Predictors of immunotherapy benefit in Merkel cell carcinoma.

Autor:	Kacew AJ; GJS Associated with Laboratory of Cellular Oncology, CCR/NCI, Bethesda, MD, USA.; Dana-Farber Cancer Institute, Boston, MA, USA.; These authors contributed equally to this work., Dharaneeswaran H; GJS Associated with Laboratory of Cellular Oncology, CCR/NCI, Bethesda, MD, USA.; Dana-Farber Cancer Institute, Boston, MA, USA.; These authors contributed equally to this work., Starrett GJ; GJS Associated with Laboratory of Cellular Oncology, CCR/NCI, Bethesda, MD, USA.; Dana-Farber Cancer Institute, Boston, MA, USA., Thakuria M; GJS Associated with Laboratory of Cellular Oncology, CCR/NCI, Bethesda, MD, USA.; Dana-Farber Cancer Institute, Boston, MA, USA., LeBoeuf NR; GJS Associated with Laboratory of Cellular Oncology, CCR/NCI, Bethesda, MD, USA.; Dana-Farber Cancer Institute, Boston, MA, USA., Silk AW; GJS Associated with Laboratory of Cellular Oncology, CCR/NCI, Bethesda, MD, USA.; Dana-Farber Cancer Institute, Boston, MA, USA., DeCaprio JA; GJS Associated with Laboratory of Cellular Oncology, CCR/NCI, Bethesda, MD, USA.; Dana-Farber Cancer Institute, Boston, MA, USA., Hanna GJ; GJS Associated with Laboratory of Cellular Oncology, CCR/NCI, Bethesda, MD, USA.; Dana-Farber Cancer Institute, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Oncotarget [Oncotarget] 2020 Nov 24; Vol. 11 (47), pp. 4401-4410. Date of Electronic Publication: 2020 Nov 24 (Print Publication: 2020).
DOI:	10.18632/oncotarget.27823
Abstrakt:	Merkel cell carcinoma is a rare cancer for which immune checkpoint blockade is standard-of-care for recurrent/metastatic disease. However, not all patients benefit from immunotherapy. A greater understanding of molecular mechanisms and predictive biomarkers are unmet needs. We retrospectively analyzed electronic health records and next-generation sequencing data of 45 patients treated at our institution from 2013 to 2020 to understand clinical and genomic correlates of benefit from immunotherapy. Our cohort predominantly included individuals with stage III disease at primary disease diagnosis and individuals with stage IV disease at recurrent/metastatic disease diagnosis. Most received immunotherapy as first-line treatment. 43% experienced objective response (median duration of response 24.2 months, 95% confidence interval 8.8-not reached). Median overall survival was 15.5 months (95% confidence interval 9.0-28.7) (median follow-up 25.2 months). Less advanced stage at primary disease diagnosis and shorter disease-free interval between completion of initial treatment and recurrence were each associated with greater odds of response (odds ratio of 0.06, p = 0.04 for stage; odds ratio 0.75, p = 0.05 for disease-free interval). Single-nucleotide variants in ARID2 and NTRK1 were associated with response ( p = 0.05, without Bonferroni correction), while none of Merkel cell polyomavirus status, total mutational burden, ultraviolet mutational signatures, and copy-number alterations predicted outcomes. Patients with shorter disease-free interval may be particularly suitable immunotherapy candidates. Our molecular findings point to ARID2 and NTRK1 as potential predictive markers and/or therapeutic targets (e.g., with Trk inhibitors), although this association needs to be confirmed in a larger sample. Competing Interests: CONFLICTS OF INTEREST AJK receives research support from the Pritzker School of Medicine and from the American Society of Hematology. Dr. Silk has received research funding (to the institution) from Biohaven Pharmaceuticals, Merck, Clinagen, and consulting fees from Bristol-Meyers Squibb, EMD Serono, Merck, and Sanofi Genzyme. JAD has received honoraria for advisory board participation with Merck & Co., Inc. and EMD Serono, Inc. JAD has received research funding from Constellation Pharmaceuticals, Inc. GJH has received research funding to institution from BMS, Exicure, GSK, Regeneron, Sanofi Genzyme, Kartos; consulting/honoraria from Regeneron, Sanofi Genzyme, BMS, Maverick, Merck, Kura, Bicara, and Exicure. (Copyright: © 2020 Kacew et al.)
Databáze:	MEDLINE
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