FGFR2-amplified gastroesophageal adenocarcinoma is a distinct genomic class: Lessons learned from a liquid biopsy platform.

Authors

null

Bushra Shariff

H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL;

Bushra Shariff , Reagan Barnett , Farshid Dayyani , Steven Brad Maron , Samuel J Klempner , Jude Masannat , Leylah Drusbosky , Rory Mcgriskin , Rutika Mehta

Organizations

H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; , Guardant Health, Inc., Redwood City, CA; , University of California Irvine Chao Family Comprehensive Cancer Center, Orange, CA; , Memorial Sloan Kettering Cancer Center, New York, NY; , Massachusetts General Hospital, Boston, MA; , Memorial Sloan Kettering, New York, NY;

Research Funding

No funding received
None.

Background: Gastroesophageal cancers (GECs) are the 2nd highest cause of cancer mortality globally. Biomarkers such as MMR, PD-L1, and HER2 are critical for treatment strategies. Emerging biomarkers in late-stage clinical development include FGFR2b. Approximately 30% of GECs express FGFR2b, which is associated with a poor prognosis. FGFR2 amplification (FGFR2amp) is seen in a subset of patients and may be particularly responsive to FGFR2-targeted approaches. We sought to elucidate the genomic landscape of FGFR2ampGECs using a ctDNA platform. Methods: We retrospectively queried the Guardant Health database from 2017-2022 for patients with advanced GECs who had ctDNA NGS (Guardant360, Redwood City, CA) performed as part of clinical care. Co-alterations were evaluated for patients who harbor FGFR2amp vs those without FGFR2amp detected via ctDNA. Fisher’s exact test was used for group comparisons. Results: Approximately 7100 patients met the diagnosis criteria. FGFR2amp was detected in 263 patients (3.7%). The majority were males (66 and median age in the cohort of FGFR2amp patients was 66 years (range 22-81 yrs). Most amps were high (+++) in gastric and GEJ (plasma CN≥4) and more frequently observed in patients who are tested at diagnosis (44%) vs progression (19%) (p=0.0147). The mean VAF across samples with high-level FGFR2amp is 22.42%. Patients with FGFR2amp were enriched for EGFR co-occuring amplifications and cell cycle pathway alterations. CDH1 was frequently mutated in pts under 50 who harbor FGFR2amp (p=0.0028). Thirty nine percent of patients with FGFR2amp were also found to harbor a gene fusion and 14% of patients with FGFR2amps harbored an activating fusion in FGFR1/2/3. Conclusions: FGFR2 is a validated target in GECs, and the contexture of FGFR2amp will be important to defining patient subgroups with responses to FGFR2-directed therapy. Here we define the FGFR2amp landscape which may help inform future combination strategies for this emerging biomarker.

GenePercent of Patients with FGFR2 AmplificationP Values
TP5377.6%<0.0001
EGFR28.1%<0.0001
CCNE121.3%<0.0001
MYC21.3%<0.0001
CDK615.6%<0.0001
FGFR114.1%<0.0001
CCND19.9%<0.0001
AR7.6%<0.0001
CDH16.8%<0.0001

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Abstract Details

Meeting

2023 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach and Other GI Cancers

Track

Esophageal and Gastric Cancer,Other GI Cancer

Sub Track

Translational Research

Citation

J Clin Oncol 41, 2023 (suppl 4; abstr 429)

DOI

10.1200/JCO.2023.41.4_suppl.429

Abstract #

429

Poster Bd #

J13

Abstract Disclosures