NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatment

Despite impressive and durable responses, nonsmall cell lung cancer (NSCLC) patients treated with anaplastic lymphoma kinase (ALK) inhibitors (ALK-Is) ultimately progress due to development of resistance. Here, we have evaluated the clinical utility of circulating tumor DNA (ctDNA) profiling by next...

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Autores: Sánchez-Herrero, Estela, Serna-Blasco, Roberto, Ivanchuk, Vadym, García-Campelo, Rosario, Dómine Gómez, Manuel, Sánchez, José M., Massutí, Bartomeu, Reguart, Noemí, Camps, Carlos, Sanz-Moreno, Sandra, Calabuig-Fariñas, Sílvia, Jantus-Lewintre, Eloisa, Arnal, Magdalena, Fernández-Orth, Dietmar, Calvo, Virginia, González-Rumayor, Víctor, Provencio, Mariano, Romero, Atocha
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/48755
Acceso en línea:http://hdl.handle.net/10230/48755
http://dx.doi.org/10.1002/1878-0261.13033
Access Level:acceso abierto
Palabra clave:EML4-ALK
ALK-TKI
NGS
NSCLC
Liquid biopsy
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spelling NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatmentSánchez-Herrero, EstelaSerna-Blasco, RobertoIvanchuk, VadymGarcía-Campelo, RosarioDómine Gómez, ManuelSánchez, José M.Massutí, BartomeuReguart, NoemíCamps, CarlosSanz-Moreno, SandraCalabuig-Fariñas, SílviaJantus-Lewintre, EloisaArnal, MagdalenaFernández-Orth, DietmarCalvo, VirginiaGonzález-Rumayor, VíctorProvencio, MarianoRomero, AtochaEML4-ALKALK-TKINGSNSCLCLiquid biopsyDespite impressive and durable responses, nonsmall cell lung cancer (NSCLC) patients treated with anaplastic lymphoma kinase (ALK) inhibitors (ALK-Is) ultimately progress due to development of resistance. Here, we have evaluated the clinical utility of circulating tumor DNA (ctDNA) profiling by next-generation sequencing (NGS) upon disease progression. We collected 26 plasma and two cerebrospinal fluid samples from 24 advanced ALK-positive NSCLC patients at disease progression to an ALK-I. These samples were analyzed by NGS and digital PCR. A tool to retrieve variants at the ALK locus was developed (VALK tool). We identified at least one resistance mutation in the ALK locus in ten (38.5%) plasma samples; the G1269A and G1202R mutations were the most prevalent among patients progressing to first- and second-generation ALK-Is, respectively. Overall, 61 somatic mutations were detected in 14 genes: TP53, ALK, PIK3CA, SMAD4, MAP2K1 (MEK1), FGFR2, FGFR3, BRAF, EGFR, IDH2, MYC, MET, CCND3, and CCND1. Specifically, a deletion in exon 19 in EGFR, a non-V600 BRAF mutation (G466V), and the F129L mutation in MAP2K1 were identified in four patients who showed no objective survival benefit from ALK-Is. Potential ALK-I-resistance mutations were also found in PIK3CA and IDH2. Finally, a c-MYC gain, along with a loss of CCND1 and FGFR3, was detected in a patient progressing on a first-line treatment with crizotinib. We conclude that NGS analysis of liquid biopsies upon disease progression identified different putative ALK-I-resistance mutations in most cases and could be a valuable approach for therapy decision making.The authors wish to thank the donors, and the BIOBANK HOSPITAL UNIVERSITARIO PUERTA DE HIERRO MAJADAHONDA (HUPHM)/INSTITUTO DE INVESTIGACIÓN SANITARIA PUERTA DE HIERRO-SEGOVIA DE ARANA (IDIPHISA) (PT17/0015/0020 in the Spanish National Biobanks Network) for the human specimens used in this study. This study has been funded by Instituto de Salud Carlos III through the project ‘PI17/01977’ (Co-funded by European Regional Development Fund/European Social Fund ‘A way to make Europe’/‘Investing in your future’). The work presented in this paper also received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 875160. ES was funded by the Consejería de Ciencia, Universidades e Innovación of the Comunidad de Madrid (Doctorados Industriales of the Comunidad de Madrid IND2019/BMD-17258). RS was funded by the Consejería de Educación, Juventud y Deporte of the Comunidad de Madrid and by the Fondo Social Europeo (Programa Operativo de Empleo Juvenil, and Iniciativa de Empleo Juvenil, PEJD-2018-PRE/BMD-8640).Wiley202120212021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/48755http://dx.doi.org/10.1002/1878-0261.13033reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésMol Oncol. 2021;15(9):2363-76info:eu-repo/grantAgreement/EC/H2020/875160© 2021 The Authors. Published by FEBS Press and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/487552026-05-29T05:05:01Z
dc.title.none.fl_str_mv NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatment
title NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatment
spellingShingle NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatment
Sánchez-Herrero, Estela
EML4-ALK
ALK-TKI
NGS
NSCLC
Liquid biopsy
title_short NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatment
title_full NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatment
title_fullStr NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatment
title_full_unstemmed NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatment
title_sort NGS-based liquid biopsy profiling identifies mechanisms of resistance to ALK inhibitors: a step toward personalized NSCLC treatment
dc.creator.none.fl_str_mv Sánchez-Herrero, Estela
Serna-Blasco, Roberto
Ivanchuk, Vadym
García-Campelo, Rosario
Dómine Gómez, Manuel
Sánchez, José M.
