|LETTER TO EDITOR
|Year : 2021 | Volume
| Issue : 2 | Page : 400-401
Authors' reply to Thien et al.
Suresh Kumar Bondili1, Anuradha Chougule2, Pratik Chandrani2, Vanita Noronha1
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 Submission||08-Jun-2021|
|Date of Decision||08-Jun-2021|
|Date of Acceptance||09-Jun-2021|
|Date of Web Publication||30-Jun-2021|
No 304, Homibhabha Block, Tata Memorial Hospital, Parel, Mumbai 400 012
Source of Support: None, Conflict of Interest: None
|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
We thank Thein et al. for their keen interest and comments on our article titled, “Rare case of Skene gland adenocarcinoma with RET-rearrangement.” 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. 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. 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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Conflicts of interest
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| References|| |
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. [Full text]
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. [Full text]
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.
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