1
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Neeb A, Figueiredo I, Bogdan D, Cato L, Stober J, Jiménez-Vacas JM, Gourain V, Lee II, Seeger R, Muhle-Goll C, Gurel B, Welti J, Nava Rodrigues D, Rekowski J, Qiu X, Jiang Y, Di Micco P, Mateos B, Bielskutė S, Riisnaes R, Ferreira A, Miranda S, Crespo M, Buroni L, Ning J, Carreira S, Bräse S, Jung N, Gräßle S, Swain A, Salvatella X, Plymate SR, Al-Lazikani B, Long HW, Yuan W, Brown M, Cato ACB, de Bono JS, Sharp A. Thio-2 inhibits key signaling pathways required for the development and progression of castration resistant prostate cancer. Mol Cancer Ther 2024:734951. [PMID: 38412481 DOI: 10.1158/1535-7163.mct-23-0354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/26/2023] [Accepted: 02/22/2024] [Indexed: 02/29/2024]
Abstract
Therapies that abrogate persistent androgen receptor (AR) signaling in castration resistant prostate cancer (CRPC) remain an unmet clinical need. The N-terminal domain (NTD) of the AR that drives transcriptional activity in CRPC remains a challenging therapeutic target. Herein we demonstrate that BAG-1 mRNA is highly expressed and associates with signaling pathways, including AR signaling, that are implicated in the development and progression of CRPC. In addition, interrogation of geometric and physiochemical properties of the BAG domain of BAG-1 isoforms identifies it to be a tractable but challenging drug target. Furthermore, through BAG-1 isoform mouse knockout studies we confirm that BAG-1 isoforms regulate hormone physiology and that therapies targeting the BAG domain will be associated with limited 'on-target' toxicity. Importantly, the postulated inhibitor of BAG-1 isoforms, Thio-2, suppressed AR signaling and other important pathways implicated in the development and progression of CRPC to reduce the growth of treatment resistant prostate cancer cell lines and patient derived models. However, the mechanism by which Thio-2 elicits the observed phenotype needs further elucidation since the genomic abrogation of BAG-1 isoforms was unable to recapitulate the Thio-2 mediated phenotype. Overall, these data support the interrogation of related compounds with improved drug-like properties as a novel therapeutic approach in CRPC, and further highlight the clinical potential of treatments that block persistent AR signaling which are currently undergoing clinical evaluation in CRPC.
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Affiliation(s)
- Antje Neeb
- Institute of Cancer Research, Surrey, United Kingdom
| | - Ines Figueiredo
- Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Denisa Bogdan
- Institute of Cancer Research, London, United Kingdom
| | - Laura Cato
- Dana-Farber Cancer Institute, Boston, MA, United States
| | | | | | | | - Irene I Lee
- AbbVie (United States), North Chicago, IL, United States
| | | | | | - Bora Gurel
- Institute of Cancer Research, London, United Kingdom
| | | | | | - Jan Rekowski
- Institute of Cancer Research, London, United Kingdom
| | - Xintao Qiu
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - Yija Jiang
- Dana-Farber Cancer Institute, United States
| | | | - Borja Mateos
- Institute of Biomedical Research of Barcelona, Spain
| | | | - Ruth Riisnaes
- Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Ana Ferreira
- Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Susana Miranda
- Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Mateus Crespo
- Institute of Cancer Research, Sutton, United Kingdom
| | | | - Jian Ning
- Institute of Cancer Research, London, United Kingdom
| | | | - Stefan Bräse
- KIT Campus South, Institute of Organic Chemistry, Karlsruhe, Germany
| | - Nicole Jung
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Simone Gräßle
- Karlsruhe Institute of Technology (KIT), Karlsruhe, Eggenstein-Leopoldshafen, Germany
| | - Amanda Swain
- Institute of Cancer Research, London, United Kingdom
| | | | | | | | - Henry W Long
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - Wei Yuan
- Institute of Cancer Research, Sutton, United Kingdom
| | - Myles Brown
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - Andrew C B Cato
- Karlsruhe Institute of Technology, Eggenstein-Leopoldshafen, Germany
| | | | - Adam Sharp
- Institute of Cancer Research, Sutton, Surrey, United Kingdom
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2
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Hedayat S, Cascione L, Cunningham D, Schirripa M, Lampis A, Hahne JC, Tunariu N, Hong SP, Marchetti S, Khan K, Fontana E, Angerilli V, Delrieux M, Nava Rodrigues D, Procaccio L, Rao S, Watkins D, Starling N, Chau I, Braconi C, Fotiadis N, Begum R, Guppy N, Howell L, Valenti M, Cribbes S, Kolozsvari B, Kirkin V, Lonardi S, Ghidini M, Passalacqua R, Elghadi R, Magnani L, Pinato DJ, Di Maggio F, Ghelardi F, Sottotetti E, Vetere G, Ciraci P, Vlachogiannis G, Pietrantonio F, Cremolini C, Cortellini A, Loupakis F, Fassan M, Valeri N. Circulating microRNA analysis in a prospective co-clinical trial identifies MIR652-3p as a response biomarker and driver of regorafenib resistance mechanisms in colorectal cancer. Clin Cancer Res 2024:734699. [PMID: 38376926 DOI: 10.1158/1078-0432.ccr-23-2748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND The multi-kinase inhibitor regorafenib has demonstrated efficacy in chemo-refractory metastatic colorectal cancer (mCRC) patients. However, lack of predictive biomarkers and concerns over significant toxicities hamper the use of regorafenib in clinical practice. METHODS Serial liquid biopsies were obtained at baseline and monthly until disease progression in chemo-refractory mCRC patients treated with regorafenib in a phase II clinical trial (PROSPECT-R n=40; NCT03010722) and in a multicentric validation cohort (n=241). Tissue biopsies collected at baseline, after 2 months and at progression in the PROSPECT-R trial were used to establish Patient-Derived Organoids (PDOs) and for molecular analyses. MicroRNA profiling was performed on baseline bloods using the NanoString nCounter platform and results were validated by digital droplet PCR and/or In Situ Hybridization in paired liquid and tissue biopsies. PDOs co-cultures and PDO-xenotransplants were generated for functional analyses. RESULTS Large-scale microRNA expression analysis in longitudinal matched liquid and tissue biopsies from the PROSPECT-R trial identified MIR652-3p as a biomarker of clinical benefit to regorafenib. These findings were confirmed in an independent validation cohort and in a "control" group of 100 patients treated with lonsurf. Using ex vivo co-culture assays paired with single-cell RNA-sequencing of PDO established pre- and post-treatment, we modelled regorafenib response observed in vivo and in patients, and showed that MIR652-3p controls resistance to regorafenib by impairing regorafenib-induced lethal autophagy and by orchestrating the switch from neo-angiogenesis to vessel co-option. CONCLUSIONS Our results identify MIR652-3p as potential biomarker and as a driver of cell and non-cell autonomous mechanisms of resistance to regorafenib.
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Affiliation(s)
| | - Luciano Cascione
- IOR - Institute of Oncology Research, Bellinzona, Ticino, Switzerland
| | | | - Marta Schirripa
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, United States
| | - Andrea Lampis
- Institute of Cancer Research, Sutton, United Kingdom
| | - Jens C Hahne
- Institute of Cancer Research, Sutton, United Kingdom
| | | | - Sung Pil Hong
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | | | - Khurum Khan
- Institute of Cancer Research, Sutton, United Kingdom
| | - Elisa Fontana
- Sarah Cannon Research Institute, London, London, United Kingdom
| | | | - Mia Delrieux
- Institute of Cancer Research, Sutton, United Kingdom
| | | | | | - Sheela Rao
- Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom
| | | | | | - Ian Chau
- Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | | | | | - Ruwaida Begum
- Royal Marsden NHS Foundation Trust, London and Surrey, United Kingdom
| | - Naomi Guppy
- Institute of Cancer Research, London, United Kingdom
| | - Louise Howell
- Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | | | | | | | | | - Sara Lonardi
- Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | | | | | | | - Luca Magnani
- Institute of Cancer Research, London, United Kingdom
| | | | | | | | | | | | - Paolo Ciraci
- Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | | | | | | | | | | | - Nicola Valeri
- Institute of Cancer Research, Sutton, London, United Kingdom
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3
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Neeb A, Figueiredo I, Gurel B, Nava Rodrigues D, Rekowski J, Riisnaes R, Ferreira A, Miranda S, Crespo M, Westaby D, de Los Dolores Fenor de La Maza M, Guo C, Carmichael J, Grochot R, Tunariu N, Cato ACB, Plymate SR, de Bono JS, Sharp A. Development and Validation of a New BAG-1L-Specific Antibody to Quantify BAG-1L Protein Expression in Advanced Prostate Cancer. J Transl Med 2023; 103:100245. [PMID: 37652207 DOI: 10.1016/j.labinv.2023.100245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023] Open
Abstract
BCL-2-associated athanogene-1L (BAG-1L) is a critical co-regulator that binds to and enhances the transactivation function of the androgen receptor, leading to prostate cancer development and progression. Studies investigating the clinical importance of BAG-1L protein expression in advanced prostate cancer have been limited by the paucity of antibodies that specifically recognize the long isoform. In this study, we developed and validated a new BAG-1L-specific antibody using multiple orthogonal methods across several cell lines with and without genomic manipulation of BAG-1L and all BAG-1 isoforms. Following this, we performed exploratory immunohistochemistry to determine BAG-1L protein expression in normal human, matched castration-sensitive prostate cancer (CSPC) and castration-resistant prostate cancer (CRPC), unmatched primary and metastatic CRPC, and early breast cancer tissues. We demonstrated higher BAG-1L protein expression in CRPC metastases than in unmatched, untreated, castration-sensitive prostatectomies from men who remained recurrence-free for 5 years. In contrast, BAG-1L protein expression did not change between matched, same patient, CSPC and CRPC biopsies, suggesting that BAG-1L protein expression may be associated with more aggressive biology and the development of castration resistance. Finally, in a cohort of patients who universally developed CRPC, there was no association between BAG-1L protein expression at diagnosis and time to CRPC or overall survival, and no association between BAG-1L protein expression at CRPC biopsy and clinical outcome from androgen receptor targeting therapies or docetaxel chemotherapy. The limitations of this study include the requirement to validate the reproducibility of the assay developed, the potential influence of pre-analytical factors, timing of CRPC biopsies, relatively small patient numbers, and heterogenous therapies on BAG-1L protein expression, and the clinical outcome analyses performed. We describe a new BAG-1L-specific antibody that the research community can further develop to elucidate the biological and clinical significance of BAG-1L protein expression in malignant and nonmalignant diseases.
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Affiliation(s)
- Antje Neeb
- Institute of Cancer Research, London, United Kingdom
| | | | - Bora Gurel
- Institute of Cancer Research, London, United Kingdom
| | | | - Jan Rekowski
- Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- Institute of Cancer Research, London, United Kingdom
| | - Ana Ferreira
- Institute of Cancer Research, London, United Kingdom
| | | | - Mateus Crespo
- Institute of Cancer Research, London, United Kingdom
| | - Daniel Westaby
- Institute of Cancer Research, London, United Kingdom; Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | - Christina Guo
- Institute of Cancer Research, London, United Kingdom; Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Juliet Carmichael
- Institute of Cancer Research, London, United Kingdom; Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Rafael Grochot
- Institute of Cancer Research, London, United Kingdom; Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Nina Tunariu
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Andrew C B Cato
- Karlsruhe Institute of Technology (KIT), Institute for Biological and Chemical Systems-Biological Information Processing (IBCS-BIP), Eggenstein-Leopoldshafen, Germany
| | - Stephen R Plymate
- University of Washington, Seattle, Washington; Geriatrics Research, Education and Clinical Center, VAPSHCS, Seattle, Washington
| | - Johann S de Bono
- Institute of Cancer Research, London, United Kingdom; Royal Marsden NHS Foundation Trust, London, United Kingdom.
| | - Adam Sharp
- Institute of Cancer Research, London, United Kingdom; Royal Marsden NHS Foundation Trust, London, United Kingdom.
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4
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de Bono JS, Harris JR, Burm SM, Vanderstichele A, Houtkamp MA, Aarass S, Riisnaes R, Figueiredo I, Nava Rodrigues D, Christova R, Olbrecht S, Niessen HWM, Ruuls SR, Schuurhuis DH, Lammerts van Bueren JJ, Breij ECW, Vergote I. Systematic study of tissue factor expression in solid tumors. Cancer Rep (Hoboken) 2023; 6:e1699. [PMID: 36806722 PMCID: PMC9940005 DOI: 10.1002/cnr2.1699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 07/19/2022] [Accepted: 07/31/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Elevated tissue factor (TF) expression, although restricted in normal tissue, has been reported in multiple solid cancers, and expression has been associated with poor prognosis. This manuscript compares TF expression across various solid tumor types via immunohistochemistry in a single study, which has not been performed previously. AIMS To increase insight in the prevalence and cellular localization of TF expression across solid cancer types, we performed a detailed and systematic analysis of TF expression in tumor tissue obtained from patients with ovarian, esophageal, bladder, cervical, endometrial, pancreatic, prostate, colon, breast, non-small cell lung cancer (NSCLC), head and neck squamous cell carcinoma (HNSCC), and glioblastoma. The spatial and temporal variation of TF expression was analyzed over time and upon disease progression in patient-matched biopsies taken at different timepoints. In addition, TF expression in patient-matched primary tumor and metastatic lesions was also analyzed. METHODS AND RESULTS TF expression was detected via immunohistochemistry (IHC) using a validated TF-specific antibody. TF was expressed in all cancer types tested, with highest prevalence in pancreatic cancer, cervical cancer, colon cancer, glioblastoma, HNSCC, and NSCLC, and lowest in breast cancer. Staining was predominantly membranous in pancreatic, cervical, and HNSCC, and cytoplasmic in glioblastoma and bladder cancer. In general, expression was consistent between biopsies obtained from the same patient over time, although variability was observed for individual patients. NSCLC biopsies of primary tumor and matched lymph node metastases showed no clear difference in TF expression overall, although individual patient changes were observed. CONCLUSION This study shows that TF is expressed across a broad range of solid cancer types, and expression is present upon tumor dissemination and over the course of treatment.
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Affiliation(s)
| | | | | | - Adriaan Vanderstichele
- Department of Gynaecology and Obstetrics, Division of Gynaecologic OncologyUniversity Hospitals Leuven, Leuven Cancer InstituteLeuvenBelgium
| | | | - Saida Aarass
- GenmabPlainsboroNew JerseyUSA
- GenmabUtrechtThe Netherlands
| | - Ruth Riisnaes
- The Institute of Cancer ResearchRoyal Cancer HospitalLondonUK
| | - Ines Figueiredo
- The Institute of Cancer ResearchRoyal Cancer HospitalLondonUK
| | | | | | - Siel Olbrecht
- Department of Gynaecology and Obstetrics, Division of Gynaecologic OncologyUniversity Hospitals Leuven, Leuven Cancer InstituteLeuvenBelgium
| | | | | | | | | | | | - Ignace Vergote
- Department of Gynaecology and Obstetrics, Division of Gynaecologic OncologyUniversity Hospitals Leuven, Leuven Cancer InstituteLeuvenBelgium
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5
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Fenor de la Maza MD, Chandran K, Rekowski J, Shui IM, Gurel B, Cross E, Carreira S, Yuan W, Westaby D, Miranda S, Ferreira A, Seed G, Crespo M, Figueiredo I, Bertan C, Gil V, Riisnaes R, Sharp A, Rodrigues DN, Rescigno P, Tunariu N, Liu XQ, Cristescu R, Schloss C, Yap C, de Bono JS. Immune Biomarkers in Metastatic Castration-resistant Prostate Cancer. Eur Urol Oncol 2022; 5:659-667. [PMID: 35491356 DOI: 10.1016/j.euo.2022.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/15/2022] [Accepted: 04/13/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Metastatic castration-resistant prostate cancer (mCRPC) is a heterogeneous disease in which molecular stratification is needed to improve clinical outcomes. The identification of predictive biomarkers can have a major impact on the care of these patients, but the availability of metastatic tissue samples for research in this setting is limited. OBJECTIVE To study the prevalence of immune biomarkers of potential clinical utility to immunotherapy in mCRPC and to determine their association with overall survival (OS). DESIGN, SETTING, AND PARTICIPANTS From 100 patients, mCRPC biopsies were assayed by whole exome sequencing, targeted next-generation sequencing, RNA sequencing, tumor mutational burden, T-cell-inflamed gene expression profile (TcellinfGEP) score (Nanostring), and immunohistochemistry for programmed cell death 1 ligand 1 (PD-L1), ataxia-telangiectasia mutated (ATM), phosphatase and tensin homolog (PTEN), SRY homology box 2 (SOX2), and the presence of neuroendocrine features. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The phi coefficient determined correlations between biomarkers of interest. OS was assessed using Kaplan-Meier curves and adjusted hazard ratios (aHRs) from Cox regression. RESULTS AND LIMITATIONS PD-L1 and SOX2 protein expression was detected by immunohistochemistry (combined positive score ≥1 and >5% cells, respectively) in 24 (33%) and 27 (27%) mCRPC biopsies, respectively; 23 (26%) mCRPC biopsies had high TcellinfGEP scores (>-0.318). PD-L1 protein expression and TcellinfGEP scores were positively correlated (phi 0.63 [0.45; 0.76]). PD-L1 protein expression (aHR: 1.90 [1.05; 3.45]), high TcellinfGEP score (aHR: 1.86 [1.04; 3.31]), and SOX2 expression (aHR: 2.09 [1.20; 3.64]) were associated with worse OS. CONCLUSIONS PD-L1, TcellinfGEP score, and SOX2 are prognostic of outcome from the mCRPC setting. If validated, predictive biomarker studies incorporating survival endpoints need to take these findings into consideration. PATIENT SUMMARY This study presents an analysis of immune biomarkers in biopsies from patients with metastatic prostate cancer. We describe tumor alterations that predict prognosis that can impact future studies.
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Affiliation(s)
| | - Khobe Chandran
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK
| | | | | | - Bora Gurel
- The Institute of Cancer Research, London, UK
| | - Emily Cross
- The Institute of Cancer Research, London, UK
| | | | - Wei Yuan
- The Institute of Cancer Research, London, UK
| | - Daniel Westaby
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK
| | - Susana Miranda
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK
| | | | - George Seed
- The Institute of Cancer Research, London, UK
| | | | | | | | | | | | - Adam Sharp
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK
| | | | | | - Nina Tunariu
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK
| | | | | | | | | | - Johann S de Bono
- The Institute of Cancer Research, London, UK; The Royal Marsden Hospital, London, UK.
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6
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Sowalsky AG, Figueiredo I, Lis RT, Coleman I, Gurel B, Bogdan D, Yuan W, Russo JW, Bright JR, Whitlock NC, Trostel SY, Ku AT, Patel RA, True LD, Welti J, Jimenez-Vacas JM, Rodrigues DN, Riisnaes R, Neeb A, Sprenger CT, Swain A, Wilkinson S, Karzai F, Dahut WL, Balk SP, Corey E, Nelson PS, Haffner MC, Plymate SR, de Bono JS, Sharp A. Assessment of Androgen Receptor Splice Variant-7 as a Biomarker of Clinical Response in Castration-Sensitive Prostate Cancer. Clin Cancer Res 2022; 28:3509-3525. [PMID: 35695870 PMCID: PMC9378683 DOI: 10.1158/1078-0432.ccr-22-0851] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/17/2022] [Accepted: 06/08/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Therapies targeting the androgen receptor (AR) have improved the outcome for patients with castration-sensitive prostate cancer (CSPC). Expression of the constitutively active AR splice variant-7 (AR-V7) has shown clinical utility as a predictive biomarker of AR-targeted therapy resistance in castration-resistant prostate cancer (CRPC), but its importance in CSPC remains understudied. EXPERIMENTAL DESIGN We assessed different approaches to quantify AR-V7 mRNA and protein in prostate cancer cell lines, patient-derived xenograft (PDX) models, publicly available cohorts, and independent institutional clinical cohorts, to identify reliable approaches for detecting AR-V7 mRNA and protein and its association with clinical outcome. RESULTS In CSPC and CRPC cohorts, AR-V7 mRNA was much less abundant when detected using reads across splice boundaries than when considering isoform-specific exonic reads. The RM7 AR-V7 antibody had increased sensitivity and specificity for AR-V7 protein detection by immunohistochemistry (IHC) in CRPC cohorts but rarely identified AR-V7 protein reactivity in CSPC cohorts, when compared with the EPR15656 AR-V7 antibody. Using multiple CRPC PDX models, we demonstrated that AR-V7 expression was exquisitely sensitive to hormonal manipulation. In CSPC institutional cohorts, AR-V7 protein quantification by either assay was associated neither with time to development of castration resistance nor with overall survival, and intense neoadjuvant androgen-deprivation therapy did not lead to significant AR-V7 mRNA or staining following treatment. Neither pre- nor posttreatment AR-V7 levels were associated with volumes of residual disease after therapy. CONCLUSIONS This study demonstrates that further analytical validation and clinical qualification are required before AR-V7 can be considered for clinical use in CSPC as a predictive biomarker.
