Association between microsatellite instability and BRAF, TP53, PTEN, and KRAS mutations in colorectal cancer.

Authors

null

Maher Albitar

NeoGenomics Laboratories, Aliso Viejo, CA

Maher Albitar , Sucha Sudarsanam , Wanlong Ma , Shiping Jiang , Wayne Chen , Vincent Anthony Funari , Forrest Blocker , Sally Agersborg

Organizations

NeoGenomics Laboratories, Aliso Viejo, CA, NeoGenomics, Aliso Viejo, CA

Research Funding

Pharmaceutical/Biotech Company

Background: Microsatellite instability (MSI) and DNA mismatch repair defect (dMMR) are dependable predictive biomarkers of colorectal cancer (CRC) response to checkpoint inhibitors. We explored the correlation between mutations in genes encoding various DNA repair proteins and other genes to PD-L1 expression in CRC. Methods: In this study, 264 CRC tissue samples were collected in a community setting and were evaluated for molecular abnormalities. TP53, KRAS, BRAF, and PTEN mutations were detected with next generation sequencing, PTEN deletions with FISH, PD-L1 expression with IHC, MLH1 promoter methylation and MSI with PCR. Correlations were evaluated using standard statistical Chi Square and Kruskal-Wallis tests. Results: MSI in CRC correlated directly with age (P < 0.0001), MLH1 promoter methylation (P < 0.0001), and BRAF mutation (P < 0.0001), and inversely with PTEN (P < 0.0001), KRAS (P = 0.002), and TP53 (P = 0.005) mutations. PD-L1 expression directly correlated with MSI (P = 0.0047), MLH1 promoter methylation (P = 0.004), and BRAF mutation (P < 0.0001). There was no correlation between PD-L1 expression and TP53 or KRAS mutations. Conclusions: CRC has been shown to express immune checkpoint proteins differently than other cancers. While PD-L1 expression may not be a good predictor of response to checkpoint inhibition, MSI predicts benefit well. The demonstration of a direct correlation between MSI and BRAF and PTEN mutation suggests that therapy targeting these abnormalities may be effective when combined with checkpoint inhibitors. Prevalence and Correlations of Mutations, MSI, and PD-L1

Prevalence
Mutant or Expressing
MSIType of correl.PD-L1
PvaluePvalue
AgeN/A0.04PositiveNS
PD-L124.9% ( 56/225)0.005Positive0.005
KRAS52.4% (129/246)0.002NegativeNS
TP5358.9% (145/246)0.005NegativeNS
BRAF15.1% ( 31/205) of PD-L1 samples
9.8% ( 21/215) of MSI samples
< 0.0001Positive0.004
KRAS +/or TP5381.3% (200/246)< 0.0001NegativeN/A
K/RAS52.4% (129/246) KRAS0.001NegativeNS
MLH1 promoter methylation20.7% ( 28/135) of PD-L1 samples
23.6% ( 56/237) of MSI samples
< 0.0001Positive0.01
PTEN Mutation5.7% ( 14/246)< 0.0001Positive0.007

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Gastrointestinal (Colorectal) Cancer

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Epidemiology/Outcomes

Citation

J Clin Oncol 36, 2018 (suppl; abstr e15604)

DOI

10.1200/JCO.2018.36.15_suppl.e15604

Abstract #

e15604

Abstract Disclosures

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