Somatic and Germline BRCA 1 and 2 Mutations in Advanced NSCLC From the SAFIR02-Lung Trial

Bibliographic Details
Title: Somatic and Germline BRCA 1 and 2 Mutations in Advanced NSCLC From the SAFIR02-Lung Trial
Authors: Jordi Remon, MD, Benjamin Besse, MD, PhD, Alexandra Leary, MD, PhD, Ivan Bièche, MD, Bastien Job, MD, Ludovic Lacroix, PhD, Aurélie Auguste, PhD, Marjorie Mauduit, PhD, Clarisse Audigier-Valette, MD, Judith Raimbourg, MD, Anne Madroszyk, MD, Stefan Michels, MD, Mohammed Amine Bayar, MD, Marta Jimenez, PhD, Jean-Charles Soria, MD, PhD, Etienne Rouleau, PhD, PharmD, MPH, Fabrice Barlesi, MD, PhD
Source: JTO Clinical and Research Reports, Vol 1, Iss 3, Pp 100068- (2020)
Publisher Information: Elsevier, 2020.
Publication Year: 2020
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: BRCA mutation, Advanced non–small cell lung cancer, PARP inhibitors, Next-generation sequencing, SAFIR trial, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Introduction: Molecular profiling is considered a standard of care in advanced NSCLC. A comprehensive next-generation sequencing panel can discover somatic or germline BRCA1/2 mutations that are new druggable molecular alterations. However, the phenotypic and potential therapeutic relevance of BRCA1/2 mutation in NSCLC remains poorly defined. Methods: From April 2014 to March 2017, 600 newly diagnosed, EGFR/ALK negative patients with advanced NSCLC were enrolled in the SAFIR02-Lung trial. Molecular profiling was done at study entry on archival tissue or frozen tissue collected from a new biopsy specimen before the third cycle of platinum-based chemotherapy. The prevalence of BRCA1/2 variants and its biological relevance were assessed. A homologous recombinant deficiency (HRD) score was based on the copy number variation data, and the germline status was determined by blood analysis. The BRCA Share database and the French CGG consortium were the references for the variant classification. Results: Of 379 patients with a molecular profile discussed in a tumor molecular board, BRCA1/2 variants were identified in 20 patients (5.3%), including eight patients (2.1%) with a confirmed pathogenic BRCA mutation. Two patients (0.5%) harbored a germline BRCA2 mutation, and for six others, a somatic BRCA mutation was identified (1.6%). All were men and mainly smokers (88%). The overall response rate to chemotherapy was 13%. BRCA variants of unknown significance were detected in 12 patients (3.2%), achieving an 8.3% overall response rate with chemotherapy. One-third of tumors carrying pathogenic BRCA mutations or variants of unknown significance had biallelic inactivation and high HRD score. Overall survival of this cohort was 12.8 months. Conclusions: Pathogenic BRCA1/2 mutations occur in 2.1% of patients with advanced NSCLC. The predictive role of BRCA mutation for making treatment decisions in NSCLC seems limited based on clinical response (low platinum sensitivity) and molecular features (discrepancy between biallelic inactivation and high HRD score).
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2666-3643
Relation: http://www.sciencedirect.com/science/article/pii/S2666364320300916; https://doaj.org/toc/2666-3643
DOI: 10.1016/j.jtocrr.2020.100068
Access URL: https://doaj.org/article/cb706811cafb4c91896d59398b20d6b7
Accession Number: edsdoj.b706811cafb4c91896d59398b20d6b7
Database: Directory of Open Access Journals
More Details
ISSN:26663643
DOI:10.1016/j.jtocrr.2020.100068
Published in:JTO Clinical and Research Reports
Language:English