The landscape of DNA damage response (DDR) pathway in colorectal cancer (CRC).

Authors

null

Hiroyuki Arai

Chiba Cancer Center, Chibashi, Japan

Hiroyuki Arai , Andrew Elliott , Jingyuan Wang , Francesca Battaglin , Shivani Soni , Wu Zhang , Davendra Sohal , Richard M. Goldberg , Michael J. Hall , Aaron James Scott , Mohd Khushman , Jimmy J. Hwang , Emil Lou , Benjamin A. Weinberg , John Marshall , Albert Craig Lockhart , Phillip Stafford , Jian Zhang , W. Michael Korn , Heinz-Josef Lenz

Organizations

Chiba Cancer Center, Chibashi, Japan, CARIS Life Sciences, Irving, TX, USC Norris Comprehensive Cancer Center, Los Angeles, CA, Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USC Keck School of Medicine, Los Angeles, CA, Cleveland Clinic, Cleveland, OH, West Virginia University Cancer Institute, Morgantown, WV, Fox Chase Cancer Center, Philadelphia, PA, Banner-University of Arizona Cancer Center, Division of Hematology and Oncology, Tucson, AZ, Mitchell Cancer Institute, Mobile, AR, Levine Cancer Institute, Charlotte, NC, University of Minnesota School of Medicine, Minneapolis, MN, Georgetown University Medical Center, Washington, DC, Georgetown University, Washington, DC, University of Miami Sylvester Cancer Center, Miami, FL, Caris Life Sciences, Phoenix, AZ

Research Funding

No funding received
None

Background: Abnormal DDR is a hallmark of cancer, relating to genome instability, anti-tumor immunity, and sensitivity to chemotherapeutic agents and radiation. We conducted a large-scale investigation to clarify the alteration of DDR pathway in CRC. Methods: Tumor samples from 9321 CRC patients were retrospectively reviewed. Next-Generation Sequencing (NGS) on a custom-designed panel enriching 592 gene targets was performed. Samples with mutations detected in any of 29 DDR-related genes were deemed DDR-mutant (DDR-MT); the rest DDR-wild type (DDR-WT). Microsatellite instability (MSI) status was tested with a combination of immunohistochemistry (IHC), fragment analysis and NGS. Tumor mutational burden (TMB) was calculated based on somatic nonsynonymous missense mutations. PD-L1 was tested by IHC (SP142). Consensus molecular subtype (CMS) was developed using RNA sequencing data. Results: Of 9321 cases, 1290 (13.8%) were DDR-MT. DDR-MT frequency was higher in right vs. left sided (20.9% vs 10.8%, p < 0.001) and MSI-H vs. MSS (76.4% vs 9.5%, p < 0.001) cases. In the MSS cases, right-sided had marginally higher frequency of DDR-MT than left-sided (10.6% vs 9.1%, p = 0.055), with much higher frequency of Fanconi anemia pathway alteration in right-sided (1.5% vs 0.7%, p < 0.01). CMS1 subtype had the highest frequency of DDR-MT (34.8%); CMS2 had the lowest (7.1%). DDR-MT cases (vs. DDR-WT) had higher mutation rate of ARID1A (55.0% vs 19.1%, p < 0.0001), PIK3CA (22.6% vs 15.8%, p < 0.0001) and BRAF (20.4% vs 7.3%, p < 0.0001), and lower mutation rate of TP53 (48.2% vs 76.1%, p < 0.0001), APC (60.5% vs 74.5%, p < 0.0001) and KRAS (44.0% vs 49.8%, p < 0.001). Mean TMB was much greater in DDR-MT than DDR-WT (All: 20.9/Mb vs 7.7/Mb, p < 0.0001; MSS: 13.7/Mb vs 7.6/Mb, p < 0.05). PD-L1 positivity was also higher in DDR-MT compared to DDR-WT (All: 10.1% vs 2.7%, p < 0.0001; MSS: 4.8% vs 2.4%, p < 0.0001). Conclusions: Alteration of the DDR pathway was strongly associated with MSI status in CRC. The primary tumor sidedness might also be related, as DDR-MT was more prevalent in right-sided tumors. Elevated TMB and PD-L1 expression in DDR-MT CRC indicate more activated anti-tumor immune profiles compared to DDR-WT, regardless of MSI status, suggesting possible therapeutic benefit from immune checkpoint inhibitors in DDR-MT CRC.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Gastrointestinal Cancer—Colorectal and Anal

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Biologic Correlates

Citation

J Clin Oncol 38: 2020 (suppl; abstr 4064)

DOI

10.1200/JCO.2020.38.15_suppl.4064

Abstract #

4064

Poster Bd #

56

Abstract Disclosures

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