Genomic instability is enriched in localized prostate cancers from men of African ancestry.

Authors

null

Jones T. Nauseef

New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY

Jones T. Nauseef , Yajas Shah , Alon Shaiber , Joel Rosiene , David Wilkes , Michael Sigouros , Jyothi Manohar , Panagiotis J. Vlachostergios , Brian D. Robinson , Olivier Elemento , David M. Nanus , Juan Miguel Mosquera , Marcin Imielinski

Organizations

New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, Weill Cornell Medicine, New York, NY, Weill Cornell Medical College, New York, NY, Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York City, NY, Department of Pathology & Laboratory Medicine, Englader Institute for Precision Medicine, Weill Cornell Medical College & New York-Presbyterian Hospital, New York, NY, Sandra and Edward Meyer Cancer Center, New York, NY, Department of Pathology & Laboratory Medicine, Englander Institute for Precision Medicine, Weill Cornell Medical College & New York-Presbyterian Hospital, New York, NY, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, NY

Research Funding

Other

Background: Whole genome sequencing (WGS) of prostate cancers (PC) from American men of African ancestry (AA) is limited despite AA men having twice the incidence of and mortality from PC as compared to their European ancestry (EA) men. Herein we describe analysis of AA PC WGS to identify genomic contributions to incidence and outcome disparities. Methods: WGS data from AA localized hormone naïve (HN) PCs (n = 23) from our institution were combined with publicly available WGS HNPC datasets (n = 5); quantitative predominant genome-wide ancestry was approximated via RFMix. A comparable EA cohort (n = 224) was similarly assembled. Ancestry groups were compared via regression models correcting for Gleason grade, PSA, and pathologic stage. Results: Analysis of known HNPC driver genes revealed lower frequency of PTEN (2/28 v 70/224, 7% v 31%, p = 0.006) and higher frequency of MYC (5/28 v 13/224, 18% v 5%, p = 0.014) and FOXA1 (7/28 v 24/224, 25% v 11%, p = 0.018) alterations in AA tumors relative to EA. An unbiased search for coding and noncoding drivers uncovered recurrent FOXA1 promoter (n = 8, p = 1.1e-8, RR = 3.92) and gene body protein-coding (n = 5, p = 1.2e-6, RR = 7.83) mutations, as targets of somatic selection and affecting nearly half of AA cases. Despite comparable tumor mutational burdens in each group, analysis of genome-wide mutational signatures revealed an AA-specific enrichment of SNVs in trinucleotide contexts associated with mismatch repair deficiency (SBS6, p = 1.68e-2, RR = 49.1). AA tumors also had significantly more small deletions (sig. ID2) relative to EA samples (p = 2.25e-31, RR = 9.47), implying replication slippage at lagging strands. Finally, AA PC genomes had consistently higher MSI scores relative to EA (median [IQR]: 4.03 [3.8-4.53] v 1.52 [1.21-1.85], p = 2.95e-44), yet lower than MSI-H colon cancers. These associations were independent of tissue preservation method or source, suggesting they reflect an ancestry-specific mutational process. Comparison of germline and somatic variants between AA and EA uncovered candidate DNA damage response genes (DDR) for further functional validation. Conclusions: Analysis of the largest AA cohort to date of WGS HNPC has revealed an ancestry-specific somatic mutational processes resulting in elevated rate of MMR-linked SNVs, replication-slippage associated small deletions, and MSI, relative to EA. The uniformity of these data suggest that AAs may harbor an inherited factor contributing to increased somatic genomic instability in the HNPC context. These results are compatible with published analyses demonstrating lower expression of DDR genes in AA versus EA PCs. Greater MSI and indels (via neoantigen formation) may explain the higher response proportions in AA PC patients treated with immune- and radiotherapies. Studies are ongoing to define mechanisms via associations between germline predisposition, somatic modification, and transcriptional outcome.

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Abstract Details

Meeting

2022 ASCO Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Translational Research, Tumor Biology, Biomarkers, and Pathology

Citation

J Clin Oncol 40, 2022 (suppl 6; abstr 270)

DOI

10.1200/JCO.2022.40.6_suppl.270

Abstract #

270

Poster Bd #

M2

Abstract Disclosures