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Boysen G, Rodrigues DN, Rescigno P, Seed G, Dolling D, Riisnaes R, Crespo M, Zafeiriou Z, Sumanasuriya S, Bianchini D, Hunt J, Moloney D, Perez-Lopez R, Tunariu N, Miranda S, Figueiredo I, Ferreira A, Christova R, Gil V, Aziz S, Bertan C, de Oliveira FM, Atkin M, Clarke M, Goodall J, Sharp A, MacDonald T, Rubin MA, Yuan W, Barbieri CE, Carreira S, Mateo J, de Bono JS. SPOP-Mutated/CHD1-Deleted Lethal Prostate Cancer and Abiraterone Sensitivity. Clin Cancer Res 2018; 24:5585-5593. [PMID: 30068710 DOI: 10.1158/1078-0432.ccr-18-0937] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/11/2018] [Accepted: 07/25/2018] [Indexed: 12/30/2022]
Abstract
Purpose: CHD1 deletions and SPOP mutations frequently cooccur in prostate cancer with lower frequencies reported in castration-resistant prostate cancer (CRPC). We monitored CHD1 expression during disease progression and assessed the molecular and clinical characteristics of CHD1-deleted/SPOP-mutated metastatic CRPC (mCRPC).Experimental Design: We identified 89 patients with mCRPC who had hormone-naive and castration-resistant tumor samples available: These were analyzed for CHD1, PTEN, and ERG expression by IHC. SPOP status was determined by targeted next-generation sequencing (NGS). We studied the correlations between these biomarkers and (i) overall survival from diagnosis; (ii) overall survival from CRPC; (iii) duration of abiraterone treatment; and (iv) response to abiraterone. Relationship with outcome was analyzed using Cox regression and log-rank analyses.Results: CHD1 protein loss was detected in 11 (15%) and 13 (17%) of hormone-sensitive prostate cancer (HSPC) and CRPC biopsies, respectively. Comparison of CHD1 expression was feasible in 56 matched, same patient HSPC and CRPC biopsies. CHD1 protein status in HSPC and CRPC correlated in 55 of 56 cases (98%). We identified 22 patients with somatic SPOP mutations, with six of these mutations not reported previously in prostate cancer. SPOP mutations and/or CHD1 loss was associated with a higher response rate to abiraterone (SPOP: OR, 14.50 P = 0.001; CHD1: OR, 7.30, P = 0.08) and a longer time on abiraterone (SPOP: HR, 0.37, P = 0.002, CHD1: HR, 0.50, P = 0.06).Conclusions: SPOP-mutated mCRPCs are strongly enriched for CHD1 loss. These tumors appear highly sensitive to abiraterone treatment. Clin Cancer Res; 24(22); 5585-93. ©2018 AACR.
