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Comprehensive assessment of actionable genomic alterations in primary colorectal carcinoma using targeted next-generation sequencing.


ABSTRACT:

Background

The clinical utility of comprehensive genomic profiling (CGP) for guiding treatment has gradually become the standard-of-care procedure for colorectal carcinoma (CRC). Here, we comprehensively assess emerging targeted therapy biomarkers using CGP in primary CRC.

Methods

A total of 575 primary CRCs were sequenced by ACTOnco® assay for genomic alterations, tumour mutational burden (TMB), and microsatellite instability (MSI).

Results

Eighteen percent of patients were detected as MSI-High (MSI-H), and the remaining cases were classified as microsatellite stable (MSS). Driver mutation prevalence in MSS CRCs were APC (74%), TP53 (67%), KRAS (47%), PIK3CA (21%) and BRAF (13%). The median TMBs for MSI-H and MSS patients were 37.8 mutations per mega base (mut/Mb) and 3.9 mut/Mb, respectively. Forty-seven percent of MSI-H CRC harboured at least one loss-of-function mutations in genes that may hamper immune checkpoint blockade. Among MSS RAS/RAF wild-type CRCs, 59% had at least one actionable mutation that may compromise the efficacy of anti-EGFR therapy. For late-stage CRC, 51% of patients are eligible for standard care actionability and the remaining 49% could be enrolled in clinical trials with investigational drugs.

Conclusions

This study highlights the essential role of CGP for identifying rational targeted therapy options in CRC.

SUBMITTER: Jan YH 

PROVIDER: S-EPMC9519871 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Comprehensive assessment of actionable genomic alterations in primary colorectal carcinoma using targeted next-generation sequencing.

Jan Yi-Hua YH   Tan Kien Thiam KT   Chen Shu-Jen SJ   Yip Timothy Tak Chun TTC   Lu Cu Tai CT   Lam Alfred King-Yin AK  

British journal of cancer 20220716 7


<h4>Background</h4>The clinical utility of comprehensive genomic profiling (CGP) for guiding treatment has gradually become the standard-of-care procedure for colorectal carcinoma (CRC). Here, we comprehensively assess emerging targeted therapy biomarkers using CGP in primary CRC.<h4>Methods</h4>A total of 575 primary CRCs were sequenced by ACTOnco® assay for genomic alterations, tumour mutational burden (TMB), and microsatellite instability (MSI).<h4>Results</h4>Eighteen percent of patients wer  ...[more]

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