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Genomic sequencing of multicystic mesothelioma finds cohesin complex mutations associated with disease recurrence in patients referred for cytoreductive surgery and HIPEC

Genomic sequencing of multicystic mesothelioma finds cohesin complex mutations associated with disease recurrence in patients referred for cytoreductive surgery and HIPEC
Genomic sequencing of multicystic mesothelioma finds cohesin complex mutations associated with disease recurrence in patients referred for cytoreductive surgery and HIPEC
Background
Multicystic mesothelioma (MCM) is a rare disease and there is debate about it’s neoplastic nature with a spectrum of disease behaviour and little known about the genomic profile. In contrast, the genomic profile of malignant peritoneal mesothelioma (MPeM) is characterised.

Methods
We characterized 24 MCM and 18 MPeM cases across a panel of cancer related regions and expanded to whole-exome sequencing for 11 MCMs. Validation by amplicon sequencing and functional assessment by molecular dynamic simulation were carried out. Kaplan-Meier analysis was carried out to assess recurrence-free survival.

Results
Few mutations were identified in MCMs across the panel. Exome sequencing revealed 28 genes mutated in >1 MCM case. We saw significant overrepresentation of mutations in the cohesin complex in SMC3, SMC1A, and STAG3. Multiple mutations in SMC3 at codon p.E1144 indicated a mutational hotspot. Molecular dynamics simulations showed mutation at this site impacts the protein function. Amplicon sequencing confirmed hotspot mutations in further MCMs. We observed a significant association (p = 0.0302) of mutation in SMC3 or SMC1A with disease recurrence.

Conclusions
We see recurrent somatic mutations in MCMs particularly at a novel mutational hotspot in SMC3, consistent with a neoplastic process. Mutations in cohesin complex genes are associated with disease recurrence.
0007-0920
1352-1359
Gibson, Jane
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Carr, Norman John
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Stanford, Sophia
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Mirandari, Amatta
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Cecil, Thomas
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Pengelly, Reuben
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Turner, Steven
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Essex, Jonathan W.
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Boukas, Konstantinos
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Hocking, Kevin
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Dominguez, Manuel
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Mohamed, Faheez
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Dayal, Sanjeev
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Tzivanakis, Alexios
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Moran, Brendan J.
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Adeleke, Gbadebo
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Mirnezami, Alex
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Ennis, Sarah
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Gibson, Jane
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Carr, Norman John
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Stanford, Sophia
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Mirandari, Amatta
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Cecil, Thomas
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Pengelly, Reuben
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Turner, Steven
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Essex, Jonathan W.
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Boukas, Konstantinos
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Hocking, Kevin
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Dominguez, Manuel
e4105944-0418-4475-9d9f-791742029b70
Mohamed, Faheez
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Dayal, Sanjeev
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Tzivanakis, Alexios
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Moran, Brendan J.
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Adeleke, Gbadebo
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Mirnezami, Alex
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Ennis, Sarah
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Gibson, Jane, Carr, Norman John, Stanford, Sophia, Mirandari, Amatta, Cecil, Thomas, Pengelly, Reuben, Turner, Steven, Essex, Jonathan W., Boukas, Konstantinos, Hocking, Kevin, Dominguez, Manuel, Mohamed, Faheez, Dayal, Sanjeev, Tzivanakis, Alexios, Moran, Brendan J., Adeleke, Gbadebo, Mirnezami, Alex and Ennis, Sarah (2026) Genomic sequencing of multicystic mesothelioma finds cohesin complex mutations associated with disease recurrence in patients referred for cytoreductive surgery and HIPEC. British Journal of Cancer, 134 (9), 1352-1359. (doi:10.1038/s41416-026-03366-5).

Record type: Article

Abstract

Background
Multicystic mesothelioma (MCM) is a rare disease and there is debate about it’s neoplastic nature with a spectrum of disease behaviour and little known about the genomic profile. In contrast, the genomic profile of malignant peritoneal mesothelioma (MPeM) is characterised.

Methods
We characterized 24 MCM and 18 MPeM cases across a panel of cancer related regions and expanded to whole-exome sequencing for 11 MCMs. Validation by amplicon sequencing and functional assessment by molecular dynamic simulation were carried out. Kaplan-Meier analysis was carried out to assess recurrence-free survival.

Results
Few mutations were identified in MCMs across the panel. Exome sequencing revealed 28 genes mutated in >1 MCM case. We saw significant overrepresentation of mutations in the cohesin complex in SMC3, SMC1A, and STAG3. Multiple mutations in SMC3 at codon p.E1144 indicated a mutational hotspot. Molecular dynamics simulations showed mutation at this site impacts the protein function. Amplicon sequencing confirmed hotspot mutations in further MCMs. We observed a significant association (p = 0.0302) of mutation in SMC3 or SMC1A with disease recurrence.

Conclusions
We see recurrent somatic mutations in MCMs particularly at a novel mutational hotspot in SMC3, consistent with a neoplastic process. Mutations in cohesin complex genes are associated with disease recurrence.

Text
s41416-026-03366-5 - Version of Record
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Submitted date: 10 April 2025
Accepted/In Press date: 19 February 2026
e-pub ahead of print date: 14 March 2026
Published date: 5 May 2026

Identifiers

Local EPrints ID: 511040
URI: http://eprints.soton.ac.uk/id/eprint/511040
ISSN: 0007-0920
PURE UUID: 910d509c-af02-4e48-83d7-317453851b01
ORCID for Jane Gibson: ORCID iD orcid.org/0000-0002-0973-8285
ORCID for Amatta Mirandari: ORCID iD orcid.org/0000-0002-3454-8723
ORCID for Reuben Pengelly: ORCID iD orcid.org/0000-0001-7022-645X
ORCID for Steven Turner: ORCID iD orcid.org/0000-0002-2913-7532
ORCID for Jonathan W. Essex: ORCID iD orcid.org/0000-0003-2639-2746
ORCID for Sarah Ennis: ORCID iD orcid.org/0000-0003-2648-0869

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Date deposited: 29 Apr 2026 16:35
Last modified: 30 Apr 2026 02:13

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Contributors

Author: Jane Gibson ORCID iD
Author: Norman John Carr
Author: Sophia Stanford
Author: Amatta Mirandari ORCID iD
Author: Thomas Cecil
Author: Reuben Pengelly ORCID iD
Author: Steven Turner ORCID iD
Author: Konstantinos Boukas
Author: Kevin Hocking
Author: Manuel Dominguez
Author: Faheez Mohamed
Author: Sanjeev Dayal
Author: Alexios Tzivanakis
Author: Brendan J. Moran
Author: Gbadebo Adeleke
Author: Alex Mirnezami
Author: Sarah Ennis ORCID iD

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