Compositions and methods for the diagnosis and treatment of lymphatic system disorders

1. A method for treating a lymphatic anomaly in a human patient, the method comprising:

a) detecting in a biological sample from said patient, a nucleic acid comprising a single nucleotide variant (SNV), wherein the SNV is selected from:

i) c.2334+1G>C in EPHB4;

ii) c.3481A>G:p.S1161G in PIK3R4;

iii) c.1393-7C>T in PIK3R6;

iv) c.6818A>G:p.P2273L in mTOR; and

v) c.640T>C:p.S214P in ARAF; and

b) administering one or more agents suitable for treatment of said lymphatic anomaly to the patient, thereby treating the lymphatic anomaly,

wherein said one or more agents suitable for treatment of said lymphatic anomaly are selected from the group consisting of one or more mTOR inhibitors, one or more PIK3K inhibitors, one or more MEK/ERK inhibitors, and a combination of one or more of any of said inhibitors.

2. The method of claim 1 , wherein said one or more agents is selected from the group consisting of rapamycin, everolimus, AZD8055, temsirolimus, KU-0063794, MHY1485, BEZ235, PI-103, torkinib, tacrolimus, selumetinib, PD0325901, trametinib, pimasertib, AZD8330, binimetinib, SL-327, refametinib, cobimetinib, ridaforolimus, INK 128, voxtalisib, torin 1, omipalisib, OSI-027, PF-04691502, apitolisib, GSK1059615, gedatolisib, WYE-354, AZD2014, torin 2, WYE-125123, PP121, WYE-687, CH5132799, WAY-600, ETP-46464, GDC-0349, XL388, zotarolimus, BGT226, palomid 529, chrysophanic acid, TAK-733, and PD184352.

3. The method of claim 1 , wherein the lymphatic anomaly is characterized by abnormal formation of lymphatic vessels and/or tissue overgrowth.

4. The method of claim 1 , wherein the lymphatic anomaly is selected from lymphangiomatosis (LAM) or generalized lymphatic anomaly (GLA).

5. The method of claim 1 , wherein the lymphatic anomaly is characterized by chylous effusions, including pericardial, pleural, or peritoneal effusions.

6. The method of claim 1 , wherein the method further comprises generating a report identifying the SNV after detection in the biological sample and identifying suggested treatment(s) for the lymphatic anomaly based upon the SNV so identified.

7. The method of claim 1 , wherein the treatment further comprises administering systemic chemotherapy, interferon alpha, radiotherapy, and/or surgery.

8. The method of claim 1 , wherein the detecting comprises analyzing a polynucleotide sample to determine the presence of said SNV by performing a process selected from the group consisting of detection of specific hybridization, measurement of allele size, restriction fragment length polymorphism analysis, allele specific hybridization analysis, single base primer extension reaction, and sequencing of an amplified polynucleotide.

9. The method of claim 1 , wherein the biological sample comprises DNA.

10. The method of claim 5 , wherein said one or more MEK/ERK inhibitor is selected from Selumetinib (AZD6244), PD0325901, Trametinib (GSK1 120212), PD184352 (CI-1040), Pimasertib (AS-703026), TAK-733, AZD8330, Binimetinib (MEK162, ARRY-162, ARRY-438162), SL-327, Refametinib (RDEA119, Bay 86-9766), and Cobimetinib (GDC-0973, RG7420).

11. The method of claim 1 , wherein a combination of agents is administered, said combination being selected from the group consisting of

a) Ridaforolimus and Trametinib;

b) Ridaforolimus and Selumetinib or Cobimetinib;

c) BEZ235 and Selumetinib;

d) Omipalisib and Selumetinib or Trametinib;

e) Everolimus and Trametinib or Selumetinib;

f) Sirolimus, Ridaforolimus and Selumetinib;

g) Sirolimus, Ridaforolimus and Trametinib;

h) Torkinib and Trametinib;

i) BEZ235, Torkinib and Trametinib; and

j) Sirolimus and Gedatolisib and Trametinib.