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Affiliation(s)
| | | | - Rosina T. Lis
- Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Ilsa Coleman
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Bora Gurel
- Institute of Cancer Research, London, UK
| | | | - Wei Yuan
- Institute of Cancer Research, London, UK
| | | | - John R. Bright
- Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | | | | | - Anson T. Ku
- Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | | | | | | | | | | | | | - Antje Neeb
- Institute of Cancer Research, London, UK
| | | | | | | | - Fatima Karzai
- Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | | | - Steven P. Balk
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Eva Corey
- University of Washington, Seattle, Washington
| | - Peter S. Nelson
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- University of Washington, Seattle, Washington
| | - Michael C. Haffner
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- University of Washington, Seattle, Washington
| | - Stephen R. Plymate
- University of Washington, Seattle, Washington
- Geriatrics Research, Education and Clinical Center, VAPSHCS, Seattle, Washington
| | - Johann S. de Bono
- Institute of Cancer Research, London, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | - Adam Sharp
- Institute of Cancer Research, London, UK
- Royal Marsden NHS Foundation Trust, London, UK
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7
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Carreira S, Porta N, Arce-Gallego S, Seed G, Llop-Guevara A, Bianchini D, Rescigno P, Paschalis A, Bertan C, Baker C, Goodall J, Miranda S, Riisnaes R, Figueiredo I, Ferreira A, Pereira R, Crespo M, Gurel B, Nava Rodrigues D, Pettitt SJ, Yuan W, Serra V, Rekowski J, Lord CJ, Hall E, Mateo J, de Bono JS. Biomarkers Associating with PARP Inhibitor Benefit in Prostate Cancer in the TOPARP-B Trial. Cancer Discov 2021; 11:2812-2827. [PMID: 34045297 PMCID: PMC9414325 DOI: 10.1158/2159-8290.cd-21-0007] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/23/2021] [Accepted: 05/21/2021] [Indexed: 01/07/2023]
Abstract
PARP inhibitors are approved for treating advanced prostate cancers (APC) with various defective DNA repair genes; however, further studies to clinically qualify predictive biomarkers are warranted. Herein we analyzed TOPARP-B phase II clinical trial samples, evaluating whole-exome and low-pass whole-genome sequencing and IHC and IF assays evaluating ATM and RAD51 foci (testing homologous recombination repair function). BRCA1/2 germline and somatic pathogenic mutations associated with similar benefit from olaparib; greater benefit was observed with homozygous BRCA2 deletion. Biallelic, but not monoallelic, PALB2 deleterious alterations were associated with clinical benefit. In the ATM cohort, loss of ATM protein by IHC was associated with a better outcome. RAD51 foci loss identified tumors with biallelic BRCA and PALB2 alterations while most ATM- and CDK12-altered APCs had higher RAD51 foci levels. Overall, APCs with homozygous BRCA2 deletion are exceptional responders; PALB2 biallelic loss and loss of ATM IHC expression associated with clinical benefit. SIGNIFICANCE: Not all APCs with DNA repair defects derive similar benefit from PARP inhibition. Most benefit was seen among patients with BRCA2 homozygous deletions, biallelic loss of PALB2, and loss of ATM protein. Loss of RAD51 foci, evaluating homologous recombination repair function, was found primarily in tumors with biallelic BRCA1/2 and PALB2 alterations.This article is highlighted in the In This Issue feature, p. 2659.
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Affiliation(s)
| | - Nuria Porta
- The Institute of Cancer Research, London, United Kingdom
| | - Sara Arce-Gallego
- Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain
| | - George Seed
- The Institute of Cancer Research, London, United Kingdom
| | - Alba Llop-Guevara
- Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain
| | - Diletta Bianchini
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Pasquale Rescigno
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alec Paschalis
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Claudia Bertan
- The Institute of Cancer Research, London, United Kingdom
| | - Chloe Baker
- The Institute of Cancer Research, London, United Kingdom
| | - Jane Goodall
- The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | | | - Ana Ferreira
- The Institute of Cancer Research, London, United Kingdom
| | - Rita Pereira
- The Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- The Institute of Cancer Research, London, United Kingdom
| | - Bora Gurel
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | - Violeta Serra
- Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain
| | - Jan Rekowski
- The Institute of Cancer Research, London, United Kingdom
| | | | - Emma Hall
- The Institute of Cancer Research, London, United Kingdom
| | - Joaquin Mateo
- The Institute of Cancer Research, London, United Kingdom.
- Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Johann S de Bono
- The Institute of Cancer Research, London, United Kingdom.
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
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8
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Arce-Gallego S, Llop-Guevara A, Carreira S, Porta N, Fasani R, Bianchini D, Seed G, Rescigno P, Paschalis A, Bertan C, Baker C, Goodall J, Miranda S, Riisnaes R, Figueiredo I, Ferreira A, Pereira R, Gurel B, Rodrigues DN, Yuan W, Rekowski J, Hall E, Serra V, de Bono JS, Mateo J. Abstract CT161: A homologous recombination repair (HRR) functional assay to stratify patients with metastatic prostate cancer for PARP inhibitor treatment in the TOPARP-B clinical trial. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-ct161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: PARP inhibitors (PARPi) are approved for the treatment of metastatic prostate cancer (mPC) associated to various DNA damage repair (DDR) gene mutations; but clinical benefit differs among patients. Biomarkers of homologous recombination repair (HRR) deficiency may help refine patient stratification for a more precise therapy selection. We report an exploratory analysis from the TOPARP-B phase II clinical trial of olaparib in mPC (NCT01682772), investigating the predictive value of an HRR function assay detecting RAD51 foci by immunofluorescence in tumor biopsies. Design: We analyzed formalin-fixed paraffin-embedded (FFPE) primary or metastatic biopsies from mPC patients treated with olaparib in the clinical trial. We evaluated baseline HRR function based on detection of RAD51 and γH2AX foci in geminin-positive tumor cells by immunofluorescence (IF). All samples were scored by two trained readers blinded to genomic and clinical data. Samples were considered HRR deficient (HRD) when RAD51 scores were low, pre-defined as <10% tumor cells presenting ≥5 RAD51 foci/cell. The association of the RAD51 score, response to olaparib and survival (radiographic progression-free survival, rPFS, and overall survival, OS) was analyzed by Chi-Square and log-rank tests. Results: RAD51 and γH2AX were successfully scored in 52 cases, in the same biopsies previously used for NGS in the clinical trial. All tumors showed abundant DNA damage (γH2AX scores >40%). The intra-class correlation score (ICC) between the two blinded readers was 0.88. Overall, 22 of 52 (42%) cases were considered as HRD based on low RAD51 scores. Response rate (based on the composite RECIST/PSA/CTC trial criteria) was 15/22 (68%) vs 7/30 (23%) for patients with low vs high RAD51 scores (p=0.001). Patients with low RAD51 scores also had longer rPFS (median 9.3 vs 2.9 months p=0.002) and overall survival (median 17.4 vs 9.5 months, p=0.05) from initiation of olaparib. All 16/16 cases with BRCA1/2 alterations were identified as RAD51 low. For patients with PALB2 mutations, 2/2 patients with biallelic loss showed RAD51 low scores and responded to olaparib, whereas 2/2 patients with monoallelic PALB2 mutations showed RAD51 high scores and did not respond to olaparib. Mutations in ATM and CDK12 did not associate with low RAD51. Indeed, 10/11 ATM-mutated and 8/10 CDK12-mutated tumors presented high RAD51 scores; RECIST/PSA responses were observed in two patients with ATM mutations and high RAD51 scores. Conclusion: A RAD51-based IF assay performed on FFPE biopsies can detect prostate cancers with deficient HRR function, including BRCA1/2 and biallelic PALB2 mutated cases, and may be useful for patient stratification for PARP inhibitor treatment in prostate cancer. Further validation of the assay in larger cohorts is warranted.
Citation Format: Sara Arce-Gallego, Alba Llop-Guevara, Suzanne Carreira, Nuria Porta, Roberta Fasani, Diletta Bianchini, George Seed, Pasquale Rescigno, Alec Paschalis, Claudia Bertan, Chloe Baker, Jane Goodall, Susana Miranda, Ruth Riisnaes, Ines Figueiredo, Ana Ferreira, Rita Pereira, Bora Gurel, Daniel Nava Rodrigues, Wei Yuan, Jan Rekowski, Emma Hall, Violeta Serra, Johann S. de Bono, Joaquin Mateo. A homologous recombination repair (HRR) functional assay to stratify patients with metastatic prostate cancer for PARP inhibitor treatment in the TOPARP-B clinical trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr CT161.
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Affiliation(s)
- Sara Arce-Gallego
- 1Vall d'Hebron Institute of Oncology and Vall d'Hebron Institute of Research, Barcelona, Spain
| | | | | | - Nuria Porta
- 3The Institute of Cancer Research, London, United Kingdom
| | | | - Diletta Bianchini
- 4The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - George Seed
- 3The Institute of Cancer Research, London, United Kingdom
| | - Pasquale Rescigno
- 4The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alec Paschalis
- 4The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Claudia Bertan
- 3The Institute of Cancer Research, London, United Kingdom
| | - Chloe Baker
- 3The Institute of Cancer Research, London, United Kingdom
| | - Jane Goodall
- 3The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- 3The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- 3The Institute of Cancer Research, London, United Kingdom
| | | | - Ana Ferreira
- 3The Institute of Cancer Research, London, United Kingdom
| | - Rita Pereira
- 3The Institute of Cancer Research, London, United Kingdom
| | - Bora Gurel
- 3The Institute of Cancer Research, London, United Kingdom
| | | | - Wei Yuan
- 3The Institute of Cancer Research, London, United Kingdom
| | - Jan Rekowski
- 3The Institute of Cancer Research, London, United Kingdom
| | - Emma Hall
- 3The Institute of Cancer Research, London, United Kingdom
| | - Violeta Serra
- 5Vall d'Hebron Institute of Oncology and Vall d'Hebron Institute of Research, Barcelona, Spain
| | - Johann S. de Bono
- 4The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Joaquin Mateo
- 6Vall d'Hebron Institute of Oncology and Vall d'Hebron University Hospital, Barcelona, Spain
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9
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Vu QD, Fong C, von Loga K, Raza SEA, Nava Rodrigues D, Patel B, Peckitt C, Begum R, Athauda A, Starling N, Chau I, Rao S, Watkins DJ, Rebelatto M, Waddell T, Wadsley J, Roques T, Hewish M, Cunningham D, Rajpoot N. Digital histological markers based on routine H&E slides to predict benefit from maintenance immunotherapy in esophagogastric adenocarcinoma. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e16074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16074 Background: Immune checkpoint inhibition (ICI) is an effective treatment for a subset of patients with inoperable esophagogastric (EG) adenocarcinoma. Robust predictive biomarkers are required to identify these patients and a variety of strategies including immunohistochemical staining of PD-L1 and tumor mutational burden (TMB) assessment have been employed. Here, we explore digital histological (dHis) markers based on routine hematoxylin and eosin (H&E) slides alone or in combination with molecular markers (PD-L1 and TMB) as predictive biomarkers of benefit from maintenance immunotherapy in patients with inoperable EG adenocarcinoma. Methods: We developed a deep learning based algorithm to construct novel digital histological (dHis) markers by summarizing the statistics of all different types of nuclei present in the tumor tissue sections, their morphological features and their colocalization across each of the whole slide image. The dHis markers were then input into a decision-tree based approach to test for prognostic and predictive power alone or in combination with molecular markers. We assessed two cohorts of patients randomized to surveillance (n=38) or maintenance durvalumab (n=35) after 18 weeks of first-line platinum-based chemotherapy in the PLATFORM trial (NCT02678182) according to the 12-week progression-free rate. We measured the accuracy as the area under the receiver operating characteristics curve (AUROC) to determine the prognostic and predictive power of each marker set. We conducted a stratified 3-fold cross-validation, repeated 5 times and report the overall AUROC results. Results: Molecular markers alone yielded an AUROC of 0.5581±0.0939 on the surveillance arm, 0.6671±0.1479 on the treatment arm, and 0.6376±0.0958 for both the arms. Digital histological markers alone yielded an AUROC of 0.8952±0.0638, 0.8995±0.0719 and 0.8488±0.0700 on surveillance, immunotherapy and both arms, respectively. When using these two sets of markers together for both arms, molecular markers offered a limited improvement (around 0.02). Patients with TMB in the highest tertile were associated with lower likelihood of having progressive disease 12 weeks after randomization. Interestingly, dHis markers from morphology of connective and inflammatory nuclei were highly predictive for treatment benefit. Conclusions: Preliminary results suggest digital histological markers offer significant improvement over PD-L1 and TMB markers alone for predicting benefit from immunotherapy in EG adenocarcinoma with the added advantages of scalable, rapid, low-cost and objective quantification on routine histology sections. We are further validating their effectiveness on a larger cohort. Clinical trial information: NCT02678182.
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Affiliation(s)
| | - Caroline Fong
- The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, United Kingdom
| | - Katharina von Loga
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | | | | | - Bijal Patel
- The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, United Kingdom
| | - Clare Peckitt
- The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, United Kingdom
| | - Ruwaida Begum
- The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, United Kingdom
| | - Avani Athauda
- The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, United Kingdom
| | - Naureen Starling
- The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, United Kingdom
| | - Ian Chau
- The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, United Kingdom
| | - Sheela Rao
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - David J. Watkins
- The Royal Marsden Hospital NHS Foundation Trust, London and Sutton, United Kingdom
| | | | - Tom Waddell
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | - Tom Roques
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
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10
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Paschalis A, Welti J, Neeb AJ, Yuan W, Figueiredo I, Pereira R, Ferreira A, Riisnaes R, Rodrigues DN, Jiménez-Vacas JM, Kim S, Uo T, Micco PD, Tumber A, Islam MS, Moesser MA, Abboud M, Kawamura A, Gurel B, Christova R, Gil VS, Buroni L, Crespo M, Miranda S, Lambros MB, Carreira S, Tunariu N, Alimonti A, Al-Lazikani B, Schofield CJ, Plymate SR, Sharp A, de Bono JS. JMJD6 Is a Druggable Oxygenase That Regulates AR-V7 Expression in Prostate Cancer. Cancer Res 2021; 81:1087-1100. [PMID: 33822745 PMCID: PMC8025710 DOI: 10.1158/0008-5472.can-20-1807] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/07/2020] [Accepted: 12/02/2020] [Indexed: 11/16/2022]
Abstract
Endocrine resistance (EnR) in advanced prostate cancer is fatal. EnR can be mediated by androgen receptor (AR) splice variants, with AR splice variant 7 (AR-V7) arguably the most clinically important variant. In this study, we determined proteins key to generating AR-V7, validated our findings using clinical samples, and studied splicing regulatory mechanisms in prostate cancer models. Triangulation studies identified JMJD6 as a key regulator of AR-V7, as evidenced by its upregulation with in vitro EnR, its downregulation alongside AR-V7 by bromodomain inhibition, and its identification as a top hit of a targeted siRNA screen of spliceosome-related genes. JMJD6 protein levels increased (P < 0.001) with castration resistance and were associated with higher AR-V7 levels and shorter survival (P = 0.048). JMJD6 knockdown reduced prostate cancer cell growth, AR-V7 levels, and recruitment of U2AF65 to AR pre-mRNA. Mutagenesis studies suggested that JMJD6 activity is key to the generation of AR-V7, with the catalytic machinery residing within a druggable pocket. Taken together, these data highlight the relationship between JMJD6 and AR-V7 in advanced prostate cancer and support further evaluation of JMJD6 as a therapeutic target in this disease. SIGNIFICANCE: This study identifies JMJD6 as being critical for the generation of AR-V7 in prostate cancer, where it may serve as a tractable target for therapeutic intervention.
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Affiliation(s)
- Alec Paschalis
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Jonathan Welti
- The Institute of Cancer Research, London, United Kingdom
| | - Antje J Neeb
- The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | | | - Rita Pereira
- The Institute of Cancer Research, London, United Kingdom
| | - Ana Ferreira
- The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | | | - Juan M Jiménez-Vacas
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Cordoba, Cordoba, Spain
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain
| | - Soojin Kim
- Department of Medicine, University of Washington School of Medicine and VAPSHCS-GRECC, Seattle, Washington
| | - Takuma Uo
- Department of Medicine, University of Washington School of Medicine and VAPSHCS-GRECC, Seattle, Washington
| | | | - Anthony Tumber
- Chemistry Research Laboratory, Department of Chemistry, University of Oxford, Oxford, United Kingdom
| | - Md Saiful Islam
- Chemistry Research Laboratory, Department of Chemistry, University of Oxford, Oxford, United Kingdom
| | - Marc A Moesser
- Chemistry Research Laboratory, Department of Chemistry, University of Oxford, Oxford, United Kingdom
| | - Martine Abboud
- Chemistry Research Laboratory, Department of Chemistry, University of Oxford, Oxford, United Kingdom
| | - Akane Kawamura
- Chemistry Research Laboratory, Department of Chemistry, University of Oxford, Oxford, United Kingdom
| | - Bora Gurel
- The Institute of Cancer Research, London, United Kingdom
| | | | - Veronica S Gil
- The Institute of Cancer Research, London, United Kingdom
| | - Lorenzo Buroni
- The Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Nina Tunariu
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | | | - Christopher J Schofield
- Chemistry Research Laboratory, Department of Chemistry, University of Oxford, Oxford, United Kingdom
| | - Stephen R Plymate
- Department of Medicine, University of Washington School of Medicine and VAPSHCS-GRECC, Seattle, Washington
| | - Adam Sharp
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Johann S de Bono
- The Institute of Cancer Research, London, United Kingdom.
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
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11
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Neeb A, Herranz N, Arce-Gallego S, Miranda S, Buroni L, Yuan W, Athie A, Casals T, Carmichael J, Rodrigues DN, Gurel B, Rescigno P, Rekowski J, Welti J, Riisnaes R, Gil V, Ning J, Wagner V, Casanova-Salas I, Cordoba S, Castro N, Fenor de la Maza MD, Seed G, Chandran K, Ferreira A, Figueiredo I, Bertan C, Bianchini D, Aversa C, Paschalis A, Gonzalez M, Morales-Barrera R, Suarez C, Carles J, Swain A, Sharp A, Gil J, Serra V, Lord C, Carreira S, Mateo J, de Bono JS. Advanced Prostate Cancer with ATM Loss: PARP and ATR Inhibitors. Eur Urol 2021; 79:200-211. [PMID: 33176972 DOI: 10.1016/j.eururo.2020.10.029] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/18/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Deleterious ATM alterations are found in metastatic prostate cancer (PC); PARP inhibition has antitumour activity against this subset, but only some ATM loss PCs respond. OBJECTIVE To characterise ATM-deficient lethal PC and to study synthetic lethal therapeutic strategies for this subset. DESIGN, SETTING, AND PARTICIPANTS We studied advanced PC biopsies using validated immunohistochemical (IHC) and next-generation sequencing (NGS) assays. In vitro cell line models modified using CRISPR-Cas9 to impair ATM function were generated and used in drug-sensitivity and functional assays, with validation in a patient-derived model. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS ATM expression by IHC was correlated with clinical outcome using Kaplan-Meier curves and log-rank test; sensitivity to different drug combinations was assessed in the preclinical models. RESULTS AND LIMITATIONS Overall, we detected ATM IHC loss in 68/631 (11%) PC patients in at least one biopsy, with synchronous and metachronous intrapatient heterogeneity; 46/71 (65%) biopsies with ATM loss had ATM mutations or deletions by NGS. ATM IHC loss was not associated with worse outcome from advanced disease, but ATM loss was associated with increased genomic instability (NtAI:number of subchromosomal regions with allelic imbalance extending to the telomere, p = 0.005; large-scale transitions, p = 0.05). In vitro, ATM loss PC models were sensitive to ATR inhibition, but had variable sensitivity to PARP inhibition; superior antitumour activity was seen with combined PARP and ATR inhibition in these models. CONCLUSIONS ATM loss in PC is not always detected by targeted NGS, associates with genomic instability, and is most sensitive to combined ATR and PARP inhibition. PATIENT SUMMARY Of aggressive prostate cancers, 10% lose the DNA repair gene ATM; this loss may identify a distinct prostate cancer subtype that is most sensitive to the combination of oral drugs targeting PARP and ATR.
