Ductal (PDC), acinar (PAC) and neuroendocrine (PNC) carcinomas of the prostate: A comparative comprehensive genomic profiling (CGP) study.

Authors

null

Gennady Bratslavsky

Urologic Oncology Branch, National Cancer Institute at the National Institutes of Health, Bethesda, MD

Gennady Bratslavsky , Joseph Jacob , Oleg Shapiro , Nick Liu , Elizabeth Kate Ferry , Julia Andrea Elvin , Jo-Anne Vergilio , Jonathan Keith Killian , Nhu Ngo , Shakti Ramkissoon , Eric Allan Severson , Amanda Hemmerich , Siraj Mahamed Ali , Jon Chung , Alexa Betzig Schrock , Prasanth Reddy , Sherri Z. Millis , Brian Alexander , Jeffrey S. Ross , Andrea Necchi

Organizations

Urologic Oncology Branch, National Cancer Institute at the National Institutes of Health, Bethesda, MD, SUNY Upstate Medical University, Syracuse, NY, SUNY Upstate University Hospital, Syracuse, NY, SUNY Upstate Medical University Hospital, Syracuse, NY, Foundation Medicine, Inc., Cambridge, MA, Foundation Medicine, Cambridge, MA, Foundation Medicine, Inc., Phoenix, AZ, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

Research Funding

Other

Background: PDC, PAC and PNC are histologic subtypes of prostate cancer (PC). We queried whether these subsets would share similar genomic alterations (GA) reflecting their disease biology and clinical features. Methods: CGP was performed using a hybrid capture-based assay on 61 PDC, 4,132 PAC and 217 PNC. 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, GA per tumor and TP53 GA of PDC, PAC and PNC were similar (Table). RB1 GA were predominant in PNC. TMPRSS2:ERG fusions were most frequent in PNC, intermediate in PAC and lowest in PDC. AR GA were more often identified in PAC than PDC or PNC whereas PTEN GA were most frequent in PDC than PAC or PNC. Targetable GA were identified in all 3 groups when focused on BRCA2 (PARP inhibitors) and PIK3CA (MTOR inhibitors). ATM GA (PARP inhibitors) were more common in PAC than PDC or PNC. BRAF GA (BRAF/MEK inhibitors) were more frequent in PDC and PAC than PNC. CDK12 GA potentially associated with immunotherapy (IO) benefit were similar in PDC and PAC and low in PNC. Low frequencies of MSI-High and low median TMB levels were similar in all 3 groups. Conclusions: The pathologic features of PDC, PAC and PNC have been classically maintained as representative of 3 different tumor types with potentially contrasting histogenesis. In the current CGP based study, all 3 tumor types did not display significant differences in genomic signatures other than the high RB1 GA. 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) especially in PDC and PAC.

Age Median
range
GA/
tumor
Top
Un-targetable GA
Top
Targetable GA
CDK12 GAMSI HighMedian TMBTMB
≥ 10 mut/Mb
TMB
≥ 20 mut/Mb
PDC 61 cases664.1TP53 46%PTEN 48%8.2%1.9%2.63.3%1.6%
(51-86)TMPRSS2 21%AR 11%
FAS 11%PIK3CA 11%
RB1 10%BRCA2 9%
BRAF 7%
RET 4%
ATM 0%
PAC 4,132 cases664.4TP53 43%PTEN 32%6.0%2.6%2.63.8%0.7%
(34-88)TMPRSS2 32%AR 21%
MYC 12%BRCA2 10%
RB1 7%PIK3CA 7%
ATM 6%
BRAF 4%
PNC
217 cases
675.0TP53 64%PTEN 33%1.8%1.0%3.58.8%2.8%
PNC
217 cases
(30-86)RB1 55%BRCA2 12%
TMPRSS2 42%AR 11%
MYC 11%PIK3CA 5%
ATM 3%
BRAF 1%

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary (Prostate) Cancer

Track

Genitourinary Cancer—Prostate, Testicular, and Penile

Sub Track

Epidemiology/Outcomes

Citation

J Clin Oncol 37, 2019 (suppl; abstr 5064)

DOI

10.1200/JCO.2019.37.15_suppl.5064

Abstract #

5064

Poster Bd #

176

Abstract Disclosures

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