Clinico-genomic Characterization of ATM and HRD in Pancreas Cancer: Application for Practice
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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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- 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.
- ORCID
- Venue
- Clinical Cancer Research
- Published
- 2022-08-30
- Volume
- 28
- Issue
- 21
- Pages
- 4782-4792
- ISSN
- 1078-0432 (ISSN-L)
- 1557-3265
- PMC
- PMC9634347
- 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
- bronze
- doi.org
- 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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