Gene mutational profile of BRCAness and clinical implication in predicting response to platinum-based chemotherapy in patients with intrahepatic cholangiocarcinoma.


Journal

European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373

Informations de publication

Date de publication:
08 2022
Historique:
received: 29 10 2021
revised: 22 04 2022
accepted: 02 05 2022
pubmed: 25 6 2022
medline: 20 7 2022
entrez: 24 6 2022
Statut: ppublish

Résumé

Biliary tract cancers are rare malignancies with a poor prognosis and scarce therapeutic strategies. The significance of BRCAness in this setting is already unknown. Tissue specimens of BTC patients treated with platinum-based chemotherapy have been analyzed through the FOUNDATIONPne assay. 72/150 (48%) BRCAness mutated and 78/150 (52.0%) wild type (WT) patients were included. The most commonly mutated genes in the BRCAness mutated group were: ARID1A (N = 32, 44%), CDKN2A (N = 23, 32%), KRAS/NRAS (N = 16, 22%), CDKN2B (N = 13, 18%), BRCA2 (N = 13, 18%), PBRM1 (N = 12, 17%), ATM (N = 11, 15%), FGFR2 (N = 10, 14%), TP53 (N = 8, 11%), IRS2 (N = 7, 10%), CREBBP (N = 7, 10%) (table 3, figure 1). At the univariate analysis BRCAness mutation was associated with longer median Progression Free Survival (mPFS) (HR 0.68; 95% CI 0.49-0.95; p = 0.0254); it was not associated with longer mOS but a trend toward a benefit in survival was found (HR 0.77; 95% CI 0.50-1.19; p = 0.2388). Patients with BRCAness mutation showed a higher percentage of disease control rate (77.8 vs 67.9; p = 0.04) compared to patients WT. Multivariate analysis confirmed BRCAness mutation (HR 0.66; 95% CI: 0.45-0.98; p = 0.0422) as independent favorable prognostic factors for PFS and a positive trend was found for OS (HR 0.84; 95% CI: 0.53-1.33; p = 0.3652). BRCAness BTC patients showed a better PFS compared BRCAnessWT patients after exposure to platinum-based chemotherapy. Moreover, the OS curves' trend showed in our analysis suggests that BRCAness mutated patients could benefit from a maintenance therapy with PARPi.

Sections du résumé

BACKGROUND AND AIMS
Biliary tract cancers are rare malignancies with a poor prognosis and scarce therapeutic strategies. The significance of BRCAness in this setting is already unknown.
METHOD
Tissue specimens of BTC patients treated with platinum-based chemotherapy have been analyzed through the FOUNDATIONPne assay.
RESULTS
72/150 (48%) BRCAness mutated and 78/150 (52.0%) wild type (WT) patients were included. The most commonly mutated genes in the BRCAness mutated group were: ARID1A (N = 32, 44%), CDKN2A (N = 23, 32%), KRAS/NRAS (N = 16, 22%), CDKN2B (N = 13, 18%), BRCA2 (N = 13, 18%), PBRM1 (N = 12, 17%), ATM (N = 11, 15%), FGFR2 (N = 10, 14%), TP53 (N = 8, 11%), IRS2 (N = 7, 10%), CREBBP (N = 7, 10%) (table 3, figure 1). At the univariate analysis BRCAness mutation was associated with longer median Progression Free Survival (mPFS) (HR 0.68; 95% CI 0.49-0.95; p = 0.0254); it was not associated with longer mOS but a trend toward a benefit in survival was found (HR 0.77; 95% CI 0.50-1.19; p = 0.2388). Patients with BRCAness mutation showed a higher percentage of disease control rate (77.8 vs 67.9; p = 0.04) compared to patients WT. Multivariate analysis confirmed BRCAness mutation (HR 0.66; 95% CI: 0.45-0.98; p = 0.0422) as independent favorable prognostic factors for PFS and a positive trend was found for OS (HR 0.84; 95% CI: 0.53-1.33; p = 0.3652).
CONCLUSION
BRCAness BTC patients showed a better PFS compared BRCAnessWT patients after exposure to platinum-based chemotherapy. Moreover, the OS curves' trend showed in our analysis suggests that BRCAness mutated patients could benefit from a maintenance therapy with PARPi.