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Affiliation(s)
- Antje Neeb
- The Institute of Cancer Research, London, UK
| | - Nicolás Herranz
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
| | - Sara Arce-Gallego
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
| | | | | | - Wei Yuan
- The Institute of Cancer Research, London, UK
| | - Alejandro Athie
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Teresa Casals
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Juliet Carmichael
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Bora Gurel
- The Institute of Cancer Research, London, UK
| | - Pasquale Rescigno
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Jon Welti
- The Institute of Cancer Research, London, UK
| | | | | | - Jian Ning
- The Institute of Cancer Research, London, UK
| | - Verena Wagner
- MRC London Institute of Medical Sciences (LMS) and Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College, London, UK
| | | | - Sarai Cordoba
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Natalia Castro
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - George Seed
- The Institute of Cancer Research, London, UK
| | - Khobe Chandran
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | | | | | | | - Diletta Bianchini
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | - Caterina Aversa
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | - Alec Paschalis
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | - Macarena Gonzalez
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain
| | - Rafael Morales-Barrera
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain
| | - Cristina Suarez
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain
| | - Joan Carles
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Adam Sharp
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | - Jesus Gil
- MRC London Institute of Medical Sciences (LMS) and Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College, London, UK
| | - Violeta Serra
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
| | | | | | - Joaquin Mateo
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain.
| | - Johann S de Bono
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK.
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12
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Alajati A, D'Ambrosio M, Troiani M, Mosole S, Pellegrini L, Chen J, Revandkar A, Bolis M, Theurillat JP, Guccini I, Losa M, Calcinotto A, De Bernardis G, Pasquini E, D'Antuono R, Sharp A, Figueiredo I, Nava Rodrigues D, Welti J, Gil V, Yuan W, Vlajnic T, Bubendorf L, Chiorino G, Gnetti L, Torrano V, Carracedo A, Camplese L, Hirabayashi S, Canato E, Pasut G, Montopoli M, Rüschoff JH, Wild P, Moch H, De Bono J, Alimonti A. CDCP1 overexpression drives prostate cancer progression and can be targeted in vivo. J Clin Invest 2021; 130:2435-2450. [PMID: 32250342 DOI: 10.1172/jci131133] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 01/22/2020] [Indexed: 12/11/2022] Open
Abstract
The mechanisms by which prostate cancer shifts from an indolent castration-sensitive phenotype to lethal castration-resistant prostate cancer (CRPC) are poorly understood. Identification of clinically relevant genetic alterations leading to CRPC may reveal potential vulnerabilities for cancer therapy. Here we find that CUB domain-containing protein 1 (CDCP1), a transmembrane protein that acts as a substrate for SRC family kinases (SFKs), is overexpressed in a subset of CRPC. Notably, CDCP1 cooperates with the loss of the tumor suppressor gene PTEN to promote the emergence of metastatic prostate cancer. Mechanistically, we find that androgens suppress CDCP1 expression and that androgen deprivation in combination with loss of PTEN promotes the upregulation of CDCP1 and the subsequent activation of the SRC/MAPK pathway. Moreover, we demonstrate that anti-CDCP1 immunoliposomes (anti-CDCP1 ILs) loaded with chemotherapy suppress prostate cancer growth when administered in combination with enzalutamide. Thus, our study identifies CDCP1 as a powerful driver of prostate cancer progression and uncovers different potential therapeutic strategies for the treatment of metastatic prostate tumors.
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Affiliation(s)
- Abdullah Alajati
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Mariantonietta D'Ambrosio
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland.,Faculty of Biology and Medicine, University of Lausanne UNIL, Lausanne, Switzerland
| | - Martina Troiani
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Simone Mosole
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Laura Pellegrini
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Jingjing Chen
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland.,Faculty of Biology and Medicine, University of Lausanne UNIL, Lausanne, Switzerland
| | - Ajinkya Revandkar
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland.,Faculty of Biology and Medicine, University of Lausanne UNIL, Lausanne, Switzerland
| | - Marco Bolis
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Jean-Philippe Theurillat
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Ilaria Guccini
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Marco Losa
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Arianna Calcinotto
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Gaston De Bernardis
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Pasquini
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland
| | - Rocco D'Antuono
- Institute for Research in Biomedicine (IRB), Bellinzona, Switzerland
| | - Adam Sharp
- Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom
| | - Ines Figueiredo
- Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom.,Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Daniel Nava Rodrigues
- Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom.,Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Jonathan Welti
- Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom.,Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Veronica Gil
- Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom.,Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Wei Yuan
- Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom.,Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Tatjana Vlajnic
- Institute for Pathology, University Hospital Basel, Basel, Switzerland
| | - Lukas Bubendorf
- Institute for Pathology, University Hospital Basel, Basel, Switzerland
| | | | - Letizia Gnetti
- Pathology Unit, University Hospital of Parma, Parma, Italy
| | - Verónica Torrano
- Center for Cooperative Research in Biosciences (CIC bioGUNE), Basque Research and Technology Alliance (BRTA), Derio, Spain.,Biochemistry and Molecular Biology Department, University of the Basque Country (UPV/EHU), Bilbao, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain
| | - Arkaitz Carracedo
- Center for Cooperative Research in Biosciences (CIC bioGUNE), Basque Research and Technology Alliance (BRTA), Derio, Spain.,Biochemistry and Molecular Biology Department, University of the Basque Country (UPV/EHU), Bilbao, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain.,Ikerbasque: Basque Foundation for Science, Bilbao, Spain
| | - Laura Camplese
- MRC London Institute of Medical Sciences (LMS), Imperial College London, London, United Kingdom
| | - Susumu Hirabayashi
- MRC London Institute of Medical Sciences (LMS), Imperial College London, London, United Kingdom
| | - Elena Canato
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Gianfranco Pasut
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Monica Montopoli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Jan Hendrik Rüschoff
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Peter Wild
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Holger Moch
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Johann De Bono
- Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom.,Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Andrea Alimonti
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita' della Svizzera Italiana, Lugano, Switzerland.,Faculty of Biology and Medicine, University of Lausanne UNIL, Lausanne, Switzerland.,Department of Medicine, University of Padua, Padua, Italy.,Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich (ETH), Zurich, Switzerland
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13
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Yap TA, Kristeleit R, Michalarea V, Pettitt SJ, Lim JSJ, Carreira S, Roda D, Miller R, Riisnaes R, Miranda S, Figueiredo I, Rodrigues DN, Ward S, Matthews R, Parmar M, Turner A, Tunariu N, Chopra N, Gevensleben H, Turner NC, Ruddle R, Raynaud FI, Decordova S, Swales KE, Finneran L, Hall E, Rugman P, Lindemann JPO, Foxley A, Lord CJ, Banerji U, Plummer R, Basu B, Lopez JS, Drew Y, de Bono JS. Phase I Trial of the PARP Inhibitor Olaparib and AKT Inhibitor Capivasertib in Patients with BRCA1/2- and Non- BRCA1/2-Mutant Cancers. Cancer Discov 2020; 10:1528-1543. [PMID: 32532747 PMCID: PMC7611385 DOI: 10.1158/2159-8290.cd-20-0163] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/20/2020] [Accepted: 06/09/2020] [Indexed: 11/16/2022]
Abstract
Preclinical studies have demonstrated synergy between PARP and PI3K/AKT pathway inhibitors in BRCA1 and BRCA2 (BRCA1/2)-deficient and BRCA1/2-proficient tumors. We conducted an investigator-initiated phase I trial utilizing a prospective intrapatient dose- escalation design to assess two schedules of capivasertib (AKT inhibitor) with olaparib (PARP inhibitor) in 64 patients with advanced solid tumors. Dose expansions enrolled germline BRCA1/2-mutant tumors, or BRCA1/2 wild-type cancers harboring somatic DNA damage response (DDR) or PI3K-AKT pathway alterations. The combination was well tolerated. Recommended phase II doses for the two schedules were: olaparib 300 mg twice a day with either capivasertib 400 mg twice a day 4 days on, 3 days off, or capivasertib 640 mg twice a day 2 days on, 5 days off. Pharmacokinetics were dose proportional. Pharmacodynamic studies confirmed phosphorylated (p) GSK3β suppression, increased pERK, and decreased BRCA1 expression. Twenty-five (44.6%) of 56 evaluable patients achieved clinical benefit (RECIST complete response/partial response or stable disease ≥ 4 months), including patients with tumors harboring germline BRCA1/2 mutations and BRCA1/2 wild-type cancers with or without DDR and PI3K-AKT pathway alterations. SIGNIFICANCE: In the first trial to combine PARP and AKT inhibitors, a prospective intrapatient dose- escalation design demonstrated safety, tolerability, and pharmacokinetic-pharmacodynamic activity and assessed predictive biomarkers of response/resistance. Antitumor activity was observed in patients harboring tumors with germline BRCA1/2 mutations and BRCA1/2 wild-type cancers with or without somatic DDR and/or PI3K-AKT pathway alterations.This article is highlighted in the In This Issue feature, p. 1426.
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Affiliation(s)
- Timothy A Yap
- Royal Marsden Hospital, London, United Kingdom.
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Stephen J Pettitt
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, United Kingdom
| | | | | | - Desamparados Roda
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Rowan Miller
- University College London, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Sarah Ward
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Ruth Matthews
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Mona Parmar
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Alison Turner
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | | | - Neha Chopra
- Royal Marsden Hospital, London, United Kingdom
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | | | - Nicholas C Turner
- Royal Marsden Hospital, London, United Kingdom
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Ruth Ruddle
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Karen E Swales
- The Institute of Cancer Research, London, United Kingdom
| | - Laura Finneran
- The Institute of Cancer Research, London, United Kingdom
| | - Emma Hall
- The Institute of Cancer Research, London, United Kingdom
| | - Paul Rugman
- Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | | | - Andrew Foxley
- Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | - Christopher J Lord
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, United Kingdom
| | - Udai Banerji
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Ruth Plummer
- Clinical and Translational Research Institute, Newcastle University, Newcastle, United Kingdom
| | - Bristi Basu
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Juanita S Lopez
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Yvette Drew
- Clinical and Translational Research Institute, Newcastle University, Newcastle, United Kingdom
| | - Johann S de Bono
- Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
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14
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Fontana E, Nyamundanda G, Cunningham D, Tu D, Cheang MC, Jonker DJ, Siu LL, Sclafani F, Eason K, Ragulan C, Bali MA, Hulkki-Wilson S, Loree JM, Waring PM, Giordano M, Lawrence P, Rodrigues DN, Begum R, Shapiro JD, Price TJ, Cremolini C, Starling N, Pietrantonio F, Trusolino L, O’Callaghan CJ, Sadanandam A. Intratumoral Transcriptome Heterogeneity Is Associated With Patient Prognosis and Sidedness in Patients With Colorectal Cancer Treated With Anti-EGFR Therapy From the CO.20 Trial. JCO Precis Oncol 2020; 4:PO.20.00050. [PMID: 33015526 PMCID: PMC7529528 DOI: 10.1200/po.20.00050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2020] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Metastatic colorectal cancers (mCRCs) assigned to the transit-amplifying (TA) CRCAssigner subtype are more sensitive to anti-epidermal growth factor receptor (EGFR) therapy. We evaluated the association between the intratumoral presence of TA signature (TA-high/TA-low, dubbed as TA-ness classification) and outcomes in CRCs treated with anti-EGFR therapy. PATIENTS AND METHODS The TA-ness classes were defined in a discovery cohort (n = 84) and independently validated in a clinical trial (CO.20; cetuximab monotherapy arm; n = 121) and other samples using an established NanoString-based gene expression assay. Progression-free survival (PFS), overall survival (OS), and disease control rate (DCR) according to TA-ness classification were assessed by univariate and multivariate analyses. RESULTS The TA-ness was measured in 772 samples from 712 patients. Patients (treated with anti-EGFR therapy) with TA-high tumors had significantly longer PFS (discovery hazard ratio [HR], 0.40; 95% CI, 0.25 to 0.64; P < .001; validation HR, 0.65; 95% CI, 0.45 to 0.93; P = .018), longer OS (discovery HR, 0.48; 95% CI, 0.29 to 0.78; P = .003; validation HR, 0.67; 95% CI, 0.46 to 0.98; P = .04), and higher DCR (discovery odds ratio [OR]; 14.8; 95% CI, 4.30 to 59.54; P < .001; validation OR, 4.35; 95% CI, 2.00 to 9.09; P < .001). TA-ness classification and its association with anti-EGFR therapy outcomes were further confirmed using publicly available data (n = 80) from metastatic samples (PFS P < .001) and patient-derived xenografts (P = .042). In an exploratory analysis of 55 patients with RAS/BRAF wild-type and left-sided tumors, TA-high class was significantly associated with longer PFS and trend toward higher response rate (PFS HR, 0.53; 95% CI, 0.28 to 1.00; P = .049; OR, 5.88; 95% CI, 0.71 to 4.55; P = .09; response rate 33% in TA-high and 7.7% in TA-low). CONCLUSION TA-ness classification is associated with prognosis in patients with mCRC treated with anti-EGFR therapy and may further help understanding the value of sidedness in patients with RAS/BRAF wild-type tumors.
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Affiliation(s)
- Elisa Fontana
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Gift Nyamundanda
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - David Cunningham
- GI Cancer Unit, The Royal Marsden Hospital, London, United Kingdom
| | - Dongsheng Tu
- Canadian Clinical Trial Group, Kingston, Ontario, Canada
| | - Maggie C.U. Cheang
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | | | - Lillian L. Siu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Francesco Sclafani
- GI Cancer Unit, The Royal Marsden Hospital, London, United Kingdom
- GI Cancer Unit, Institut Jules Bordet, Brussels, Belgium
| | - Katherine Eason
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Chanthirika Ragulan
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | - Maria Antonietta Bali
- Radiology Department, The Royal Marsden Hospital, London, United Kingdom
- Radiology Department, Jules Bordet, Brussels, Belgium
| | - Sanna Hulkki-Wilson
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | | | - Paul M. Waring
- Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Mirella Giordano
- Department of Surgical, Medical, Molecular Pathology, and Critical Area, University of Pisa, Pisa, Italy
| | - Patrick Lawrence
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
| | | | - Ruwaida Begum
- GI Cancer Unit, The Royal Marsden Hospital, London, United Kingdom
| | - Jeremy D. Shapiro
- Cabrini Health, Department of Medical Oncology, Malvern, Victoria, Australia
| | | | - Chiara Cremolini
- Medical Oncology Unit, Azienda Ospedaliero‐Universitaria Pisana, Pisa, Italy
- Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Naureen Starling
- GI Cancer Unit, The Royal Marsden Hospital, London, United Kingdom
| | - Filippo Pietrantonio
- Medical Oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy
- Oncology and Hemato-Oncology Department, Milan University, Milan, Italy
| | - Livio Trusolino
- Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
- Translational Cancer Medicine, Candiolo Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, Candiolo, Torino, Italy
| | | | - Anguraj Sadanandam
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden Hospital, London, United Kingdom
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15
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Yap TA, O’Carrigan B, Penney MS, Lim JS, Brown JS, de Miguel Luken MJ, Tunariu N, Perez-Lopez R, Rodrigues DN, Riisnaes R, Figueiredo I, Carreira S, Hare B, McDermott K, Khalique S, Williamson CT, Natrajan R, Pettitt SJ, Lord CJ, Banerji U, Pollard J, Lopez J, de Bono JS. Phase I Trial of First-in-Class ATR Inhibitor M6620 (VX-970) as Monotherapy or in Combination With Carboplatin in Patients With Advanced Solid Tumors. J Clin Oncol 2020; 38:3195-3204. [PMID: 32568634 PMCID: PMC7499606 DOI: 10.1200/jco.19.02404] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Preclinical studies demonstrated that ATR inhibition can exploit synthetic lethality (eg, in cancer cells with impaired compensatory DNA damage responses through ATM loss) as monotherapy and combined with DNA-damaging drugs such as carboplatin. PATIENTS AND METHODS This phase I trial assessed the ATR inhibitor M6620 (VX-970) as monotherapy (once or twice weekly) and combined with carboplatin (carboplatin on day 1 and M6620 on days 2 and 9 in 21-day cycles). Primary objectives were safety, tolerability, and maximum tolerated dose; secondary objectives included pharmacokinetics and antitumor activity; exploratory objectives included pharmacodynamics in timed paired tumor biopsies. RESULTS Forty patients were enrolled; 17 received M6620 monotherapy, which was safe and well tolerated. The recommended phase II dose (RP2D) for once- or twice-weekly administration was 240 mg/m2. A patient with metastatic colorectal cancer harboring molecular aberrations, including ATM loss and an ARID1A mutation, achieved RECISTv1.1 complete response and maintained this response, with a progression-free survival of 29 months at last assessment. Twenty-three patients received M6620 with carboplatin, with mechanism-based hematologic toxicities at higher doses, requiring dose delays and reductions. The RP2D for combination therapy was M6620 90 mg/m2 with carboplatin AUC5. A patient with advanced germline BRCA1 ovarian cancer achieved RECISTv1.1 partial response and Gynecologic Cancer Intergroup CA125 response despite being platinum refractory and PARP inhibitor resistant. An additional 15 patients had RECISTv1.1 stable disease as best response. Pharmacokinetics were dose proportional and exceeded preclinical efficacious levels. Pharmacodynamic studies demonstrated substantial inhibition of phosphorylation of CHK1, the downstream ATR substrate. CONCLUSION To our knowledge, this report is the first of an ATR inhibitor as monotherapy and combined with carboplatin. M6620 was well tolerated, with target engagement and preliminary antitumor responses observed.
