Shallow whole genome sequencing approach to detect Homologous Recombination Deficiency in the PAOLA-1/ENGOT-OV25 phase-III trial.

The bevacizumab (bev)/olaparib (ola) maintenance regimen was approved for BRCA1/2-mutated (BRCAmut) and Homologous Recombination Deficient (HRD) high-grade Advanced Ovarian Cancer (AOC) first line setting, based on a significantly improved progression-free survival (PFS) compared to bev alone in the PAOLA-1/ENGOT-ov25 trial (NCT02477644), where HRD was detected by MyChoice CDx PLUS test. The academic shallowHRDv2 test was developed based on shallow whole-genome sequencing as an alternative to MyChoice. Analytical and clinical validities of shallowHRDv2 as compared to MyChoice on 449 PAOLA-1 tumor samples are presented. The overall agreement between shallowHRDv2 and MyChoice was 94% (369/394). Less non-contributive tests were observed with shallowHRDv2 (15/449; 3%) than with MyChoice (51/449; 11%). Patients with HRD tumors according to shallowHRDv2 (including BRCAmut) showed a significantly prolonged PFS with bev+ola versus bev (median PFS: 65.7 versus 20.3 months, hazard ratio (HR): 0.36 [95% CI: 0.24-0.53]). This benefit was significant also for BRCA1/2 wild-type tumors (40.8 versus 19.5 months, HR: 0.45 [95% CI: 0.26-0.76]). ShallowHRDv2 is a performant, clinically validated, and cost-effective test for HRD detection.

Circulating tumor DNA in unresectable pancreatic cancer is a strong predictor of first-line treatment efficacy: The KRASCIPANC prospective study.

BACKGROUND: There is no robust predictor of response to chemotherapy (CT) in unresectable pancreatic adenocarcinomas (UPA). The objective of the KRASCIPANC study was to analyze the kinetics of cell-free DNA (cfDNA)/circulating tumor DNA (ctDNA) as a predictor of response to CT in UPA. METHODS: Blood samples were collected just before first CT and at day 28. The primary endpoint was the kinetics of KRAS-mutated ctDNA by digital droplet PCR between D0 and D28 as a predictor of progression-free survival (PFS). RESULTS: We analyzed 65 patients with a KRAS-mutated tumor. A high level of cfDNA and KRAS-mutated ctDNA at D0, as well as the presence of KRAS-mutated ctDNA at D28, were strongly associated with lower centralized disease control rate (cDCR), shorter cPFS and OS in multivariate analysis. A score combining cfDNA level at diagnosis ≥ or <30 ng/mL and presence or not of KRAS-mutated ctDNA at D28 was an optimal predictor of cDCR (OR=30.7, IC95% 4.31-218 P=.001), PFS (HR=6.79, IC95% 2.76-16.7, P<.001) and OS (HR=9.98, IC95% 4.14-24.1, P<.001). CONCLUSION: A combined score using cfDNA level at diagnosis and KRAS-mutated ctDNA at D28 is strongly associated with patient survival/response to chemotherapy in UPA. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04560270.

p210bcr-abl induces amoeboid motility by recruiting ADF/destrin through RhoA/ROCK1.

We previously demonstrated that the Bcr-Abl oncogene, p210(bcr-abl), through its unique GEF domain, specifically activates RhoA and induces spontaneous amoeboid motility. We intend to study the pathways downstream RhoA controlling amoeboid motility. Mouse prolymphoblastic cells (Ba/F3 cell line) expressing different forms of Bcr-Abl were embedded in 3-dimensional (3D) Matrigel to study motility and explore the effects of inhibiting Rho pathway (inhibitors and siRNAs). The phosphorylation levels of cofilin-1 and destrin were analyzed by 2-dimensional electrophoresis. Composition of Bcr-Abl signalplex in different conditions was determined by coimmunoprecipitation. Ba/F3p190 and Ba/F3 expressing a mutant form of p210(bcr-abl) (unable to activate RhoA) cells presented a spontaneous motility, but not an amoeboid type. p210(bcr-abl)-induced amoeboid motility in a 3D matrix requires isoform-specific RhoA/ROCK-1/destrin signaling. Next to the conventional Rho/ROCK/MLC/myosin pathway, this pathway is a crucial determinant for amoeboid motility, specific for the destrin isoform (and not its coexpressed homologue cofilin-1). Also, the presence of destrin (and not cofilin-1) in the p210(bcr-abl) complex is dependent on ROCK1, and this signalplex is required for amoeboid motility. This underscores isoform-specific function within the ADF/cofilin family and provides new insight into Bcr-Abl signaling to amoeboid motility and possible impact on understanding chronic myeloid leukemia progression.

Invadopodia and rolling-type motility are specific features of highly invasive p190(bcr-abl) leukemic cells.

Philadelphia chromosome results of a reciprocal translocation between chromosome 9 and 22. The translocation generates a chimeric oncogene, which, depending on the precise location of the fusion causes chronic myelogenous leukemia, CML (p210(bcr-abl)) or acute lymphoblastic leukemia, ALL (p190(bcr-abl)). The difference between p190(bcr-abl) and p210(bcr-abl) resides in the unique presence of the DH/PH domain in p210(bcr-abl). Ba/F3 cells are not motile but acquire spontaneous motility upon ectopic expression of either p190(bcr-abl) or p210(bcr-abl). Whereas p210(bcr-abl)-expressing cells present typical amoeboid motility, p190(bcr-abl)-expressing cells motility appears dependent on rolling movements. Both motility types are triggered by Vav1 in complex with Bcr-Abl, and dependent on Rac1 activity. Interestingly, the RhoA specific p210(bcr-abl) DH/PH domain regulates the motility mode by shifting motility from a rolling type toward an amoeboid one. In this study, we show that Ba/F3p190(bcr-abl)-expressing cells assemble invadopodia-like structures visualized as dense F-actin dots containing the actin polymerization machinery and bestowed with matrix degradation activities. The formation of these structures is driven by the reduction of RhoA activity associated with the loss of the DH/PH domain in p190(bcr-abl) and correlates with an increase in Cdc42 activity. Such phenotype could also be obtained by impairing p210(bcr-abl) RhoA GEF function. Thus, invadopodia formation in association with rolling-type motility characterizes p190(bcr-abl) leukemic cells. The description of invadopodia in cells harboring the p190(bcr-abl) oncoprotein presents a novel feature of these highly invasive leukemic cells and provides a novel therapeutic drug target to treat the disease.