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Autor(en) / Beteiligte
Titel
Radiologic and Genomic Evolution of Individual Metastases during HER2 Blockade in Colorectal Cancer
Ist Teil von
  • Cancer cell, 2018-07, Vol.34 (1), p.148-162.e7
Ort / Verlag
United States: Elsevier Inc
Erscheinungsjahr
2018
Quelle
MEDLINE
Beschreibungen/Notizen
  • Targeting HER2 is effective in 24% of ERBB2 amplified metastatic colorectal cancer; however, secondary resistance occurs in most of the cases. We studied the evolution of individual metastases during treatment to discover spatially resolved determinants of resistance. Circulating tumor DNA (ctDNA) analysis identified alterations associated with resistance in the majority of refractory patients. ctDNA profiles and lesion-specific radiographic reports revealed organ- or metastasis-private evolutionary patterns. When radiologic assessments documented progressive disease in target lesions, response to HER2 blockade was retained in other metastases. Genomic and functional analyses on samples and cell models from eight metastases of a patient co-recruited to a postmortem study unveiled lesion-specific evolutionary trees and pharmacologic vulnerabilities. Lesion size and contribution of distinct metastases to plasma ctDNA were correlated. [Display omitted] •ERBB2, RAS, PIK3CA mutations are associated with resistance to HER2 blockade in mCRC•A liquid biopsy test would have identified >85% primary resistance cases•Lesion size and contribution to plasma ctDNA were correlated•Patterns of lesion-specific mutations and TCR were longitudinally compared in blood Siravegna et al. identify genetic events associated with ERBB2 amplified metastatic colorectal cancers resistant to trastuzumab plus lapatinib treatment and reveal lesion-private evolutionary patterns. Analyses of metastases from a patient unveil metastasis-specific evolution and pharmacologic vulnerabilities.
Sprache
Englisch
Identifikatoren
ISSN: 1535-6108
eISSN: 1878-3686
DOI: 10.1016/j.ccell.2018.06.004
Titel-ID: cdi_proquest_miscellaneous_2068345310
Format
Schlagworte
Adenocarcinoma - diagnostic imaging, Adenocarcinoma - drug therapy, Adenocarcinoma - genetics, Adenocarcinoma - secondary, Animals, Antineoplastic Combined Chemotherapy Protocols - adverse effects, Antineoplastic Combined Chemotherapy Protocols - therapeutic use, Class I Phosphatidylinositol 3-Kinases - genetics, Clinical Decision-Making, clonal evolution, colorectal cancer, Colorectal Neoplasms - diagnostic imaging, Colorectal Neoplasms - drug therapy, Colorectal Neoplasms - genetics, Colorectal Neoplasms - pathology, ctDNA, Disease Progression, DNA Mutational Analysis, Drug Resistance, Neoplasm - genetics, Female, Gene Amplification, HER2 amplification, Humans, Italy, lapatinib, Lapatinib - administration & dosage, Lapatinib - adverse effects, Liquid Biopsy, Liver Neoplasms - diagnostic imaging, Liver Neoplasms - drug therapy, Liver Neoplasms - genetics, Liver Neoplasms - secondary, Magnetic Resonance Imaging, Male, Mice, Inbred NOD, Mice, SCID, Mice, Transgenic, Predictive Value of Tests, Progression-Free Survival, Protein Kinase Inhibitors - administration & dosage, Protein Kinase Inhibitors - adverse effects, rapid autopsy, ras Proteins - genetics, Receptor, ErbB-2 - antagonists & inhibitors, Receptor, ErbB-2 - genetics, resistance, Risk Factors, Signal Transduction - drug effects, targeted therapy, Time Factors, Tomography, X-Ray Computed, trastuzumab, Trastuzumab - administration & dosage, Trastuzumab - adverse effects, Treatment Outcome, Tumor Cells, Cultured

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