Serial Tumor Molecular Profiling of Newly Diagnosed HER2-Negative Breast Cancers During Chemotherapy in Combination with Angiogenesis Inhibitors

Background Breast cancers are heterogeneous with variable clinical courses and treatment responses. Objective We sought to evaluate dynamic changes in the molecular landscape of HER2-negative tumors treated with chemotherapy and anti-angiogenic agents. Patients and Methods Newly diagnosed HER2-negative breast cancer patients received low-dose sunitinib or bevacizumab prior to four 2-weekly cycles of dose-dense doxorubicin and cyclophosphamide. Tumor biopsies were obtained at baseline, after 2 weeks and after 8 weeks of chemotherapy. Next-generation sequencing was performed to assess for single nucleotide variants (SNVs) and copy number alterations (CNAs) of 440 cancer-related genes ($ ACTOnco^{®} $). Observed genomic changes were correlated with the Miller-Payne histological response to treatment. Results Thirty-four patients received sunitinib and 18 received bevacizumab. In total, 77% were hormone receptor positive (HER2−/HR+) and 23% were triple negative breast cancers (TNBC). New therapy-induced mutations were infrequent, occurring only in 13%, and appeared early after a single cycle of treatment. Seventy-two percent developed changes in the variant allele frequency (VAF) of pathogenic SNVs; the majority (51%) of these changes occurred early at 2 weeks and were sustained for 8 weeks. Changes in VAF of SNVs were most commonly seen in the PI3K/mTOR/AKT pathway; 13% developed changes in pathogenic mutations, which potentially confer sensitivity to PIK3CA inhibitors. Tumors with poor Miller-Payne response to treatment were less likely to experience changes in VAF of SNVs compared with those with good response (50% [7/14] vs 15% [4/24] had no changes observed at any timepoint, p = 0.029). Conclusions Serial molecular profiling identifies early therapy-induced genomic alterations, which may guide future selection of targeted therapies in breast cancer patients who progress after standard chemotherapy. Clinical trial registration ClinicalTrials.gov: NCT02790580 (first posted June 6, 2016)..

Medienart:	E-Artikel

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	Zur Gesamtaufnahme - volume:17
Enthalten in:	Targeted oncology - 17(2022), 3 vom: Mai, Seite 355-368

Sprache:	Englisch

Beteiligte Personen:

Choo, Joan R. E. [VerfasserIn] Jan, Yi-Hua [VerfasserIn] Ow, Samuel G. W. [VerfasserIn] Wong, Andrea [VerfasserIn] Lee, Matilda Xinwei [VerfasserIn] Ngoi, Natalie [VerfasserIn] Yadav, Kritika [VerfasserIn] Lim, Joline S. J. [VerfasserIn] Lim, Siew Eng [VerfasserIn] Chan, Ching Wan [VerfasserIn] Hartman, Mikael [VerfasserIn] Tang, Siau Wei [VerfasserIn] Goh, Boon Cher [VerfasserIn] Tan, Hon Lyn [VerfasserIn] Chong, Wan Qin [VerfasserIn] Yvonne, Ang Li En [VerfasserIn] Chan, Gloria H. J. [VerfasserIn] Chen, Shu-Jen [VerfasserIn] Tan, Kien Thiam [VerfasserIn] Lee, Soo Chin [VerfasserIn]

Links:	Volltext [kostenfrei]

Anmerkungen:	© The Author(s) 2022

doi:	10.1007/s11523-022-00886-x

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC2131027796