Discovery of a potential predictive marker for eribulin treatment and novel target genes in BRAF V600E mutant metastatic colorectal cancer using an AI-driven RNA-seq analysis platform: Translational research of the BRAVERY study (EPOC1701).

Authors

null

Toshiki Masuishi

Aichi Cancer Center Hospital, Aichi, Japan

Toshiki Masuishi , Hiroya Taniguchi , Daisuke Kotani , Hideaki Bando , Taroh Satoh , Taito Esaki , Yoshito Komatsu , Yu Sunakawa , Tomohiro Nishina , Eiji Shinozaki , Naohiro Nishida , Masato Komoda , Satoshi Yuki , Naoki Izawa , Gaurav Sharma , Stan Skrzypczak , Eric Schultz , Carl Kingsford , Akihiro Sato , Takayuki Yoshino

Organizations

Aichi Cancer Center Hospital, Aichi, Japan, Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan, Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Osaka, Japan, Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan, Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Japan, Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, CA, Japan, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan, Department of Gastrointestinal Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan, Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan, Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan, Ocean Genomics, Inc., Pittsburgh, PA, Clinical Research Support Office, National Cancer Center Hospital East, Kashiwa, Japan, National Cancer Center Hospital East, Kashiwa, Japan

Research Funding

Other
Aichi Cancer Center Hospital

Background: Patients (pts) with BRAF V600E mutant (mt) metastatic colorectal cancer (mCRC) still have a poor prognosis even when treated with encorafenib plus cetuximab. We reported that eribulin that inhibits G2-M cell cycle had limited activity for these pts in the phase II BRAVERY study (Masuishi T, et al. WCGC 2020). Barras D, et al. (2017) reported that BRAF V600E mt mCRCs were classified into BM1 and BM2 characterized by KRAS/AKT pathway activation and deregulation of the cell cycle with G2-M phase activation, respectively, based on gene expression. Methods: Whole transcriptome RNA-seq of FFPE pre-treatment tumor samples was performed using NovaSeq 6000 in the BRAVERY study. Molecular features were extracted using the Txome.ai platform (Ocean Genomics Inc., PA, USA) which included transcript- and gene-level expression quantification, expression-based clustering, and structural variant calling. Efficacy of eribulin was classified as “good” if pts had a tumor reduction and/or progression-free survival (PFS) of more than 6 months, and “poor” otherwise. The differential gene expression analysis was performed between pts with “good” and “poor” using Txome.ai. In addition, BM and consensus molecular subtype (CMS) classification were performed using the model developed by Barras D, et al. (2017) and Guinney J, et al. (2015), respectively. Results: Among 27 pts, 26 tumor samples were available to perform RNA-seq and analyze gene expression despite low mapping rates. Patient characteristics were as follows: median age of 58.5 (range, 33–71) years; ECOG PS of 0/1 (16/10); primary tumor location of right/left (11/15); and all 26 pts had MSS/pMMR. Four and 22 pts were classified into “good” and “poor” groups, respectively. Among 52 differentially expressed genes (GENCODE v31) with false discovery rate-adjusted P- value < 0.05, the top 5 genes with the lowest P-values are provided in the table. All 4 pts in the “good” group were classified into BM2 and pts in the “poor” group were classified into BM1 (8/22) and BM2 (14/22) (p = 0.07). In addition, all but 2 pts were classified into CMS4. These two pts belong to the “poor” group with one of them classified into CMS1 and the other into CMS2. Conclusions: These gene expression analyses suggest that BM2 subtype could be a predictive marker for the efficacy of eribulin and some genes could be novel targets with the goal to improve prognosis of pts with BRAF V600E mt mCRC. This is the first finding for a potential biomarker in this subgroup using RNA-seq analysis tools. These findings will require additional validation. Clinical trial information: UMIN000031552.

Gene
Highly expressed group
Log2 Fold Change
MUC12
Poor
8.9
CEACAM7
Poor
7.9
SLC26A3
Poor
10.1
MUC4
Poor
4.9
PI3
Poor
9.3
GPR155
Good
5.0
AC007608.4
Good
6.0
LINC00538
Good
6.4
AC007493.1
Good
8.2
WIF1
Good
9.2

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Gastrointestinal Cancer—Colorectal and Anal

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Epidemiology/Outcomes

Clinical Trial Registration Number

UMIN000031552

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr e15532)

DOI

10.1200/JCO.2021.39.15_suppl.e15532

Abstract #

e15532

Abstract Disclosures