Massutí, Bartomeu
Reguart, Noemí
Camps, Carlos
Sanz-Moreno, Sandra
Calabuig-Fariñas, Sílvia
Jantus-Lewintre, Eloisa
Arnal, Magdalena
Fernández-Orth, Dietmar
Calvo, Virginia
González-Rumayor, Víctor
Provencio, Mariano
Romero, Atocha
author Sánchez-Herrero, Estela
author_facet Sánchez-Herrero, Estela
Serna-Blasco, Roberto
Ivanchuk, Vadym
García-Campelo, Rosario
Dómine Gómez, Manuel
Sánchez, José M.
Massutí, Bartomeu
Reguart, Noemí
Camps, Carlos
Sanz-Moreno, Sandra
Calabuig-Fariñas, Sílvia
Jantus-Lewintre, Eloisa
Arnal, Magdalena
Fernández-Orth, Dietmar
Calvo, Virginia
González-Rumayor, Víctor
Provencio, Mariano
Romero, Atocha
author_role author
author2 Serna-Blasco, Roberto
Ivanchuk, Vadym
García-Campelo, Rosario
Dómine Gómez, Manuel
Sánchez, José M.
Massutí, Bartomeu
Reguart, Noemí
Camps, Carlos
Sanz-Moreno, Sandra
Calabuig-Fariñas, Sílvia
Jantus-Lewintre, Eloisa
Arnal, Magdalena
Fernández-Orth, Dietmar
Calvo, Virginia
González-Rumayor, Víctor
Provencio, Mariano
Romero, Atocha
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv EML4-ALK
ALK-TKI
NGS
NSCLC
Liquid biopsy
topic EML4-ALK
ALK-TKI
NGS
NSCLC
Liquid biopsy
description Despite impressive and durable responses, nonsmall cell lung cancer (NSCLC) patients treated with anaplastic lymphoma kinase (ALK) inhibitors (ALK-Is) ultimately progress due to development of resistance. Here, we have evaluated the clinical utility of circulating tumor DNA (ctDNA) profiling by next-generation sequencing (NGS) upon disease progression. We collected 26 plasma and two cerebrospinal fluid samples from 24 advanced ALK-positive NSCLC patients at disease progression to an ALK-I. These samples were analyzed by NGS and digital PCR. A tool to retrieve variants at the ALK locus was developed (VALK tool). We identified at least one resistance mutation in the ALK locus in ten (38.5%) plasma samples; the G1269A and G1202R mutations were the most prevalent among patients progressing to first- and second-generation ALK-Is, respectively. Overall, 61 somatic mutations were detected in 14 genes: TP53, ALK, PIK3CA, SMAD4, MAP2K1 (MEK1), FGFR2, FGFR3, BRAF, EGFR, IDH2, MYC, MET, CCND3, and CCND1. Specifically, a deletion in exon 19 in EGFR, a non-V600 BRAF mutation (G466V), and the F129L mutation in MAP2K1 were identified in four patients who showed no objective survival benefit from ALK-Is. Potential ALK-I-resistance mutations were also found in PIK3CA and IDH2. Finally, a c-MYC gain, along with a loss of CCND1 and FGFR3, was detected in a patient progressing on a first-line treatment with crizotinib. We conclude that NGS analysis of liquid biopsies upon disease progression identified different putative ALK-I-resistance mutations in most cases and could be a valuable approach for therapy decision making.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/48755
http://dx.doi.org/10.1002/1878-0261.13033
url http://hdl.handle.net/10230/48755
http://dx.doi.org/10.1002/1878-0261.13033
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Mol Oncol. 2021;15(9):2363-76
info:eu-repo/grantAgreement/EC/H2020/875160
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
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