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Affiliation(s)
- Timothy A. Yap
- Drug Development Unit, Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Brent O’Carrigan
- Drug Development Unit, Royal Marsden Hospital, London, United Kingdom
| | | | - Joline S. Lim
- Drug Development Unit, Royal Marsden Hospital, London, United Kingdom
| | - Jessica S. Brown
- Drug Development Unit, Royal Marsden Hospital, London, United Kingdom
| | | | - Nina Tunariu
- Drug Development Unit, Royal Marsden Hospital, London, United Kingdom
| | | | | | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | | | | | | | | | - Saira Khalique
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Chris T. Williamson
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
- CRUK Gene Function Laboratory, The Institute of Cancer Research, London, United Kingdom
| | - Rachael Natrajan
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Stephen J. Pettitt
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
- CRUK Gene Function Laboratory, The Institute of Cancer Research, London, United Kingdom
| | - Christopher J. Lord
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
- CRUK Gene Function Laboratory, The Institute of Cancer Research, London, United Kingdom
| | - Udai Banerji
- Drug Development Unit, Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - John Pollard
- Vertex Pharmaceuticals, Oxfordshire, United Kingdom
| | - Juanita Lopez
- Drug Development Unit, Royal Marsden Hospital, London, United Kingdom
| | - Johann S. de Bono
- Drug Development Unit, Royal Marsden Hospital, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
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16
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Mateo J, Seed G, Bertan C, Rescigno P, Dolling D, Figueiredo I, Miranda S, Nava Rodrigues D, Gurel B, Clarke M, Atkin M, Chandler R, Messina C, Sumanasuriya S, Bianchini D, Barrero M, Petermolo A, Zafeiriou Z, Fontes M, Perez-Lopez R, Tunariu N, Fulton B, Jones R, McGovern U, Ralph C, Varughese M, Parikh O, Jain S, Elliott T, Sandhu S, Porta N, Hall E, Yuan W, Carreira S, de Bono JS. Genomics of lethal prostate cancer at diagnosis and castration resistance. J Clin Invest 2020; 130:1743-1751. [PMID: 31874108 PMCID: PMC7108902 DOI: 10.1172/jci132031] [Citation(s) in RCA: 172] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 12/18/2019] [Indexed: 12/11/2022] Open
Abstract
The genomics of primary prostate cancer differ from those of metastatic castration-resistant prostate cancer (mCRPC). We studied genomic aberrations in primary prostate cancer biopsies from patients who developed mCRPC, also studying matching, same-patient, diagnostic, and mCRPC biopsies following treatment. We profiled 470 treatment-naive prostate cancer diagnostic biopsies and, for 61 cases, mCRPC biopsies, using targeted and low-pass whole-genome sequencing (n = 52). Descriptive statistics were used to summarize mutation and copy number profile. Prevalence was compared using Fisher's exact test. Survival correlations were studied using log-rank test. TP53 (27%) and PTEN (12%) and DDR gene defects (BRCA2 7%; CDK12 5%; ATM 4%) were commonly detected. TP53, BRCA2, and CDK12 mutations were markedly more common than described in the TCGA cohort. Patients with RB1 loss in the primary tumor had a worse prognosis. Among 61 men with matched hormone-naive and mCRPC biopsies, differences were identified in AR, TP53, RB1, and PI3K/AKT mutational status between same-patient samples. In conclusion, the genomics of diagnostic prostatic biopsies acquired from men who develop mCRPC differ from those of the nonlethal primary prostatic cancers. RB1/TP53/AR aberrations are enriched in later stages, but the prevalence of DDR defects in diagnostic samples is similar to mCRPC.
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Affiliation(s)
- Joaquin Mateo
- Vall d’Hebron Institute of Oncology (VHIO) and Vall d’Hebron University Hospital, Barcelona, Spain
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - George Seed
- The Institute of Cancer Research, London, United Kingdom
| | - Claudia Bertan
- The Institute of Cancer Research, London, United Kingdom
| | - Pasquale Rescigno
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - David Dolling
- The Institute of Cancer Research, London, United Kingdom
| | | | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | | | - Bora Gurel
- The Institute of Cancer Research, London, United Kingdom
| | - Matthew Clarke
- The Institute of Cancer Research, London, United Kingdom
| | - Mark Atkin
- The Institute of Cancer Research, London, United Kingdom
| | - Rob Chandler
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Carlo Messina
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Semini Sumanasuriya
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Diletta Bianchini
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Maialen Barrero
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Antonella Petermolo
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Zafeiris Zafeiriou
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Mariane Fontes
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Instituto Oncoclinicas-Grupo Oncoclinicas, Rio de Janeiro, Brazil
| | - Raquel Perez-Lopez
- Vall d’Hebron Institute of Oncology (VHIO) and Vall d’Hebron University Hospital, Barcelona, Spain
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Nina Tunariu
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ben Fulton
- The Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Robert Jones
- The Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | - Christy Ralph
- St James’s University Hospital, Leeds, United Kingdom
| | | | - Omi Parikh
- Royal Blackburn Hospital, Blackburn, United Kingdom
| | - Suneil Jain
- Belfast City Hospital, Belfast, United Kingdom
| | - Tony Elliott
- The Christie Hospital, Manchester, United Kingdom
| | | | - Nuria Porta
- The Institute of Cancer Research, London, United Kingdom
| | - Emma Hall
- The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | | | - Johann S. de Bono
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
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17
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Li Y, Yang R, Henzler CM, Ho Y, Passow C, Auch B, Carreira S, Nava Rodrigues D, Bertan C, Hwang TH, Quigley DA, Dang HX, Morrissey C, Fraser M, Plymate SR, Maher CA, Feng FY, de Bono JS, Dehm SM. Diverse AR Gene Rearrangements Mediate Resistance to Androgen Receptor Inhibitors in Metastatic Prostate Cancer. Clin Cancer Res 2020; 26:1965-1976. [PMID: 31932493 DOI: 10.1158/1078-0432.ccr-19-3023] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 12/04/2019] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Prostate cancer is the second leading cause of male cancer deaths. Castration-resistant prostate cancer (CRPC) is a lethal stage of the disease that emerges when endocrine therapies are no longer effective at suppressing activity of the androgen receptor (AR) transcription factor. The purpose of this study was to identify genomic mechanisms that contribute to the development and progression of CRPC. EXPERIMENTAL DESIGN We used whole-genome and targeted DNA-sequencing approaches to identify mechanisms underlying CRPC in an aggregate cohort of 272 prostate cancer patients. We analyzed structural rearrangements at the genome-wide level and carried out a detailed structural rearrangement analysis of the AR locus. We used genome engineering to perform experimental modeling of AR gene rearrangements and long-read RNA sequencing to analyze effects on expression of AR and truncated AR variants (AR-V). RESULTS AR was among the most frequently rearranged genes in CRPC tumors. AR gene rearrangements promoted expression of diverse AR-V species. AR gene rearrangements occurring in the context of AR amplification correlated with AR overexpression. Cell lines with experimentally derived AR gene rearrangements displayed high expression of tumor-specific AR-Vs and were resistant to endocrine therapies, including the AR antagonist enzalutamide. CONCLUSIONS AR gene rearrangements are an important mechanism of resistance to endocrine therapies in CRPC.
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Affiliation(s)
- Yingming Li
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Rendong Yang
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,The Hormel Institute, University of Minnesota, Austin, Minnesota
| | - Christine M Henzler
- Minnesota Supercomputing Institute, University of Minnesota, Minneapolis, Minnesota
| | - Yeung Ho
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Courtney Passow
- University of Minnesota Genomics Center, University of Minnesota, Minneapolis, Minnesota
| | - Benjamin Auch
- University of Minnesota Genomics Center, University of Minnesota, Minneapolis, Minnesota
| | | | | | - Claudia Bertan
- The Institute for Cancer Research, London, United Kingdom
| | - Tae Hyun Hwang
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - David A Quigley
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Ha X Dang
- McDonnell Genome Institute, Washington University in St. Louis, St. Louis, Missouri.,Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Colm Morrissey
- Department of Urology, University of Washington, Seattle, Washington
| | - Michael Fraser
- Computational Biology Program, Ontario Institute for Cancer Research, Toronto, Ontario
| | - Stephen R Plymate
- Division of Gerontology, Geriatric Medicine, University of Washington, Seattle, Washington.,Geriatric Research Education and Clinical Centers, VA Puget Sound Health Care System, Seattle, Washington
| | - Christopher A Maher
- McDonnell Genome Institute, Washington University in St. Louis, St. Louis, Missouri.,Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Felix Y Feng
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California.,Department of Radiation Oncology, University of California, San Francisco, San Francisco, California
| | - Johann S de Bono
- The Institute for Cancer Research, London, United Kingdom.,The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Scott M Dehm
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota. .,Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.,Department of Urology, University of Minnesota, Minneapolis, Minnesota
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Mateo J, Porta N, Bianchini D, McGovern U, Elliott T, Jones R, Syndikus I, Ralph C, Jain S, Varughese M, Parikh O, Crabb S, Robinson A, McLaren D, Birtle A, Tanguay J, Miranda S, Figueiredo I, Seed G, Bertan C, Flohr P, Ebbs B, Rescigno P, Fowler G, Ferreira A, Riisnaes R, Pereira R, Curcean A, Chandler R, Clarke M, Gurel B, Crespo M, Nava Rodrigues D, Sandhu S, Espinasse A, Chatfield P, Tunariu N, Yuan W, Hall E, Carreira S, de Bono JS. Olaparib in patients with metastatic castration-resistant prostate cancer with DNA repair gene aberrations (TOPARP-B): a multicentre, open-label, randomised, phase 2 trial. Lancet Oncol 2020; 21:162-174. [PMID: 31806540 PMCID: PMC6941219 DOI: 10.1016/s1470-2045(19)30684-9] [Citation(s) in RCA: 391] [Impact Index Per Article: 97.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Metastatic castration-resistant prostate cancer is enriched in DNA damage response (DDR) gene aberrations. The TOPARP-B trial aims to prospectively validate the association between DDR gene aberrations and response to olaparib in metastatic castration-resistant prostate cancer. METHODS In this open-label, investigator-initiated, randomised phase 2 trial following a selection (or pick-the-winner) design, we recruited participants from 17 UK hospitals. Men aged 18 years or older with progressing metastatic castration-resistant prostate cancer previously treated with one or two taxane chemotherapy regimens and with an Eastern Cooperative Oncology Group performance status of 2 or less had tumour biopsies tested with targeted sequencing. Patients with DDR gene aberrations were randomly assigned (1:1) by a computer-generated minimisation method, with balancing for circulating tumour cell count at screening, to receive 400 mg or 300 mg olaparib twice daily, given continuously in 4-week cycles until disease progression or unacceptable toxicity. Neither participants nor investigators were masked to dose allocation. The primary endpoint of confirmed response was defined as a composite of all patients presenting with any of the following outcomes: radiological objective response (as assessed by Response Evaluation Criteria in Solid Tumors 1.1), a decrease in prostate-specific antigen (PSA) of 50% or more (PSA50) from baseline, or conversion of circulating tumour cell count (from ≥5 cells per 7·5 mL blood at baseline to <5 cells per 7·5 mL blood). A confirmed response in a consecutive assessment after at least 4 weeks was required for each component. The primary analysis was done in the evaluable population. If at least 19 (43%) of 44 evaluable patients in a dose cohort responded, then the dose cohort would be considered successful. Safety was assessed in all patients who received at least one dose of olaparib. This trial is registered at ClinicalTrials.gov, NCT01682772. Recruitment for the trial has completed and follow-up is ongoing. FINDINGS 711 patients consented for targeted screening between April 1, 2015, and Aug 30, 2018. 161 patients had DDR gene aberrations, 98 of whom were randomly assigned and treated (49 patients for each olaparib dose), with 92 evaluable for the primary endpoint (46 patients for each olaparib dose). Median follow-up was 24·8 months (IQR 16·7-35·9). Confirmed composite response was achieved in 25 (54·3%; 95% CI 39·0-69·1) of 46 evaluable patients in the 400 mg cohort, and 18 (39·1%; 25·1-54·6) of 46 evaluable patients in the 300 mg cohort. Radiological response was achieved in eight (24·2%; 11·1-42·3) of 33 evaluable patients in the 400 mg cohort and six (16·2%; 6·2-32·0) of 37 in the 300 mg cohort; PSA50 response was achieved in 17 (37·0%; 23·2-52·5) of 46 and 13 (30·2%; 17·2-46·1) of 43; and circulating tumour cell count conversion was achieved in 15 (53·6%; 33·9-72·5) of 28 and 13 (48·1%; 28·7-68·1) of 27. The most common grade 3-4 adverse event in both cohorts was anaemia (15 [31%] of 49 patients in the 300 mg cohort and 18 [37%] of 49 in the 400 mg cohort). 19 serious adverse reactions were reported in 13 patients. One death possibly related to treatment (myocardial infarction) occurred after 11 days of treatment in the 300 mg cohort. INTERPRETATION Olaparib has antitumour activity against metastatic castration-resistant prostate cancer with DDR gene aberrations, supporting the implementation of genomic stratification of metastatic castration-resistant prostate cancer in clinical practice. FUNDING Cancer Research UK, AstraZeneca, Prostate Cancer UK, the Prostate Cancer Foundation, the Experimental Cancer Medicine Centres Network, and the National Institute for Health Research Biomedical Research Centres.
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Affiliation(s)
- Joaquin Mateo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Porta
- The Institute of Cancer Research, London, UK
| | - Diletta Bianchini
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Ursula McGovern
- University College Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Tony Elliott
- The Christie NHS Foundation Trust, Manchester, UK
| | - Robert Jones
- University of Glasgow and Beatson West of Scotland Cancer Centre, Glasgow, UK
| | | | - Christy Ralph
- St James's Institute of Oncology, University of Leeds, Leeds, UK
| | | | | | | | | | | | | | | | | | | | | | - George Seed
- The Institute of Cancer Research, London, UK
| | | | - Penny Flohr
- The Institute of Cancer Research, London, UK
| | - Berni Ebbs
- The Institute of Cancer Research, London, UK
| | - Pasquale Rescigno
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | | | | | | | | | - Andra Curcean
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Robert Chandler
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Bora Gurel
- The Institute of Cancer Research, London, UK
| | | | | | | | | | | | - Nina Tunariu
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Wei Yuan
- The Institute of Cancer Research, London, UK
| | - Emma Hall
- The Institute of Cancer Research, London, UK
| | | | - Johann S de Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK.
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Abstract
The classification of human cancers has traditionally relied on the tissue of origin, the histologic appearance and anatomical extent of disease, otherwise referred to as grade and stage. However, this system fails to explain the highly variable clinical behaviour seen for any one cancer. Molecular characterization through techniques such as next-generation sequencing (NGS) has led to an appreciation of the extreme genetic heterogeneity that underlies most human cancers. Because of the difficulties associated with fresh tissue biopsy, interest has increased in using circulating tumour material, such as circulating tumour cells (CTCs), as a non-invasive way to access tumour tissue. CTC enumeration has been demonstrated to have prognostic value in metastatic breast, colon and prostate cancers. Recent studies have also shown that CTCs are suitable material for molecular characterization, using techniques such as reverse transcription-polymerase chain reaction (RT-PCR), fluorescence in situ hybridization (FISH), array comparative genomic hybridization (aCGH) and NGS. Furthermore, genetic analysis of CTCs may be more suitable to study tumour heterogeneity and clonal evolution than fresh tissue biopsy. Whether blood-based biopsy techniques will be accepted as a replacement to fresh tissue biopsies remains to be seen, but there is reason for optimism. While significant barriers to this acceptance exist, blood-based biopsy techniques appear to be reliable and representative alternatives to fresh tissue biopsy.
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Affiliation(s)
- Michael Paul Kolinsky
- The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
- Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T61Z2, Canada
| | | | - Maryou Lambros
- The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Veronica Gil
- The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Suzanne Carreira
- The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Zafeiris Zafeiriou
- The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Johann Sebastian de Bono
- The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.
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Scaranti M, Nava Rodrigues D, Banerji U. Deep and sustained radiological response after MEK-RAF inhibition in HRAS mutant apocrine carcinoma of the scalp. Eur J Cancer 2019; 122:9-11. [PMID: 31600639 DOI: 10.1016/j.ejca.2019.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/16/2019] [Accepted: 08/18/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Mariana Scaranti
- Drug Development Unit, The Royal Marsden NHS Foundation Trust, The Institute of Cancer Research, Downs Road, London, SM2 5PT, United Kingdom.
| | - Daniel Nava Rodrigues
- Drug Development Unit, The Royal Marsden NHS Foundation Trust, The Institute of Cancer Research, Downs Road, London, SM2 5PT, United Kingdom.
| | - Udai Banerji
- Drug Development Unit, The Royal Marsden NHS Foundation Trust, The Institute of Cancer Research, Downs Road, London, SM2 5PT, United Kingdom.
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21
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Paschalis A, Sheehan B, Riisnaes R, Rodrigues DN, Gurel B, Bertan C, Ferreira A, Lambros MBK, Seed G, Yuan W, Dolling D, Welti JC, Neeb A, Sumanasuriya S, Rescigno P, Bianchini D, Tunariu N, Carreira S, Sharp A, Oyen W, de Bono JS. Prostate-specific Membrane Antigen Heterogeneity and DNA Repair Defects in Prostate Cancer. Eur Urol 2019; 76:469-478. [PMID: 31345636 PMCID: PMC6853166 DOI: 10.1016/j.eururo.2019.06.030] [Citation(s) in RCA: 248] [Impact Index Per Article: 49.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/25/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Prostate-specific membrane antigen (PSMA; folate hydrolase) prostate cancer (PC) expression has theranostic utility. OBJECTIVE To elucidate PC PSMA expression and associate this with defective DNA damage repair (DDR). DESIGN, SETTING, AND PARTICIPANTS Membranous PSMA (mPSMA) expression was scored immunohistochemically from metastatic castration-resistant PC (mCRPC) and matching, same-patient, diagnostic biopsies, and correlated with next-generation sequencing (NGS) and clinical outcome data. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Expression of mPSMA was quantitated by modified H-score. Patient DNA was tested by NGS. Gene expression and activity scores were determined from mCRPC transcriptomes. Statistical correlations utilised Wilcoxon signed rank tests, survival was estimated by Kaplan-Meier test, and sample heterogeneity was quantified by Shannon's diversity index. RESULTS AND LIMITATIONS Expression of mPSMA at diagnosis was associated with higher Gleason grade (p=0.04) and worse overall survival (p=0.006). Overall, mPSMA expression levels increased at mCRPC (median H-score [interquartile range]: castration-sensitive prostate cancer [CSPC] 17.5 [0.0-60.0] vs mCRPC 55.0 [2.8-117.5]). Surprisingly, 42% (n=16) of CSPC and 27% (n=16) of mCRPC tissues sampled had no detectable mPSMA (H-score <10). Marked intratumour heterogeneity of mPSMA expression, with foci containing no detectable PSMA, was observed in all mPSMA expressing CSPC (100%) and 37 (84%) mCRPC biopsies. Heterogeneous intrapatient mPSMA expression between metastases was also observed, with the lowest expression in liver metastases. Tumours with DDR had higher mPSMA expression (p=0.016; 87.5 [25.0-247.5] vs 20 [0.3-98.8]; difference in medians 60 [5.0-95.0]); validation cohort studies confirmed higher mPSMA expression in patients with deleterious aberrations in BRCA2 (p<0.001; median H-score: 300 [165-300]; difference in medians 195.0 [100.0-270.0]) and ATM (p=0.005; 212.5 [136.3-300]; difference in medians 140.0 [55.0-200]) than in molecularly unselected mCRPC biopsies (55.0 [2.75-117.5]). Validation studies using mCRPC transcriptomes corroborated these findings, also indicating that SOX2 high tumours have low PSMA expression. CONCLUSIONS Membranous PSMA expression is upregulated in some but not all PCs, with mPSMA expression demonstrating marked inter- and intrapatient heterogeneity. DDR aberrations are associated with higher mPSMA expression and merit further evaluation as predictive biomarkers of response for PSMA-targeted therapies in larger, prospective cohorts. PATIENT SUMMARY Through analysis of prostate cancer samples, we report that the presence of prostate-specific membrane antigen (PSMA) is extremely variable both within one patient and between different patients. This may limit the usefulness of PSMA scans and PSMA-targeted therapies. We show for the first time that prostate cancers with defective DNA repair produce more PSMA and so may respond better to PSMA-targeting treatments.
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Affiliation(s)
- Alec Paschalis
- The Institute of Cancer Research, Sutton, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | | | | | | | - Bora Gurel
- The Institute of Cancer Research, Sutton, UK
| | | | | | | | - George Seed
- The Institute of Cancer Research, Sutton, UK
| | - Wei Yuan
- The Institute of Cancer Research, Sutton, UK
| | | | - Jon C Welti
- The Institute of Cancer Research, Sutton, UK
| | - Antje Neeb
- The Institute of Cancer Research, Sutton, UK
| | - Semini Sumanasuriya
- The Institute of Cancer Research, Sutton, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Pasquale Rescigno
- The Institute of Cancer Research, Sutton, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK; Department of Clinical Medicine and Surgery, AOU Federico II, Naples, Italy; Department of Translational Medical Sciences, AOU Federico II, Naples, Italy
| | - Diletta Bianchini
- The Institute of Cancer Research, Sutton, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Nina Tunariu
- The Institute of Cancer Research, Sutton, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | | | - Adam Sharp
- The Institute of Cancer Research, Sutton, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Wim Oyen
- The Institute of Cancer Research, Sutton, UK
| | - Johann S de Bono
- The Institute of Cancer Research, Sutton, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK.
