The spectrum of homologous recombination deficiency in cervical cancer: Is it also a cervical issue?

Authors

null

Muhammad Danyal Ahsan

Weill Cornell Medicine - Qatar, Doha, Qatar

Muhammad Danyal Ahsan , Emily M. Webster , Ryan M Kahn , Sarah R. Levi , Murtaza Qazi , Luiza Perez , Jesse T. Brewer , Laura Keenahan , Evelyn Cantillo , Eloise Chapman-Davis , Kevin Holcomb , Melissa Kristen Frey

Organizations

Weill Cornell Medicine - Qatar, Doha, Qatar, Weill Cornell Medicine, New York, NY, Memorial Sloan Kettering Cancer Center, New York, NY

Research Funding

No funding received
None.

Background: Tumors deficient in homologous recombination DNA damage repair (HR-DDR) demonstrate sensitivity to therapeutic agents targeting the HR-DDR pathway, such as poly-ADP ribose phosphate (PARP) inhibitors. The landscape of homologous recombination deficiency (HRD) is not well-characterized for cervical cancer; thus, we sought to analyze the prevalence of somatic pathogenic gene variants (PGVs) in HRD genes in cervical cancers. Methods: The American Association for Cancer Research’s (AACR) Project Genomics Evidence Neoplasia Information Exchange (GENIE) database version 13.0 was queried for all cervical cancer tumors via cBioPortal (http://genie.cbioportal.org). This is a publicly available, multi-institutional database of next-generation sequencing (NGS) genomic profiles of multiple tumors. PGV frequencies of 27 genes involved in HR-DDR were descriptively reported for cervical cancer tumors, with histologic stratification: ATM, ARID1A, ATRX, BRCA1, BRCA2, BARD1, BRIP1, BLM, BAP1, CHEK1, CHEK2, FANCA, FANCC, FANCD2, FANCE, FANCF, FANCG, FANCL, MRE11, NBN, PALB2, RAD50, RAD51, RAD51B, RAD51C, RAD51D, WRN. Results: A total of 857 cervical tumors from 817 patients were included for analysis. At least one somatic PGV in an HRD gene was found in 16.5% of all tumors (141/857). When stratified by histological subtypes with at least 25 tumors sequenced, highest frequencies of ≥1 PGV in HRD genes were observed in mucinous cervical cancer (13/66, 19.7%), cervical adenocarcinoma (48/262, 18.3%), squamous cell cervical cancer (53/349, 15.2%), adenosquamous cervical cancer (6/43, 14.0%) and neuroendocrine cervical cancers (5/42, 11.9%). Substantial rates of PGVs in HRD genes were also observed in histological subtypes with fewer than 25 sequenced tumors. Across all tumors, HRD genes with the highest frequencies of PGVs were ARID1A (9%), BAP1 (3%), ATM (1.6%) and BRCA1 (1.6%). Conclusions: NGS data demonstrate a substantial rate of somatic PGVs in HRD genes in cervical cancers, including among HPV related subtypes. These data suggest the need to expand routine functional HRD status assessment to cervical cancers in order to further characterize the landscape of HRD in these tumors. Furthermore, genetically driven clinical trials are warranted to evaluate the efficacy of HRD-targeted therapies such as PARP inhibitors, ataxia telangiectasia, and Rad-3 related kinase (ATR) inhibitors.

Tumor Histology (n = tumors sequenced for ≥1 HRD gene)Frequency of tumors with ≥1 HRD PGVHRD gene with highest PGV frequency*
Squamous Cell (349)15.2%BAP1, 6.5%
Adenocarcinoma (262)18.3%ARID1A, 11.2%
Mucinous (66)19.7%ARID1A, 11.6%
Adenosquamous (43)14.0%ARID1A, 8.8%
Neuroendocrine (42)11.9%ARID1A, 16.1%
Serous (22)13.6%ARID1A, 8.8%
Endometrioid (21)9.5%ARID1A, 12.5%
Clear Cell (19)42.1%ARID1A, 37.5%
Mesonephric (10)20.0%ARID1A, 8.0%, NBN, 8.0%
Rhabdomyosarcoma 333.3%CHEK2, 50.0%

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Cervical Cancer

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 5543)

DOI

10.1200/JCO.2023.41.16_suppl.5543

Abstract #

5543

Poster Bd #

238

Abstract Disclosures

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