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Identification of kinase fusion oncogenes in post-Chernobyl radiation-induced thyroid cancers
Julio C. Ricarte-Filho, Sheng Li, Maria E.R. Garcia-Rendueles, Cristina Montero-Conde, Francesca Voza, Jeffrey A. Knauf, Adriana Heguy, Agnes Viale, Tetyana Bogdanova, Geraldine A. Thomas, Christopher E. Mason, James A. Fagin
Julio C. Ricarte-Filho, Sheng Li, Maria E.R. Garcia-Rendueles, Cristina Montero-Conde, Francesca Voza, Jeffrey A. Knauf, Adriana Heguy, Agnes Viale, Tetyana Bogdanova, Geraldine A. Thomas, Christopher E. Mason, James A. Fagin
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Research Article

Identification of kinase fusion oncogenes in post-Chernobyl radiation-induced thyroid cancers

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Abstract

Exposure to ionizing radiation during childhood markedly increases the risk of developing papillary thyroid cancer. We examined tissues from 26 Ukrainian patients with thyroid cancer who were younger than 10 years of age and living in contaminated areas during the time of the Chernobyl nuclear reactor accident. We identified nonoverlapping somatic driver mutations in all 26 cases through candidate gene assays and next-generation RNA sequencing. We found that 22 tumors harbored fusion oncogenes that arose primarily through intrachromosomal rearrangements. Altogether, 23 of the oncogenic drivers identified in this cohort aberrantly activate MAPK signaling, including the 2 somatic rearrangements resulting in fusion of transcription factor ETS variant 6 (ETV6) with neurotrophic tyrosine kinase receptor, type 3 (NTRK3) and fusion of acylglycerol kinase (AGK) with BRAF. Two other tumors harbored distinct fusions leading to overexpression of the nuclear receptor PPARγ. Fusion oncogenes were less prevalent in tumors from a cohort of children with pediatric thyroid cancers that had not been exposed to radiation but were from the same geographical regions. Radiation-induced thyroid cancers provide a paradigm of tumorigenesis driven by fusion oncogenes that activate MAPK signaling or, less frequently, a PPARγ-driven transcriptional program.

Authors

Julio C. Ricarte-Filho, Sheng Li, Maria E.R. Garcia-Rendueles, Cristina Montero-Conde, Francesca Voza, Jeffrey A. Knauf, Adriana Heguy, Agnes Viale, Tetyana Bogdanova, Geraldine A. Thomas, Christopher E. Mason, James A. Fagin

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Figure 1

Screen for genetic alterations in radiation-exposed pediatric thyroid cancer.

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Screen for genetic alterations in radiation-exposed pediatric thyroid ca...
(A) Analysis of RET unbalanced expression (exons 10 and 11/exons 12 and 13) to detect samples with RET fusion oncogenes. The figure shows representative CT plots from quantitative RT-PCR of exons 10 and 11 (encoding extracellular domain) and 12 and 13 (encoding cytoplasmic domain) of a sample without RET fusion oncogene (ratio ~1:1) (left) and a sample with RET fusion (right). (B) RT-PCR and Sanger sequencing for the identification and validation of TPR-NTRK1 and AKAP9-BRAF fusion oncogenes in 2 radiation-exposed cancers. (C) Summary of genetic alterations found in 26 radiation-exposed pediatric thyroid cancers. All but 5 harbored one of the previously described oncogenic events. The 5 tumors with no identifiable defect on the candidate gene screen underwent RNA-seq.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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