Detection of <i>BRCA1</i>, and <i>BRCA2</i> Alterations in Matched Tumor Tissue and Circulating Cell-Free DNA in Patients with Prostate Cancer in a Real-World Setting

Background: Poly (ADP-ribose) polymerase (PARP) inhibitors are approved for patients with metastatic castration-resistant prostate cancer harboring deleterious or suspected deleterious <i>BRCA1</i> and/or <i>2</i> mutations. Identifying patients with prostate cancer harboring...

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Main Authors: Taylor Ryan McFarland, Vinay Mathew Thomas, Roberto Nussenzveig, Georges Gebrael, Nicolas Sayegh, Nishita Tripathi, Kamal Kant Sahu, Divyam Goel, Benjamin L. Maughan, Deepika Sirohi, Neeraj Agarwal, Umang Swami
Format: Article
Language:English
Published: MDPI AG 2022-12-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/10/12/3170
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author Taylor Ryan McFarland
Vinay Mathew Thomas
Roberto Nussenzveig
Georges Gebrael
Nicolas Sayegh
Nishita Tripathi
Kamal Kant Sahu
Divyam Goel
Benjamin L. Maughan
Deepika Sirohi
Neeraj Agarwal
Umang Swami
author_facet Taylor Ryan McFarland
Vinay Mathew Thomas
Roberto Nussenzveig
Georges Gebrael
Nicolas Sayegh
Nishita Tripathi
Kamal Kant Sahu
Divyam Goel
Benjamin L. Maughan
Deepika Sirohi
Neeraj Agarwal
Umang Swami
author_sort Taylor Ryan McFarland
collection DOAJ
description Background: Poly (ADP-ribose) polymerase (PARP) inhibitors are approved for patients with metastatic castration-resistant prostate cancer harboring deleterious or suspected deleterious <i>BRCA1</i> and/or <i>2</i> mutations. Identifying patients with prostate cancer harboring these mutations may be challenging. Circulating cell-free DNA (cfDNA) provides an avenue for an easier detection of these mutations. Herein, we aimed to evaluate the concordance of <i>BRCA</i> mutations in the tumor tissue and cfDNA in patients with metastatic prostate cancer in the real-world setting. Methods: Somatic genomic profiling results were obtained from a clinical cohort of patients at our institution who had at least two samples tested. One of the samples needed to be from either primary or metastatic tissue. Concordance was adjusted to not include mutation types that the cfDNA platforms were not designed to detect. Results: The presence or absence of mutations in the <i>BRCA</i> gene was assessed in a total of 589 samples, including 327 cfDNA samples, from 260 patients with metastatic prostate cancer. The median time between the first test and any subsequent test was 22.8 (0.0–232) months. <i>BRCA</i> mutation was present in the patient’s original prostate tissue in 23 samples (3.9%) of patients. The adjusted concordance between prostate tumor tissue and cfDNA was 97.9% [95% CI, 95.3–99.1%]. The adjusted concordance between metastatic samples and cfDNA was 93.5% [95% CI, 86.4–97.3%]. Of the patients who had a <i>BRCA</i> mutation detected in their prostate tissue, there was a 70% probability of detecting a <i>BRCA</i> mutation in the patient’s cfDNA as well. For patients who did not have a detectable <i>BRCA</i> mutation in their primary prostate tissue, the probability of detecting a subsequent one later in the disease course was less than 0.9%. Conclusion: There is a high level of concordance between tissue and blood for <i>BRCA</i> mutations. Testing cfDNA can provide reliable information on <i>BRCA</i> mutational status and is a viable alternative to solid tissue sequencing when unavailable. The development of a new <i>BRCA</i> mutation later in the disease course is a rare event.
