Cited by 48Pancreatic and Hepatic Oncology ResearchBRCA gene mutations in cancerCancer Genomics and Diagnostics

Clinico-genomic Characterization of ATM and HRD in Pancreas Cancer: Application for Practice

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Park, Wungki, O'Connor, Catherine A., Bandlamudi, Chaitanya, Forman, Daniella, Chou, Joanne F., Umeda, Shigeaki, Reyngold, Marsha, Varghese, Anna M. +8 more·2022·Clinical Cancer Research

Published version of a preprint

Abstract

Purpose: Characterizing germline and somatic ATM variants (gATMm, sATMm) zygosity and their contribution to homologous recombination deficiency (HRD) is important for therapeutic strategy in pancreatic ductal adenocarcinoma (PDAC). Experimental Design: Clinico-genomic data for patients with PDAC and other cancers with ATM variants were abstracted. Genomic instability scores (GIS) were derived from ATM-mutant cancers and overall survival (OS) was evaluated. Results: Forty-six patients had PDAC and pathogenic ATM variants including 24 (52%) stage III/IV: gATMm (N = 24), and sATMm (N = 22). Twenty-seven (59%) had biallelic, 15 (33%) monoallelic, and 4 indeterminate (8%) variants. Median OS for advanced-stage cohort at diagnosis (N = 24) was 19.7 months [95% confidence interval (CI): 12.3–not reached (NR)], 27.1 months (95% CI: 22.7–NR) for gATMm (n = 11), and 12.3 months for sATMm (n = 13; 95% CI: 11.9–NR; P = 0.025). GIS was computed for 33 patients with PDAC and compared with other ATM-mutant cancers enriched for HRD. The median was lower (median, 11; range, 2–29) relative to breast (18, 3–55) or ovarian (25, 3–56) ATM-mutant cancers (P < 0.001 and P = 0.003, respectively). Interestingly, biallelic pathogenic ATM variants were mutually exclusive with TP53. Other canonical driver gene (KRAS, CDKN2A, SMAD4) variants were less frequent in ATM-mutant PDAC. Conclusions: ATM variants in PDAC represent a distinct biologic group and appear to have favorable OS. Nonetheless, pathogenic ATM variants do not confer an HRD signature in PDAC and ATM should be considered as a non-core HR gene in this disease.

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  • Bi-allelic ATM mutations have not been shown to result in susceptibility to PARP inhibitor monotherapy like BRCA1/2.

    “bi-allelic mutations of ATM have not been shown to result in susceptibility to PARP inhibitor monotherapy like BRCA1/292,93.”

    From Pancreatic cancer: Advances and challenges (2023) · cites this paper as [92]

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  1. [42]Telli ML, Timms KM, Reid J, Hennessy B, Mills GB, Jensen KC, Homologous Recombination Deficiency (HRD) Score Predicts Response to Platinum-Containing Neoadjuvant Chemotherapy in Patients with Triple-Negative Breast Cancer. Clin Cancer Res 2016; 22(15): 3764– 73 doi 10.1158/1078-0432.Ccr-15-2477. 26957554 PMC6773427 · DOI · Paper page

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Authors
Park, W., O'Connor, C. A., Bandlamudi, C., Forman, D., Chou, J. F., Umeda, S., Reyngold, M., Varghese, A. M., Keane, F., Balogun, F., Yu, K. H., Kelsen, D. P., Crane, C., Capanu, M., Iacobuzio-Donahue, C., & O'Reilly, E. M.
Affiliations
  • Memorial Sloan Kettering Cancer Center (US)
  • 4David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York.
Corresponding author
O'Reilly, Eileen M.
Venue
Clinical Cancer Research
Published
2022-08-30
Volume
28
Issue
21
Pages
4782-4792
ISSN
  • 1078-0432 (ISSN-L)
  • 1557-3265
OpenAlex
W4293572521
Cited by
34
References
71
Citations by year
2026: 6 · 2025: 6 · 2024: 11 · 2023: 10 · 2022: 1
FWCI
4.39
Type
journal article
Language
en
Open access
Locations
  • Clinical Cancer Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Cancer Institute (P30 CA008748)
  • Parker Institute for Cancer Immunotherapy
  • National Institutes of Health (K12 CA184746)
Topics
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
Keywords
pancreatic ductal adenocarcinoma, homologous recombination deficiency, zygosity, genomic instability score, overall survival, TP53, KRAS, CDKN2A, SMAD4
MeSH terms
Humans, Pancreatic Neoplasms, Cohort Studies, Carcinoma, Pancreatic Ductal, Genomics, Ataxia Telangiectasia Mutated Proteins

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