SUNY Upstate University Hospital, Syracuse, NY
Nick Liu , Leszek Kotula , Timothy Byler , Joseph Jacob , Brian Michael Alexander , Laurie M. Gay , Oleg Shapiro , Sherri Z. Millis , Julia Andrea Elvin , Jon Chung , Jo-Anne Vergilio , Shakti Ramkissoon , Eric Allan Severson , Jonathan Keith Killian , Siraj Mahamed Ali , Alexa Betzig Schrock , Vincent A. Miller , Andrea Necchi , Gustavo de La Roza , Jeffrey S. Ross
Background: Prostatic ductal carcinoma (PDC) is an uncommon centrally located prostate with a characteristic tubulopapillary histology. PDC shares some biomarker features with the more common prostatic acinar carcinoma (PAC) including PSA expression. Methods: In this comparative comprehensive genomic profiling (CGP) study, FFPE samples from 61 clinically advanced PDC and 4,132 PAC were profiled for all classes of genomic alterations (GA). Tumor mutational burden (TMB) was determined on 1.1 Mbp of sequenced DNA and microsatellite instability (MSI) was determined on 114 loci. Results: The age, frequency of genomic alterations (GA) per tumor and TP53 GA of PDA and PAC were similar (Table). TMPRSS2:ERG fusions and AR GA were more often identified in PAC than PDC whereas PTEN GA were more common in PDC than PAC. Targetable GA were identified at similar frequencies in both groups focused on BRCA2 (PARP inhibitors), BRAF (BRAF/MEK inhibitors) and PIK3CA (MTOR inhibitors). ATM GA (PARP inhibitors) were more common in PAC than PDC. CDK12 GA potentially associated with immunotherapy (IO) benefit were similar in PDA and PAC as were the frequencies of MSI-High status, median TMB and high TMB levels. Conclusions: The pathologic features of PDC and PAC have been classically maintained as representative of 2 different tumor types with potentially contrasting histogenesis. In the current CGP-based study, PDA and PAC did not display significant differences in genomic signatures. CGP may reveal biomarkers that could direct patients to targeted (PARP, MTOR and BRAF/MEK inhibitors) or immunotherapies (CDK12 GA, MSI-High or high TMB status) in both PDA and PAC.
Age Median range | GA/ tumor | Top GA | Top Targetable GA | CDK12 GA | MSI High | Median TMB | TMB > 10 mut/Mb | TMB > 20 mut/Mb | |
---|---|---|---|---|---|---|---|---|---|
PDA 61 cases | 66 | 4.1 | PTEN 48% | PTEN 48% | 8.2% | 1.9% | 2.6 | 3.3% | 1.6% |
(51-86) | TP53 46% | AR 11% | |||||||
TMPRSS2 21% | PIK3CA 11% | ||||||||
AR 11% | BRCA2 9% | ||||||||
PIK3CA 11% | BRAF 7% | ||||||||
FAS 11% | RET 4% | ||||||||
RB1 10% | |||||||||
PAC 4,132 cases | 66 (34-88) | 4.4 | TP53 43% | PTEN 32% | 6.0% | 2.6% | 2.6% | 3.8% | 0.7% |
TMPRSS2 32% | AR 21% | ||||||||
PTEN 32% | BRCA2 10% | ||||||||
AR 21% | PIK3CA 7% | ||||||||
MYC 12% | ATM 6% | ||||||||
BRCA2 10% | BRAF 4% | ||||||||
PIK3CA 7% |
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Abstract Disclosures
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First Author: Gennady Bratslavsky
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