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22
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Paschalis A, Sheehan B, Riisnaes R, Nava Rodrigues D, Gurel B, Bertan C, Ferreira A, Lambros MB, Seed G, Yuan W, Dolling D, Welti J, Neeb A, Sumanasuriya S, Rescigno P, Bianchini D, Tunariu N, Carreira S, Sharp A, De Bono JS. PSMA heterogeneity and DNA repair defects in prostate cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5002 Background: Prostate-specific membrane antigen (PSMA) is a promising target for theranostics in metastatic castration resistant prostate cancer (mCRPC). Methods: Membranous PSMA (mPSMA) expression was immunohistochemically evaluated in castration sensitive (CSPC) (n = 38) and mCRPC (n = 60) tissue biopsies, and associations with molecular aberrations (next-generation sequencing; NGS) and clinical outcome were determined. Results: mPSMA expression was significantly higher (p = 0.005) in mCRPC biopsies (median H-score [interquartile range]; 55.0 [2.8-117.5]) compared to CSPC biopsies (17.5 [0.0-60.0]). Furthermore, patients with higher mPSMA expression ( > median H-score) at diagnosis had higher Gleason Grade (p = 0.04) and shorter OS (p = 0.006). Critically, 42% (16/38) of CSPC biopsies and 27% (16/60) of mCRPC biopsies were completely negative for mPSMA expression. In addition, CSPC and mCRPC biopsies expressing mPSMA demonstrated marked intra-tumor heterogeneity in expression levels, commonly exhibiting areas without detectable PSMA (CSPC – 100%; mCRPC – 84%), while heterogeneous mPSMA expression between metastases from the same patient was also observed. Subsequent genomic analysis showed that mCRPC patients with deleterious DNA damage repair (DDR) aberrations have higher (p = 0.016) mPSMA expression (87.5 [25.0-247.5]) than those without these (20 [0.3-98.8]). Furthermore, 9 of the 11 patients (82%) responding to PARP inhibition had a mPSMA H-Score above the median. The association between mPSMA expression and DDR aberrations was validated in an independent cohort with known DDR aberrations. Tumors with DDR aberrations had significantly higher mPSMA (ATM 212.5 [136.3-300] p = 0.005; BRCA2 300 [165-300] p = < 0.001) than unselected mCRPC biopsies (55.0 [2.75-117.5]). Finally, analyses of 122 mCRPC biopsy transcriptomes confirmed a negative correlation between PSMA and BRCA2 mRNA expression (p = 1.5x10-5). Conclusions: mPSMA expression in CSPC and mCRPC exhibits marked intra- and inter-patient heterogeneity, limiting the clinical utility of PSMA-targeted theranostics. We show for the first time that DDR gene aberrations associate with high mPSMA expression and may serve as predictive biomarkers for PSMA-targeted therapies.
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Affiliation(s)
- Alec Paschalis
- The Institute of Cancer Research, London, United Kingdom
| | | | - Ruth Riisnaes
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Bora Gurel
- The Institute of Cancer Research, London, United Kingdom
| | - Claudia Bertan
- The Institute of Cancer Research, London, United Kingdom
| | - Ana Ferreira
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Maryou B. Lambros
- The Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - George Seed
- The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | - David Dolling
- The Institute of Cancer Research, Belmont, Sutton, United Kingdom
| | - Jon Welti
- Institute of Cancer Research, London, United Kingdom
| | - Antje Neeb
- The Institute of Cancer Research, London, United Kingdom
| | - Semini Sumanasuriya
- Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, United Kingdom
| | | | | | - Nina Tunariu
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | - Adam Sharp
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Johann S. De Bono
- Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, United Kingdom
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23
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Sharp A, Coleman I, Welti J, Lambros MB, Yuan W, Nava Rodrigues D, Sprenger C, Dolling D, Russo J, Figueiredo I, Neeb A, Uo T, Morrissey C, Carreira S, Nelson PS, Balk SP, True LD, Luo J, Plymate SR, De Bono JS. Measurement science of the androgen receptor splice variant-7 protein in primary and castration-resistant prostate cancer tissue. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
151 Background: Liquid biopsies demonstrate the constitutively active androgen receptor splice variant-7 (AR-V7) associates with reduced benefit from endocrine therapies in castration resistant prostate cancer (CRPC). These studies provide little information pertaining to AR-V7 expression in PC tissue. Methods: AR-V7 protein expression was determined for 358 primary PC samples and 293 metastatic CRPC biopsies by immunohistochemistry. Associations with disease progression, full length AR (AR-FL) expression, response to therapy, gene expression, and circulating tumor cell (CTC) AR-V7 status were investigated. Results: AR-V7 protein is rarely expressed ( < 1% of 358 cases) in primary PC but is frequently detected (75% of 40 cases) following primary androgen deprivation therapy (ADT) alone (H-score 40; interquartile range 1.25-92.5), with a further significant (p = 0.020) increase following abiraterone or enzalutamide therapy (90; 20-150). In CRPC, AR-V7 expression is mainly nuclear (94% of 144 cases), correlates with AR-FL expression (p = < 0.001), and is homogeneous within single metastases (p = 0.997) but heterogeneous in different metastases from the same patient (p < 0.001). In addition, AR-V7 expression correlates with a 59-gene signature, including HOXB13, a co-regulator of AR-V7 function. Moreover, AR-V7 negative disease associates with better PSA response (p = 0.03) and overall survival (p = 0.02) from endocrine therapies. Finally, CTC+/AR-V7+ blood samples had significantly (p = 0.004) higher AR-V7 protein expression (100; 62.5-147.5) in paired tissue biopsy compared to CTC+/AR-V7- blood samples (15; 0.0-112.5), and AR-V7 protein expression is frequently detected (63% of 16 samples) in tissue of patients with CTC- blood samples. Conclusions: AR-V7 protein is not expressed until castration resistance and occurs after primary ADT alone. Levels of AR-V7 protein vary between metastases, and although AR-V7 associates with response to endocrine therapies, this suggests multiple resistance mechanisms exist in the same patient. If developed, agents targeting AR-V7 may be best explored earlier in the course of disease and in combination with other therapies.
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Affiliation(s)
- Adam Sharp
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Ilsa Coleman
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA., Seattle, WA
| | - Jon Welti
- Institute of Cancer Research, London, United Kingdom
| | - Maryou B. Lambros
- The Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | - David Dolling
- Drug Development Unit - The Institute of Cancer Research and The Royal Marsden Hospital, Sutton, United Kingdom
| | - Joshua Russo
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA, Boston, MA
| | - Ines Figueiredo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Antje Neeb
- The Institute of Cancer Research, London, UK, London, United Kingdom
| | - Takuma Uo
- University of Washington, Seattle, Washington, USA, Seattle, WA
| | | | | | | | | | | | - Jun Luo
- James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Johann S. De Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
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24
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Sundar R, Miranda S, Rodrigues DN, Chénard-Poirier M, Dolling D, Clarke M, Figueiredo I, Bertan C, Yuan W, Ferreira A, Chistova R, Boysen G, Perez DR, Tunariu N, Mateo J, Wotherspoon A, Chau I, Cunningham D, Valeri N, Carreira S, de Bono J. Ataxia Telangiectasia Mutated Protein Loss and Benefit From Oxaliplatin-based Chemotherapy in Colorectal Cancer. Clin Colorectal Cancer 2018; 17:280-284. [PMID: 30042009 DOI: 10.1016/j.clcc.2018.05.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/15/2018] [Accepted: 05/31/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Loss of ataxia telangiectasia mutated (ATM), a key protein regulating DNA repair signaling, has been suggested to increase sensitivity to DNA damaging agents. We conducted a study analyzing the loss of ATM protein expression in colorectal cancer and correlated this with clinical outcomes. MATERIALS AND METHODS The clinical outcomes data and tumor samples from metastatic colorectal cancer patients referred to the Royal Marsden Hospital Drug Development Unit (United Kingdom) from 2012 to 2016 and providing consent for a molecular characterization study were analyzed. Immunohistochemistry (IHC) slides were assessed by a pathologist for nuclear staining intensity of ATM and semiquantitatively scored. ATM loss was defined as a nuclear H-score of ≤ 10. RESULTS Of 223 colorectal cancer samples, ATM IHC loss was identified in 17 (8%). ATM loss was independent of the RAS and RAF mutational status. ATM loss was associated with superior overall survival after first-line oxaliplatin-based therapy (49 vs. 32 months; hazard ratio [HR], 2.52) but not with irinotecan-based therapy (24 vs. 33 months; HR, 0.72). ATM loss was not prognostic for survival from the diagnosis (50 vs. 44 months; HR, 1.43). CONCLUSION ATM could be considered a biomarker for the development of novel DNA repair targeting agents and treatment of colorectal cancer.
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Affiliation(s)
- Raghav Sundar
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Trust, London, UK; Department of Haematology-Oncology, National University Health System, Singapore
| | | | | | | | | | | | | | | | - Wei Yuan
- The Institute of Cancer Research, London, UK
| | | | | | | | | | - Nina Tunariu
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Trust, London, UK
| | | | | | - Ian Chau
- The Royal Marsden NHS Trust, London, UK
| | | | | | | | - Johann de Bono
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Trust, London, UK.
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25
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Sharp A, Coleman I, Yuan W, Sprenger C, Dolling D, Rodrigues DN, Russo JW, Figueiredo I, Bertan C, Seed G, Riisnaes R, Uo T, Neeb A, Welti J, Morrissey C, Carreira S, Luo J, Nelson PS, Balk SP, True LD, de Bono JS, Plymate SR. Androgen receptor splice variant-7 expression emerges with castration resistance in prostate cancer. J Clin Invest 2018; 129:192-208. [PMID: 30334814 PMCID: PMC6307949 DOI: 10.1172/jci122819] [Citation(s) in RCA: 242] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/09/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Liquid biopsies have demonstrated that the constitutively active androgen receptor splice variant-7 (AR-V7) associates with reduced response and overall survival from endocrine therapies in castration-resistant prostate cancer (CRPC). However, these studies provide little information pertaining to AR-V7 expression in prostate cancer (PC) tissue. METHODS Following generation and validation of a potentially novel AR-V7 antibody for IHC, AR-V7 protein expression was determined for 358 primary prostate samples and 293 metastatic biopsies. Associations with disease progression, full-length androgen receptor (AR-FL) expression, response to therapy, and gene expression were determined. RESULTS We demonstrated that AR-V7 protein is rarely expressed (<1%) in primary PC but is frequently detected (75% of cases) following androgen deprivation therapy, with further significant (P = 0.020) increase in expression following abiraterone acetate or enzalutamide therapy. In CRPC, AR-V7 expression is predominantly (94% of cases) nuclear and correlates with AR-FL expression (P ≤ 0.001) and AR copy number (P = 0.026). However, dissociation of expression was observed, suggesting that mRNA splicing remains crucial for AR-V7 generation. AR-V7 expression was heterogeneous between different metastases from a patient, although AR-V7 expression was similar within a metastasis. Moreover, AR-V7 expression correlated with a unique 59-gene signature in CRPC, including HOXB13, a critical coregulator of AR-V7 function. Finally, AR-V7-negative disease associated with better prostate-specific antigen (PSA) responses (100% vs. 54%, P = 0.03) and overall survival (74.3 vs. 25.2 months, hazard ratio 0.23 [0.07-0.79], P = 0.02) from endocrine therapies (pre-chemotherapy). CONCLUSION This study provides impetus to develop therapies that abrogate AR-V7 signaling to improve our understanding of AR-V7 biology and to confirm the clinical significance of AR-V7. FUNDING Work at the University of Washington and in the Plymate and Nelson laboratories is supported by the Department of Defense Prostate Cancer Research Program (W81XWH-14-2-0183, W81XWH-12-PCRP-TIA, W81XWH-15-1-0430, and W81XWH-13-2-0070), the Pacific Northwest Prostate Cancer SPORE (P50CA97186), the Institute for Prostate Cancer Research, the Veterans Affairs Research Program, the NIH/National Cancer Institute (P01CA163227), and the Prostate Cancer Foundation. Work in the de Bono laboratory was supported by funding from the Movember Foundation/Prostate Cancer UK (CEO13-2-002), the US Department of Defense (W81XWH-13-2-0093), the Prostate Cancer Foundation (20131017 and 20131017-1), Stand Up To Cancer (SU2C-AACR-DT0712), Cancer Research UK (CRM108X-A25144), and the UK Department of Health through an Experimental Cancer Medicine Centre grant (ECMC-CRM064X).
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Affiliation(s)
- Adam Sharp
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden, London, United Kingdom
| | - Ilsa Coleman
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | - Cynthia Sprenger
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - David Dolling
- The Institute of Cancer Research, London, United Kingdom
| | | | - Joshua W Russo
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | - Claudia Bertan
- The Institute of Cancer Research, London, United Kingdom
| | - George Seed
- The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | - Takuma Uo
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Antje Neeb
- The Institute of Cancer Research, London, United Kingdom
| | - Jonathan Welti
- The Institute of Cancer Research, London, United Kingdom
| | - Colm Morrissey
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Jun Luo
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peter S Nelson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Steven P Balk
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Lawrence D True
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Johann S de Bono
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden, London, United Kingdom
| | - Stephen R Plymate
- Department of Medicine, University of Washington, Seattle, Washington, USA.,Puget Sound VA Health Care System, Geriatric Research Education and Clinical Center (PSVAHCS-GRECC), Seattle, Washington, USA
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26
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Lambros MB, Seed G, Sumanasuriya S, Gil V, Crespo M, Fontes M, Chandler R, Mehra N, Fowler G, Ebbs B, Flohr P, Miranda S, Yuan W, Mackay A, Ferreira A, Pereira R, Bertan C, Figueiredo I, Riisnaes R, Rodrigues DN, Sharp A, Goodall J, Boysen G, Carreira S, Bianchini D, Rescigno P, Zafeiriou Z, Hunt J, Moloney D, Hamilton L, Neves RP, Swennenhuis J, Andree K, Stoecklein NH, Terstappen LWMM, de Bono JS. Single-Cell Analyses of Prostate Cancer Liquid Biopsies Acquired by Apheresis. Clin Cancer Res 2018; 24:5635-5644. [PMID: 30093450 DOI: 10.1158/1078-0432.ccr-18-0862] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/01/2018] [Accepted: 07/18/2018] [Indexed: 12/22/2022]
Abstract
Purpose: Circulating tumor cells (CTCs) have clinical relevance, but their study has been limited by their low frequency.Experimental Design: We evaluated liquid biopsies by apheresis to increase CTC yield from patients suffering from metastatic prostate cancer, allow precise gene copy-number calls, and study disease heterogeneity.Results: Apheresis was well tolerated and allowed the separation of large numbers of CTCs; the average CTC yield from 7.5 mL of peripheral blood was 167 CTCs, whereas the average CTC yield per apheresis (mean volume: 59.5 mL) was 12,546 CTCs. Purified single CTCs could be isolated from apheresis product by FACS sorting; copy-number aberration (CNA) profiles of 185 single CTCs from 14 patients revealed the genomic landscape of lethal prostate cancer and identified complex intrapatient, intercell, genomic heterogeneity missed on bulk biopsy analyses.Conclusions: Apheresis facilitated the capture of large numbers of CTCs noninvasively with minimal morbidity and allowed the deconvolution of intrapatient heterogeneity and clonal evolution. Clin Cancer Res; 24(22); 5635-44. ©2018 AACR.
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Affiliation(s)
- Maryou B Lambros
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - George Seed
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Semini Sumanasuriya
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Veronica Gil
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Mariane Fontes
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Rob Chandler
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Niven Mehra
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Gemma Fowler
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Berni Ebbs
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Penny Flohr
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Alan Mackay
- Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer, Research, London, United Kingdom
| | - Ana Ferreira
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Rita Pereira
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Claudia Bertan
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Ines Figueiredo
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Daniel Nava Rodrigues
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Adam Sharp
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Jane Goodall
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Gunther Boysen
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Suzanne Carreira
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Diletta Bianchini
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Pasquale Rescigno
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Zafeiris Zafeiriou
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Joanne Hunt
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Deirdre Moloney
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Lucy Hamilton
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Rui P Neves
- Department of General, Visceral and Pediatric Surgery, University Hospital of the, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Joost Swennenhuis
- Department of Medical Cell BioPhysics, University of Twente, Enschede, the Netherlands
| | - Kiki Andree
- Department of Medical Cell BioPhysics, University of Twente, Enschede, the Netherlands
| | - Nikolas H Stoecklein
- Department of General, Visceral and Pediatric Surgery, University Hospital of the, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Leon W M M Terstappen
- Department of Medical Cell BioPhysics, University of Twente, Enschede, the Netherlands
| | - Johann S de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom.
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
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27
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Rodrigues DN, Rescigno P, Liu D, Yuan W, Carreira S, Lambros MB, Seed G, Mateo J, Riisnaes R, Mullane S, Margolis C, Miao D, Miranda S, Dolling D, Clarke M, Bertan C, Crespo M, Boysen G, Ferreira A, Sharp A, Figueiredo I, Keliher D, Aldubayan S, Burke KP, Sumanasuriya S, Fontes MS, Bianchini D, Zafeiriou Z, Mendes LST, Mouw K, Schweizer MT, Pritchard CC, Salipante S, Taplin ME, Beltran H, Rubin MA, Cieslik M, Robinson D, Heath E, Schultz N, Armenia J, Abida W, Scher H, Lord C, D'Andrea A, Sawyers CL, Chinnaiyan AM, Alimonti A, Nelson PS, Drake CG, Van Allen EM, de Bono JS. Immunogenomic analyses associate immunological alterations with mismatch repair defects in prostate cancer. J Clin Invest 2018; 128:5185. [PMID: 30382943 DOI: 10.1172/jci125184] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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28
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Zafeiriou Z, Bianchini D, Chandler R, Rescigno P, Yuan W, Carreira S, Barrero M, Petremolo A, Miranda S, Riisnaes R, Rodrigues DN, Gurel B, Sumanasuriya S, Paschalis A, Sharp A, Mateo J, Tunariu N, Chinnaiyan AM, Pritchard CC, Kelly K, de Bono JS. Genomic Analysis of Three Metastatic Prostate Cancer Patients with Exceptional Responses to Carboplatin Indicating Different Types of DNA Repair Deficiency. Eur Urol 2018; 75:184-192. [PMID: 30340782 PMCID: PMC6291437 DOI: 10.1016/j.eururo.2018.09.048] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/27/2018] [Indexed: 11/17/2022]
Abstract
Platinum-based regimens have not been proved to increase survival from advanced prostate cancer (PCa). Incontrovertible evidence that a proportion of prostate cancers have homologous recombination DNA (HRD) repair defects, and that such genomic aberrations are synthetically lethal with both poly(ADP)-ribose polymerase inhibition and platinum, has increased interest in the utilisation of these drugs against a subset of these diseases. Here in we report three patients with advanced castration-resistant PCa with HRD defects having exceptional responses to carboplatin.
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Affiliation(s)
- Zafeiris Zafeiriou
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom; Theageneion Anticancer Hospital, Thessaloniki, Greece
| | - Diletta Bianchini
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | - Robert Chandler
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | - Pasquale Rescigno
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom; Department of Clinical Medicine and Surgery, Department of Translational Medical Sciences, AOU Federico II, Naples, Italy
| | - Wei Yuan
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | - Suzanne Carreira
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | - Maialen Barrero
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | | | - Susana Miranda
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | | | - Bora Gurel
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | | | - Alec Paschalis
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | - Adam Sharp
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | - Joaquin Mateo
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | - Nina Tunariu
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom
| | - Arul M Chinnaiyan
- Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Colin C Pritchard
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Kevin Kelly
- Sidney Kimmel School of Medicine at Thomas Jefferson University, Philadelphia, PA, USA
| | - Johann S de Bono
- The Institute of Cancer Research, The Royal Marsden, London, United Kingdom.
