Mutations and Response to Rapalogs in Patients with Metastatic Renal Cell Carcinoma.

Autor:	Nassar AH; Cancer Genetics Lab, Division of Pulmonary Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Hamieh L; Cancer Genetics Lab, Division of Pulmonary Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Gray KP; Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard T.H. Chan School of Public Health, Boston, Massachusetts., Thorner AR; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.; Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, Massachusetts., Fay AP; Pontificia Universidade Catolica do Rio Grande do Sul School of Medicine, Porto Alegre, Brazil., Lasseter KD; Cancer Genetics Lab, Division of Pulmonary Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Abou Alaiwi S; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Nuzzo PV; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Flippot R; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Krajewski KM; Department of Radiology, Dana-Farber Cancer Institute, Boston, Massachusetts., Signoretti S; Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts., Choueiri TK; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Kwiatkowski DJ; Cancer Genetics Lab, Division of Pulmonary Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. dk@rics.bwh.harvard.edu.
Jazyk:	angličtina
Zdroj:	Molecular cancer therapeutics [Mol Cancer Ther] 2020 Feb; Vol. 19 (2), pp. 690-696. Date of Electronic Publication: 2019 Oct 25.
DOI:	10.1158/1535-7163.MCT-19-0642
Abstrakt:	We previously showed that alterations in mTOR pathway genes were correlated with response to rapalog therapy in metastatic renal cell carcinoma (mRCC), when the analysis focused on extremes of response. Herein, we expand on the prior cohort and examine genetic correlations with rapalog response in a dataset not selected for extremes of response. Tumors from 58 patients from the phase III trial of temsirolimus and 51 local patients with mRCC treated with rapalogs were studied. Somatic mutations were investigated using a targeted sequencing platform covering 27 genes. Clinical benefit (CB) was defined as patients with complete remission, partial response, or stable disease lasting at least 22 weeks. Mutational analyses focused on 5 mTOR pathway genes ( TSC1, TSC2, MTOR, PTEN, PIK3CA ) and 6 genes commonly mutated in RCC ( BAP1, KDM5C, PBRM1 SETD2, TP53 , and VHL ). Among the 109 patients, 93 (85%) patients had clear cell histology, and 31 (28%) showed CB. Nine of 30 (30%) patients harboring mTOR pathway mutations in their tumor achieved CB versus 22 of 79 (28%) in the wild-type group. There was no distinct association between any individual or combination of mTOR pathway gene mutations and CB. Three of 7 patients with TSC1 mutations showed CB. In addition, none of the 6 genes commonly mutated in RCC showed a mutation pattern that correlated with CB. Overall, in this large and diverse population of patients with mRCC, there is no suggestion of a correlation between response to rapalog therapy and mutation status for mTOR pathway genes. (©2019 American Association for Cancer Research.)
Databáze:	MEDLINE
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