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Ross JS, Wang K, Chmielecki J, Gay L, Johnson A, Chudnovsky J, Yelensky R, Lipson D, Ali SM, Elvin JA, Vergilio JA, Roels S, Miller VA, Nakamura BN, Gray A, Wong MK, Stephens PJ. The distribution of BRAF gene fusions in solid tumors and response to targeted therapy. Int J Cancer 2015; 138:881-90. [PMID: 26314551 PMCID: PMC5049644 DOI: 10.1002/ijc.29825] [Citation(s) in RCA: 228] [Impact Index Per Article: 25.3] [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: 04/25/2015] [Revised: 08/16/2015] [Accepted: 08/19/2015] [Indexed: 12/12/2022]
Abstract
Although the BRAF V600E base substitution is an approved target for the BRAF inhibitors in melanoma, BRAF gene fusions have not been investigated as anticancer drug targets. In our study, a wide variety of tumors underwent comprehensive genomic profiling for hundreds of known cancer genes using the FoundationOne™ or FoundationOne Heme™ comprehensive genomic profiling assays. BRAF fusions involving the intact in-frame BRAF kinase domain were observed in 55 (0.3%) of 20,573 tumors, across 12 distinct tumor types, including 20 novel BRAF fusions. These comprised 29 unique 5' fusion partners, of which 31% (9) were known and 69% (20) were novel. BRAF fusions included 3% (14/531) of melanomas; 2% (15/701) of gliomas; 1.0% (3/294) of thyroid cancers; 0.3% (3/1,062) pancreatic carcinomas; 0.2% (8/4,013) nonsmall-cell lung cancers and 0.2% (4/2,154) of colorectal cancers, and were enriched in pilocytic (30%) vs. nonpilocytic gliomas (1%; p < 0.0001), Spitzoid (75%) vs. nonSpitzoid melanomas (1%; p = 0.0001), acinar (67%) vs. nonacinar pancreatic cancers (<1%; p < 0.0001) and papillary (3%) vs. nonpapillary thyroid cancers (0%; p < 0.03). Clinical responses to trametinib and sorafenib are presented. In conclusion, BRAF fusions are rare driver alterations in a wide variety of malignant neoplasms, but enriched in Spitzoid melanoma, pilocytic astrocytomas, pancreatic acinar and papillary thyroid cancers.
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Affiliation(s)
- Jeffrey S Ross
- Foundation Medicine, Inc., Cambridge, MA.,Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, NY
| | - Kai Wang
- Foundation Medicine, Inc., Cambridge, MA
| | | | - Laurie Gay
- Foundation Medicine, Inc., Cambridge, MA
| | | | | | | | | | | | | | | | | | | | - Brooke N Nakamura
- Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Adam Gray
- Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Michael K Wong
- Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
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