Patho-genomic feature of PI3K / AKT / mTOR pathway mutations in Chinese patients with non-small cell lung cancer.

Authors

null

Weiwei Li

BGI Genomics, BGI-Shenzhen, Shenzhen, China

Weiwei Li , Yuan Qiu , Hanzhang Chen , Haihong Yang , Qiuhua Deng , Liping Liu , Dakai Xiao , Changbin Zhu , Wenxi Jiang , Di Shao , Yongping Lin , Jianxing He

Organizations

BGI Genomics, BGI-Shenzhen, Shenzhen, China, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China, Thoracic Oncology Department, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China, Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University; Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease., Guangzhou, China, BGI-Shenzhen, Shenzhen, China

Research Funding

No funding received
None

Background: Inhibition of PI3K/AKT/mTOR pathway has emerged as a promising anticancer strategy. Measuring genetic alterations in PI3K/AKT/mTOR pathway are critical for clinical decision making for patients with lung cancer. This study aims to analyze PI3K/AKT/mTOR pathway-related gene mutations in non-small cell lung cancer (NSCLC) in a consecutive cohort. Methods: 536 surgically resected tumor tissues were collected. Target region capture sequencing for 508 cancer-related genes was conducted on MGI-seq 2000 platform. Results: PI3K/AKT/mTOR pathway genes were mutated in 120 samples (22.4%). Female or older patients displayed higher mutation incidence of PI3K/AKT/mTOR pathway (P = 0.06 for female, P = 0.05 for patients ≥60 y). In NSCLC samples, mutations mainly occurred in NF1/2(18/499), PTEN (7/499), MTOR (4/499), TSC1/2(18/499), PIK3CA (26/499), PDK1 (2/499), AKT1/2/3 (5/499) and KRAS (49/499) genes. Genetic alterations of AKT2 (p = 0.003), mTOR (P = 0.03), PTEN (P = 0.005) and PIK3CA (P < 0.001) are preferred to occur in squamous NSCLC. PIK3CA variants (p.E542K, p.E545K, p.Q546K) were more enriched in non-squamous NSCLC, while amplification of PIK3CA was more prevalent in squamous NSCLC (P = 0.038). Histologically, TSC1/2 mutations were more correlate with micro-invasion subtype in non-squamous NSCLC (P = 0.002). Meanwhile, PIK3CA alterations, especially, amplification occurred more often in keratinizing squamous NSCLC (P < 0.001). In addition, four patients with biallelic NF1 loss of function mutations were exclusively found in non-squamous NSCLC without co-occurrence of mutation in known driver genes like EGFR or TP53, which indicated biallelic loss of function of NF1 might be sufficient to drive oncogenesis of non-squamous NSCLC. Conclusions: PI3K/AKT/mTOR pathway alterations present a heterogenous distribution across various types of lung malignancies especially in NSCLC. As more small molecule inhibitors developed to target PI3K/AKT/mTOR pathway, this study might shed light on further clinical investigation of these lately developed therapeutic approaches.

MutationWild typeP-valueMutationWild typeP-value
TSC1/20.002NF1/20.143
Invasive7343Invasive15335
Micro-invasive687Micro-invasive192
In situ416In situ119
Keratinizing014Keratinizing212
Non keratinizing110Non keratinizing011
KRAS0.055PIK3CA< 0.001
Invasive38312Invasive14336
Micro-invasive489Micro-invasive093
In situ515In situ119
Keratinizing113Keratinizing77
Non keratinizing110Non keratinizing29

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Publication Only

Session Title

Publication Only: Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers

Track

Lung Cancer

Sub Track

Local-Regional Non–Small Cell Lung Cancer

Citation

J Clin Oncol 38: 2020 (suppl; abstr e21049)

DOI

10.1200/JCO.2020.38.15_suppl.e21049

Abstract #

e21049

Abstract Disclosures

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