Genomic landscape of ERBB2/3 alterations in colorectal cancer: Comutations, immuno-oncology biomarkers, and consensus molecular subtype.

Authors

Jeanne Tie

Jeanne Tie

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia

Jeanne Tie , Sherif Mohamed El-Refai , Takayuki Yoshino , Salvatore Siena , Sara Lonardi , Andrea Sartore-Bianchi , Yoshiaki Nakamura , Hideaki Bando , Takao Fujisawa , Sheau Wen Lok , Hui-Li Wong , Kunal C. Kadakia , Elizabeth Mauer , Mohamed E. Salem

Organizations

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia, Tempus Labs, Chicago, IL, National Cancer Center Hospital East, Kashiwa, Japan, Grande Ospedale Metropolitano Niguarda and Università degli Studi di Milano, Milan, Italy, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy, Peter MacCallum Cancer Centre, Melbourne, Australia, Levine Cancer Institute, Atrium Health, Charlotte, NC

Research Funding

No funding received

Background: ERBB2 is a rapidly emerging therapeutic target for a subset of colorectal cancer (CRC) harboring oncogenic alterations in this gene. Oncogenic ERBB3 mutations have been reported in various cancers including CRC, but little is known about its functional impact. Optimal targeting of this pathway requires understanding of the genomic context in which somatic ERBB2/3 alterations (ERBB2/3-alt) occur in a real-world CRC population. Methods: We analyzed 7,688 de-identified records from CRC patients that underwent next generation sequencing with the Tempus|xT assay (DNA-seq of 648 genes at 500x coverage, full transcriptome RNA-seq). We assessed the prevalence and association of ERBB2/3-alt with demographics, co-occurring alterations, immuno-oncology biomarkers (microsatellite instability [MSI], tumor mutational burden [TMB], PD-L1 expression), and consensus molecular subtype (CMS, available for the subgroup with primary biopsies and RNA data [n = 2,686]). Results: Overall, 5% (376/7688) of tumors harbored an ERBB2 or ERBB3-alt. 1.9% (n = 143) ERBB2-amplified, 1.3% (n = 97) ERBB2-mutated, 0.9% (n = 72) ERBB3-mutated, < 1% other combinations (excluded from analyses). There were no significant differences in baseline demographics (e.g., age of onset, race and gender) between groups. Patients with ERBB2/3-alt were more likely to be MSI-high and TMB-high (Table). There was a trend towards higher prevalence of positive PD-L1 in ERBB3-alt vs ERBB3-WT tumors. We observed significant differences in co-occurring alterations among ERBB2/3-alt and WT groups (Table). CMS classification did not identify significant differences by ERBB2-alt or ERBB3-alt; ERBB2-alt compared to WT (CMS1: 8.6% vs 13%; CMS2: 24% vs 26%; CMS3: 20% vs 17%; CMS4: 30% vs 34%; p = 0.12) and ERBB3-alt compared to WT (CMS1: 24% vs 13%; CMS2: 12% vs 26%; CMS3: 16% vs 17%; CMS4: 40% vs 34%; p = 0.3). Conclusions:ERBB2/3 mutated CRC are more frequently MSI-H, TMB-high and KRAS mutated than ERBB2/3-WT tumors. Correlation of ERBB2/3 alterations with other genomic alterations including BRAF, TP53, CDK12, PIK3CA, and TOP2A will help advance the clinical development of HER2-targeted therapies.


ERBB2 amplified (n = 143)
ERBB2 mutated (n = 97)
ERBB3 mutated (n = 72)
ERBB2/3 WT (n = 7,312)
p-value
Immuno-biomarkers





 MSI-H
0 (0%)
12 (12%)
15 (21%)
404 (5.6%)
< 0.001
 TMB ≥10
4 (3.0%)
17 (18%)
20 (28%)
675 (9.4%)
< 0.001
 PD-L1+
4 (6.6%)
1 (3.3%)
3 (10%)
205 (7.5%)
0.8
Co-mutated Genes





TP53
115 (80%)
59 (61%)
42 (58%)
4,234 (58%)
< 0.001
CDK12
101 (71%)
1 (1.0%)
0 (0%)
37 (0.5%)
< 0.001
KRAS
15 (10%)
48 (49%)
41 (57%)
2,764 (38%)
< 0.001
PIK3CA
12 (8.4%)
16 (16%)
20 (28%)
950 (13%)
< 0.001
BRAF
1 (0.7%)
5 (5.2%)
2 (2.8%)
525 (7.2%)
0.010
TOP2A
39 (27%)
0 (0%)
0 (0%)
5 (< 0.1%)
< 0.001

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Abstract Details

Meeting

2022 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Colorectal Cancer,Anal Cancer

Sub Track

Tumor Biology, Biomarkers, and Pathology

DOI

10.1200/JCO.2022.40.4_suppl.176

Abstract #

176

Poster Bd #

J3

Abstract Disclosures

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