Incidence of PI3K pathway aberrations and their impact on response to neoadjuvant chemotherapy (NACT) in triple-negative breast cancer (TNBC) subtypes.

Authors

Reva Basho

Reva K Basho

Cedars-Sinai Medical Center, Los Angeles, CA

Reva K Basho , Alex Trevarton , Chunxiao Fu , Rosanna Lau , Chih-Hsu Lin , Olivier Lichtarge , Wei Tse Yang , William Fraser Symmans , Stacy L. Moulder , Kenneth R. Hess

Organizations

Cedars-Sinai Medical Center, Los Angeles, CA, The University of Texas MD Anderson Cancer Center, Houston, TX, The University of Texas MD Anderson Cancer Center, Houston, TX, US, Baylor College of Medicine, Houston, TX

Research Funding

Conquer Cancer Foundation of the American Society of Clinical Oncology

Background: TNBC cell lines characterized as mesenchymal (M) and luminal androgen receptor (LAR) commonly have aberrations in the PI3K pathway. However, the incidence in human tumors and impact on response to therapy is less clear. Methods: Pre-treatment biopsies were collected from TNBC patients (pts) prior to NACT. Tumors were categorized into 5 groups using the Pietenpol criteria (Lehmann JCI 2011): basal-like (BL) comprised of BL-1 and BL-2, M comprised of M and mesenchymal stem-like, immunomodulatory (IM), LAR, or unspecified (UNS). Using RNAseq data, variants were identified in 16 PI3K pathway genes: AKT1, AKT2, AKT3, CRKL, IRS2, MTOR, PIK3CA, PIK3CG, PIK3R1, PTEN, RICTOR, RPTOR, RNF43, TSC1, TSC2. Results: Data was available in 63 pts (N = 4 stage I; N = 41 stage II; N = 18 stage III). There was no significant association between stage and subtype. 67 PI3K pathway variants were identified in 39 (62%) tumors. The incidence of mutated tumors and their differential response to NACT defined by residual cancer burden (RCB) in each subtype is presented in the table. There was no significant association between subtype and incidence of mutated tumors (P = 0.10). However, there were more mutated tumors in the LAR compared to non-LAR subsets (100% vs 57%); the majority of LAR tumors (5/7) had a variant in the PIK3R1 gene. The incidence of mutated tumors in the M vs non-M subsets was similar (57% vs 63%). Pts with mutated tumors did not have a significantly worse response to NACT overall (46% vs 54%; P = 0.61) or within the M subset (25% vs 50%; P = 0.58). Conclusions: In this cohort of TNBC pts, the incidence of PI3K pathway aberrations was higher than previously reported, likely due to the comprehensive genes evaluated. There was no significant difference in incidence of aberrations across subtypes, and PI3K pathway aberration was not associated with altered response to NACT. Larger cohorts are needed to clarify the impact of PI3K pathway aberrations in TNBC subtypes.

SubtypeNPI3K Mutated Tumors
N (%)
RCB 0-I if PI3K Wild Type
N (%)
RCB 0-I if PI3K Mutated
N (%)
All6339 (62)13 (54)18 (46)
BL2011 (55)5 (56)6 (55)
M148 (57)3 (50)2 (25)
IM129 (75)2 (67)6 (67)
LAR77 (100)-2 (29)
UNS104 (41)3 (50)2 (50)

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Breast Cancer—Local/Regional/Adjuvant

Track

Breast Cancer

Sub Track

Neoadjuvant Therapy

Citation

J Clin Oncol 36, 2018 (suppl; abstr 588)

DOI

10.1200/JCO.2018.36.15_suppl.588

Abstract #

588

Poster Bd #

80

Abstract Disclosures

Funded by Conquer Cancer

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