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29
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Nava Rodrigues D, Casiraghi N, Romanel A, Crespo M, Miranda S, Rescigno P, Figueiredo I, Riisnaes R, Carreira S, Sumanasuriya S, Gasperini P, Sharp A, Mateo J, Makay A, McNair C, Schiewer M, Knudsen K, Boysen G, Demichelis F, de Bono JS. RB1 Heterogeneity in Advanced Metastatic Castration-Resistant Prostate Cancer. Clin Cancer Res 2018; 25:687-697. [PMID: 30257982 DOI: 10.1158/1078-0432.ccr-18-2068] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/09/2018] [Accepted: 09/18/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE Metastatic castration-resistant prostate cancer (mCRPC) is a lethal but clinically heterogeneous disease, with patients having variable benefit from endocrine and cytotoxic treatments. Intrapatient genomic heterogeneity could be a contributing factor to this clinical heterogeneity. Here, we used whole-genome sequencing (WGS) to investigate genomic heterogeneity in 21 previously treated CRPC metastases from 10 patients to investigate intrapatient molecular heterogeneity (IPMH).Experimental Design: WGS was performed on topographically separate metastases from patients with advanced metastatic prostate cancer. IPMH of the RB1 gene was identified and further evaluated by FISH and IHC assays. RESULTS WGS identified limited IPMH for putative driver events. However, heterogeneous genomic aberrations of RB1 were detected. We confirmed the presence of these RB1 somatic copy-number aberrations, initially identified by WGS, with FISH, and identified novel structural variants involving RB1 in 6 samples from 3 of these 10 patients (30%; 3/10). WGS uncovered a novel deleterious RB1 structural lesion constituted of an intragenic tandem duplication involving multiple exons and associating with protein loss. Using RB1 IHC in a large series of mCRPC biopsies, we identified heterogeneous expression in approximately 28% of mCRPCs. CONCLUSIONS mCRPCs have a high prevalence of RB1 genomic aberrations, with structural variants, including rearrangements, being common. Intrapatient genomic and expression heterogeneity favors RB1 aberrations as late, subclonal events that increase in prevalence due to treatment-selective pressures.
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Affiliation(s)
- Daniel Nava Rodrigues
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Nicola Casiraghi
- Centre for Integrative Biology (CIBIO), University of Trento, Laboratory of Functional and Computational Oncology, Trento, Italy
| | - Alessandro Romanel
- Centre for Integrative Biology (CIBIO), University of Trento, Laboratory of Bioinformatics and Computational Genomics, Trento, Italy
| | - Mateus Crespo
- The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | - Pasquale Rescigno
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | | | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | | | - Semini Sumanasuriya
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Paola Gasperini
- Centre for Integrative Biology (CIBIO), University of Trento, Laboratory of Functional and Computational Oncology, Trento, Italy
| | - Adam Sharp
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research, London, United Kingdom
| | - Joaquin Mateo
- Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alan Makay
- The Institute of Cancer Research, London, United Kingdom
| | - Christopher McNair
- Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital-Weill Cornell Medicine, New York, New York
| | - Matthew Schiewer
- Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital-Weill Cornell Medicine, New York, New York
| | - Karen Knudsen
- Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital-Weill Cornell Medicine, New York, New York
| | - Gunther Boysen
- The Institute of Cancer Research, London, United Kingdom
| | - Francesca Demichelis
- Centre for Integrative Biology (CIBIO), University of Trento, Laboratory of Functional and Computational Oncology, Trento, Italy.
- Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital-Weill Cornell Medicine, New York, New York
| | - Johann S de Bono
- The Royal Marsden NHS Foundation Trust, London, United Kingdom.
- The Institute of Cancer Research, London, United Kingdom
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30
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Heindl A, Khan AM, Rodrigues DN, Eason K, Sadanandam A, Orbegoso C, Punta M, Sottoriva A, Lise S, Banerjee S, Yuan Y. Microenvironmental niche divergence shapes BRCA1-dysregulated ovarian cancer morphological plasticity. Nat Commun 2018. [PMID: 30254278 DOI: 10.1038/s41467-018-06130-3] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
How tumor microenvironmental forces shape plasticity of cancer cell morphology is poorly understood. Here, we conduct automated histology image and spatial statistical analyses in 514 high grade serous ovarian samples to define cancer morphological diversification within the spatial context of the microenvironment. Tumor spatial zones, where cancer cell nuclei diversify in shape, are mapped in each tumor. Integration of this spatially explicit analysis with omics and clinical data reveals a relationship between morphological diversification and the dysregulation of DNA repair, loss of nuclear integrity, and increased disease mortality. Within the Immunoreactive subtype, spatial analysis further reveals significantly lower lymphocytic infiltration within diversified zones compared with other tumor zones, suggesting that even immune-hot tumors contain cells capable of immune escape. Our findings support a model whereby a subpopulation of morphologically plastic cancer cells with dysregulated DNA repair promotes ovarian cancer progression through positive selection by immune evasion.
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Affiliation(s)
- Andreas Heindl
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK.,Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Adnan Mujahid Khan
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK.,Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Daniel Nava Rodrigues
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Katherine Eason
- Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Anguraj Sadanandam
- Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK.,Centre for Molecular Pathology, Royal Marsden Hospital, London, SM2 5NG, UK
| | - Cecilia Orbegoso
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, SW3 6JJ, UK
| | - Marco Punta
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Andrea Sottoriva
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Stefano Lise
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Susana Banerjee
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, SW3 6JJ, UK.,Division of Clinical Studies, the Institute of Cancer Research, London, UK, SM2 5NG
| | - Yinyin Yuan
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK. .,Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK.
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31
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Heindl A, Khan AM, Rodrigues DN, Eason K, Sadanandam A, Orbegoso C, Punta M, Sottoriva A, Lise S, Banerjee S, Yuan Y. Microenvironmental niche divergence shapes BRCA1-dysregulated ovarian cancer morphological plasticity. Nat Commun 2018; 9:3917. [PMID: 30254278 PMCID: PMC6156340 DOI: 10.1038/s41467-018-06130-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 08/15/2018] [Indexed: 12/22/2022] Open
Abstract
How tumor microenvironmental forces shape plasticity of cancer cell morphology is poorly understood. Here, we conduct automated histology image and spatial statistical analyses in 514 high grade serous ovarian samples to define cancer morphological diversification within the spatial context of the microenvironment. Tumor spatial zones, where cancer cell nuclei diversify in shape, are mapped in each tumor. Integration of this spatially explicit analysis with omics and clinical data reveals a relationship between morphological diversification and the dysregulation of DNA repair, loss of nuclear integrity, and increased disease mortality. Within the Immunoreactive subtype, spatial analysis further reveals significantly lower lymphocytic infiltration within diversified zones compared with other tumor zones, suggesting that even immune-hot tumors contain cells capable of immune escape. Our findings support a model whereby a subpopulation of morphologically plastic cancer cells with dysregulated DNA repair promotes ovarian cancer progression through positive selection by immune evasion.
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Affiliation(s)
- Andreas Heindl
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Adnan Mujahid Khan
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Daniel Nava Rodrigues
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Katherine Eason
- Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Anguraj Sadanandam
- Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK
- Centre for Molecular Pathology, Royal Marsden Hospital, London, SM2 5NG, UK
| | - Cecilia Orbegoso
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, SW3 6JJ, UK
| | - Marco Punta
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Andrea Sottoriva
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Stefano Lise
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK
| | - Susana Banerjee
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, SW3 6JJ, UK
- Division of Clinical Studies, the Institute of Cancer Research, London, UK, SM2 5NG
| | - Yinyin Yuan
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, SM2 5NG, UK.
- Division of Molecular Pathology, The Institute of Cancer Research, London, SM2 5NG, UK.
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32
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Nava Rodrigues D, Rescigno P, Liu D, Yuan W, Carreira S, Lambros MB, Seed G, Mateo J, Riisnaes R, Mullane S, Margolis C, Miao D, Miranda S, Dolling D, Clarke M, Bertan C, Crespo M, Boysen G, Ferreira A, Sharp A, Figueiredo I, Keliher D, Aldubayan S, Burke KP, Sumanasuriya S, Fontes MS, Bianchini D, Zafeiriou Z, Teixeira Mendes LS, Mouw K, Schweizer MT, Pritchard CC, Salipante S, Taplin ME, Beltran H, Rubin MA, Cieslik M, Robinson D, Heath E, Schultz N, Armenia J, Abida W, Scher H, Lord C, D'Andrea A, Sawyers CL, Chinnaiyan AM, Alimonti A, Nelson PS, Drake CG, Van Allen EM, de Bono JS. Immunogenomic analyses associate immunological alterations with mismatch repair defects in prostate cancer. J Clin Invest 2018; 128:4441-4453. [PMID: 30179225 PMCID: PMC6159966 DOI: 10.1172/jci121924] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND. Understanding the integrated immunogenomic landscape of advanced prostate cancer (APC) could impact stratified treatment selection. METHODS. Defective mismatch repair (dMMR) status was determined by either loss of mismatch repair protein expression on IHC or microsatellite instability (MSI) by PCR in 127 APC biopsies from 124 patients (Royal Marsden [RMH] cohort); MSI by targeted panel next-generation sequencing (MSINGS) was then evaluated in the same cohort and in 254 APC samples from the Stand Up To Cancer/Prostate Cancer Foundation (SU2C/PCF). Whole exome sequencing (WES) data from this latter cohort were analyzed for pathogenic MMR gene variants, mutational load, and mutational signatures. Transcriptomic data, available for 168 samples, was also performed. RESULTS. Overall, 8.1% of patients in the RMH cohort had some evidence of dMMR, which associated with decreased overall survival. Higher MSINGS scores associated with dMMR, and these APCs were enriched for higher T cell infiltration and PD-L1 protein expression. Exome MSINGS scores strongly correlated with targeted panel MSINGS scores (r = 0.73, P < 0.0001), and higher MSINGS scores associated with dMMR mutational signatures in APC exomes. dMMR mutational signatures also associated with MMR gene mutations and increased immune cell, immune checkpoint, and T cell–associated transcripts. APC with dMMR mutational signatures overexpressed a variety of immune transcripts, including CD200R1, BTLA, PD-L1, PD-L2, ADORA2A, PIK3CG, and TIGIT. CONCLUSION. These data could impact immune target selection, combination therapeutic strategy selection, and selection of predictive biomarkers for immunotherapy in APC. FUNDING. We acknowledge funding support from Movember, Prostate Cancer UK, The Prostate Cancer Foundation, SU2C, and Cancer Research UK.
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Affiliation(s)
- Daniel Nava Rodrigues
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden, London, United Kingdom
| | - Pasquale Rescigno
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden, London, United Kingdom.,Department of Clinical Medicine and Surgery, Department of Translational Medical Sciences, Azienda Ospedaliera Universitaria (AOU) Federico II, Naples, Italy
| | - David Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,The Broad Institute, Cambridge, Massachusetts, USA
| | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - George Seed
- The Institute of Cancer Research, London, United Kingdom
| | - Joaquin Mateo
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | - Stephanie Mullane
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,The Broad Institute, Cambridge, Massachusetts, USA
| | - Claire Margolis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,The Broad Institute, Cambridge, Massachusetts, USA
| | - Diana Miao
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,The Broad Institute, Cambridge, Massachusetts, USA
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | - David Dolling
- The Institute of Cancer Research, London, United Kingdom
| | - Matthew Clarke
- The Institute of Cancer Research, London, United Kingdom
| | - Claudia Bertan
- The Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- The Institute of Cancer Research, London, United Kingdom
| | - Gunther Boysen
- The Institute of Cancer Research, London, United Kingdom
| | - Ana Ferreira
- The Institute of Cancer Research, London, United Kingdom
| | - Adam Sharp
- The Institute of Cancer Research, London, United Kingdom
| | | | - Daniel Keliher
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,The Broad Institute, Cambridge, Massachusetts, USA
| | - Saud Aldubayan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,The Broad Institute, Cambridge, Massachusetts, USA
| | - Kelly P Burke
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Mariane Sousa Fontes
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden, London, United Kingdom
| | - Diletta Bianchini
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden, London, United Kingdom
| | - Zafeiris Zafeiriou
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden, London, United Kingdom
| | | | - Kent Mouw
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Michael T Schweizer
- University of Washington, Seattle, Washington, USA.,Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | | | - Mary-Ellen Taplin
- Department of Clinical Medicine and Surgery, Department of Translational Medical Sciences, Azienda Ospedaliera Universitaria (AOU) Federico II, Naples, Italy
| | - Himisha Beltran
- Weill Medical College of Cornell University, New York, New York, USA
| | - Mark A Rubin
- Weill Medical College of Cornell University, New York, New York, USA
| | - Marcin Cieslik
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Dan Robinson
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | | | - Joshua Armenia
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Wassim Abida
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Howard Scher
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Alan D'Andrea
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | | | - Andrea Alimonti
- Institute of Oncology Research (IOR), Bellinzona and Faculty of Biomedical Sciences, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Peter S Nelson
- University of Washington, Seattle, Washington, USA.,Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Eliezer M Van Allen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,The Broad Institute, Cambridge, Massachusetts, USA
| | - Johann S de Bono
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden, London, United Kingdom
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Sharp A, Welti J, Yuan W, Figueiredo I, Gil V, Rodrigues DN, Lambros M, Knight E, Ning J, Francis J, Dolling D, Pope L, Neeb A, Boysen G, Zhu Y, Crespo M, Paschalis A, Luo J, Plymate S, Al-Lazikani B, Swain A, Bono JD. Abstract A067: Targeting the bromodomain and extra-terminal (BET) family proteins and beyond in metastatic castration-resistant prostate cancer (mCRPC): Overcoming aberrant androgen receptor (AR) signaling. Cancer Res 2018. [DOI: 10.1158/1538-7445.prca2017-a067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Despite robust responses to androgen deprivation therapy and AR targeting therapies (including abiraterone and enzalutamide), nearly all cases of advanced prostate cancer progress to lethal mCRPC and develop therapeutic resistance. This progression is associated with persistent AR signaling, in part due to expression of constitutively active AR splice variants that include AR variant 7 (AR-V7). We show that AR-V7 expression in patient biopsies (protein) and circulating tumor cells (RNA) associates with poor outcome from mCRPC. Therapies that regulate AR-V7 and induce robust anticancer responses are required to confirm the clinical importance of AR-V7 in mCRPC. One such promising approach, currently in clinical trials, is inhibitors of BET family proteins, which include BRD2, BRD3, and BRD4. Preclinical studies have shown that BRD4 binds to AR at the androgen response element and facilitates the recruitment of the transcriptional machinery. We show that BRD4 protein expression increases as patients develop mCRPC and at diagnosis associates with patient outcome and more advanced disease. In addition, through RNAseq analysis we show that expression levels of BRD2, 3, and 4 in mCRPC associated with degree of AR activity. We, and others, have shown that the use of BET inhibitors (BETi) in vitro on AR/AR-V7 expressing cell lines not only decreased AR activity but also preferentially decreased the production on AR-V7 mRNA. In light of BETi having efficacy against BRD2, 3, and 4, and all isoforms being expressed in mCRPC, we explored the effect of genetic knockdown of each isoform. We show that BETi treatment is sufficient to decrease AR-V7 mRNA and protein in CRPC cell lines. Moreover, we demonstrate that BRD4 knockdown, and to a greater extent, the combination of BRD2, 3, and 4 knockdown blocked AR and AR-V7 signaling. Furthermore, C-MYC knockdown did not recapitulate the effect of BETi and led to an increase in AR signaling. Consistent with these findings, BETi and the combination of BRD2, 3, and 4 knockdown reduced the growth of CRPC cell lines. To further investigate whether BETi is sufficient to inhibit AR-V7 production in patients with mCRPC, we treated patient-derived organoids (PDOs) and a mouse xenograft (PDX) grown from patient metastatic biopsies who had progressed on enzalutamide and/or abiraterone. In this study 4 out of 9 PDOs were sensitive to BETi. Consistent with cell culture experiments, BETi treatment of PDO and PDX led to downregulation of both AR-V7 mRNA and protein expression, and growth inhibition. In light of the pleotropic effects of BETi on cancer cell biology and potential for treatment-related toxicities, we explored whether we could identify critical factors for BETi mediated AR-V7 regulation in CRPC. The ability of BETi to regulate AR-V7 may suggest an effect of BETi on pre-mRNA splicing of AR resulting in the observed decrease of AR-V7 expression. RNAseq analysis of the AR-V7 expressing CRPC cell line LNCaP95 treated with BETi demonstrated an increase in total splicing. Despite this, focused analysis of splicing factors and spliceosome components identified a subset of eight splicing factors being downregulated by BETi treatment, including one yet-uncharacterized factor (splicing factor B; Sf-B) that is crucial for AR-V7 expression and LNCaP95 cell growth. In addition, mCRPC patients who express high levels of Sf-B had a significantly poorer outcome and the protein structure of Sf-B is druggable using the drug discovery knowledgebase canSAR. Based on our results, we propose that inhibition of Sf-B may lead to decreased splicing and expression of AR-V7; providing a novel approach to target AR-V7 in mCRPC.
Citation Format: Adam Sharp, Jon Welti, Wei Yuan, Ines Figueiredo, Veronica Gil, Daniel Nava Rodrigues, Maryou Lambros, Eleanor Knight, Jian Ning, Jeff Francis, David Dolling, Lorna Pope, Antje Neeb, Gunther Boysen, Yezi Zhu, Mateus Crespo, Alec Paschalis, Jun Luo, Stephen Plymate, Bissan Al-Lazikani, Amanda Swain, Johann de Bono. Targeting the bromodomain and extra-terminal (BET) family proteins and beyond in metastatic castration-resistant prostate cancer (mCRPC): Overcoming aberrant androgen receptor (AR) signaling [abstract]. In: Proceedings of the AACR Special Conference: Prostate Cancer: Advances in Basic, Translational, and Clinical Research; 2017 Dec 2-5; Orlando, Florida. Philadelphia (PA): AACR; Cancer Res 2018;78(16 Suppl):Abstract nr A067.