Identifiants

pubmed: 35749808
pii: S0959-8049(22)00282-9
doi: 10.1016/j.ejca.2022.05.004
pii:
doi:

Substances chimiques

Antineoplastic Agents 0
Organoplatinum Compounds 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

232-241

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest statement The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: DR. TERESA MACARULLA MERCADE. Dr. Teresa Macarulla reports honoraria for consultancy from (SOBI) Swedish Orpahn Biovitrum AB, Ability Pharmaceuticals SL, Advance Medical HCMS, S.A., Aptitude Health, AstraZeneca, Basilea Pharma, Baxter, BioLineRX Ltd, Celgene, Eisai, Genzyme, Got It Consulting SL, IATTGI, Imedex, Incyte, Ipsen Bioscience, Inc, Laboratorios Menarini, Lilly. Marketing Farmacéutico & Investigación Clínica, S.L, MDS, Medscape, Monte Verde SA, Novocure, Paraxel, PPD Development, QED Therapeutics, Roche Farma, Sanofi-Aventis, Servier, TRANSWORLD EDITORS, SL and Zymeworks. Dr. Teresa Macarulla declares institutional interest in form of financial support for clinical trials or contracted research: Agios, Aslan, AstraZecena, Bayer, Celgene, Genentech, Hallozyme, Immunomedics, Lilly, Merimarck, Millenim, Novartis, Pfizer, Pharmacyclics, and Roche. DR. HELENA VERDAGUER MATA declares: speaker's Bureau: Astrazeneca. Advisory Role: Merck. OTHER COAUTHORS: Declare no conflict of interest.

Auteurs

Margherita Rimini (M)

IRCCS San Raffaele Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy. Electronic address: margherita.rimini@gmail.com.

Teresa Macarulla (T)

Gastrointestinal Cancer Unit, Vall d'Hebron University Hospital & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.

Valentina Burgio (V)

IRCCS San Raffaele Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy.

Sara Lonardi (S)

Oncology Unit 3, Veneto Institute of Oncology - IRCCS, Padua, Italy.

Monica Niger (M)

Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori di Milano, Italy.

Mario Scartozzi (M)

Medical Oncology, University and University Hospital, Cagliari, Italy.

Ilario G Rapposelli (IG)

Department of Medical Oncology, IRCCS Istituto Romagnolo per Lo Studio Dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.

Giuseppe Aprile (G)

Department of Oncology, San Bortolo General Hospital, Azienda ULSS8 Berica, Vicenza, Italy.

Francesca Ratti (F)

Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy.

Federica Pedica (F)

Department of Experimental Oncology, Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy.

Helena Verdaguer (H)

Gastrointestinal Cancer Unit, Vall d'Hebron University Hospital & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.

Floriana Nappo (F)

Oncology Unit 3, Veneto Institute of Oncology - IRCCS, Padua, Italy; Oncology Unit 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.

Federico Nichetti (F)

Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori di Milano, Italy.

Eleonora Lai (E)

Medical Oncology, University and University Hospital, Cagliari, Italy.

Martina Valgiusti (M)

Department of Medical Oncology, IRCCS Istituto Romagnolo per Lo Studio Dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.

Alessandro Cappetta (A)

Department of Oncology, San Bortolo General Hospital, Azienda ULSS8 Berica, Vicenza, Italy.

Carles Febregat (C)

Gastrointestinal Cancer Unit, Vall d'Hebron University Hospital & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.

Matteo Fassan (M)

Oncology Unit 3, Veneto Institute of Oncology - IRCCS, Padua, Italy.

Filippo De Braud (F)

Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori di Milano, Italy.

Marco Puzzoni (M)

Medical Oncology, University and University Hospital, Cagliari, Italy.

Giovanni L Frassineti (GL)

Department of Medical Oncology, IRCCS Istituto Romagnolo per Lo Studio Dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.

Francesca Simionato (F)

Department of Oncology, San Bortolo General Hospital, Azienda ULSS8 Berica, Vicenza, Italy.

Francesco De Cobelli (F)

School of Medicine, Vita-Salute San Raffaele University, Milan 20132, Italy.

Luca Aldrighetti (L)

Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy.

Lorenzo Fornaro (L)

Medical Oncology, University Hospital of Pisa, Italy.

Stefano Cascinu (S)

School of Medicine, Vita-Salute San Raffaele University, Milan 20132, Italy.

Andrea Casadei-Gardini (A)

School of Medicine, Vita-Salute San Raffaele University, Milan 20132, Italy.

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