancer patient-derived xenograft SA501 passage 5 on DLP+ library A95670A

  Dataset EGAD00001009448