Schubart Christoph, Tögel Lars, Carta Maria Giulia, Hetzner Philip, Helbig Lina, Zaglas Charlotte, Ziegler Maria, Stöhr Robert, Hölsken Annett, Hoyer Juliane, Ferrazzi Fulvia, Neufert Clemens, Lettmaier Sebastian, Pavel Marianne, Golcher Henriette, Mueller Sarina K, Fuchs Florian, Schulmeyer Carla E, Beckmann Matthias W, Wullich Bernd, Agaimy Abbas, Reis Andre, Hartmann Arndt, Meidenbauer Norbert, Spoerl Silvia, Haller Florian, Moskalev Evgeny A
Institute of Pathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
Int J Cancer. 2025 Sep 1;157(5):964-979. doi: 10.1002/ijc.35457. Epub 2025 Apr 25.
Alterations in Homologous Recombination Repair (HRR) Pathway genes have been found to be associated with HR-Deficiency (HRD), which is an approved biomarker for PARP Inhibitor (PARPi) treatment. The aim of a Molecular Tumor Board (MTB) is to identify molecular alterations in cancer patients with advanced tumors that may suggest off-label treatment options. So far, few studies have analyzed the presence of HRR gene mutations and their association with HRD outside of clinical studies. Currently, no data on HRD testing in the setting of a MTB have been published. For the present study, a cohort of 237 patients encompassing 24 different tumor entities was collected from the MTB of the Comprehensive Cancer Center Erlangen-EMN. We show that an elevated Genomic Instability Score (GIS ≥42) can occur in samples with and without mutations in HRR-related genes. Overall, 38.1% of cancer samples with BRCA1/2 mutations, 10.9% of tumors with alterations in HRR genes other than BRCA1/2, and 4.3% of cancer samples without HRR gene mutations harbored an elevated GIS. Notably, our data show that various inactivating BRCA1/2 mutations are not associated with an elevated GIS. Taken together, panCancer assessment of HRD in addition to BRCA1/2 and other HRR gene mutational analysis is recommended to guide decisions regarding PARPi treatment. Further studies are needed to establish thresholds for GIS in non-ovarian cancer entities. Finally, HRD can be observed in 4.3% of BRCA1/2 and other HRR gene wildtype cancer samples, and may emerge as an independent biomarker for PARPi in the future.
同源重组修复(HRR)通路基因的改变已被发现与HR缺陷(HRD)相关,HRD是一种已获批准的PARP抑制剂(PARPi)治疗生物标志物。分子肿瘤委员会(MTB)的目的是识别晚期肿瘤癌症患者中可能提示非标签治疗选择的分子改变。到目前为止,很少有研究在临床研究之外分析HRR基因突变的存在及其与HRD的关联。目前,尚未发表关于MTB背景下HRD检测的数据。在本研究中,从埃尔朗根综合癌症中心 - EMN的MTB收集了237名患者的队列,涵盖24种不同的肿瘤实体。我们表明,在有和没有HRR相关基因突变的样本中都可能出现基因组不稳定评分升高(GIS≥42)。总体而言,38.1%的BRCA1/2突变癌症样本、10.9%的BRCA1/2以外的HRR基因改变的肿瘤以及4.3%的无HRR基因突变的癌症样本的GIS升高。值得注意的是,我们的数据表明,各种失活的BRCA1/2突变与GIS升高无关。综上所述,除了BRCA1/2和其他HRR基因突变分析外,建议对HRD进行泛癌评估,以指导PARPi治疗决策。需要进一步研究来确定非卵巢癌实体中GIS的阈值。最后,在4.3%的BRCA1/2和其他HRR基因野生型癌症样本中可观察到HRD,未来它可能成为PARPi的独立生物标志物。