Comprehensive genomic profiling of histologic subtypes of urethral carcinomas.


Journal

Urologic oncology
ISSN: 1873-2496
Titre abrégé: Urol Oncol
Pays: United States
ID NLM: 9805460

Informations de publication

Date de publication:
10 2021
Historique:
received: 18 09 2020
revised: 17 12 2020
accepted: 19 12 2020
pubmed: 4 7 2021
medline: 19 2 2022
entrez: 3 7 2021
Statut: ppublish

Résumé

Carcinoma of the urethra (UrthCa) is an uncommon Genitourinary (GU) malignancy that can progress to advanced metastatic disease. One hundred twenty-seven metastatic UrthCa underwent hybrid capture-based comprehensive genomic profiling to evaluate all classes of genomic alterations (GA). Tumor mutational burden was determined on up to 1.1 Mbp of sequenced DNA, and microsatellite instability was determined on 114 loci. PD-L1 expression was determined by IHC (Dako 22C3). Forty-nine (39%) urothelial (UrthUC), 31 (24%) squamous (UrthSCC), 24 (19%) adenocarcinomas NOS (UrthAC), and 12 (9%) clear cell (UrthCC) were evaluated. UrthUC and UrthSCC are more common in men; UrthAC and UrthCC are more common in women. Ages were similar in all 4 groups. GA in PIK3CA were the most frequent potentially targetable GA; mTOR pathway GA in PTEN were also identified. GA in other potentially targetable genes were also identified including ERBB2 (6% in UrthUC, 3% in UrthSCC, and 12% in UrthAC), FGFR1-3 (3% in UrthSCC), BRAF (3% in UrthAC), PTCH1 (8% in UrthCC), and MET (8% in UrthCC). Possibly reflecting their higher GA/tumor status, potential for immunotherapy benefit associated with higher tumor mutational burden and PD-L1 staining levels were seen in UrthUC and UrthSCC compared to UrthAC and UrthCC. Microsatellite instability high status was absent throughout. Comprehensive genomic profiling reveals GA that may be predictive of both targeted and immunotherapy benefit in patients with advanced UrthCa and that could potentially be used in future adjuvant, neoadjuvant, and metastatic disease trials.

Sections du résumé

BACKGROUND
Carcinoma of the urethra (UrthCa) is an uncommon Genitourinary (GU) malignancy that can progress to advanced metastatic disease.
METHODS
One hundred twenty-seven metastatic UrthCa underwent hybrid capture-based comprehensive genomic profiling to evaluate all classes of genomic alterations (GA). Tumor mutational burden was determined on up to 1.1 Mbp of sequenced DNA, and microsatellite instability was determined on 114 loci. PD-L1 expression was determined by IHC (Dako 22C3).
RESULTS
Forty-nine (39%) urothelial (UrthUC), 31 (24%) squamous (UrthSCC), 24 (19%) adenocarcinomas NOS (UrthAC), and 12 (9%) clear cell (UrthCC) were evaluated. UrthUC and UrthSCC are more common in men; UrthAC and UrthCC are more common in women. Ages were similar in all 4 groups. GA in PIK3CA were the most frequent potentially targetable GA; mTOR pathway GA in PTEN were also identified. GA in other potentially targetable genes were also identified including ERBB2 (6% in UrthUC, 3% in UrthSCC, and 12% in UrthAC), FGFR1-3 (3% in UrthSCC), BRAF (3% in UrthAC), PTCH1 (8% in UrthCC), and MET (8% in UrthCC). Possibly reflecting their higher GA/tumor status, potential for immunotherapy benefit associated with higher tumor mutational burden and PD-L1 staining levels were seen in UrthUC and UrthSCC compared to UrthAC and UrthCC. Microsatellite instability high status was absent throughout.
CONCLUSIONS
Comprehensive genomic profiling reveals GA that may be predictive of both targeted and immunotherapy benefit in patients with advanced UrthCa and that could potentially be used in future adjuvant, neoadjuvant, and metastatic disease trials.

Identifiants

pubmed: 34215504
pii: S1078-1439(20)30650-5
doi: 10.1016/j.urolonc.2020.12.021
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

731.e1-731.e15

Informations de copyright

Copyright © 2020. Published by Elsevier Inc.

Auteurs

Joseph Jacob (J)

SUNY Upstate Medical University, Department of Urology, Syracuse, NY.

Andrea Necchi (A)

Foundation Medicine, Cambridge, MA.

Petros Grivas (P)

Foundation Medicine, Cambridge, MA.

Michael Hughes (M)

SUNY Upstate Medical University, Department of Urology, Syracuse, NY.

Thomas Sanford (T)

SUNY Upstate Medical University, Department of Urology, Syracuse, NY.

Mehdi Mollapour (M)

SUNY Upstate Medical University, Department of Urology, Syracuse, NY; SUNY Upstate Medical University Department of Biochemistry and Molecular Biology, Syracuse, NY.

Oleg Shapiro (O)

SUNY Upstate Medical University, Department of Urology, Syracuse, NY.

Ahmad Talal (A)

Foundation Medicine, Cambridge, MA.

Ethan Sokol (E)

Foundation Medicine, Cambridge, MA.

Jo-Anne Vergilio (JA)

Foundation Medicine, Cambridge, MA.

Jonathan Killian (J)

Foundation Medicine, Cambridge, MA.

Douglas Lin (D)

Foundation Medicine, Cambridge, MA.

Erik Williams (E)

Foundation Medicine, Cambridge, MA.

Julie Tse (J)

Foundation Medicine, Cambridge, MA.

Shakti Ramkissoon (S)

Foundation Medicine, Cambridge, MA.

Eric Severson (E)

Foundation Medicine, Cambridge, MA.

Amanda Hemmerich (A)

Foundation Medicine, Cambridge, MA.

Naomi Ferguson (N)

Foundation Medicine, Cambridge, MA.

Clair Edgerly (C)

Foundation Medicine, Cambridge, MA.

Daniel Duncan (D)

Foundation Medicine, Cambridge, MA.

Richard Huang (R)

Foundation Medicine, Cambridge, MA.

Jon Chung (J)

Foundation Medicine, Cambridge, MA.

Russell Madison (R)

Foundation Medicine, Cambridge, MA.

Brian Alexander (B)

Foundation Medicine, Cambridge, MA.

Jeffrey Venstrom (J)

Foundation Medicine, Cambridge, MA.

Prasanth Reddy (P)

Foundation Medicine, Cambridge, MA.

Kimberly McGregor (K)

Foundation Medicine, Cambridge, MA.

Julia Elvin (J)

Foundation Medicine, Cambridge, MA.

Alexa Schrock (A)

Foundation Medicine, Cambridge, MA.

Natalie Danziger (N)

Foundation Medicine, Cambridge, MA.

Dean Pavlick (D)

Foundation Medicine, Cambridge, MA.

Jeffrey Ross (J)

SUNY Upstate Medical University, Department of Urology, Syracuse, NY; Foundation Medicine, Cambridge, MA.

Gennady Bratslavsky (G)

SUNY Upstate Medical University, Department of Urology, Syracuse, NY; SUNY Upstate Medical University Department of Biochemistry and Molecular Biology, Syracuse, NY. Electronic address: bratslav@upstate.edu.

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Classifications MeSH