Genomic profiling of squamous malignancies across anatomic sites.

Authors

Christine Chung

Christine H. Chung

Moffitt Cancer Center, Tampa, FL

Christine H. Chung , Garrett Michael Frampton , Zachary Rockow Chalmers , Jon Chung , Saad A. Khan , Alexa Betzig Schrock , Laurie M. Gay , Neelesh Sharma , Julia Andrea Elvin , David Fabrizio , Caitlin F. Connelly , Hyunseok Kang , Philip J. Stephens , Vincent A. Miller , Jennifer Maria Johnson , Jeffrey S. Ross , Siraj Mahamed Ali , Shridar Ganesan

Organizations

Moffitt Cancer Center, Tampa, FL, Foundation Medicine, Inc., Cambridge, MA, The University of Texas Southwestern Medical Center, Dallas, TX, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, Foundation Medicine, Inc., Boston, MA, The Sidney Kimmel Comprehensive Cancer Center and Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, Thomas Jefferson University Hospital, Philadelphia, PA, Albany Medical College, Albany, NY, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ

Research Funding

Other

Background: Primary squamous cell carcinomas (SCCs) have diverse etiologies, but can share genomic features. We reviewed the genomic profiles of a series of SCC cases of differing anatomic origin. Methods: Hybrid-capture based genomic profiling of 182 or 236 or 315 genes was performed on 4783 squamous malignancies in the course of clinical care, with baits for HPV6, 11, 16, and 18, and assessment of tumor mutation burden (TMB; mutations/Mb) and microsatellite instability. Results: Sites of origin were head and neck (HNSCC, n = 1300), cervical (cSCC; n = 318), anal (aSCC, n = 248), esophageal (n = 242), lung (lSCC, n = 2386), and cutaneous (sSCC, n = 289) SCC cases. For HNSCC, cSCC, and aSCC (collectively termed HCA SCC), 395 (30%), 215 (68%), and 211 (83%) were HPV positive, respectively. For HCA SCC, the most common GA were in TP53 (45%), CDKN2A (29%), PIK3CA (24%), TERT (21%), and FAT1 (14%). The most frequent GA differentially associated with HPV status were in PIK3CA (34.9% versus 16.0%), CYLD (11.4% versus 1.4%) and PTEN (14.8% versus 6.1%) for HPV+ cases, and TP53 (3.8% versus 76.5%), CDKN2A ()1.4% versus 49.8%), and TERT (4.3% versus 33.0%) for HPV- cases. Mean TMB for HPV+ and HPV- cases were 6.6 (STDEV 7.3) and 13.7 (STDEV 29.7), respectively. TMB of all SCC cases was significantly different (p < 10-12) when stratified by HPV status. For lSCC and eSCC, the most common GA were found in TP53 (86%) CDKN2A (40%), and PIK3CA (26%) and mean TMB was 11.6 with HPV found in 3.1% of cases. In sSCC, the most common GA were in TP53 (85.5%), CDKN2A (54.3%), and TERT(44.0%), and mean TMB was 59.5 with HPV in 3.1% of cases. Subsets of SCC cases had defining and targetable GA including bi-allelic deletion of SMARCB1 ( < 0.3%), amplification of PD-L1 (~2%), and various kinase fusions. Cases demonstrating radiologic response to immunotherapy and matched targeted therapies, as well as subsequent development of multiple mechanisms of acquired resistance, will be presented. Conclusions: HPV driven SCC have similar genomic profiles regardless of of site origin, and have a significantly lower median TMB than HPV negative SCC. Early consistency of responses of SCC to matched therapies may strengthen the case for site independent genomic predictors of therapy response.

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Tumor Biology

Track

Tumor Biology

Sub Track

Molecular Diagnostics and Imaging

Citation

J Clin Oncol 35, 2017 (suppl; abstr 11512)

DOI

10.1200/JCO.2017.35.15_suppl.11512

Abstract #

11512

Poster Bd #

212

Abstract Disclosures

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