Key result
The rs2815063-A variant near KCNK17 was associated with a 1.6% reduction in ejection fraction (P=2.1x10-8) and a 1.80-fold increased risk of severe cancer therapy-induced cardiac dysfunction.
Why the study?
Adult survivors of childhood cancer are at increased risk of cardiac late effects.
Is the genetic variant rs2815063-A associated with cancer treatment-induced cardiac dysfunction and reduced ejection fraction in childhood cancer survivors?
Cohort (n=6,191)
Yes
Is the genetic variant rs2815063-A associated with cancer treatment-induced cardiac dysfunction and reduced ejection fraction in childhood cancer survivors?
Odds Ratio: 1.8
p-value: p=0.008
A novel genetic locus near KCNK17 (rs2815063-A) is associated with an increased risk of doxorubicin-induced cardiac dysfunction and reduced ejection fraction in childhood cancer survivors.
May support targeted surveillance in carriers; leaves open whether genetic testing improves outcomes in survivors.
BACKGROUND: Adult survivors of childhood cancer are at increased risk of cardiac late effects. METHODS: Using whole-genome sequencing data from 1870 survivors of European ancestry in the St. Jude Lifetime Cohort (SJLIFE) study, genetic variants were examined for association with ejection fraction (EF) and clinically assessed cancer therapy-induced cardiac dysfunction (CCD). Statistically significant findings were validated in 301 SJLIFE survivors of African ancestry and 4020 survivors of European ancestry from the Childhood Cancer Survivor Study. All statistical tests were 2-sided. RESULTS: A variant near KCNK17 showed genome-wide significant association with EF (rs2815063-A: EF reduction = 1.6%; P = 2.1 × 10-8) in SJLIFE survivors of European ancestry, which replicated in SJLIFE survivors of African ancestry (EF reduction = 1.5%; P = .004). The rs2815063-A also showed a 1.80-fold (P = .008) risk of severe or disabling or life-threatening CCD and replicated in 4020 Childhood Cancer Survivor Study survivors of European ancestry (odds ratio = 1.40; P = .04). Notably, rs2815063-A was specifically associated among survivors exposed to doxorubicin only, with a stronger effect on EF (3.3% EF reduction) and CCD (2.97-fold). Whole blood DNA methylation data in 1651 SJLIFE survivors of European ancestry showed statistically significant correlation of rs2815063-A with dysregulation of KCNK17 enhancers (false discovery rate <5%), which replicated in 263 survivors of African ancestry. Consistently, the rs2815063-A was associated with KCNK17 downregulation based on RNA sequencing of 75 survivors. CONCLUSIONS: Leveraging the 2 largest cohorts of childhood cancer survivors in North America and survivor-specific polygenomic functional data, we identified a novel risk locus for CCD, which showed specificity with doxorubicin-induced cardiac dysfunction and highlighted dysregulation of KCNK17 as the likely molecular mechanism underlying this genetic association.
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Sapkota et al. (2022) conducted a cohort in Cancer treatment-induced cardiac dysfunction (n=6,191). rs2815063-A variant near KCNK17 vs. Reference allele was evaluated on Ejection fraction (EF) and clinically assessed cancer therapy-induced cardiac dysfunction (CCD) (OR 1.80, p=0.008). The rs2815063-A variant near KCNK17 was associated with a 1.6% reduction in ejection fraction (P=2.1x10-8) and a 1.80-fold increased risk of severe cancer therapy-induced cardiac dysfunction.
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