Identification of a subpopulation of patients with gastric cancer responsive to PARP inhibitors.

Authors

null

Simona Corso

University of Torino, Dept of Oncology; Candiolo Cancer Institute - FPO, IRCCS, Candiolo (Torino), Italy;

Simona Corso , Annalisa Petrelli , Sabrina Rizzolio , Filippo Pietrantonio , Sara Bellomo , Matteo Benelli , Loris De Cecco , Dario Romagnoli , Violeta Serra , Benedetta Pellegrino , Silvia Giordano

Organizations

University of Torino, Dept of Oncology; Candiolo Cancer Institute - FPO, IRCCS, Candiolo (Torino), Italy; , Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy, Candiolo (Torino), Italy; , Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; , Department of Oncology and Bioinformatics Unit, Ospedale di Prato, Azienda USL Toscana Centro, Prato, Italy; , Molecular Mechanisms Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; , Bioinformatic Unit, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy; , Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; , Department of Medicine and Surgery, University of Parma, Parma, Italy; , University of Torino, Candiolo (Torino), Italy;

Research Funding

Other
Association for Cancer Research (AIRC), Ricerca Locale Dept. Oncology 2021, ESMO with a Clinical Translational Fellowship aid supported by Roche; research grants from GOIRC; Fondazione CR Firenze

Background: Treatment with PARP inhibitors (PARPi) has been approved in some tumors bearing a deficient Homologous Recombination (HR) system. Despite negative results of clinical trials conducted on the overall population of gastric cancer (GC) patients, we wondered whether a PARPi therapeutic strategy might represent a window of opportunity for a subpopulation of these patients. 7-12% of gastric cancers exhibit a mutational signature associated with HR failure, suggesting that these patients might benefit from PARPi. Methods: To analyze responsiveness to PARPi we exploited a proprietary human Gastro-Esophageal Adenocarcinoma (GEA) annotated platform of Patient-Derived Xenografts (PDXs) and PDX-derived primary cells on which we performed in vivo and in vitro experiments. Results: We selected 10 PDXs with loss-of-function mutations in HR pathway genes. Cell viability assays and preclinical trials showed that treatment with PARPi was effective in PDXs harbouring BRCA2 germline mutations and somatic inactivation of the second allele in a microsatellite stable background. PARPi responsive tumors were sensitive to oxaliplatin as well. Evaluation of HR deficiency and mutational signatures efficiently stratified responder vs non-responder PDXs. A retrospective analysis on 57 GEA patients showed that those carrying BRCA2 inactivating variants had longer PFS upon platinum-based regimens (used as proxy). In 5 out of 7 BRCA2 germline mutated patients we identified the p.K3326* variant, currently classified as “benign”. However, familial history of cancer, the absence of RAD51 foci in the tumor cells and a high HR deficiency score suggest a deleterious effect for this mutation in gastric cancer. Conclusions: PARP inhibition could represent a new therapeutic perspective for BRCA2 mutated and/or high HRD score GEA patients, including familial intestinal gastric cancer patients.

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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 432)

DOI

10.1200/JCO.2023.41.4_suppl.432

Abstract #

432

Poster Bd #

J16

Abstract Disclosures