Cell intrinsic signaling in MEN1 mutant pancreatic neuroendocrine tumors unveils novel signaling pathways associated with de-differentiation

Objectives Preliminary genomic analysis of primary pancreatic neuroendocrine tumors revealed a complex mutational landscape with four common oncogenic events; however, critical activation pathways responsible for pancreatic neuroendocrine tumor progression and metastasis have yet to be elucidated. Here, we analyzed six primary pancreatic neuroendocrine tumors to determine which pathways are deregulated and responsible for progression. Methods Selected genomic profiling of six primary pancreatic neuroendocrine tumors was performed using the Ion Torrent Comprehensive Cancer Panel with matched transcriptomes analyzed by Affymetrix Clariom D arrays. Validation of gene expression changes were measured by quantitative PCR using TaqMan assays and immunohistochemistry on tumor specimens. Results MEN1 was mutated in half (50%) of our sequenced tumors while FGFR3 was mutated in 2/6 (33%). Transcriptome analysis revealed that ITGA2 and EZH2 were overexpressed in MEN1 mutant tumors whereas ALK and VEGFA were overexpressed in FGFR3 mutant tumors. Immunohistochemistry revealed increased nuclear ITGA2 and EZH2 staining along with increased VE-Cadherin staining and loss of membranous E-cadherin localization in MEN1 and FGFR3 mutant tumors. Conclusions Our results suggest that pancreatic neuroendocrine tumors containing MEN1 and FGFR3 mutations are more aggressive and de-differentiated than their wild-type counterparts. Additionally, we provide novel chemotherapeutic target FGFR3 for patients with this disease. ### Competing Interest Statement The authors have declared no competing interest.