Abstract Chromosomal rearrangements of the fibroblast growth factor receptor (FGFR) genes that give rise to fusions are one of several mechanisms by which the FGF/FGFR signaling axis can become deregulated and result in enhanced signaling in cancer. We have previously identified truncation of exon (E) 18 of FGFR2 as a potent single-driver alteration in cancer, independently of the rearrangement (RE) partner. In contrast, the same does not appear to hold true for its E18-truncated ortholog FGFR3. We mined human oncogenomic datasets from Hartwig Medical Foundation (>2,500 WGS profiles) and Foundation Medicine (>200,000 hybrid-capture panel-seq profiles) for alterations affecting FGFR3. Examination of the structural variants affecting FGFR3 uncovered that 85% of all E18-truncating FGFR3 REs involved transforming acidic coiled-coil-containing protein 3 (TACC3) as the downstream fusion partner gene, while REs with intergenic regions and other known protein-encoding genes were much less frequent. Additionally, there was a clear predominance of self-interacting domains (95%) among all FGFR3 RE partners, with the coiled-coil domain being the most recurrent, suggesting enhanced receptor dimerization and downstream signaling capacity for the majority of the FGFR3 fusions. Our findings led to the generation of a compendium of FGFR3 structural variants which we then functionally tested. In vitro testing of mouse mammary epithelial cells expressing Fgfr3ΔE18-Tacc3E7-E16 fusion variants showed that both E18-truncation and a fusion partner were required for 3D outgrowth and signaling induction. In vivo evaluation of the oncogenic capacity of Fgfr3 variants using somatic delivery of lentiviruses to the mouse mammary gland via intraductal injection and lung via intratracheal injection found that Fgfr3ΔE18-Tacc3E7-E16 fusion variants rapidly induced mammary and lung tumor formation in wild-type and Wap-Cre;Cdh1F/F, and in wild-type and Trp53F/F mice, respectively. In contrast, Fgfr3full-length(FL), Fgfr3ΔE18 and Fgfr3FL–Tacc3E7-E16 were non-tumorigenic. Noteworthy, mammary tumors driven by Fgfr3ΔE18-Tacc3E7-E16 fusions were sensitive to the FGFR inhibitor AZD4547 during a drug intervention study. In summary, our findings show that E18-truncating FGFR3 alterations are recurrent across human cancers and, as opposed to FGFR2 E18-truncating alterations, FGFR3 appears to depend both on E18-truncation and an additional fusion partner with dimerizing capacity. Notably, TACC3 is the most recurrent 3’ fusion partner across all FGFR3 E18-truncating alterations, and somatic tumor modeling has shown that Fgfr3ΔE18-Tacc3 fusions drive mouse mammary and lung tumorigenesis, and are sensitive to FGFR targeted therapy. Citation Format: Julia Yemelyanenko, Jinhyuk Bhin, Sjoerd Klarenbeek, Ji-Ying Song, Catrin Lutz, Marieke van de Ven, Shridar Ganesan, Lodewyk F. A. Wessels, Daniel Zingg, Jos Jonkers. Deciphering FGFR3-TACC3 oncogenic fusions [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2023 Oct 11-15; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2023;22(12 Suppl):Abstract nr LB_B04.
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