Correlation of tumor mutational burden (TMB) with CDKN2A and TP53 mutation in HPV-negative head and neck squamous cell carcinoma (HNSCC).

Authors

null

Barbara Burtness

Yale School of Medicine and Yale Cancer Center, New Haven, CT

Barbara Burtness , Alexander Deneka , Yasmine Baca , Ilya Serebriiskii , Mitchell I. Parker , Emmanuelle Nicolas , Jong Woo Lee , Trisha Wise-Draper , Ammar Sukari , Bradley G. Somer , Erica Golemis

Organizations

Yale School of Medicine and Yale Cancer Center, New Haven, CT, Fox Chase Cancer Center, Philadelphia, PA, Caris Life Sciences, Phoenix, AZ, Drexel University, Philadelphia, PA, Yale School of Medicine, New Haven, CT, University of Cincinnati, Cincinnati, OH, Department of Oncology, Karmanos Cancer Institute/Wayne State University, Detriot, MI, West Cancer Center and Research Institute, Germantown, TN

Research Funding

Pharmaceutical/Biotech Company
Caris Life Sciences

Background: The tumor suppressors TP53 and CDKN2A are commonly mutated or lost in HNSCC, impairing G1 checkpoints. This reduces ability to repair DNA damage arising from hypoxia, replication stress, and mutagen exposure, thus increasing TMB, a potential predictive biomarker for immunotherapy benefit. TP53 mutations can be classified as loss-of-function (LOF) with or without dominant negative (DNE) activity, gain-of-function (GOF) and benign. We investigated whether specific categories of TP53 mutation were associated with increased TMB, and whether these cooperated with CDKN2A mutation to elevate TMB. Methods: We analyzed 1010 HPV- HNSCC tumor samples (246 female) profiled with a 592-gene panel by Caris Life Sciences from 2015 to 2019. Predominant subsites were oral cavity (285), oropharynx (225) and larynx (153). TMB reflected all somatic nonsynonymous missense mutations detected. We report mean TMB per megabase (MB). Pathogenicity of TP53 and CDKN2A mutations was determined according to American College of Medical Genetics (ACMG) guidelines. We also used four alternative methods of characterizing TP53 mutations based on analysis of protein structure, public databases (IARC, ClinVar, InterVar), and publications (PMID: 25108461 and others) assessing structure-function relations. Results: 60% of cases had TP53 mutations (TP53mut) designated pathogenic by ACMG guidelines. Estimates of frequency of LOF/DNE mutations ranged from 30-42.8% of cases among the alternative classification methods. Damaging CDKN2A mutations were present in 20%. Average TMB per MB varied from 8.2/8.6 (females/males) in oral cavity cancers to 26.5/27.7 (females/males) in cancer of the lip. Mean TMB was typically higher in the presence of damaging LOF/DNE TP53 mutations or CDKN2A mutations, but not TP53 GOF mutations. Based on ACMG, for tumors with TP53 and CDKN2A wild type (WT) TMB was 8.03, for those with CDKN2Amut-only 9.82, for TP53mut-only 10.56, and TP53 mut/CDKN2A mut 17.6 (p < 0.001). For disruptive TP53mut (Poeta algorithm), mean TMB for WT/WT was 8.67, for TP53mut 11.31, CDKN2Amut 17.9 and TP53mut/CDKN2A mut 15.83 (p < 0.001). Conclusions: Mutation of TP53 and/or CDKN2A is associated with increased mean TMB relative to WT; mean TMB was highest for tumors bearing damaging mutations in both genes. GOF TP53 mutation was not clearly associated with increased TMB. As TMB is evaluated as a predictive biomarker in the immunotherapy of HNSCC, specific TP53/CDKN2A mutational status should also be evaluated.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Head and Neck Cancer

Track

Head and Neck Cancer

Sub Track

Biologic Correlates

Citation

J Clin Oncol 38: 2020 (suppl; abstr 6552)

DOI

10.1200/JCO.2020.38.15_suppl.6552

Abstract #

6552

Poster Bd #

213

Abstract Disclosures

Similar Abstracts

First Author: David R. Braxton

Abstract

2024 ASCO Gastrointestinal Cancers Symposium

Association between TP53 gain of function and loss of function mutational subgroups and survival in pancreatic adenocarcinoma.

First Author: Nitzan Zohar

First Author: Juying Liu

First Author: Tung Hoang