Abstract 4918
Background
Oncogenic MET signaling is often deployed by tumors for malignant transformation through genomic events like tyrosine kinase domain mutations, juxtamembrane splicing mutation and amplified copy numbers, which can be inhibited by c-MET small molecule inhibitors. We present biochemical and clinical findings on a polymorphism of MET, which is common in the East Asian population.
Methods
Germline DNA (gDNA) of lung, nasopharyngeal, liver, breast, gastric and colon cancer cohorts among East Asians (n = 1,076) were genotyped for MET (p.N375S) polymorphism using digital droplet PCR (ddPCR). Relapse free survival (RFS) with curative intent was compared using log-rank test. Screening for protein-protein interaction was performed with SILAC. Clinical study is now enrolling MET-N375S+ squamous cell (SCC) head and neck patients to be given 30mg afatinib daily. Treatment outcome was determined with F-FDG PET/CT scan. Baseline (BL) and post-treatment biopsies were analyzed with immunohistochemistry for response biomarkers and in situ hybridization-proximity ligation assay (ISH-PLA) for receptor interaction.
Results
Fraction of the MET-N375S+ cases is comparable across cancer patients and cancer-free controls (9-18%). METN375S was associated with significantly shorter relapse-free survival (RFS) in SCC of the head and neck (HNSCC; P = 0.005) and lung (LUSC; P = 0.029). SILAC revealed interaction of MET-N375S with HER2 (P < 0.05). Two patients with refractory HNSCC who completed 1 cycle of afatinib, a pan-HER inhibitor, showed radiological tumour shrinkage and reduction in metabolic activity, with partial response by RECIST 1.1 measurement observed in one patient. Evaluable BL biopsy showed strong MET-HER2 interaction (ISH-PLA) with strong staining of phosphorylated MET and HER2 (IHC), which were significantly reduced post-treatment, indicative of successive intervention of MET-N375S/HER2 signaling.
Conclusions
We established MET-N375S as a biologically-distinct molecular subset of SCC that drives malignancy through HER2 signaling, and could serve as a predictive biomarker to select refractory patients with dismal prognosis for afatinib treatment.
Clinical trial identification
NCT03938012. Actual study start date: October 3, 2017; Estimated primary completion date: October 2021; Estimated study completion date: October 2022.
Editorial acknowledgement
Legal entity responsible for the study
National University Cancer Institute, Singapore.
Funding
National Medical Research Council, Singapore.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4900 - Molecular profiling and prognostic significance of TP53 mutations in Diffuse Large B Cell Lymphoma: identifying a high-risk subgroup
Presenter: Yuan-Kai Shi
Session: Poster Display session 3
Resources:
Abstract
3809 - Differential expression of various miRNAs in Pediatric Cytogenetically Normal Acute Myeloid Leukemia (CN-AML)
Presenter: Vikas Gaur
Session: Poster Display session 3
Resources:
Abstract
4750 - Circulating tumour cells in head and neck and non-small cell lung cancer
Presenter: Kenneth O'Byrne
Session: Poster Display session 3
Resources:
Abstract
3704 - OX40/OX40L protein expression in Non-small cell lung cancer and its role in clinical outcome and relationships with other immune biomarkers
Presenter: Xiaoshen Zhang
Session: Poster Display session 3
Resources:
Abstract
2235 - Effect of Serum Survivin on Survival among Non-Small Cell Lung Cancer Patients; NCI Experience
Presenter: Reham Rashed
Session: Poster Display session 3
Resources:
Abstract
2788 - Enhanced performance of prognostic estimation from TCGA RNAseq data using transfer learning.
Presenter: Helene Vanacker
Session: Poster Display session 3
Resources:
Abstract
4689 - Analysis of Circulating Tumor DNA for Early Relapse Detection in Stage III Colorectal Cancer After Adjuvant Chemotherapy
Presenter: Samuel Jacobs
Session: Poster Display session 3
Resources:
Abstract
1454 - Ascites-derived circulating microRNAs as potential diagnostic biomarkers of gastric cancer-associated malignant ascites
Presenter: Hye Sook Han
Session: Poster Display session 3
Resources:
Abstract
5574 - Results from TRIO030, a Pre-Surgical Tissue-Acquisition Study to Evaluate Molecular Alterations in Human Breast Cancer Tissue Following Short-Term Exposure to the Androgen Receptor Antagonist Darolutamide
Presenter: Hsiao-Wang Chen
Session: Poster Display session 3
Resources:
Abstract
1787 - JMJD2A is a novel epigenetic factor of chemotherapeutic susceptibility in gastric cancer
Presenter: Yasushi Sato
Session: Poster Display session 3
Resources:
Abstract