Diverse BRCA1 and BRCA2 Reversion Mutations in Circulating Cell-Free DNA of Therapy-Resistant Breast or Ovarian Cancer.
View/ Open
Date
2017-11-01Author
Weigelt, B
Comino-Méndez, I
de Bruijn, I
Tian, L
Meisel, JL
García-Murillas, I
Fribbens, C
Cutts, R
Martelotto, LG
Ng, CKY
Lim, RS
Selenica, P
Piscuoglio, S
Aghajanian, C
Norton, L
Murali, R
Hyman, DM
Borsu, L
Arcila, ME
Konner, J
Reis-Filho, JS
Greenberg, RA
Robson, ME
Turner, NC
Type
Journal Article
Metadata
Show full item recordAbstract
Purpose: Resistance to platinum-based chemotherapy or PARP inhibition in germline BRCA1 or BRCA2 mutation carriers may occur through somatic reversion mutations or intragenic deletions that restore BRCA1 or BRCA2 function. We assessed whether BRCA1/2 reversion mutations could be identified in circulating cell-free DNA (cfDNA) of patients with ovarian or breast cancer previously treated with platinum and/or PARP inhibitors.Experimental Design: cfDNA from 24 prospectively accrued patients with germline BRCA1 or BRCA2 mutations, including 19 patients with platinum-resistant/refractory ovarian cancer and five patients with platinum and/or PARP inhibitor pretreated metastatic breast cancer, was subjected to massively parallel sequencing targeting all exons of 141 genes and all exons and introns of BRCA1 and BRCA2 Functional studies were performed to assess the impact of the putative BRCA1/2 reversion mutations on BRCA1/2 function.Results: Diverse and often polyclonal putative BRCA1 or BRCA2 reversion mutations were identified in cfDNA from four patients with ovarian cancer (21%) and from two patients with breast cancer (40%). BRCA2 reversion mutations were detected in cfDNA prior to PARP inhibitor treatment in a patient with breast cancer who did not respond to treatment and were enriched in plasma samples after PARP inhibitor therapy. Foci formation and immunoprecipitation assays suggest that a subset of the putative reversion mutations restored BRCA1/2 function.Conclusions: Putative BRCA1/2 reversion mutations can be detected by cfDNA sequencing analysis in patients with ovarian and breast cancer. Our findings warrant further investigation of cfDNA sequencing to identify putative BRCA1/2 reversion mutations and to aid the selection of patients for PARP inhibition therapy. Clin Cancer Res; 23(21); 6708-20. ©2017 AACR.
Collections
Subject
Humans
Breast Neoplasms
Ovarian Neoplasms
Platinum
BRCA1 Protein
BRCA2 Protein
Drug Resistance, Neoplasm
Mutation
Germ-Line Mutation
Adult
Aged
Middle Aged
Female
Poly(ADP-ribose) Polymerase Inhibitors
Cell-Free Nucleic Acids
Research team
Molecular Oncology
Language
eng
Date accepted
2017-07-28
License start date
2017-11
Citation
Clinical cancer research : an official journal of the American Association for Cancer Research, 2017, 23 (21), pp. 6708 - 6720
Publisher
AMER ASSOC CANCER RESEARCH