Newswise — Bethesda, Md. – Scientists have discovered a new “mastermind fusion gene” may be associated with a rare cancer-causing tumor – pheochromocytomas (“pheo”) and paragangliomas, according to a study published Feb. 13 in Cancer Cell, by researchers at the Uniformed Services University (USU) and the National Cancer Institutes’ The Cancer Genome Atlas. This breakthrough discovery could lead to more precise treatment as well as a better understanding of cancer itself.

These adrenal gland tumors are often benign, but they can become malignant, and in some cases lead to life-threatening hypertension, arrhythmia, and stroke, but it’s not clear which tumors will become metastatic because of the disease’s rarity and complex biology. Therefore, patients with the metastatic disease have few treatment options and poor prognosis. To help detect genetic mutations and better understand this disease, a group of researchers at USU and the nationwide Cancer Genome Atlas Research Network examined 173 tumors, performing six genomic tests, such as DNA and RNA sequencing.

The researchers found what they refer to as the mastermind fusion gene – the first fusion gene associated with this type of tumor. This hybrid gene forms from two previously separate genes and only occurs in a new subtype of this disease. The researchers suggest this disrupts the normal biology of the cell and thus producing tumor cells. The researchers believe this mastermind fusion gene will help describe for some patients why the tumor has developed, and better predict patient outcome. The fusion gene may also lead to future targeted therapy and have implications for other cancers.

Additionally, the researchers found 18 “driver” genes in this type of tumor, meaning there are 18 different ways this tumor could become cancerous. This is an unusually large amount of drivers, not typical for many other tumor types, according the study’s senior author Dr. Matthew Wilkerson, associate professor and Bioinformatics Director of The American Genome Center and the Collaborative Health Initiative Research Program at USU. This finding allowed their team to classify tumors into four major molecular subtypes, which could also lead to developing new therapies.

“For patients who have this diagnosis, surrounded by its uncertainties, this new discovery sheds light on the disease. We think these results will ultimately lead to individuals and their families having a better understanding of their prognosis and more precise treatment,” Wilkerson said.

The paper’s co-senior authors are Dr. Katherine Nathanson, a professor in the division of Translational Medicine and Human Genetics at the University of Pennsylvania’s Abramson Cancer Center, and Dr. Karel Pacak, chief of the section on Medical Neuroendocrinology at the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health.

The study was supported with grants by the National Institutes of Health (U54 HG003273, U54 HG003067, U54 HG003079, U24 CA143799, U24 CA143835, U24 CA143840, U24 CA143843, U24 CA143845, U24 CA143848, U24 CA143858, U24 CA143866, U24 CA143867, U24 CA143882, U24 CA143883, U24 CA144025, P30 AC016672).

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About the Uniformed Services University of the Health SciencesThe Uniformed Services University of the Health Sciences, founded by an act of Congress in 1972, is the nation’s federal health sciences university and the academic heart of the Military Health System. USU students are primarily active duty uniformed officers in the Army, Navy, Air Force and Public Health Service who receive specialized education in tropical and infectious diseases, TBI and PTSD, disaster response and humanitarian assistance, global health, and acute trauma care. A large percentage of the university’s more than 5,500 physician and 1,000 advanced practice nursing alumni are supporting operations around the world, offering their leadership and expertise. USU also has graduate programs in biomedical sciences and public health committed to excellence in research, and in oral biology. The University’s research program covers a wide range of clinical and other topics important to both the military and public health. For more information about USU and its programs, visit