Exploration of tumor genetic alterations and associations with clinical outcomes: Retrospective genomic analysis of archived liposarcoma (LPS) and leiomyosarcoma (LMS) samples from phase III trial of trabectedin (T) versus dacarbazine (D).

Authors

null

Shibu Thomas

Janssen Research and Development, Spring House, PA

Shibu Thomas , Shilpy Joshi , Dong Shen , Roland Elmar Knoblauch , Michael Gormley , George C. Wang , Deborah S. Ricci , Clifford Motley , Robert G. Maki , Margaret von Mehren , Shreyaskumar Patel , George D. Demetri

Organizations

Janssen Research and Development, Spring House, PA, Janssen Research and Development, Raritan, NJ, Division of Medical Oncology and Hematology, Department of Medicine, Monter Cancer Center, Lake Success, NY, Fox Chase Cancer Center, Philadelphia, PA, The University of Texas MD Anderson Cancer Center, Houston, TX, Dana-Farber Cancer Institute and Ludwig Center at Harvard Medical School, Boston, MA

Research Funding

Other

Background: To explore tumor genomic associations with response/resistance as potential predictive or prognostic biomarkers for T and D in metastatic LMS and LPS tumor samples. Methods: Genomic alterations [single nucleotide variants (SNVs) or gene copy number variations (CNVs)] were identified using whole exome sequencing (WES) of archived tumor samples from NCT01343277. Association of tumor-subtype or genetic alterations with clinical outcomes including maximum tumor volume reduction (MTVR), overall survival (OS), progression free survival (PFS) and treatment cycles received was assessed using multivariate Cox proportional hazard models. Results: A total of 178 uterine LMS (uLMS), 121 non-uterine LMS (non-uLMS), 60 de-differentiated LPS (ddLPS), 40 myxoid LPS (mLPS) and 14 pleomorphic LPS (pLPS) tumors underwent WES. Homozygous deletions (HD) were observed at relatively high frequency in 4 genes -AC092821.1 (36.4%), LCE3B (35.4%), LCE3C (32.1%), HEATR4 (24.4%) across all sarcoma subtypes. These genes are involved in cell proliferation, innate immune response and differentiation. HD in any of these genes was associated with improved OS in the T treatment arm. Tumors with MDM2 amplifications showed worse clinical outcome in the T treatment arm in terms of PFS and OS consistent with T-mediated induction of p-53 dependent apoptosis (Table). Conclusions: HD in any of 4 genes was associated with longer OS in patients treated with T. This molecular signature, which covers 40% of total sarcoma and 0.4% of overall solid tumors population, warrants further prospective validation. Novel genetic alterations and clinical associations.

SubtypeGeneVar. typeEndpointArmP valueHR (95% CI)
AllACO92821.1+LCE3B+ LCE3C + HEATR4HDOST0.0210.69 (0.5;0.95)
AllMDM2AMPOST0.0191.59 (1.08;2.35)
AllMDM2AMPPFST0.0011.76 (1.23;2.52)
µLMSHEATR4HDMTVRD0.009NA
µLMSHEATR4HDNo. of cyclesD0.045NA
Non-µLMSHEATR4HDMTVRT0.023NA
ddLPSLCE3BHDOST0.0040.3 (0.13;0.69)
ddLPSLCE3CHDOST0.0040.3 (0.13;0.69)

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Sarcoma

Track

Sarcoma

Sub Track

Soft Tissue Tumors

Citation

J Clin Oncol 37, 2019 (suppl; abstr 11019)

DOI

10.1200/JCO.2019.37.15_suppl.11019

Abstract #

11019

Poster Bd #

342

Abstract Disclosures