Predictive biomarkers for immune checkpoint inhibitor (ICI) and poly (ADP-ribose) polymerase (PARP) inhibitor (PARPi) in advanced-stage breast carcinoma

Sarah A. Anderson , Brooke B. Bartow , Gene P. Siegal , Shuko Harada , Ceren Yalniz , Katia Khoury , Lei Huo , Qingqing Ding , Aysegul A. Sahin , Shi Wei , Xiao Huang
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引用次数: 0

Abstract

Purpose

Poly (adenosine diphosphate-ribose) polymerase inhibitors (PARPi) have demonstrated antitumoral activity in cancers with a homologous recombination deficiency (HRD) and have been approved in 2018 by the U.S. Food and Drug Administration (FDA) for the treatment of germline BRCA1/2-mutation-associated breast cancer (BC). Clinical trials evaluating the combination of the immune checkpoint inhibitor (ICI) and PARPi are on-going. PD-L1-immunohistochemistry (IHC) and tumor mutation burden (TMB) are FDA approved predictive markers for ICI therapy in a subset of patients with breast cancer. We investigated the associations between these two biomarkers and HRD parameters in advanced stage BC.

Methods

Patients diagnosed with invasive BC between 2014 and 2022 whose tumors underwent a PD-L1 22C3 assay and/or comprehensive genomic profiling by NGS were identified. TMB, homologous recombination repair (HRR) gene mutations, and the loss of heterozygosity (LOH) score were collected. PD-L1 IHC and TMB were considered as markers for ICI. The BRCA1/2 gene, BRCAwt-HRR genes, and the LOH score were flagged as HRD criteria.

Results

Sixty-eight patients with locally advanced or metastatic BC were included. There were no significant difference in LOH status, BRCAwt-HRR gene mutations or BRCA1/2 mutations between PD-L1-positive and PD-L1-negative groups. The TMB score was not significantly associated with BRCAwt-HRR or BRCA1/2 gene mutations. LOH-high tumors showed a slightly higher TMB score than the LOH-low tumors.
Among the 68 patients, two received both ICIs and PARPi therapies sequentially, one had a complete response (CR) (TMB: 5 muts/Mb; BRCA1 mutated) and the other had progressive disease (BRCA VUS, variants of uncertain significance).

Conclusions

Our study failed to show significant associations between PD-L1 IHC and HRD parameters. The TMB score was positively associated with LOH-high status, but not a HRR gene mutation. Independently evaluating these markers needs to be considered to select patients for targeting therapies. Clinical outcome needs further evaluation.
免疫检查点抑制剂(ICI)和聚(adp -核糖)聚合酶(PARP)抑制剂(PARPi)在晚期乳腺癌中的预测性生物标志物
聚二磷酸腺苷核糖聚合酶抑制剂(PARPi)在同源重组缺陷(HRD)癌症中显示出抗肿瘤活性,并于2018年被美国食品和药物管理局(FDA)批准用于治疗种系brca1 /2突变相关乳腺癌(BC)。评估免疫检查点抑制剂(ICI)和PARPi联合使用的临床试验正在进行中。pd - l1免疫组织化学(IHC)和肿瘤突变负荷(TMB)是FDA批准的乳腺癌患者ICI治疗的预测指标。我们研究了这两种生物标志物与晚期BC HRD参数之间的关系。方法对2014年至2022年间诊断为浸润性BC的患者进行鉴定,这些患者的肿瘤接受了PD-L1 22C3检测和/或NGS的综合基因组分析。收集TMB、同源重组修复(HRR)基因突变、杂合性缺失(LOH)评分。PD-L1 IHC和TMB被认为是ICI的标志物。BRCA1/2基因、brcat - hrr基因和LOH评分被标记为HRD标准。结果本组纳入68例局部晚期或转移性BC患者。pd - l1阳性组与pd - l1阴性组的LOH状态、brcat - hrr基因突变、BRCA1/2突变无显著差异。TMB评分与brcat - hrr或BRCA1/2基因突变无显著相关性。高loh肿瘤的TMB评分略高于低loh肿瘤。在68例患者中,2例患者先后接受了ICIs和PARPi治疗,1例患者完全缓解(CR) (TMB: 5 muts/Mb;BRCA1突变),另一个有进展性疾病(BRCA VUS,不确定意义的变体)。结论我们的研究未显示PD-L1 IHC与HRD参数之间存在显著相关性。TMB评分与高loh状态呈正相关,但与HRR基因突变无关。在选择患者进行靶向治疗时,需要考虑独立评估这些标志物。临床结果有待进一步评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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