Molecular profiling and analysis of genetic aberrations aimed at identifying potential therapeutic targets in fibrolamellar carcinoma of the liver.

DNAJ homolog Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT) TERT catalytic subunit of protein kinase A (PRKACA) fibrolamellar carcinoma (FLC) member 1 (DNAJB1) subfamily B

Journal

Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236

Informations de publication

Date de publication:
15 09 2020
Historique:
received: 16 02 2020
revised: 23 03 2020
accepted: 13 04 2020
pubmed: 15 7 2020
medline: 16 6 2021
entrez: 15 7 2020
Statut: ppublish

Résumé

Fibrolamellar carcinoma (FLC) is a rare primary liver cancer of young adults. A functional chimeric transcript resulting from the in-frame fusion of the DNAJ homolog, subfamily B, member 1 (DNAJB1), and the catalytic subunit of protein kinase A (PRKACA) genes on chromosome 19 is believed to be unique in FLC, with a possible role in pathogenesis, yet with no established therapeutic value. The objective of the current study was to understand the molecular landscape of FLC and to identify potential novel therapeutic targets. Archival fresh, formalin-fixed, paraffin-embedded samples from patients with FLC who prospectively consented to an institutional review board-approved protocol were analyzed using Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT), a next-generation sequencing assay encompassing up to 468 key cancer genes. Custom targeted RNA-Seq was performed in selected patients. Demographics, treatment, and outcome data were collected prospectively. Survival outcomes were estimated and correlated with mutation and/or copy number alterations. A total of 33 tumor samples from 31 patients with FLC were analyzed. The median age of the patients at the time of diagnosis was 18 years and approximately 53% were women. The DNAJB1-PRKACA fusion transcript was detected in 100% of patients. In 10 of 31 patients in which MSK-IMPACT did not detect the fusion, its presence was confirmed by targeted RNA-Seq. TERT promoter mutation was the second most common, and was detected in 7 patients. The median follow up was 30 months (range, 6-153 months). The 3-year overall survival rate was 84% (95% CI, 61%-93%). The DNAJB1-PRKACA fusion transcript is nonspecific and nonsensitive to FLC. Its potential therapeutic value currently is under evaluation. Opportunities currently are under development for therapy that may be driven or related to the DNAJB1-PRKACA fusion transcript or any therapeutic target identified from next-generation sequencing in patients with FLC.

Sections du résumé

BACKGROUND
Fibrolamellar carcinoma (FLC) is a rare primary liver cancer of young adults. A functional chimeric transcript resulting from the in-frame fusion of the DNAJ homolog, subfamily B, member 1 (DNAJB1), and the catalytic subunit of protein kinase A (PRKACA) genes on chromosome 19 is believed to be unique in FLC, with a possible role in pathogenesis, yet with no established therapeutic value. The objective of the current study was to understand the molecular landscape of FLC and to identify potential novel therapeutic targets.
METHODS
Archival fresh, formalin-fixed, paraffin-embedded samples from patients with FLC who prospectively consented to an institutional review board-approved protocol were analyzed using Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT), a next-generation sequencing assay encompassing up to 468 key cancer genes. Custom targeted RNA-Seq was performed in selected patients. Demographics, treatment, and outcome data were collected prospectively. Survival outcomes were estimated and correlated with mutation and/or copy number alterations.
RESULTS
A total of 33 tumor samples from 31 patients with FLC were analyzed. The median age of the patients at the time of diagnosis was 18 years and approximately 53% were women. The DNAJB1-PRKACA fusion transcript was detected in 100% of patients. In 10 of 31 patients in which MSK-IMPACT did not detect the fusion, its presence was confirmed by targeted RNA-Seq. TERT promoter mutation was the second most common, and was detected in 7 patients. The median follow up was 30 months (range, 6-153 months). The 3-year overall survival rate was 84% (95% CI, 61%-93%).
CONCLUSIONS
The DNAJB1-PRKACA fusion transcript is nonspecific and nonsensitive to FLC. Its potential therapeutic value currently is under evaluation. Opportunities currently are under development for therapy that may be driven or related to the DNAJB1-PRKACA fusion transcript or any therapeutic target identified from next-generation sequencing in patients with FLC.

Identifiants

pubmed: 32663328
doi: 10.1002/cncr.32960
pmc: PMC8224539
mid: NIHMS1712870
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

4126-4135

Subventions

Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : National Cancer Institute Cancer Center
ID : P30-CA008748
Organisme : Josée and Henry R. Kravis Center for Molecular Oncology

Informations de copyright

© 2020 American Cancer Society.

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Auteurs

Imane El Dika (I)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Weill Cornell College of Medicine, New York, New York, USA.

Anita S Bowman (AS)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Michael F Berger (MF)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Weill Cornell College of Medicine, New York, New York, USA.

Marinela Capanu (M)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Joanne F Chou (JF)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Ryma Benayed (R)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Ahmet Zehir (A)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Jinru Shia (J)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Weill Cornell College of Medicine, New York, New York, USA.

Eileen M O'Reilly (EM)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Weill Cornell College of Medicine, New York, New York, USA.

David S Klimstra (DS)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Weill Cornell College of Medicine, New York, New York, USA.

David B Solit (DB)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Weill Cornell College of Medicine, New York, New York, USA.

Ghassan K Abou-Alfa (GK)

Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Weill Cornell College of Medicine, New York, New York, USA.

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Classifications MeSH