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Breininger SP, Izadi F, Sharpe B, Secrier M, Gibson J, Walker R, Rahman S, Devonshire G, Lloyd M, Walters Z, Fitzgerald R, Rose-Zerilli M, Underwood T. O086 Genomic analysis of response to neoadjuvant chemotherapy in oesophageal adenocarcinoma. Br J Surg 2022. [DOI: 10.1093/bjs/znac242.086] [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: 11/06/2022]
Abstract
Abstract
Introduction
Oesophageal adenocarcinoma (OAC) is the ninth most common cancer worldwide with a mortality of over 500,000 deaths yearly. Neoadjuvant chemotherapy (NAC) followed by surgery is the standard of care (SOC) for locally advanced OAC. Although almost all patients receive chemotherapy as SOC, fewer than 20% obtain a clinically meaningful response and benefit before surgery. The OAC genome is complex and heterogeneous between patients, and it is not yet understood whether specific mutational patterns result in chemotherapy sensitivity or resistance.
Methods
To identify associations between genomic events and response to NAC in OAC, a comparative genomic analysis was performed in 65 patients using whole-genome sequencing. We defined response to NAC using Mandard Tumour Regression Grade TRG), with responders classified as TRG1-2 (n=27) and non-responders classified as TRG4- 5 (n=38).
Results
We report a higher non-synonymous mutation burden in responders (median 2.08/Mb vs 1.70/Mb, P=0.036) and elevated copy number variation (CNV) in non-responders (282 vs 136/patient, P<0.001). We identified CNVs unique to each group, with cell cycle (CDKN2A, CCND1), c-Myc (MYC), RTK/PIK3 (KRAS, EGFR) and gastrointestinal differentiation (GATA6) pathway genes being specifically altered in non-responders. Of particular interest was the identification of the Neuron Navigator-3 (NAV3), a known tumour suppressor downstream of EGFR, which was mutated exclusively in 22% of non-responders.
Conclusion
We characterise genetic features and mutations that are uniquely associated with response to NAC. We envision a treatment pipeline that incorporates driver mutation profiling in OAC, combining response prediction with targeted therapies enhancing response to NAC and improving survival outcomes.
Take-home message
Developing a method of determining an OAC patient's response to neoadjuvant chemotherapy before treatment is administered is desperately needed and will improve patient outcome and quality of life. We identified a number of aberrations in the genome that were unique to non-responders to chemotherapy compared to responders, particularly a known tumour suppressor gene namely Neuron Navigator-3, suggesting that these events may contribute to chemoresistance in these patients. Our work characterises pre-existing genomic alterations that have potential as biomarkers for resistance or sensitivity to NAC.
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Affiliation(s)
- SP Breininger
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
| | - F Izadi
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
- Centre for NanoHealth, Swansea University Medical School , Singleton Campus, Swansea
| | - B Sharpe
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
- Institute for Life Sciences, University of Southampton
| | - M Secrier
- UCL Genetics Institute, Division of Biosciences, University College London
| | - J Gibson
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
- Institute for Life Sciences, University of Southampton
| | - R Walker
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
| | - S Rahman
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
| | - G Devonshire
- Cancer Research UK Cambridge Institute, University of Cambridge
| | - M Lloyd
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
| | - Z Walters
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
- Institute for Life Sciences, University of Southampton
| | - R Fitzgerald
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge
| | - M Rose-Zerilli
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
- Institute for Life Sciences, University of Southampton
| | - T Underwood
- School of Cancer Sciences, Cancer Research UK Centre, Faculty of Medicine, University of Southampton, Southampton General Hospital , Southampton
