1
|
Ruiz S, Maza MDFDL, Moreno JFR, Sevillano E, Navarro P, Amarilla S, Donas TG, Caleiras E, Torrego JC, Donas JG. Abstract 4475: Targeting c-MET and MAPK pathway in metastatic castration-resistant prostate cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-4475] [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: 11/16/2022]
Abstract
Abstract
Identification of “agnostic” genetic drivers in cancer is foreseen as a major step forward in precision medicine. Thus, treatment selection could be based on the molecular background of the disease rather than on tumor histology in the near future.
However clinical validation of most alterations is lacking and only preclinical models are available.
We describe a prostate cancer patient refractory to standard therapies that was found to harbor both a c-Met activating mutation and a BRAF fusion that greatly responded to the MEK inhibitor (MEKi) trametinib.
EXPERIMENTAL PROCEDURES
The Next Generation Sequencing (NGS) platforms (Oncomine Assay and Archer Variant Plex) were used to characterize molecularly FFPE tissue from the primary tumor of a 73 years old man with metastatic castration-resistant prostate cancer (mCRPC) refractory to Docetaxel, Enzalutamide and Radium 223.
Immunostaining was performed to evaluate the status of protumoral pathways activated by the identified genomic alterations.
RESULTS
Oncomine assay detected a pathogenic c-MET mutation that affected the splicing of exon 14 and the patient was included in a clinical trial with a c-MET inhibidor. He developed Grade 3 anemia, G3 bone pain which required major opioids, a rise of PSA over 900 ng/ml and progressive disease as best response.
An extended screening using Archer platform detected a SND1/BRAF fusion. Immunohistochemistry revealed homogeneous tumor positive staining for c-MET, and a punctured staining on pERK in FFPE regions with perineural tumor invasion suggesting a critical role of the BRAF fusion in the spread of the disease.
After a comprehensive review of the literature a similar model was identified, where the SND1/BAF function raised in a cell culture of gastric cancer as mechanism of resistance to MET inihibitors (Lee NV et al PLoS One 2012). In preclinical experiments the MEKi trametinib induced significant cell mortality.
After given written consent, the patient was put on trametinib (2mg/day) under compassionate use.
We observed a large decrease of PSA levels to 90 ng/ml after two weeks of treatment, an increase of hemoglobin levels and significant clinical benefit, with no need of analgesics. After two months on treatment the patient continues on tumor response by the time of communication of this abstract.
CONCLUSIONS
According to our knowledge, this is the first published study able to demonstrate that cancer patients harboring c-MET exon 14 splicing mutation and SND1-BRAF fusion genes could benefit from therapies with MEK inhibitors. Further experimental procedures are needed to validate this hypothesis.
1. Lee NV, Lira ME, Pavlicek A, Ye J, Buckman D, et al. (2012) A Novel SND1-BRAF Fusion Confers Resistance to c-Met Inhibitor PF-04217903 in GTL16 Cells though MAPK Activation. PLoS ONE 7(6): e39653. doi:10.1371/journal.pone.0039653.
Citation Format: Sergio Ruiz, María Dolores Fenor de la Maza, Juan Francisco Rodríguez Moreno, Elena Sevillano, Paloma Navarro, Sandra Amarilla, Teresa García Donas, Eduardo Caleiras, Juan Carlos Torrego, Jesus García Donas. Targeting c-MET and MAPK pathway in metastatic castration-resistant prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4475.