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Affiliation(s)
- Adam Sharp
- 1Institute of Cancer Research, London, United Kingdom,
| | - Jon Welti
- 1Institute of Cancer Research, London, United Kingdom,
| | - Wei Yuan
- 1Institute of Cancer Research, London, United Kingdom,
| | | | - Veronica Gil
- 1Institute of Cancer Research, London, United Kingdom,
| | | | | | | | - Jian Ning
- 1Institute of Cancer Research, London, United Kingdom,
| | - Jeff Francis
- 1Institute of Cancer Research, London, United Kingdom,
| | - David Dolling
- 1Institute of Cancer Research, London, United Kingdom,
| | - Lorna Pope
- 1Institute of Cancer Research, London, United Kingdom,
| | - Antje Neeb
- 1Institute of Cancer Research, London, United Kingdom,
| | | | - Yezi Zhu
- 2Johns Hopkins University, Baltimore, MD,
| | - Mateus Crespo
- 1Institute of Cancer Research, London, United Kingdom,
| | | | - Jun Luo
- 2Johns Hopkins University, Baltimore, MD,
| | | | | | - Amanda Swain
- 1Institute of Cancer Research, London, United Kingdom,
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de Bono JS, De Giorgi U, Rodrigues DN, Massard C, Bracarda S, Font A, Arranz Arija JA, Shih KC, Radavoi GD, Xu N, Chan WY, Ma H, Gendreau S, Riisnaes R, Patel PH, Maslyar DJ, Jinga V. Randomized Phase II Study Evaluating Akt Blockade with Ipatasertib, in Combination with Abiraterone, in Patients with Metastatic Prostate Cancer with and without PTEN Loss. Clin Cancer Res 2018; 25:928-936. [DOI: 10.1158/1078-0432.ccr-18-0981] [Citation(s) in RCA: 181] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/15/2018] [Accepted: 07/13/2018] [Indexed: 11/16/2022]
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35
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Sharp A, Welti J, Lambros MB, Dolling D, Aversa C, Pope L, Nava Rodrigues D, Figueiredo I, Rescigno P, Kolinsky MP, Riisnaes R, Flohr P, Bianchini D, Chandler R, Mateo J, Tunariu N, Plymate SR, Luo J, De Bono JS. The prognostic and predictive value of AR-V7 quantification in mCRPC. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.12026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Adam Sharp
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Jon Welti
- Institute of Cancer Research, London, United Kingdom
| | - Maryou B. Lambros
- The Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - David Dolling
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Caterina Aversa
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Lorna Pope
- Institute of Cancer Research, Sutton, United Kingdom
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Ines Figueiredo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Pasquale Rescigno
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Michael Paul Kolinsky
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Penelope Flohr
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, United Kingdom
| | - Diletta Bianchini
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Robert Chandler
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Joaquin Mateo
- The Institute of Cancer Research & The Royal Marsden, London, Spain
| | - Nina Tunariu
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | - Jun Luo
- James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Johann S. De Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
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36
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Rescigno P, Boysen G, Nava Rodrigues D, Seed G, Dolling D, Riisnaes R, Crespo M, Bianchini D, Sumanasuriya S, Figueiredo I, Christova R, Gil V, Goodall J, Sharp A, Rubin MA, Yuan W, Barbieri C, Mateo J, Carreira S, De Bono JS. Molecular and clinical implications of CHD1 loss and SPOP mutations in advanced prostate cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Pasquale Rescigno
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Gunther Boysen
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - George Seed
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - David Dolling
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Mateus Crespo
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Diletta Bianchini
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | - Ines Figueiredo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | - Veronica Gil
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Jane Goodall
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Adam Sharp
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | - Wei Yuan
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | - Joaquin Mateo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | - Johann S. De Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
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37
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Barrero M, Rediti M, Crespo M, Dolling D, Rescigno P, Messina C, Chandler R, Bianchini D, Petremolo A, Riisnaes R, Ferreira A, Nava Rodrigues D, Bertan C, Sharp A, Sumanasuriya S, Paschalis A, Tunariu N, Mateo J, Carreira S, De Bono JS. Tumor-infiltrating lymphocytes in biallelic-CDK12 mutated prostate cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Maialen Barrero
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Mattia Rediti
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Mateus Crespo
- The Institute of Cancer Research, Sutton, United Kingdom
| | - David Dolling
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Pasquale Rescigno
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Carlo Messina
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Robert Chandler
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Diletta Bianchini
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Antonella Petremolo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Ana Ferreira
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Claudia Bertan
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Adam Sharp
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | - Alec Paschalis
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Nina Tunariu
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Joaquin Mateo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | - Johann S. De Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
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Mateo J, Carreira S, Seed G, Chandler R, Dolling D, Figueiredo I, Miranda S, Nava Rodrigues D, Bertan C, Bianchini D, Ralph C, Jones RJ, McGovern UB, Varughese MA, Parikh O, Jain S, Elliott T, Porta N, Hall E, De Bono JS. Genomic profiling of primary prostate tumors from patients who develop metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Joaquin Mateo
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - George Seed
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Robert Chandler
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - David Dolling
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Ines Figueiredo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Claudia Bertan
- The Institute of Cancer Research, Sutton, United Kingdom
| | - Diletta Bianchini
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Christy Ralph
- St. James's Institute of Oncology, St. James's University Hospital, Leeds, United Kingdom
| | - Robert J Jones
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | | | - Omni Parikh
- Royal Blackburn Hospital, Blackburn, United Kingdom
| | - Suneil Jain
- Queen's University Belfast, Belfast, United Kingdom
| | - Tony Elliott
- Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Nuria Porta
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, Sutton, United Kingdom
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Johann S. De Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
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Rescigno P, Lorente D, Dolling D, Ferraldeschi R, Rodrigues DN, Riisnaes R, Miranda S, Bianchini D, Zafeiriou Z, Sideris S, Ferreira A, Figueiredo I, Sumanasuriya S, Mateo J, Perez-Lopez R, Sharp A, Tunariu N, de Bono JS. Docetaxel Treatment in PTEN- and ERG-aberrant Metastatic Prostate Cancers. Eur Urol Oncol 2018; 1:71-77. [PMID: 29911685 PMCID: PMC5995869 DOI: 10.1016/j.euo.2018.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Loss of PTEN is a common genomic aberration in castration-resistant prostate cancer (CRPC) and is frequently concurrent with ERG rearrangements, causing resistance to next-generation hormonal treatment (NGHT) including abiraterone. The relationship between PTEN loss and docetaxel sensitivity remains uncertain. OBJECTIVE To study the antitumor activity of docetaxel in metastatic CRPC in relation to PTEN and ERG aberrations. DESIGN SETTING AND PARTICIPANTS Single-centre, retrospective analysis of PTEN loss and ERG expression using a previously described immunohistochemistry (IHC) binary classification system. Patients received docetaxel between January 1, 2006 and July 31, 2016. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Response correlations were analyzed using Pearson's χ2 tests and independent-sample t tests. Overall (OS) and progression-free survival (PFS) were analyzed using univariate and multivariate (MVA) Cox regression and Kaplan-Meier methods. RESULTS AND LIMITATIONS Overall, 215 patients were eligible. Established metastatic CRPC prognostic factors were well balanced between PTEN loss (39%) and normal patients (61%). PTEN loss was associated with shorter median OS (25.4 vs 34.7 mo; hazard ratio [HR] 1.66, 95% confidence interval [CI] 1.18-2.13; p = 0.001). There were no differences in median PFS (8.0 vs 9.1 mo; univariate HR 1.20, 95% CI 0.86-1.68; p = 0.28) and PSA response (53.4% vs 50.6%; p = 0.74). PTEN loss was an independent prognostics factor in MVA. ERG status was available for 100 patients. ERG positivity was not associated with OS or PFS. Limitations include the retrospective nature and the single-centre analysis. CONCLUSIONS Our findings suggest that metastatic CRPC with PTEN loss might benefit more from docetaxel than from NGHT. PATIENT SUMMARY In this study we found that metastatic prostate cancer with loss of the PTEN switch may benefit more from docetaxel than from abiraterone.
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Affiliation(s)
- Pasquale Rescigno
- The Institute of Cancer Research, Sutton, UK; Department of Clinical Medicine and Surgery, Department of Translational Medical Sciences, AOU Federico II, Naples, Italy
| | - David Lorente
- Medical Oncology Service, Hospital Universitario La Fe, Valencia, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Adam Sharp
- The Institute of Cancer Research, Sutton, UK
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Zhu Y, Sharp A, Anderson CM, Silberstein JL, Taylor M, Lu C, Zhao P, De Marzo AM, Antonarakis ES, Wang M, Wu X, Luo Y, Su N, Nava Rodrigues D, Figueiredo I, Welti J, Park E, Ma XJ, Coleman I, Morrissey C, Plymate SR, Nelson PS, de Bono JS, Luo J. Novel Junction-specific and Quantifiable In Situ Detection of AR-V7 and its Clinical Correlates in Metastatic Castration-resistant Prostate Cancer. Eur Urol 2018; 73:727-735. [PMID: 28866255 PMCID: PMC6538073 DOI: 10.1016/j.eururo.2017.08.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/09/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Androgen receptor splice variant 7 (AR-V7) has been implicated in resistance to abiraterone and enzalutamide treatment in men with metastatic castration-resistant prostate cancer (mCRPC). Tissue- or cell-based in situ detection of AR-V7, however, has been limited by lack of specificity. OBJECTIVE To address current limitations in precision measurement of AR-V7 by developing a novel junction-specific AR-V7 RNA in situ hybridization (RISH) assay compatible with automated quantification. DESIGN, SETTING, AND PARTICIPANTS We designed a RISH method to visualize single splice junctions in cells and tissue. Using the validated assay for junction-specific detection of the full-length AR (AR-FL) and AR-V7, we generated quantitative data, blinded to clinical data, for 63 prostate tumor biopsies. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We evaluated clinical correlates of AR-FL/AR-V7 measurements, including association with prostate-specific antigen progression-free survival (PSA-PFS) and clinical and radiographic progression-free survival (PFS), in a subset of patients starting treatment with abiraterone or enzalutamide following biopsy. RESULTS AND LIMITATIONS Quantitative AR-FL/AR-V7 data were generated from 56 of the 63 (88.9%) biopsy specimens examined, of which 44 were mCRPC biopsies. Positive AR-V7 signals were detected in 34.1% (15/44) mCRPC specimens, all of which also co-expressed AR-FL. The median AR-V7/AR-FL ratio was 11.9% (range 2.7-30.3%). Positive detection of AR-V7 was correlated with indicators of high disease burden at baseline. Among the 25 CRPC biopsies collected before treatment with abiraterone or enzalutamide, positive AR-V7 detection, but not higher AR-FL, was significantly associated with shorter PSA-PFS (hazard ratio 2.789, 95% confidence interval 1.12-6.95; p=0.0081). CONCLUSIONS We report for the first time a RISH method for highly specific and quantifiable detection of splice junctions, allowing further characterization of AR-V7 and its clinical significance. PATIENT SUMMARY Higher AR-V7 levels detected and quantified using a novel method were associated with poorer response to abiraterone or enzalutamide in prostate cancer.
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Affiliation(s)
- Yezi Zhu
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Adam Sharp
- The Institute for Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | | | - John L Silberstein
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Maritza Taylor
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Changxue Lu
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pei Zhao
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Angelo M De Marzo
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Mindy Wang
- Advanced Cell Diagnostics, Newark, CA, USA
| | | | - Yuling Luo
- Advanced Cell Diagnostics, Newark, CA, USA
| | - Nan Su
- Advanced Cell Diagnostics, Newark, CA, USA
| | | | | | | | - Emily Park
- Advanced Cell Diagnostics, Newark, CA, USA
| | | | - Ilsa Coleman
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Peter S Nelson
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA; University of Washington, Seattle, WA, USA
| | - Johann S de Bono
- The Institute for Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK.
| | - Jun Luo
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Welti J, Sharp A, Yuan W, Dolling D, Nava Rodrigues D, Figueiredo I, Gil V, Neeb A, Clarke M, Seed G, Crespo M, Sumanasuriya S, Ning J, Knight E, Francis JC, Hughes A, Halsey WS, Paschalis A, Mani RS, Raj GV, Plymate SR, Carreira S, Boysen G, Chinnaiyan AM, Swain A, de Bono JS. Targeting Bromodomain and Extra-Terminal (BET) Family Proteins in Castration-Resistant Prostate Cancer (CRPC). Clin Cancer Res 2018; 24:3149-3162. [PMID: 29555663 DOI: 10.1158/1078-0432.ccr-17-3571] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/23/2018] [Accepted: 03/14/2018] [Indexed: 11/16/2022]
Abstract
Purpose: Persistent androgen receptor (AR) signaling drives castration-resistant prostate cancer (CRPC) and confers resistance to AR-targeting therapies. Novel therapeutic strategies to overcome this are urgently required. We evaluated how bromodomain and extra-terminal (BET) protein inhibitors (BETi) abrogate aberrant AR signaling in CRPC.Experimental Design: We determined associations between BET expression, AR-driven transcription, and patient outcome; and the effect and mechanism by which chemical BETi (JQ1 and GSK1210151A; I-BET151) and BET family protein knockdown regulates AR-V7 expression and AR signaling in prostate cancer models.Results: Nuclear BRD4 protein expression increases significantly (P ≤ 0.01) with castration resistance in same patient treatment-naïve (median H-score; interquartile range: 100; 100-170) and CRPC (150; 110-200) biopsies, with higher expression at diagnosis associating with worse outcome (HR, 3.25; 95% CI, 1.50-7.01; P ≤ 0.001). BRD2, BRD3, and BRD4 RNA expression in CRPC biopsies correlates with AR-driven transcription (all P ≤ 0.001). Chemical BETi, and combined BET family protein knockdown, reduce AR-V7 expression and AR signaling. This was not recapitulated by C-MYC knockdown. In addition, we show that BETi regulates RNA processing thereby reducing alternative splicing and AR-V7 expression. Furthermore, BETi reduce growth of prostate cancer cells and patient-derived organoids with known AR mutations, AR amplification and AR-V7 expression. Finally, BETi, unlike enzalutamide, decreases persistent AR signaling and growth (P ≤ 0.001) of a patient-derived xenograft model of CRPC with AR amplification and AR-V7 expression.Conclusions: BETi merit clinical evaluation as inhibitors of AR splicing and function, with trials demonstrating their blockade in proof-of-mechanism pharmacodynamic studies. Clin Cancer Res; 24(13); 3149-62. ©2018 AACR.
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Affiliation(s)
- Jonathan Welti
- The Institute for Cancer Research, London, United Kingdom
| | - Adam Sharp
- The Institute for Cancer Research, London, United Kingdom.,The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Wei Yuan
- The Institute for Cancer Research, London, United Kingdom
| | - David Dolling
- The Institute for Cancer Research, London, United Kingdom
| | | | | | - Veronica Gil
- The Institute for Cancer Research, London, United Kingdom
| | - Antje Neeb
- The Institute for Cancer Research, London, United Kingdom
| | - Matthew Clarke
- The Institute for Cancer Research, London, United Kingdom
| | - George Seed
- The Institute for Cancer Research, London, United Kingdom
| | - Mateus Crespo
- The Institute for Cancer Research, London, United Kingdom
| | - Semini Sumanasuriya
- The Institute for Cancer Research, London, United Kingdom.,The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Jian Ning
- The Institute for Cancer Research, London, United Kingdom
| | - Eleanor Knight
- The Institute for Cancer Research, London, United Kingdom
| | | | | | | | - Alec Paschalis
- The Institute for Cancer Research, London, United Kingdom.,The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ram S Mani
- The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ganesh V Raj
- The University of Texas Southwestern Medical Center, Dallas, Texas
| | | | | | | | | | - Amanda Swain
- The Institute for Cancer Research, London, United Kingdom
| | - Johann S de Bono
- The Institute for Cancer Research, London, United Kingdom. .,The Royal Marsden NHS Foundation Trust, London, United Kingdom
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42
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Zhang L, Koeppen H, Maslyar DJ, Fillos D, Xu N, Chan WY, Font Pous A, Jinga V, Massard C, Bracarda S, Radavoi GD, De Giorgi U, Arranz Arija JA, Riisnaes R, Nava Rodrigues D, De Bono JS, Gendreau S. NGS, RNA-Seq, TIL, and PTEN analyses in prostate cancer specimens from patients enrolled in the study of the Akt inhibitor ipatasertib (Ipat) combined with abiraterone acetate (AA). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
310 Background: In Phase III studies, ipilimumab did not extend OS in unselected populations with metastatic castration-resistant prostate cancer (mCRPC) (Kwon, 2014; Beer, 2014), suggesting that successful cancer immunotherapy development strategies require the evaluation of treatment effects in biomarker-driven segments. In addition, PTEN loss has been identified as a potential mechanism of resistance to immunotherapy (Peng, 2016). Therefore, we explored possible associations between cancer immunity (CI)-related biomarkers and PTEN loss in mCRPC samples. Methods: Tumor samples obtained in the Phase II study of AA ± Ipat in patients with mCRPC (de Bono, ESMO 2016) were retrospectively profiled. DNA alterations and tumor mutational burden (TMB) were assessed by FoundationOne. RNA-seq analysis of multiple CI-related expression signatures was performed. Tumor-immune lymphocyte (TIL) scores were analyzed in 3 compartments (stromal, sTIL; intratumoral, iTIL; peritumoral, pTIL) based on H&E stained specimens. Up to 10 evenly distributed fields were examined; the average of these fields was used to estimate the %TILs for each compartment. Results: Strong associations were observed between multiple CI-related signatures (e.g., INFγ-induced, immune checkpoints, Treg, checkpoint inhibitors). Fewer than 10% of the samples had a high level (≥ 10% of the tumor area) of TIL infiltration in any compartment (Table). TIL scores, TMB values, PTEN status and Gleason score all appeared to be independently associated, and none were associated with CI-related gene signatures, except for a possible association between pTILs and the B-cell signature (ρ = 0.49, P < 0.0001). Conclusions: Comprehensive high-content profiling of prostate cancer samples suggests that PTEN status and CI-related biomarkers were independently associated, while TMB and TIL values were generally not associated with CI-related signatures. Clinical trial information: NCT01485861. [Table: see text]
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Affiliation(s)
| | | | | | | | - Na Xu
- Genentech, Inc., South San Francisco, CA
| | | | - Albert Font Pous
- Institut Català d’Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Viorel Jinga
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | | | | | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | | | - Ruth Riisnaes
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Daniel Nava Rodrigues
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Johann S. De Bono
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
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43
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Heindl A, Lan C, Rodrigues DN, Koelble K, Yuan Y. Similarity and diversity of the tumor microenvironment in multiple metastases: critical implications for overall and progression-free survival of high-grade serous ovarian cancer. Oncotarget 2018; 7:71123-71135. [PMID: 27661102 PMCID: PMC5342067 DOI: 10.18632/oncotarget.12106] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/24/2016] [Indexed: 12/29/2022] Open
Abstract
The tumor microenvironment is pivotal in influencing cancer progression and metastasis. Different cells co-exist with high spatial diversity within a patient, yet their combinatorial effects are poorly understood. We investigate the similarity of the tumor microenvironment of 192 local metastatic lesions in 61 ovarian cancer patients. An ecologically inspired measure of microenvironmental diversity derived from multiple metastasis sites is correlated with clinicopathological characteristics and prognostic outcome. We demonstrate a high accuracy of our automated analysis across multiple sites. A low level of similarity in microenvironmental composition is observed between ovary tumor and corresponding local metastases (stromal ratio r = 0.30, lymphocyte ratio r = 0.37). We identify a new measure of microenvironmental diversity derived from Shannon entropy that is highly predictive of poor overall (p = 0.002, HR = 3.18, 95% CI = 1.51-6.68) and progression-free survival (p = 0.0036, HR = 2.83, 95% CI = 1.41-5.7), independent of and stronger than clinical variables, subtype stratifications based on single cell types alone and number of sites. Although stromal influence in ovary tumors is known to have significant clinical implications, our findings reveal an even stronger impact orchestrated by diverse cell types. Quantitative histology-based measures can further enable objective selection of patients who are in urgent need of new therapeutic strategies such as combinatorial treatments targeting heterogeneous tumor microenvironment.
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Affiliation(s)
- Andreas Heindl
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK.,Centre for Molecular Pathology, Royal Marsden Hospital, London, UK.,Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Chunyan Lan
- Department of Gynecologic Oncology, Sun Yat-sen University Cancer Centre, Guangzhou, China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, China
| | | | - Konrad Koelble
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK.,Department of Histopathology, Royal Marsden Hospital, London, UK
| | - Yinyin Yuan
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK.,Centre for Molecular Pathology, Royal Marsden Hospital, London, UK.,Division of Molecular Pathology, The Institute of Cancer Research, London, UK
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44
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Perez-Lopez R, Nava Rodrigues D, Figueiredo I, Mateo J, Collins DJ, Koh DM, de Bono JS, Tunariu N. Multiparametric Magnetic Resonance Imaging of Prostate Cancer Bone Disease: Correlation With Bone Biopsy Histological and Molecular Features. Invest Radiol 2018; 53:96-102. [PMID: 28906339 PMCID: PMC5768227 DOI: 10.1097/rli.0000000000000415] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/29/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The aim of this study was to correlate magnetic resonance imaging (MRI) of castration-resistant prostate cancer (CRPC) bone metastases with histological and molecular features of bone metastases. MATERIALS AND METHODS Forty-three bone marrow biopsies from 33 metastatic CRPC (mCRPC) patients with multiparametric MRI and documented bone metastases were evaluated. A second cohort included 10 CRPC patients with no bone metastases. Associations of apparent diffusion coefficient (ADC), normalized b900 diffusion-weighted imaging (nDWI) signal, and signal-weighted fat fraction (swFF) with bone marrow biopsy histological parameters were evaluated using Mann-Whitney U test and Spearman correlations. Univariate and multivariate logistic regression models were analyzed. RESULTS Median ADC and nDWI signal was significantly higher, and median swFF was significantly lower, in bone metastases than nonmetastatic bone (P < 0.001). In the metastatic cohort, 31 (72.1%) of 43 biopsies had detectable cancer cells. Median ADC and swFF were significantly lower and median nDWI signal was significantly higher in biopsies with tumor cells versus nondetectable tumor cells (898 × 10 mm/s vs 1617 × 10 mm/s; 11.5% vs 62%; 5.3 vs 2.3, respectively; P < 0.001). Tumor cellularity inversely correlated with ADC and swFF, and positively correlated with nDWI signal (P < 0.001). In serial biopsies, taken before and after treatment, changes in multiparametric MRI parameters paralleled histological changes. CONCLUSIONS Multiparametric MRI provides valuable information about mCRPC bone metastases. These data further clinically qualify DWI as a response biomarker in mCRPC.
