Diverse BRCA1 and BRCA2 reversion mutations in circulating cell-free DNA of therapy-resistant breast or ovarian cancer Journal Article

   

Authors:	Weigelt, B.; Comino-Méndez, I.; de Bruijn, I.; Tian, L.; Meisel, J. L.; Garcia-Murillas, I.; Fribbens, C.; Cutts, R.; Martelotto, L. G.; Ng, C. K. Y.; Lim, R. S.; Selenica, P.; Piscuoglio, S.; Aghajanian, C.; Norton, L.; Murali, R.; Hyman, D. M.; Borsu, L.; Arcila, M. E.; Konner, J.; Reis, J. S.; Greenberg, R. A.; Robson, M. E.; Turner, N. C.
Article Title:	Diverse BRCA1 and BRCA2 reversion mutations in circulating cell-free DNA of therapy-resistant breast or ovarian cancer
Abstract:	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. (C) 2017 AACR.
Keywords:	carcinoma; repair; pathway; heterogeneity; landscape; roles; poly(adp-ribose) polymerase; copy number; parp inhibitors; tumor dna
Journal Title:	Clinical Cancer Research
Volume:	23
Issue:	21
ISSN:	1078-0432
Publisher:	American Association for Cancer Research
Date Published:	2017-11-01
Start Page:	6708
End Page:	6720
Language:	English
ACCESSION:	WOS:000414165200033
DOI:	10.1158/1078-0432.ccr-17-0544
PROVIDER:	wos
PUBMED:	28765325
PMCID:	PMC5728372
Notes:	Article -- Source: Wos