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Affiliation(s)
| | | | - Pasquale Rescigno
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - George Seed
- Institute of Cancer Research, London, United Kingdom
| | - David Dolling
- Institute of Cancer Research, London, United Kingdom
| | - Ruth Riisnaes
- Institute of Cancer Research, London, United Kingdom
| | - Mateus Crespo
- Institute of Cancer Research, London, United Kingdom
| | - Zafeiris Zafeiriou
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Semini Sumanasuriya
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Diletta Bianchini
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Joanne Hunt
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Deirdre Moloney
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | - Nina Tunariu
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | | | - Ana Ferreira
- Institute of Cancer Research, London, United Kingdom
| | | | - Veronica Gil
- Institute of Cancer Research, London, United Kingdom
| | - Sara Aziz
- Institute of Cancer Research, London, United Kingdom
| | | | | | - Mark Atkin
- Institute of Cancer Research, London, United Kingdom
| | | | - Jane Goodall
- Institute of Cancer Research, London, United Kingdom
| | - Adam Sharp
- Institute of Cancer Research, London, United Kingdom
| | - Theresa MacDonald
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York, New York.,Englander Institute for Precision Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York
| | - Mark A Rubin
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York, New York.,Englander Institute for Precision Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York.,Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Wei Yuan
- Institute of Cancer Research, London, United Kingdom
| | - Christopher E Barbieri
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York, New York.,Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York
| | | | - Joaquin Mateo
- Vall D'Hebron Institute of Oncology, Barcelona, Spain
| | - Johann S de Bono
- Institute of Cancer Research, London, United Kingdom. .,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
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Sundar R, Basu B, Wilson RH, Spicer JF, Jones RH, Krebs M, Brada M, Talbot DC, Steele N, Hall E, Tovey H, Carreira S, de Oliveira FM, Swales KE, Balarajah G, Dawes JC, Parmar M, De Bono JS, Banerji U. TAX-TORC: A phase I trial of vistusertib (AZD2014) in combination with weekly paclitaxel with integrated pharmacodynamic (PD) and molecular characterization (MC) studies. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.2571] [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: 11/20/2022] Open
Abstract
2571 Background: In ovarian cells isolated from ascites, p-S6K levels were found to correlate with resistance to chemotherapy. We hypothesised that inhibiting p-S6K signalling with dual m-TORC1/2 inhibitor vistusertib (V) in addition to paclitaxel (P) would improve outcomes of patients with high-grade serous ovarian cancer (HGSOC). Methods: In the dose escalation part, weekly P 80mg/m2IV (6/7 weeks) was evaluated in combination with two schedules of V; Schedule A: V (25, 50 or 75mg) BID PO on day(D) 1-3/week and Schedule B: V (75 or 100mg) BID PO D1-2/week. This was followed by an expansion cohort in 25 HGSOC patients. Results: Dose limiting toxicities in Schedule A were fatigue and mucositis and in Schedule B were diarrhoea, rash and fatigue. The AUC, Cmax and half-life of V in the 50mg-cohort were 2821ng.hr/ml, 926ng/ml and 3hrs, comparable to single agent studies. PD analysis (from six 50mg-cohort patients) in platelet-rich plasma showed increased phosphorylation of Ser473 AKT following P induction (1.4 fold, p = 0.1378). Following addition of V to P, phosphorylation levels 4hrs post-treatment with V fell significantly to 53% of pre-dose levels (p = 0.0495). This was 61% lower than the corresponding time point following P alone. Based on toxicity, pharmacokinetic and PD evaluation, recommended phase 2 dose was established as P 80mg/m2 D1 and V 50mg BID D1-3 for 6/7 weeks. In the HGSOC expansion, 96% of patients had relapsed within 12 months of last platinum therapy and 100% had received previous paclitaxel, with a median of 3 previous lines of treatments. RECIST and GCIG CA125 response rates were 13/25 (52%) and 15/25 (60%) respectively, with median progression free survival of 5.5 months. MC was performed on archival tumor tissue of 24/25 HGSOC expansion cohort patients, with the most common mutations occurring in p53 (100%), BRCA (17%), and MUC16 (17%). ATM mutations occurred in 17% (n = 4), 3 of whom had a response. Conclusions: We report a highly active combination of paclitaxel with an intermittent schedule of vistusertib in patients with HGSOC. This combination is now being evaluated in a randomised controlled trial for this indication. Clinical trial information: NCT02193633.
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Affiliation(s)
- Raghav Sundar
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Bristi Basu
- University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Richard H. Wilson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, United Kingdom
| | | | - Robert Hugh Jones
- Cardiff University and Velindre Cancer Centre, Cardiff, United Kingdom
| | - Matthew Krebs
- The Christie NHS Foundation Trust and The University of Manchester, Manchester, United Kingdom
| | | | | | - Nicola Steele
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Holly Tovey
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | | | | | - Karen E Swales
- The Institute of Cancer Research, London, United Kingdom
| | | | - Joanna C Dawes
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Mona Parmar
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Johann S. De Bono
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Udai Banerji
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
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