Collapse
Affiliation(s)
- Sergio Ruiz
- 1CLARA CAMPAL COMPREHENSIVE CANCER CENTRE, MADRID, Spain
| | | | | | | | - Paloma Navarro
- 1CLARA CAMPAL COMPREHENSIVE CANCER CENTRE, MADRID, Spain
| | | | | | | | | | | |
Collapse
|
2
|
Paumard‐Hernández B, Calvete O, Inglada Pérez L, Tejero H, Al‐Shahrour F, Pita G, Barroso A, Carlos Triviño J, Urioste M, Valverde C, González Billalabeitia E, Quiroga V, Francisco Rodríguez Moreno J, Fernández Aramburo A, López C, Maroto P, Sastre J, José Juan Fita M, Duran I, Lorenzo‐Lorenzo I, Iranzo P, García del Muro X, Ros S, Zambrana F, María Autran A, Benítez J. Whole exome sequencing identifies
PLEC
,
EXO5
and
DNAH7
as novel susceptibility genes in testicular cancer. Int J Cancer 2018; 143:1954-1962. [DOI: 10.1002/ijc.31604] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 12/27/2022]
Affiliation(s)
| | - Oriol Calvete
- Human Genetics Group, Spanish National Cancer Research Center (CNIO)Madrid Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER)Madrid Spain
| | - Lucia Inglada Pérez
- Center for Biomedical Network Research on Rare Diseases (CIBERER)Madrid Spain
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Program, Spanish National Cancer Centre (CNIO)Madrid Spain
| | - Héctor Tejero
- Bioinformatics Unit, Spanish National Cancer Research Center (CNIO)Madrid Spain
| | - Fátima Al‐Shahrour
- Bioinformatics Unit, Spanish National Cancer Research Center (CNIO)Madrid Spain
| | - Guillermo Pita
- Human Genotyping‐CEGEN Unit, Human Cancer Genetic Program, Spanish National Cancer Research Centre (CNIO)Madrid Spain
| | - Alicia Barroso
- Human Genetics Group, Spanish National Cancer Research Center (CNIO)Madrid Spain
| | - Juan Carlos Triviño
- Bioinformatic Unit, Sistemas Genómicos, Valencia Spain, Spanish National Cancer Research Centre (CNIO)Madrid Spain
| | - Miguel Urioste
- Center for Biomedical Network Research on Rare Diseases (CIBERER)Madrid Spain
- Familial Cancer Clinical Unit, Spanish National Cancer Research Center (CNIO)Madrid Spain
| | - Claudia Valverde
- Department of Medical OncologyVall d'Hebron Institute of Oncology, Vall d'Hebron University HospitalBarcelona Spain
- Spanish Germ Cell Group (SGCCG)
| | - Enrique González Billalabeitia
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology‐Haematology DepartmentHospital Universitario Morales MeseguerMurcia Spain
| | - Vanesa Quiroga
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology DepartmentHospital Universitari Germans Trias i Pujol, Institut Català d'Oncologia‐BadalonaBarcelona Spain
| | | | - Antonio Fernández Aramburo
- Spanish Germ Cell Group (SGCCG)
- Department of OncologyComplejo Hospitalario Universitario AlbaceteAlbacete Spain
| | - Cristina López
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology DepartmentInstituto de Investigación Sanitaria Gregorio MarañónMadrid Spain
| | - Pablo Maroto
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology and Biochemistry DepartmentsHospital de la Santa Creu i Sant PauBarcelona Spain
| | - Javier Sastre
- Spanish Germ Cell Group (SGCCG)
- Department of Medical OncologyHospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC)Madrid Spain
| | - María José Juan Fita
- Spanish Germ Cell Group (SGCCG)
- Medical OncologyFundación Instituto Valenciano de OncologíaValencia Spain
| | - Ignacio Duran
- Spanish Germ Cell Group (SGCCG)
- Department of Medical OncologyInstituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de SevillaSevilla Spain
| | | | - Patricia Iranzo
- Spanish Germ Cell Group (SGCCG)
- Department of Medical OncologyHospital Clinico Universitario Lozano BlesaZaragoza Spain
| | - Xavier García del Muro
- Spanish Germ Cell Group (SGCCG)
- Sarcoma Multidisciplinary Unit and Medical Oncology DepartmentInstitut Català d'Oncologia Hospitalet, IDIBELLBarcelona Spain
| | - Silverio Ros
- Department of Clinical OncologyHospital Universitario Virgen ArrixacaMurcia Spain
| | - Francisco Zambrana
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology DepartmentHospital Universitario Infanta Sofía, San Sebastián De Los Reyes Spain
| | - Ana María Autran
- Spanish Germ Cell Group (SGCCG)
- Medical Urology departmentFundación Jiménez DíazMadrid Spain
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Center (CNIO)Madrid Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER)Madrid Spain
- Human Genotyping‐CEGEN Unit, Human Cancer Genetic Program, Spanish National Cancer Research Centre (CNIO)Madrid Spain
| |
Collapse
|
3
|
Alonso Gordoa T, García-Sáenz JÁ, Rodríguez Moreno JF, Hernández Pérez FJ, Díaz-Rubio E. Is trastuzumab-induced cardiotoxicity involved in onco-cardiology outcome? Clin Transl Oncol 2011; 13:451-9. [PMID: 21775272 DOI: 10.1007/s12094-011-0682-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Targeted therapies alone or combined with chemotherapy have improved response rates as well as the progression-free survival and overall survival in several solid tumors. Trastuzumab is a monoclonal antibody with a revolutionary effect on tumoral breast cells, but also on the myocardium, as has been identified recently, following the inherent cascade signaling shared between both cells. Instead of decreasing the use of trastuzumab, investigations based on the results of Metastatic and Adjuvant Breast Cancer Trials tend to develop monitoring schemes as well as risk factor identification and prophylactic applications in order to improve the number of patients receiving full treatment instead of restricting it. Moreover, the largely reversible trastuzumab effect (different from anthracyclines) allows its reintroduction or its later withdrawal with cardiologic directed therapy. In conclusion, every action is aiming at optimizing trastuzumab's application instead of abandoning.
Collapse
|