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Defining the genomic landscape of vulvar squamous cell carcinoma (VSCC) using next generation sequencing: the role of HPV infection

Date

08 Oct 2016

Session

Poster Display

Presenters

Johanne Weberpals

Citation

Annals of Oncology (2016) 27 (6): 296-312. 10.1093/annonc/mdw374

Authors

J. Weberpals1, A. Clancy1, B. Lo2, H. Sekhon3, J. Dimitroulakos4, G. Goss5, J. Spaans4, M. Duciaume4

Author affiliations

  • 1 Obstetrics And Gynecology, University of Ottawa Faculty of Medicine, K1H 8L6 - Ottawa/CA
  • 2 Molecular Medicine, The Ottawa Hospital, K1H 8L6 - Ottawa/CA
  • 3 Pathology And Laboratory Medicine, The Ottawa Hospital Regional Cancer Centre, K1H 8L6 - Ottawa/CA
  • 4 Cancer Therapeutics, Ottawa Hospital Research Institute, K1H 8L6 - Ottawa/CA
  • 5 Medical Oncology, The Ottawa Hospital Regional Cancer Centre, K1H 8L6 - Ottawa/CA
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Resources

Abstract 3212

Background

Surgery for vulvar squamous cell carcinoma (VSCC) is associated with physical and psychological morbidity. Targeted therapies have not influenced outcomes, in part because the genomic landscape of VSCC remains incompletely understood and is complicated by two etiologies: HPV-dependent and HPV-independent disease. Next-generation sequencing (NGS) was used to identify somatic mutations by HPV status (+/-).

Methods

We conducted a retrospective review of patients (pts) seen at the Ottawa Hospital, Ottawa, Canada between 2000-2012 for VSCC. Clinical and pathological data was collected and pts with adequate tumor for HPV and molecular analysis were identified. HPV status was determined by polymerase chain reaction (PCR) with primers targeting the L1 region of HPV DNA. The Ion AmpliSeq™ Cancer Hotspot Panel v2 is being used to examine the presence of 50 known mutations.

Results

Forty-seven pts with VSCC were included. 22/47 (47%) were HPV+ and 25/47 (53%) were HPV-. Median age at diagnosis was 60 years (IQR 49-76) and 69 years (IQR 58-77), for HPV+ and HPV-, respectively. Disease stage by HPV status (+ vs -) was: I (15 vs 16), II (2 vs 0), III (2 vs 9) and IV (3 vs 0). Molecular data is available on 31 pts (17 HPV + , 14 HPV-). Among HPV+ pts, 15/17 had ≥ 1 mutation. Mutational frequencies among HPV+ pts were: TP53 7/17, PIK3CA 6/17, KDR 5/17, KIT: 3/17, FGFR3 3/17, and one mutation each of PTEN, CTNNB1, APC, KRAS, ERBB4, ATM, SMARCB1, FLT3, CDK2A. Among the HPV- pts, 12/14 had ≥ 1 mutation. Mutational frequencies among HPV- pts were: TP53 8/14, HRAS 3/14, CDKN2A 2/14, PI3KCA 2/14, KDR 1/14 and GNA11 1/14.

Conclusions

VSCC is characterized by a high mutation rate and a high prevalence of HPV infection. HPV-dependent and HPV-independent disease have unique mutational profiles. The high prevalence of “actionable” mutations supports the need for trials of targeted therapies. Molecular data on the full study cohort (n = 47) will be presented.

Clinical trial identification

none

Legal entity responsible for the study

N/A

Funding

University of Ottawa Pathology and Laboratory Medicine (PALM) Enrichment Fund

Disclosure

G. Goss: Previously received honoraria and consulting fees from AstraZeneca, Roche, Boehringer-Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb and Pfizer and research monies from AstraZeneca. All other authors have declared no conflicts of interest.

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