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Affiliation(s)
- Raquel Perez-Lopez
- From the *The Institute of Cancer Research; and †The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Daniel Nava Rodrigues
- From the *The Institute of Cancer Research; and †The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ines Figueiredo
- From the *The Institute of Cancer Research; and †The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Joaquin Mateo
- From the *The Institute of Cancer Research; and †The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - David J. Collins
- From the *The Institute of Cancer Research; and †The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Dow-Mu Koh
- From the *The Institute of Cancer Research; and †The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Johann S. de Bono
- From the *The Institute of Cancer Research; and †The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Nina Tunariu
- From the *The Institute of Cancer Research; and †The Royal Marsden NHS Foundation Trust, London, United Kingdom
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45
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Shenoy TR, Boysen G, Wang MY, Xu QZ, Guo W, Koh FM, Wang C, Zhang LZ, Wang Y, Gil V, Aziz S, Christova R, Rodrigues DN, Crespo M, Rescigno P, Tunariu N, Riisnaes R, Zafeiriou Z, Flohr P, Yuan W, Knight E, Swain A, Ramalho-Santos M, Xu DY, de Bono J, Wu H. CHD1 loss sensitizes prostate cancer to DNA damaging therapy by promoting error-prone double-strand break repair. Ann Oncol 2018; 28:1495-1507. [PMID: 28383660 DOI: 10.1093/annonc/mdx165] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Indexed: 01/08/2023] Open
Abstract
Background Deletion of the chromatin remodeler chromodomain helicase DNA-binding protein 1 (CHD1) is a common genomic alteration found in human prostate cancers (PCas). CHD1 loss represents a distinct PCa subtype characterized by SPOP mutation and higher genomic instability. However, the role of CHD1 in PCa development in vivo and its clinical utility remain unclear. Patients and methods To study the role of CHD1 in PCa development and its loss in clinical management, we generated a genetically engineered mouse model with prostate-specific deletion of murine Chd1 as well as isogenic CHD1 wild-type and homozygous deleted human benign and PCa lines. We also developed patient-derived organoid cultures and screened patients with metastatic PCa for CHD1 loss. Results We demonstrate that CHD1 loss sensitizes cells to DNA damage and causes a synthetic lethal response to DNA damaging therapy in vitro, in vivo, ex vivo, in patient-derived organoid cultures and in a patient with metastatic PCa. Mechanistically, CHD1 regulates 53BP1 stability and CHD1 loss leads to decreased error-free homologous recombination (HR) repair, which is compensated by increased error-prone non-homologous end joining (NHEJ) repair for DNA double-strand break (DSB) repair. Conclusions Our study provides the first in vivo and in patient evidence supporting the role of CHD1 in DSB repair and in response to DNA damaging therapy. We uncover mechanistic insights that CHD1 modulates the choice between HR and NHEJ DSB repair and suggest that CHD1 loss may contribute to the genomic instability seen in this subset of PCas.
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Affiliation(s)
- T R Shenoy
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA
| | - G Boysen
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - M Y Wang
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Q Z Xu
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - W Guo
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - F M Koh
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research and Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
| | - C Wang
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA
| | - L Z Zhang
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Y Wang
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA
| | - V Gil
- The Institute of Cancer Research, London, UK
| | - S Aziz
- The Institute of Cancer Research, London, UK
| | - R Christova
- The Institute of Cancer Research, London, UK
| | - D N Rodrigues
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - M Crespo
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - P Rescigno
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - N Tunariu
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - R Riisnaes
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Z Zafeiriou
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - P Flohr
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - W Yuan
- The Institute of Cancer Research, London, UK
| | - E Knight
- The Institute of Cancer Research, London, UK
| | - A Swain
- The Institute of Cancer Research, London, UK
| | - M Ramalho-Santos
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research and Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
| | - D Y Xu
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - J de Bono
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - H Wu
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA.,The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
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46
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Goodall J, Mateo J, Yuan W, Mossop H, Porta N, Miranda S, Perez-Lopez R, Dolling D, Robinson DR, Sandhu S, Fowler G, Ebbs B, Flohr P, Seed G, Rodrigues DN, Boysen G, Bertan C, Atkin M, Clarke M, Crespo M, Figueiredo I, Riisnaes R, Sumanasuriya S, Rescigno P, Zafeiriou Z, Sharp A, Tunariu N, Bianchini D, Gillman A, Lord CJ, Hall E, Chinnaiyan AM, Carreira S, de Bono JS. Circulating Cell-Free DNA to Guide Prostate Cancer Treatment with PARP Inhibition. Cancer Discov 2017; 7:1006-1017. [PMID: 28450425 PMCID: PMC6143169 DOI: 10.1158/2159-8290.cd-17-0261] [Citation(s) in RCA: 299] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/15/2017] [Accepted: 04/26/2017] [Indexed: 12/13/2022]
Abstract
Biomarkers for more precise patient care are needed in metastatic prostate cancer. We have reported a phase II trial (TOPARP-A) of the PARP inhibitor olaparib in metastatic prostate cancer, demonstrating antitumor activity associating with homologous recombination DNA repair defects. We now report targeted and whole-exome sequencing of serial circulating cell-free DNA (cfDNA) samples collected during this trial. Decreases in cfDNA concentration independently associated with outcome in multivariable analyses (HR for overall survival at week 8: 0.19; 95% CI, 0.06-0.56; P = 0.003). All tumor tissue somatic DNA repair mutations were detectable in cfDNA; allele frequency of somatic mutations decreased selectively in responding patients (χ2P < 0.001). At disease progression, following response to olaparib, multiple subclonal aberrations reverting germline and somatic DNA repair mutations (BRCA2, PALB2) back in frame emerged as mechanisms of resistance. These data support the role of liquid biopsies as a predictive, prognostic, response, and resistance biomarker in metastatic prostate cancer.Significance: We report prospectively planned, serial, cfDNA analyses from patients with metastatic prostate cancer treated on an investigator-initiated phase II trial of olaparib. These analyses provide predictive, prognostic, response, and resistance data with "second hit" mutations first detectable at disease progression, suggesting clonal evolution from treatment-selective pressure and platinum resistance. Cancer Discov; 7(9); 1006-17. ©2017 AACR.See related commentary by Domchek, p. 937See related article by Kondrashova et al., p. 984See related article by Quigley et al., p. 999This article is highlighted in the In This Issue feature, p. 920.
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Affiliation(s)
- Jane Goodall
- The Institute of Cancer Research, London, United Kingdom
| | - Joaquin Mateo
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | - Helen Mossop
- The Institute of Cancer Research, London, United Kingdom
| | - Nuria Porta
- The Institute of Cancer Research, London, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | - Raquel Perez-Lopez
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - David Dolling
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Gemma Fowler
- The Institute of Cancer Research, London, United Kingdom
| | - Berni Ebbs
- The Institute of Cancer Research, London, United Kingdom
| | - Penny Flohr
- The Institute of Cancer Research, London, United Kingdom
| | - George Seed
- The Institute of Cancer Research, London, United Kingdom
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Gunther Boysen
- The Institute of Cancer Research, London, United Kingdom
| | - Claudia Bertan
- The Institute of Cancer Research, London, United Kingdom
| | - Mark Atkin
- The Institute of Cancer Research, London, United Kingdom
| | - Matthew Clarke
- The Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- The Institute of Cancer Research, London, United Kingdom
| | | | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | - Semini Sumanasuriya
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Pasquale Rescigno
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Zafeiris Zafeiriou
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Adam Sharp
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Nina Tunariu
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Diletta Bianchini
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alexa Gillman
- The Institute of Cancer Research, London, United Kingdom
| | | | - Emma Hall
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Johann S de Bono
- The Institute of Cancer Research, London, United Kingdom.
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
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47
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Cato L, Neeb A, Sharp A, Buzón V, Ficarro SB, Yang L, Muhle-Goll C, Kuznik NC, Riisnaes R, Nava Rodrigues D, Armant O, Gourain V, Adelmant G, Ntim EA, Westerling T, Dolling D, Rescigno P, Figueiredo I, Fauser F, Wu J, Rottenberg JT, Shatkina L, Ester C, Luy B, Puchta H, Troppmair J, Jung N, Bräse S, Strähle U, Marto JA, Nienhaus GU, Al-Lazikani B, Salvatella X, de Bono JS, Cato ACB, Brown M. Development of Bag-1L as a therapeutic target in androgen receptor-dependent prostate cancer. eLife 2017; 6:e27159. [PMID: 28826504 PMCID: PMC5629025 DOI: 10.7554/elife.27159] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 08/07/2017] [Indexed: 12/12/2022] Open
Abstract
Targeting the activation function-1 (AF-1) domain located in the N-terminus of the androgen receptor (AR) is an attractive therapeutic alternative to the current approaches to inhibit AR action in prostate cancer (PCa). Here we show that the AR AF-1 is bound by the cochaperone Bag-1L. Mutations in the AR interaction domain or loss of Bag-1L abrogate AR signaling and reduce PCa growth. Clinically, Bag-1L protein levels increase with progression to castration-resistant PCa (CRPC) and high levels of Bag-1L in primary PCa associate with a reduced clinical benefit from abiraterone when these tumors progress. Intriguingly, residues in Bag-1L important for its interaction with the AR AF-1 are within a potentially druggable pocket, implicating Bag-1L as a potential therapeutic target in PCa.
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Seed G, Yuan W, Mateo J, Carreira S, Bertan C, Lambros M, Boysen G, Ferraldeschi R, Miranda S, Figueiredo I, Riisnaes R, Crespo M, Rodrigues DN, Talevich E, Robinson DR, Kunju LP, Wu YM, Lonigro R, Sandhu S, Chinnaiyan AM, de Bono JS. Gene Copy Number Estimation from Targeted Next-Generation Sequencing of Prostate Cancer Biopsies: Analytic Validation and Clinical Qualification. Clin Cancer Res 2017; 23:6070-6077. [PMID: 28751446 DOI: 10.1158/1078-0432.ccr-17-0972] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/01/2017] [Accepted: 07/19/2017] [Indexed: 11/16/2022]
Abstract
Purpose: Precise detection of copy number aberrations (CNA) from tumor biopsies is critically important to the treatment of metastatic prostate cancer. The use of targeted panel next-generation sequencing (NGS) is inexpensive, high throughput, and easily feasible, allowing single-nucleotide variant calls, but CNA estimation from this remains challenging.Experimental Design: We evaluated CNVkit for CNA identification from amplicon-based targeted NGS in a cohort of 110 fresh castration-resistant prostate cancer biopsies and used capture-based whole-exome sequencing (WES), array comparative genomic hybridization (aCGH), and FISH to explore the viability of this approach.Results: We showed that this method produced highly reproducible CNA results (r = 0.92), with the use of pooled germline DNA as a coverage reference supporting precise CNA estimation. CNA estimates from targeted NGS were comparable with WES (r = 0.86) and aCGH (r = 0.7); for key selected genes (BRCA2, MYC, PIK3CA, PTEN, and RB1), CNA estimation correlated well with WES (r = 0.91) and aCGH (r = 0.84) results. The frequency of CNAs in our population was comparable with that previously described (i.e., deep deletions: BRCA2 4.5%; RB1 8.2%; PTEN 15.5%; amplification: AR 45.5%; gain: MYC 31.8%). We also showed, utilizing FISH, that CNA estimation can be impacted by intratumor heterogeneity and demonstrated that tumor microdissection allows NGS to provide more precise CNA estimates.Conclusions: Targeted NGS and CNVkit-based analyses provide a robust, precise, high-throughput, and cost-effective method for CNA estimation for the delivery of more precise patient care. Clin Cancer Res; 23(20); 6070-7. ©2017 AACR.
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Affiliation(s)
- George Seed
- The Institute of Cancer Research, London, United Kingdom
| | - Wei Yuan
- The Institute of Cancer Research, London, United Kingdom
| | - Joaquin Mateo
- The Institute of Cancer Research, London, United Kingdom
| | | | - Claudia Bertan
- The Institute of Cancer Research, London, United Kingdom
| | - Maryou Lambros
- The Institute of Cancer Research, London, United Kingdom
| | - Gunther Boysen
- The Institute of Cancer Research, London, United Kingdom
| | - Roberta Ferraldeschi
- The Institute of Cancer Research, London, United Kingdom.,The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Susana Miranda
- The Institute of Cancer Research, London, United Kingdom
| | | | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- The Institute of Cancer Research, London, United Kingdom
| | | | - Eric Talevich
- University of California San Francisco, San Francisco, California
| | - Dan R Robinson
- Michigan Centre for Translational Pathology, Ann Arbor, Michigan
| | - Lakshmi P Kunju
- Michigan Centre for Translational Pathology, Ann Arbor, Michigan
| | - Yi-Mi Wu
- Michigan Centre for Translational Pathology, Ann Arbor, Michigan
| | - Robert Lonigro
- Michigan Centre for Translational Pathology, Ann Arbor, Michigan
| | | | | | - Johann S de Bono
- The Institute of Cancer Research, London, United Kingdom. .,The Royal Marsden NHS Foundation Trust, London, United Kingdom
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49
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Ferraldeschi R, Welti J, Powers MV, Yuan W, Smyth T, Seed G, Riisnaes R, Hedayat S, Wang H, Crespo M, Nava Rodrigues D, Figueiredo I, Miranda S, Carreira S, Lyons JF, Sharp S, Plymate SR, Attard G, Wallis N, Workman P, de Bono JS. Second-Generation HSP90 Inhibitor Onalespib Blocks mRNA Splicing of Androgen Receptor Variant 7 in Prostate Cancer Cells. Cancer Res 2017; 76:2731-42. [PMID: 27197266 DOI: 10.1158/0008-5472.can-15-2186] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 01/27/2016] [Indexed: 12/19/2022]
Abstract
Resistance to available hormone therapies in prostate cancer has been associated with alternative splicing of androgen receptor (AR) and specifically, the expression of truncated and constitutively active AR variant 7 (AR-V7). The transcriptional activity of steroid receptors, including AR, is dependent on interactions with the HSP90 chaperone machinery, but it is unclear whether HSP90 modulates the activity or expression of AR variants. Here, we investigated the effects of HSP90 inhibition on AR-V7 in prostate cancer cell lines endogenously expressing this variant. We demonstrate that AR-V7 and full-length AR (AR-FL) were depleted upon inhibition of HSP90. However, the mechanisms underlying AR-V7 depletion differed from those for AR-FL. Whereas HSP90 inhibition destabilized AR-FL and induced its proteasomal degradation, AR-V7 protein exhibited higher stability than AR-FL and did not require HSP90 chaperone activity. Instead, HSP90 inhibition resulted in the reduction of AR-V7 mRNA levels but did not affect total AR transcript levels, indicating that HSP90 inhibition disrupted AR-V7 splicing. Bioinformatic analyses of transcriptome-wide RNA sequencing data confirmed that the second-generation HSP90 inhibitor onalespib altered the splicing of at least 557 genes in prostate cancer cells, including AR. These findings indicate that the effects of HSP90 inhibition on mRNA splicing may prove beneficial in prostate cancers expressing AR-V7, supporting further clinical investigation of HSP90 inhibitors in malignancies no longer responsive to androgen deprivation. Cancer Res; 76(9); 2731-42. ©2016 AACR.
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Affiliation(s)
- Roberta Ferraldeschi
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom. Prostate Cancer Targeted Therapies Group, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom
| | - Jonathan Welti
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Marissa V Powers
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Wei Yuan
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Tomoko Smyth
- Astex Pharmaceuticals, Cambridge, United Kingdom
| | - George Seed
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Ruth Riisnaes
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Somaieh Hedayat
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Hannah Wang
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Mateus Crespo
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Daniel Nava Rodrigues
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Ines Figueiredo
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Susana Miranda
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Suzanne Carreira
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - John F Lyons
- Astex Pharmaceuticals, Cambridge, United Kingdom
| | - Swee Sharp
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Stephen R Plymate
- Department of Medicine, University of Washington School of Medicine and GRECC at VAPSHCS Seattle, Washington. Department of Urology, University of Washington School of Medicine and GRECC at VAPSHCS Seattle, Washington
| | - Gerhardt Attard
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom. Prostate Cancer Targeted Therapies Group, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom
| | | | - Paul Workman
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom
| | - Johann S de Bono
- Division of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom. Prostate Cancer Targeted Therapies Group, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom.
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50
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Sundar R, Miranda S, Carreira S, Chénard-Poirier M, Rodrigues DN, Figueiredo I, Bertan C, Yuan W, Perez DR, Ferreira A, Tunariu N, Mateo J, Bono JD. Abstract 3807: ATM protein loss and clinical outcomes with platinum chemotherapy in patients with advanced solid tumors. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-3807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Loss of ataxia telangiectasia mutated (ATM), a key protein regulating DNA damage repair signaling, appears to sensitize tumors to platinum chemotherapy in preclinical studies. In this study, the incidence of ATM loss in patients with advanced solid tumors and clinical outcomes with platinum chemotherapy was analyzed.
Methods Archival tumor and biopsy samples of primary or metastatic sites of patients treated in a phase I trial unit were retrieved and ATM immunohistochemistry (IHC), as well as targeted next generation sequencing (NGS) was performed. Analytic validation and assay optimization of rabbit monoclonal antibody [Y170] to ATM (Abcam ab32420) was undertaken using known positive (VCaP xenograft material and GM14680 cell pellet) and negative (GM01526 cell pellet) controls. IHC slides were assessed by a trained pathologist for nuclear staining intensity of ATM and semi-quantitatively scored. ATM loss was defined as a nuclear H score of ≤10. Clinical data were collected retrospectively from case records. Duration on platinum therapy was defined as time from start of first platinum therapy to time to subsequent therapy (adjuvant platinum excluded).
Results Overall, 679 samples of 587 patients were tested for ATM IHC, of which 517 samples had NGS performed; 5% of patients (n = 31) had ATM IHC loss, and 5% (n = 27) had somatic ATM mutations detected by NGS (Table 1). In 70 matched primary/metastatic or different metastatic sites, concordance of ATM IHC loss occurred in 99% (n = 69; 7 with ATM IHC loss) of samples. Of the colorectal cancer cohort (n = 223), duration on platinum therapy was significantly longer for the ATM loss group (11 vs 8 months, HR: 0.57, 95% CI: 0.35 to 0.93, p = 0.04).
Discussion Loss of ATM expression was detected among 5% of this cohort of advanced solid cancers, primarily in breast and gastrointestinal tumors. Sensitivity to platinum therapy is significantly higher in ATM loss colorectal cancer. Further prospective studies with larger cohorts are required to validate these findings.
ATM IHC and ATM mutation by NGS by tumor groupTumor typesTotalATM IHC loss (%)ATM mutation (%)Concomitant ATM loss and ATM mutationConcomitant TP53 mutation with ATM IHC loss or mutationTotalMisense nFrameshift nTruncating n(as % of those with ATM IHC loss)(as % of those with ATM IHC loss/mutation)Colorectal22316(7)9(4)544 (25)10 (48)Gynaecological1051(1)7(7)4125 (63)Thoracic801(1)3(4)211 (100)2 (67)Breast448(18)4(9)223 (38)4 (44)Upper GI372(5)1(3)12 (67)Hepatobiliary221(5)1(5)11 (50)Others762(3)2(3)21 (50)Total58731(5)27(5)14 (52)3 (11)10 (37)9 (29)24 (49)
Citation Format: Raghav Sundar, Susana Miranda, Suzanne Carreira, Maxime Chénard-Poirier, Daniel Nava Rodrigues, Ines Figueiredo, Claudia Bertan, Wei Yuan, Desamparados Roda Perez, Ana Ferreira, Nina Tunariu, Joaquin Mateo, Johann de Bono. ATM protein loss and clinical outcomes with platinum chemotherapy in patients with advanced solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3807. doi:10.1158/1538-7445.AM2017-3807
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Affiliation(s)
- Raghav Sundar
- Institute of Cancer Research, London, United Kingdom
| | | | | | | | | | | | | | - Wei Yuan
- Institute of Cancer Research, London, United Kingdom
| | | | - Ana Ferreira
- Institute of Cancer Research, London, United Kingdom
| | - Nina Tunariu
- Institute of Cancer Research, London, United Kingdom
| | - Joaquin Mateo
- Institute of Cancer Research, London, United Kingdom
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