Genome-wide association study (GWAS) and novel prognostic markers in metastatic colorectal cancer (mCRC).

Authors

null

Yan Yang

Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA

Yan Yang , Francesca Battaglin , Shivani Soni , Sandra Algaze , Jae Ho Lo , Pooja Mittal , Lesly Torres-Gonzalez , Federico Innocenti , Alan P. Venook , Sebastian Stintzing , Aparna Raj Parikh , Christoph Mancao , Volker Heinemann , Chiara Cremolini , Wu Zhang , Joshua Millstein , Heinz-Josef Lenz

Organizations

Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, The University of North Carolina at Chapel Hill, Chapel Hill, NC, Department of Medicine, University of California, San Francisco, San Francisco, CA, Medical Department, Division of Hematology, Oncology, and Cancer Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany, Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, Oncology Biomarker Development, Genentech Inc., Basel, Switzerland, Department of Hematology and Oncology, LMU Klinikum, University of Munich, Comprehensive Cancer Center, Munich, Germany, Department of Oncology, University Hospital of Pisa, Pisa, Italy

Research Funding

U10CA180821, U10CA180882, UG1CA180830, U10CA180888 (SWOG); https://acknowledgments.alliancefound.org. Genentech

Background: Few genome-wide investigations have examined germline variants associated with mCRC outcomes following primary treatment. Here, we performed a GWAS meta-analysis to explore the impact of germline genetic variation on progression-free survival (PFS) and overall survival (OS) in four clinical trials of mCRC. Methods: The GWAS comprised 1,324 mCRC patients (pts) enrolled in four randomized Phase II/III trials for first line treatment: FIRE-3 (FOLFIRI-bevacizumab [bev]; FOLFIRI-cetuximab[cet]), MAVERICC (FOLFIRI-bev; FOLFOX6-bev), TRIBE (FOLFIRI-bev; FOLFOXIRI-bev), and TRIBE2 (mFOLFOX6-bev; FOLFOXIRI-bev). DNA isolated from blood was genotyped using the OncoArray and imputed against the Haplotype Reference Consortium panel. In each trial arm, associations between SNPs and PFS and OS were assessed using an additive coding in a Cox proportional hazard framework, adjusting for trial specific patient characteristics and principal components. Meta-analysis was carried out using an inverse-variance weighted fixed effect model. All reported GWAS p-values were adjusted for genomic inflation. To further investigate significant hits, we evaluated associations between gene expression measured from FFPE tumor samples and PFS and OS in 433 pts enrolled in an independent randomized first-line Phase III trial, CALGB/SWOG 80405. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated in multivariable Cox models for expression levels in the top (Q4, high) vs the bottom quartile (Q1, low). Results: Two SNPs in the MLPH intronic region and one SNP in the TYR intronic region surpassed the GWAS significance threshold for PFS and OS, respectively. The top ranked SNPs associated with PFS and OS, rs13409241 (A>G, PFS HR: 1.35, 95% CI [1.21, 1.51], P=4.34E-8) and rs10765199 (T>A, OS HR: 1.45, 95%CI [1.27, 1.65], P=4.69E-8), showed similar effects across all eight treatment arms (I2 = 0% and 38.5%, respectively). No significant heterogeneity variant was found. In the CALGB/SWOG 80405 cohort, pts with MLPH-low tumors (N=109) showed significantly longer PFS (median 14.8 vs 7.6 months, low vs. high (as reference) adjusted HR 0.53, 95% CI [0.38, 0.74], P=2.1E-4) and OS (median 35.8 vs. 18.2 months, adjusted HR 0.65, 95% CI [0.46, 0.92], P=0.015) compared to MLPH-high (N=107). No significant associations for TYR expression and outcomes were found. MLPH and TYR are involved in melanosome transport and melanogenesis. Melanin has been shown to reduce vitamin D levels, which can affect CRC prognosis. MLPH has also been reported to accelerate epithelial-mesenchymal transition and metastasis in lung and prostate cancers. Conclusions: These results suggest that germline genetic variation in MLPH and TYR may affect mCRC prognosis via a mechanism that involves melanin and possibly the epithelial-mesenchymal transition. Note: Authors Millstein and Lenz contributed equally to this work.

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Abstract Details

Meeting

2024 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Colorectal Cancer,Anal Cancer

Sub Track

Tumor Biology, Biomarkers, and Pathology

Citation

J Clin Oncol 42, 2024 (suppl 3; abstr 174)

DOI

10.1200/JCO.2024.42.3_suppl.174

Abstract #

174

Poster Bd #

L2

Abstract Disclosures