Genomic Analysis of Circulating Tumor DNA in 3,334 Patients with Advanced Prostate Cancer Identifies Targetable BRCA Alterations and AR Resistance Mechanisms
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- Hanna Tukachinsky
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Russell W. Madison
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Jon H. Chung
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Ole V. Gjoerup
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Eric A. Severson
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Lucas Dennis
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Bernard J. Fendler
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Samantha Morley
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Lei Zhong
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Ryon P. Graf
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Jeffrey S. Ross
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Brian M. Alexander
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Wassim Abida
- 3Memorial Sloan Kettering Cancer Center, New York, New York.
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- Simon Chowdhury
- 4Guy's, King's, and St. Thomas' Hospital, London, England, United Kingdom.
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- Charles J. Ryan
- 5University of Minnesota Medical School, Minneapolis, Minnesota.
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- Karim Fizazi
- 6Institut Gustave Roussy, Villejuif, France.
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- Tony Golsorkhi
- 7Clovis Oncology, Boulder, Colorado.
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- Simon P. Watkins
- 7Clovis Oncology, Boulder, Colorado.
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- Andrew Simmons
- 7Clovis Oncology, Boulder, Colorado.
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- Andrea Loehr
- 7Clovis Oncology, Boulder, Colorado.
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- Jeffrey M. Venstrom
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
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- Geoffrey R. Oxnard
- 1Foundation Medicine Inc., Cambridge, Massachusetts.
抄録
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Purpose:</jats:title> <jats:p>Comprehensive genomic profiling (CGP) is of increasing value for patients with metastatic castration-resistant prostate cancer (mCRPC). mCRPC tends to metastasize to bone, making tissue biopsies challenging to obtain. We hypothesized CGP of cell-free circulating tumor DNA (ctDNA) could offer a minimally invasive alternative to detect targetable genomic alterations (GA) that inform clinical care.</jats:p> </jats:sec> <jats:sec> <jats:title>Experimental Design:</jats:title> <jats:p>Using plasma from 3,334 patients with mCRPC (including 1,674 screening samples from TRITON2/3), we evaluated the landscape of GAs detected in ctDNA and assessed concordance with tissue-based CGP.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>A total of 3,129 patients (94%) had detectable ctDNA with a median ctDNA fraction of 7.5%; BRCA1/2 was mutated in 295 (8.8%). In concordance analysis, 72 of 837 patients had BRCA1/2 mutations detected in tissue, 67 (93%) of which were also identified using ctDNA, including 100% of predicted germline variants. ctDNA harbored some BRCA1/2 alterations not identified by tissue testing, and ctDNA was enriched in therapy resistance alterations, as well as possible clonal hematopoiesis mutations (e.g., in ATM and CHEK2). Potential androgen receptor resistance alterations were detected in 940 of 2,213 patients (42%), including amplifications, polyclonal and compound mutations, rearrangements, and novel deletions in exon 8.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Genomic analysis of ctDNA from patients with mCRPC recapitulates the genomic landscape detected in tissue biopsies, with a high level of agreement in detection of BRCA1/2 mutations, but more acquired resistance alterations detected in ctDNA. CGP of ctDNA is a compelling clinical complement to tissue CGP, with reflex to tissue CGP if negative for actionable variants.</jats:p> <jats:p>See related commentary by Hawkey and Armstrong, p. 2961</jats:p> </jats:sec>
収録刊行物
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- Clinical Cancer Research
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Clinical Cancer Research 27 (11), 3094-3105, 2021-02-08
American Association for Cancer Research (AACR)