1. FGFR2Extracellular Domain In-Frame Deletions Are Therapeutically Targetable Genomic Alterations That Function as Oncogenic Drivers in Cholangiocarcinoma
- Author
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Giulia Siravegna, Thomas A. Abrams, Isobel J Fetter, Atul B. Shinagare, Kimmie Ng, Sarah L. Denning, William C. Hahn, Maureen Loftus, Anuj K. Patel, Yvonne Y. Li, James M. Cleary, Liam F. Spurr, Srivatsan Raghavan, Ryan J. Sullivan, Douglas A. Rubinson, Matthew Meyerson, Hersh Gupta, Nabeel Bardeesy, Emma R. Hill, Antoine Daina, Brian M. Wolpin, Ryan B. Corcoran, Jiping Wang, Lauren K. Brais, Pasi A. Jänne, Claudio Zanna, Qibiao Wu, Lipika Goyal, Andrew D. Cherniack, Lei Shi, Anne Vaslin Chessex, Jonathan A. Nowak, Anna Pokorska-Bocci, Rachel B. Keller, Thomas E. Clancy, Jason L. Hornick, Vincent Zoete, Geoffrey I. Shapiro, Deborah Schrag, and Franck Brichory
- Subjects
musculoskeletal diseases ,0301 basic medicine ,congenital, hereditary, and neonatal diseases and abnormalities ,Mutation ,integumentary system ,business.industry ,medicine.disease_cause ,Article ,DNA sequencing ,stomatognathic diseases ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Oncology ,Protein kinase domain ,Biliary tract ,Fibroblast growth factor receptor ,030220 oncology & carcinogenesis ,embryonic structures ,Extracellular ,Cancer research ,medicine ,business ,Function (biology) ,Intrahepatic Cholangiocarcinoma - Abstract
We conducted next-generation DNA sequencing on 335 biliary tract cancers and characterized the genomic landscape by anatomic site within the biliary tree. In addition to frequent FGFR2 fusions among patients with intrahepatic cholangiocarcinoma (IHCC), we identified FGFR2 extracellular domain in-frame deletions (EID) in 5 of 178 (2.8%) patients with IHCC, including two patients with FGFR2 p.H167_N173del. Expression of this FGFR2 EID in NIH3T3 cells resulted in constitutive FGFR2 activation, oncogenic transformation, and sensitivity to FGFR inhibitors. Three patients with FGFR2 EIDs were treated with Debio 1347, an oral FGFR1/2/3 inhibitor, and all showed partial responses. One patient developed an acquired L618F FGFR2 kinase domain mutation at disease progression and experienced a further partial response for 17 months to an irreversible FGFR2 inhibitor, futibatinib. Together, these findings reveal FGFR2 EIDs as an alternative mechanism of FGFR2 activation in IHCC that predicts sensitivity to FGFR inhibitors in the clinic.Significance:FGFR2 EIDs are transforming genomic alterations that occur predominantly in patients with IHCC. These FGFR2 EIDs are sensitive to FGFR inhibition in vitro, and patients with these alterations benefited from treatment with FGFR inhibitors in the clinic.This article is highlighted in the In This Issue feature, p. 2355
- Published
- 2021