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Karachaliou N, Arrieta O, Giménez-Capitán A, Aldeguer E, Drozdowskyj A, Chaib I, Reguart N, Garcia-Campelo R, Chen JH, Molina-Vila MA, Rosell R. BRCA1 Expression and Outcome in Patients With EGFR-Mutant NSCLC Treated With Gefitinib Alone or in Combination With Olaparib. JTO Clin Res Rep 2021; 2:100113. [PMID: 34589994 PMCID: PMC8474244 DOI: 10.1016/j.jtocrr.2020.100113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/18/2020] [Revised: 09/30/2020] [Accepted: 10/17/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction DNA repair capacity, as exemplified by BRCA1 gene expression, is related with outcome to EGFR tyrosine kinase inhibitors in patients with EGFR-mutant NSCLC. Olaparib, a PARP inhibitor, reduces BRCA1 expression. Olaparib was tested in combination with gefitinib versus gefitinib single agent, as a first-line therapy for patients with EGFR-mutant NSCLC in the GOAL study (trial registration: NCT01513174). Here, we report the results of the biomarker-related prespecified secondary objectives of the GOAL study. Methods We evaluated the impact of BRCA1 mRNA expression in 91 patients with EGFR-mutant NSCLC. Of those 91 patients, 51 were randomized to treatment with gefitinib and 40 were randomized to treatment with gefitinib plus olaparib. We explored in vitro whether BRCA1 mRNA levels are related with outcome to gefitinib plus olaparib. The expression levels of 53BP1, CtIP, and AXL were also explored and correlated with the treatment outcome. Results Overall, as what happened in the GOAL study, no statistically significant difference was observed in median progression-free survival (PFS) between the two treatment arms, for the 91 patients of the present study (p = 0.2419). For patients with high BRCA1 mRNA expression (BRCA1-high group), median PFS was 12.9 months in the gefitinib plus olaparib arm, compared with 9.2 months in the gefitinib arm (p = 0.0449). In the gefitinib arm, median PFS was 9.1 months for the BRCA1-high group and 10.2 months for the BRCA1-low group (p = 0.0193). We observed a more pronounced synergism of gefitinib plus olaparib in cells with higher BRCA1 compared with those with low BRCA1 mRNA expression. Conclusions High BRCA1 mRNA expression identified patients with NSCLC who benefited from gefitinib plus olaparib in the GOAL phase 2 clinical trial.
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Affiliation(s)
- Niki Karachaliou
- Pangaea Oncology, Quirón-Dexeus University Hospital, Barcelona, Spain.,Instituto Oncológico Dr Rosell (IOR), University Hospital Sagrat Cor, Quirón Salud Group, Barcelona, Spain
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | - Erika Aldeguer
- Pangaea Oncology, Quirón-Dexeus University Hospital, Barcelona, Spain
| | - Ana Drozdowskyj
- Molecular and Cellular Oncology Laboratory, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Imane Chaib
- Molecular and Cellular Oncology Laboratory, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Noemí Reguart
- Medical Oncology Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - Rosario Garcia-Campelo
- Medical Oncology Department, University Hospital A Coruña (XXIAC-SERGAS), A Coruña, Spain
| | - Jing-Hua Chen
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.,Medical Oncology Department, Guangzhou Twelfth People's Hospital, Guangzhou, People's Republic of China
| | | | - Rafael Rosell
- Pangaea Oncology, Quirón-Dexeus University Hospital, Barcelona, Spain.,Molecular and Cellular Oncology Laboratory, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
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