Effect of therapeutic pressure on stability of EGFR amplification in glioblastoma.

Authors

Manmeet Ahluwalia

Manmeet Singh Ahluwalia

Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH

Manmeet Singh Ahluwalia , Cara R. Dimino , Mahesh M. Mansukhani , Vundavalli V. Murty , Peter Canoll , Yoshitaka Narita , Yoshihiro Muragaki , Hui Kong Gan , Ryan Thomas Merrell , Martin J. Van Den Bent , Zheng Zha , Lisa Roberts-Rapp , Fang Jiang , Maria Guseva , Earle E. Bain , Christopher Joseph Ocampo , Peter J Ansell , Andrew B. Lassman

Organizations

Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, Columbia University Medical Center, New York, NY, National Cancer Center Hospital, Tokyo, Japan, Tokyo Women’s Medical University Hospital, Tokyo, Japan, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Australia, NorthShore University Health System, Evanston, IL, Erasmus MC Cancer Centre, Rotterdam, Netherlands, AbbVie Inc., North Chicago, IL, AbbVie Inc., Chicago, IL

Research Funding

Pharmaceutical/Biotech Company

Background: Depatuxizumab mafodotin (depatux-m, formerly ABT-414) is an EGFR-directed antibody-drug conjugate being developed for treatment of EGFR-amplified glioblastoma (GBM). As therapeutic pressure engenders tumor adaptations, it is important to understand the stability of biomarkers targeted by precision medicine approaches such as depatux-m. Therefore, we assessed EGFR amplification (amp) and expression in longitudinally-sampled GBMs from patients (pts) treated +/- depatux-m to explore biomarker stability. Methods: Formalin-fixed, paraffin embedded GBM tumor tissue was analyzed from 68 patients who underwent at least 2 surgeries; EGFR amp was detected by in situ hybridization (e.g., FISH) or next-generation sequencing in all samples. Fifty-six pts did not receive depatux-m; among 12 pts who did, EGFR expression was also evaluated by RNA sequencing. Results: Of 56 pts who did not receive depatux-m, 31 (55%) had tumors harboring EGFR amp at 1st surgery (initial diagnosis); among those, EGFR amp was maintained at re-operation in 27 (87%), and not maintained in 4 (13%). None of the 25 cases without baseline EGFR amp acquired it at the 2nd surgery. Of 12 pts treated with depatux-m between surgeries, 9 cases harbored EGFR amp at baseline which was maintained in 4 (44%) at the 2nd surgery, all 4 of which had the highest levels of EGFR expression at baseline. Of the 3 cases without EGFR amp at baseline, none acquired amplification at the 2nd surgery, and all 3 had the lowest levels of EGFR expression at study start. Conclusions: The presence of EGFR amp in GBM tissue at baseline was maintained at 2nd surgery in 87% of pts who received treatment other than depatux-m, and in 44% following depatux-m exposure. Therefore, depatux-m exposure appears to reduce EGFR amp maintenance (p = 0.0159 by Fisher’s exact test); accordingly, the therapeutic approach may influence EGFR status. In no case was EGFR amp acquired at recurrence, regardless of depatux-m therapy. Ongoing analyses of additional tumor samples will increase power and further examine concordance among EGFR amp assays.

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Citation

J Clin Oncol 36, 2018 (suppl; abstr 2033)

DOI

10.1200/JCO.2018.36.15_suppl.2033

Abstract #

2033

Poster Bd #

191

Abstract Disclosures

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