- Institute for Life Sciences, University of Southampton
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Albibas A, Rose-Zerilli M, Lai C, Pengelly R, Lockett G, Theaker J, Ennis S, Holloway J, Healy E. 543 Multiple cancer-related genes are mutated in p53 mutant patches in human skin. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Turaj A, Rose-Zerilli M, Cox K, James S, Al-Shamkhani A, Keler T, Johnson P, Thirdborough S, Beers S, Glennie M, Cragg M, Lim S. CD27 STIMULATION ENHANCES CD20 MAB THERAPY THROUGH ACTIVATION OF INNATE IMMUNITY. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_123] [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: 11/09/2022]
Affiliation(s)
- A.H. Turaj
- Antibody and Vaccine Group, Cancer Sciences Unit; University of Southampton; Southampton UK
| | - M. Rose-Zerilli
- Cancer Sciences Unit; University of Southampton; Southampton UK
| | - K. Cox
- Antibody and Vaccine Group, Cancer Sciences Unit; University of Southampton; Southampton UK
| | - S. James
- Antibody and Vaccine Group, Cancer Sciences Unit; University of Southampton; Southampton UK
| | - A. Al-Shamkhani
- Antibody and Vaccine Group, Cancer Sciences Unit; University of Southampton; Southampton UK
| | - T. Keler
- Celldex Therapeutics; Celldex Therapeutics; Hampton USA
| | - P.W. Johnson
- Southampton Cancer Research UK Centre; University of Southampton; Southampton UK
| | | | - S.A. Beers
- Antibody and Vaccine Group, Cancer Sciences Unit; University of Southampton; Southampton UK
| | - M.J. Glennie
- Antibody and Vaccine Group, Cancer Sciences Unit; University of Southampton; Southampton UK
| | - M.S. Cragg
- Antibody and Vaccine Group, Cancer Sciences Unit; University of Southampton; Southampton UK
| | - S.H. Lim
- Antibody and Vaccine Group, Cancer Sciences Unit; University of Southampton; Southampton UK
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Henderson AJ, Newson RB, Rose-Zerilli M, Ring SM, Holloway JW, Shaheen SO. Maternal Nrf2 and gluthathione-S-transferase polymorphisms do not modify associations of prenatal tobacco smoke exposure with asthma and lung function in school-aged children. Thorax 2010; 65:897-902. [PMID: 20805158 DOI: 10.1136/thx.2009.125856] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Maternal smoking during pregnancy has detrimental effects on the respiratory health of infants and children. Polymorphisms of antioxidant genes including glutathione-S-transferases (GSTs) have been proposed as candidates for asthma and reduced lung function in children. METHODS Women enrolled in the Avon Longitudinal Study of Parents and Children reported smoking habits during pregnancy. Asthma status in their children was established at age 7.5 years from parental reports and lung function was measured by spirometry at age 8.5 years. Maternal and child DNA were genotyped for deletions of GSTM1 and GSTT1 and functional polymorphisms of GSTP1 and Nrf2 genes. Associations of prenatal tobacco smoke exposure with asthma and lung function in children were stratified by maternal genotype. RESULTS In 6606 children, maternal smoking during pregnancy was negatively associated with maximal mid expiratory flow (FEF(25-75)) (-0.05 SD units, 95% CI -0.07 to -0.03, p<0.001). There was little evidence for interactions between maternal smoking and any maternal genotype considered on children's asthma or lung function. Maternal smoking was associated with reduced childhood FEF(25-75) only in mother-child pairs (n=1227) with both copies of GSTM1 deleted (-0.08 SD units, 95% CI -0.14 to -0.02, p=0.01) or (n=2313) at least one copy of GSTT1 present (-0.05 SD units, 95% CI -0.09 to 0, p=0.03). CONCLUSION This study confirms a detrimental effect of intrauterine tobacco smoke exposure on childhood lung function but no strong evidence of modification by maternal genotype for important antioxidant genes. Adverse effects of fetal exposure to tobacco smoke on the respiratory health of children may be mediated by pathways other than oxidative stress.
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Affiliation(s)
- A J Henderson
- Department of Community-based Medicine, University of Bristol, UK.
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