Comprehensive genomic profiling (CGP) of chromophobe renal cell carcinoma (chrRCC) compared with non-chromophobe RCC (nonchrRCC): Impact of FLCN genomic alteration (GA) status.

Authors

null

Gennady Bratslavsky

SUNY Upstate Medical University, Syracuse, NY

Gennady Bratslavsky , Andrea Necchi , Petros Grivas , Joseph M Jacob , Oleksandr Kravtsov , Richard S.P. Huang , Natalie Danziger , Jeffrey S. Ross

Organizations

SUNY Upstate Medical University, Syracuse, NY, Vita-Salute San Raffaele University and Genitourinary Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA, SUNY Upstate Medical University, Department of Urology, Syracuse, NY, Foundation Medicine, Inc., Cambridge, MA, Foundation Medicine, Cambridge, MA

Research Funding

Pharmaceutical/Biotech Company

Background: FLCN is a tumor suppressor gene associated with cutaneous hair follicle development. FLCN germline mutations are linked to inherited chrRCC in the Birt-Hogg-Dube (BHD) syndrome. We queried whether clinically sporadic chrRCC featured FLCN mutations by comparing the genomic profiles of chrRCC with nonchrRCC. Methods: 109 chrRCC and 5,862 nonchrRCC underwent hybrid-capture based comprehensive genomic profiling (CGP) to evaluate all classes of genomic alterations (GA). Tumor mutational burden (TMB) was determined on up to 1.1 Mb of sequenced DNA and microsatellite instability (MSI) was determined on 114 loci. PD-L1 expression was determined by IHC (Dako 22C3). Results: Patients (pts) with chrRCC were more frequently female (37 [34%] vs. 1,817 [31%]) and younger than pts with nonchrRCC (median age 58 vs 62 years, p <.0001). None of the submitted clinical records in the chrRCC cases listed signs of BHD syndrome. FLCN GA were identified in the nonchrRCC cases only at 2.3% with 37% of the GA being germline. 1/109 (0.9%) of chrRCC featured a germline FLCN GA. GA/tumor were slightly higher in nonchrRCC vs chrRCC (3.6 vs 2.4; NS). There were no significant differences in gLOH, genomic signatures or ancestry between the groups. GA more frequent in chrRCC included TP53, RB1, PTEN. GA more frequent in the nonchrRCC included VHL, BAP1, PBRM1, SETD2, CDKN2A/B, ARID1A, NF2, PIK3CA and TERT. Biomarkers of immune checkpoint inhibitor (ICPI) drug response revealed higher mean TMB, TMB ≥10 mutations/Mb and PBRM1 inactivating mutation frequencies in the nonchrRCC than the chrRCC indicating possible differences in IO drug response. Conclusions:FLCN mutations that are associated with familial incidence of chrRCC are rarely associated with sporadic chrRCC. Sporadic chrRCC has a substantially different genomic profile from nonchrRCC and appears to harbor fewer opportunities for both targeted and immunotherapies.


chrRCC (109 cases)
nonchrRCC 5,862 cases)
P Value
FLCN
0.9% (0% germline)
2.3% (37% germline)
NS
TP53
64.8%
18.5%
<.0001
VHL
6.5%
47.4%
<.0001
PBRM1
2.8%
24.8%
<.0001
CDKN2A/B
3.7%/1.9%
25.8%/19.7%
<.0001
PTEN
21.3%
9.7%
=.0005
NF2
0%
10.5%
<.0001
PIK3CA
0%
4.9%
=.009
Mean TMB
1.8
3.3
<.0001

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary Cancer—Kidney and Bladder

Track

Genitourinary Cancer—Kidney and Bladder

Sub Track

Kidney Cancer

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 4550)

DOI

10.1200/JCO.2022.40.16_suppl.4550

Abstract #

4550

Poster Bd #

41

Abstract Disclosures

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