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Table of Contents
LETTER TO EDITOR
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 400-401

Authors' reply to Thien et al.


1 Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
2 Department of Molecular Pathology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India

Date of Submission08-Jun-2021
Date of Decision08-Jun-2021
Date of Acceptance09-Jun-2021
Date of Web Publication30-Jun-2021

Correspondence Address:
Vanita Noronha
No 304, Homibhabha Block, Tata Memorial Hospital, Parel, Mumbai 400 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_136_21

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How to cite this article:
Bondili SK, Chougule A, Chandrani P, Noronha V. Authors' reply to Thien et al. Cancer Res Stat Treat 2021;4:400-1

How to cite this URL:
Bondili SK, Chougule A, Chandrani P, Noronha V. Authors' reply to Thien et al. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Sep 17];4:400-1. Available from: https://www.crstonline.com/text.asp?2021/4/2/400/320229



We thank Thein et al.[1] for their keen interest and comments on our article titled, “Rare case of Skene gland adenocarcinoma with RET-rearrangement.”[2] Skene glands are gland-like structures which open into the female urethra and are homologous to the male prostate gland. These structures are lined by different types of cells such as the columnar cells also known as secretory cells, cuboidal cells, or basal-like cells. As Skene gland adenocarcinomas can arise from various cell types, prostate-specific antigen (PSA), or prostatic-specific acid phosphatase (PSAP) reactivity may not always be present; PSA or PSAP reactivity is usually seen in about 50%–60% of the cases.[3] In our patient, the tumor cells were positive for the estrogen and androgen receptors, p16, alpha-methylacyl-CoA racemase, CK7, CDX2, and vimentin on immunohistochemistry. Other markers, such as the paired box gene 8, carcinoembryonic antigen, p40, and Wilms' tumor protein 1 were negative, thus supporting the diagnosis of a Skene gland adenocarcinoma. However, immunohistochemistry for PSAP, prostein, and NKX3.1 was not performed for our patient, and we agree with Thein et al. that this could have provided additional information.

The TATA-box-binding protein (TBP) is a transcription factor. It binds to the TATA-box sequence present in the promotor region of approximately 10%–20% of the human genes and results in the formation of the preinitiation complex, thereby regulating gene transcription.[4] We concur with the interesting hypothesis put forward by Thien et al. that the dimerization domain of TBP could lead to the constitutive activation of the RET kinase and that it requires further research. As we performed targeted next-generation sequencing (NGS), the exact fusion junction could not be determined as there is a gap of 200–400 base pairs between the two NGS reads. However, we were able to detect nine reads which support the fusion. The output of the computational analysis using the ClinOme database is given in [Table 1]. As this fusion has not been studied before, its oncogenic potential and response to the newer selective RET inhibitors like selpercatinib and pralsetinib need to be elucidated further. As these drugs are currently unavailable in India, we have applied for pralsetinib through an expanded access program and are awaiting procurement for this patient. With the advent of newer drugs, it becomes necessary to perform detailed genomic testing, especially in case of rare tumors to identify targetable mutations and increase the therapeutic armamentarium and improve outcomes for these patients.
Table 1: Output of the gene fusion analysis of the patient with Skene gland adenocarcinoma with RET-rearrangement

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Thein KZ, Wu J, Subbiah V. Novel TBP-RET (TATA-binding protein-rearranged during transfection) fusion in a rare case of Skene gland adenocarcinoma: Sequencing unicorns. Cancer Res Stat Treat 2021;4:398-400.   Back to cited text no. 1
  [Full text]  
2.
Bondili SK, Abraham G, Noronha V, Joshi A, Patil VM, Menon N, et al. Rare case of skene gland adenocarcinoma with RET-rearrangement. Cancer Res Stat Treat 2021;4:130-5.  Back to cited text no. 2
  [Full text]  
3.
Dietrich W, Susani M, Stifter L, Haitel A. The human female prostate-Immunohistochemical study with prostate-specific antigen, prostate-specific alkaline phosphatase, and androgen receptor and 3-D Remodeling. J Sex Med 2011;8:2816-21.  Back to cited text no. 3
    
4.
Coleman RA, Pugh BF. Slow dimer dissociation of the TATA binding protein dictates the kinetics of DNA binding. Proc Natl Acad Sci U S A 1997;94:7221-6.  Back to cited text no. 4
    



 
 
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