Soft Tissue and Visceral Organ Sarcomas With BCOR Alterations.

ABSTRACT

Sarcomas with BCOR alteration are a heterogenous group characterized by changes including internal tandem duplications (ITDs) and recurring fusions with CCNB3, ZC3H7B, and other rare partners. With widespread genomic testing, these alterations are now associated with histologies such as Ewing-like sarcoma (BCORCCNB3), high-grade endometrial stromal sarcoma (ZC3H7BBCOR), and clear cell sarcoma of kidney (BCOR-ITD). BCOR altered sarcomas of soft tissues and organs were identified through PubMed using keywords "Sarcoma (AND) BCOR" from 2005 through October 2021. Summary statistics and outcome data were calculated using STATA v12.1. Forty-one publications described 190 patients with BCOR altered soft tissue or organ sarcomas. BCOR-ITD was most common, followed by BCORCCNB3, ZC3H7BBCOR. BCOR-ITD tumors occurred mainly in infants, BCORCCNB3 commonly occurred in adolescent young adults, and ZC3H7BBCOR only in adults. The most common site for BCORCCNB3 fused tumors was extremity, BCOR-ITD kidney and ZC3H7BBCOR uterus. Metastasis was rare in patients with BCORCCNB3. While most underwent resection and chemotherapy, few received radiation. Median follow-up of survivors was 24 months. Five year overall survival for patients with BCORCCNB3 fusions was 68% (95% confidence interval [CI] 46%-83%). Patients with BCOR-ITD and ZC3H7BBCOR had worse prognoses with 5 years overall survival of 35% (95% CI 15%-56%) and 41% (95% CI 11%-71%), respectively, demonstrating need for collaborative efforts identifying optimal treatments to improve outcomes.