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Identifying homologous recombination deficiency in breast cancer: genomic instability score distributions differ among breast cancer subtypes.


ABSTRACT:

Purpose

A 3-biomarker homologous recombination deficiency (HRD) score is a key component of a currently FDA-approved companion diagnostic assay to identify HRD in patients with ovarian cancer using a threshold score of ≥ 42, though recent studies have explored the utility of a lower threshold (GIS ≥ 33). The present study evaluated whether the ovarian cancer thresholds may also be appropriate for major breast cancer subtypes by comparing the genomic instability score (GIS) distributions of BRCA1/2-deficient estrogen receptor-positive breast cancer (ER + BC) and triple-negative breast cancer (TNBC) to the GIS distribution of BRCA1/2-deficient ovarian cancer.

Methods

Ovarian cancer and breast cancer (ER + BC and TNBC) tumors from ten study cohorts were sequenced to identify pathogenic BRCA1/2 mutations, and GIS was calculated using a previously described algorithm. Pathologic complete response (pCR) to platinum therapy was evaluated in a subset of TNBC samples. For TNBC, a threshold was set and threshold validity was assessed relative to clinical outcomes.

Results

A total of 560 ovarian cancer, 805 ER + BC, and 443 TNBC tumors were included. Compared to ovarian cancer, the GIS distribution of BRCA1/2-deficient samples was shifted lower for ER + BC (p = 0.015), but not TNBC (p = 0.35). In the subset of TNBC samples, univariable logistic regression models revealed that GIS status using thresholds of ≥ 42 and ≥ 33 were significant predictors of response to platinum therapy.

Conclusions

This study demonstrated that the GIS thresholds used for ovarian cancer may also be appropriate for TNBC, but not ER + BC. GIS thresholds in TNBC were validated using clinical response data to platinum therapy.

SUBMITTER: Lenz L 

PROVIDER: S-EPMC10504389 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature

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Identifying homologous recombination deficiency in breast cancer: genomic instability score distributions differ among breast cancer subtypes.

Lenz Lauren L   Neff Chris C   Solimeno Cara C   Cogan Elizabeth S ES   Abramson Vandana G VG   Boughey Judy C JC   Falkson Carla C   Goetz Matthew P MP   Ford James M JM   Gradishar William J WJ   Jankowitz Rachel C RC   Kaklamani Virginia G VG   Marcom P Kelly PK   Richardson Andrea L AL   Storniolo Anna Maria AM   Tung Nadine M NM   Vinayak Shaveta S   Hodgson Darren R DR   Lai Zhongwu Z   Dearden Simon S   Hennessy Bryan T BT   Mayer Erica L EL   Mills Gordon B GB   Slavin Thomas P TP   Gutin Alexander A   Connolly Roisin M RM   Telli Melinda L ML   Stearns Vered V   Lanchbury Jerry S JS   Timms Kirsten M KM  

Breast cancer research and treatment 20230817 1


<h4>Purpose</h4>A 3-biomarker homologous recombination deficiency (HRD) score is a key component of a currently FDA-approved companion diagnostic assay to identify HRD in patients with ovarian cancer using a threshold score of ≥ 42, though recent studies have explored the utility of a lower threshold (GIS ≥ 33). The present study evaluated whether the ovarian cancer thresholds may also be appropriate for major breast cancer subtypes by comparing the genomic instability score (GIS) distributions  ...[more]

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