A pan-tumor description of the genomic, transcriptomic, and immunological landscape of sodium-glucose cotransporter-2 (SGLT2) and association with clinical outcomes.

Authors

null

Heng Tan

University of Miami/Jackson Memorial Hospital, Miami, FL

Heng Tan , Samuel A. Kareff , Harris Benjamin Krause , Andrew Elliott , Stephen V. Liu , Patrick C. Ma , Fernando Gerchman , Bernardo Spiazzi , Emmanuel S. Antonarakis , Ari M. Vanderwalde , Milan Radovich , Gilberto Lopes

Organizations

University of Miami/Jackson Memorial Hospital, Miami, FL, University of Miami Sylvester Comprehensive Cancer Center/Jackson Memorial Hospital, Miami, FL, Caris Life Sciences, Irving, TX, Caris Life Sciences, Phoenix, AZ, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, Penn State Milton S. Hershey Medical Center, Hershey, PA, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, University of Minnesota Masonic Cancer Center, Minneapolis, MN, West Cancer Center and Research Institute, Caris Life Sciences, Germantown and Memphis, TN, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL

Research Funding

No funding sources reported

Background: SGLT2 has been identified as being overexpressed in a diverse set of cancers. Retrospective data has demonstrated a correlation between the use of SGLT2 inhibitors and a reduced incidence of lung cancer. We explored the association of SGLT2-coding gene SLC5A2 with the transcriptomic, genomic, immunological landscape and outcomes in a subset of solid tumors. Methods: Breast ([N = 5623], HR+HER2- [6044] or TNBC [3040]), Colorectal carcinoma (CRC, 15425), NSCLC ([21603], Adenocarcinoma [AC, 8180] or Squamous Cell Carcinoma [SCC, 3579]), Pancreatic (Panc: 5488) and Prostate (PC: 5500) tumors were tested at Caris Life Sciences (Phoenix, AZ) with NextGen Sequencing on DNA (592 genes or whole exome) and RNA (whole transcriptome). PD-L1+ (22C3: TPS 1% for lung or SP142: 2+, 5% all other), Her2/Neu (+: ≥3+ and > 10%) and HR (ER or PR+: ≥1+ and ≥1%) expression was assessed by IHC. Mutations were defined as pathogenic SNVs/indels (-Mt). SLC5A2-H and -L expression (transcripts per million, TPM) was defined by cancer type as top and bottom quartile, respectively. Cell infiltration was estimated by QuantiSEQ. A transcriptomic signature predictive of response to immunotherapy was applied (T cell-inflamed). The Mann-Whitney U test was applied as appropriate (p < .05, adjusted for multiple comparisons). Real-world overall survival (OS) was obtained from insurance claims and Kaplan-Meier estimates were calculated for molecularly defined patients. Results:SLC5A2 expression varied across cohorts (TNBC: 1.2 TPM, HR+HER2-BC: 1.7, CRC: 2.2, AC: 1.8, SCC: 1.3, Panc: 1.7, PC: 1.7, p < .05). SLC5A2-H had a higher prevalence of FGF3 amplifications in HR+HER2- BC (17.4% -H v 10.4 -L), CRC (1.4 v .45) and PC (4.4 v .89, p < .05 all). KRAS-Mt was more prevalent in SLC5A2-L CRC (41% v 53) as was BRAF-Mt (6 v 14, p < .05 all). There was a lower prevalence of PDL1+ in SLC5A2-H for HR+HER- BC (14% -H v 24 -L), CRC (2 v 6), AC (47 v 68), SCC (50 v 66) and Panc (10 v 19, p < .05 all). All SLC5A2-H tumors had increased Neutrophil, B, NK cell infiltrate (Table) and an increased prevalence of T cell-inflamed tumors (p < .05, all). SLC5A2-H had longer OS v -L in CRC (HR .82 [.76-.88], p <.001), PC (HR .85 [.74-.99], p =.03), HR+HER2- BC (HR .79 [.68-.91], p < .001) and AC (HR .79 [.73-.85], p < .001). Conclusions:SCL5A2-H across all investigated tumors was associated with increased immune infiltrate and a T cell-inflamed phenotype in addition to improved survival in multiple cancer types. Future research on SGLT2 should delineate its role in cancer formation versus its association as a potential positive prognostic marker.

TNBCHR+HER2-CRCACSCCPancPC
SLC5A2 Quartiles-L-H-L-H-L-H-L-H-L-H-L-H-L-H
Neutrophil2.6%3.52.33.35.37.14.47.15.57.44.86.34.86.3
B cell3.94.75.26.63.13.73.94.74.15.63.94.94.05.0
NK cell2.83.92.83.72.94.12.33.22.13.22.43.13.74.9

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Abstract Details

Meeting

2024 ASCO Breakthrough

Session Type

Poster Session

Session Title

Poster Session B

Track

Thoracic Cancers,Breast Cancer,Gynecologic Cancer,Head and Neck Cancer,Hematologic Malignancies,Genetics/Genomics/Multiomics,Healthtech Innovations,Models of Care and Care Delivery,Viral-Mediated Malignancies,Other Malignancies or Topics

Sub Track

Omics for precision medicine

Citation

J Clin Oncol 42, 2024 (suppl 23; abstr 104)

DOI

10.1200/JCO.2024.42.23_suppl.104

Abstract #

104

Poster Bd #

C4

Abstract Disclosures