Abstract

Abstract Background: Although several studies have reported genomic characterisation of primary breast tumors, little is known about the genomic alterations of the metastatic tissues. Breast cancer patients who were prospectively enrolled in a trial (SAFIR01) underwent a biopsy of metastasis. The primary aim of this biopsy was to drive the treatment according to the results of whole genome CGH arrays and sanger sequencing on two genes (PIK3CA and AKT1). The results of the clinical trial were previously reported (André et al ASCO 2013). The secondary goal of the biopsies was to perform genomic characterisation of metastases in breast cancer patients. Here we report the analyses of such metastatic samples using next generation sequencing (NGS) approaches. Patients and methods: Two approaches were applied. In order to describe the incidence of targetable genomic alterations, we performed in depth targeted sequencing on 100 genes (200x coverage) using Illumina HiSeq 2000 (DNA vision). This analysis was performed on 240 metastatic samples. The second approach was more exploratory and aimed at discovering new genes involved in the metastatic process and/or resistance to therapies. In order to achieve this goal, we performed whole exome sequencing in 100 pairs of metastatic tissue (100x) and normal DNA (Integragen Inc, Hiseq platform). Finally, phosphor-S6K staining was performed in 300 samples in order to explore the activation status of mTOR pathway in metastatic disease, and to correlate with genomic data. Results: Targeted sequencing was performed on 240 metastatic samples in order to report the prevalence of targetable genomic alterations in metastatic breast cancer. Results are available for the first 159 samples. In addition to the already reported PIK3CA (26%) and AKT1 mutations (4%), NGS identified mutations of PTEN (4%), ERBB2 (2%), K-Ras (1%), ATM (2%), CDH1 (2%), GATA3 (2%), PTPN11 (1%), PTPRD (1%), ROS1 (1%). Results on the 81 samples, together with whole exome sequencing (n = 100) and phosphoproteins are being analysed and results will be available mid-november 2013. Conclusion: This is the first large study that aims at defining the genomic landscape of metastatic samples. Results will provide insights into the prevalence of targetable genomic alterations in metastatic tissue, together with candidate genes involved in the metastatic process and resistance to therapies. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr S6-07.

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