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spelling doaj.art-41ebdd18609e4ee39eb8a08fe9e5851e2023-11-24T13:28:02ZengMDPI AGBiomedicines2227-90592022-12-011012317010.3390/biomedicines10123170Detection of <i>BRCA1</i>, and <i>BRCA2</i> Alterations in Matched Tumor Tissue and Circulating Cell-Free DNA in Patients with Prostate Cancer in a Real-World SettingTaylor Ryan McFarland0Vinay Mathew Thomas1Roberto Nussenzveig2Georges Gebrael3Nicolas Sayegh4Nishita Tripathi5Kamal Kant Sahu6Divyam Goel7Benjamin L. Maughan8Deepika Sirohi9Neeraj Agarwal10Umang Swami11Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADigital Diagnostic Foundation, Cedar City, UT 84720, USADivision of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Pathology, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USABackground: Poly (ADP-ribose) polymerase (PARP) inhibitors are approved for patients with metastatic castration-resistant prostate cancer harboring deleterious or suspected deleterious <i>BRCA1</i> and/or <i>2</i> mutations. Identifying patients with prostate cancer harboring these mutations may be challenging. Circulating cell-free DNA (cfDNA) provides an avenue for an easier detection of these mutations. Herein, we aimed to evaluate the concordance of <i>BRCA</i> mutations in the tumor tissue and cfDNA in patients with metastatic prostate cancer in the real-world setting. Methods: Somatic genomic profiling results were obtained from a clinical cohort of patients at our institution who had at least two samples tested. One of the samples needed to be from either primary or metastatic tissue. Concordance was adjusted to not include mutation types that the cfDNA platforms were not designed to detect. Results: The presence or absence of mutations in the <i>BRCA</i> gene was assessed in a total of 589 samples, including 327 cfDNA samples, from 260 patients with metastatic prostate cancer. The median time between the first test and any subsequent test was 22.8 (0.0–232) months. <i>BRCA</i> mutation was present in the patient’s original prostate tissue in 23 samples (3.9%) of patients. The adjusted concordance between prostate tumor tissue and cfDNA was 97.9% [95% CI, 95.3–99.1%]. The adjusted concordance between metastatic samples and cfDNA was 93.5% [95% CI, 86.4–97.3%]. Of the patients who had a <i>BRCA</i> mutation detected in their prostate tissue, there was a 70% probability of detecting a <i>BRCA</i> mutation in the patient’s cfDNA as well. For patients who did not have a detectable <i>BRCA</i> mutation in their primary prostate tissue, the probability of detecting a subsequent one later in the disease course was less than 0.9%. Conclusion: There is a high level of concordance between tissue and blood for <i>BRCA</i> mutations. Testing cfDNA can provide reliable information on <i>BRCA</i> mutational status and is a viable alternative to solid tissue sequencing when unavailable. The development of a new <i>BRCA</i> mutation later in the disease course is a rare event.https://www.mdpi.com/2227-9059/10/12/3170metastatic prostate cancerBRCAPARP inhibitorcancer evolutioncfDNAnext-generation sequencing
spellingShingle Taylor Ryan McFarland
Vinay Mathew Thomas
Roberto Nussenzveig
Georges Gebrael
Nicolas Sayegh
Nishita Tripathi
Kamal Kant Sahu
Divyam Goel
Benjamin L. Maughan
Deepika Sirohi
Neeraj Agarwal
Umang Swami
Detection of <i>BRCA1</i>, and <i>BRCA2</i> Alterations in Matched Tumor Tissue and Circulating Cell-Free DNA in Patients with Prostate Cancer in a Real-World Setting
Biomedicines
metastatic prostate cancer
BRCA
PARP inhibitor
cancer evolution
cfDNA
next-generation sequencing
title Detection of <i>BRCA1</i>, and <i>BRCA2</i> Alterations in Matched Tumor Tissue and Circulating Cell-Free DNA in Patients with Prostate Cancer in a Real-World Setting
title_full Detection of <i>BRCA1</i>, and <i>BRCA2</i> Alterations in Matched Tumor Tissue and Circulating Cell-Free DNA in Patients with Prostate Cancer in a Real-World Setting
title_fullStr Detection of <i>BRCA1</i>, and <i>BRCA2</i> Alterations in Matched Tumor Tissue and Circulating Cell-Free DNA in Patients with Prostate Cancer in a Real-World Setting
title_full_unstemmed Detection of <i>BRCA1</i>, and <i>BRCA2</i> Alterations in Matched Tumor Tissue and Circulating Cell-Free DNA in Patients with Prostate Cancer in a Real-World Setting
title_short Detection of <i>BRCA1</i>, and <i>BRCA2</i> Alterations in Matched Tumor Tissue and Circulating Cell-Free DNA in Patients with Prostate Cancer in a Real-World Setting
title_sort detection of i brca1 i and i brca2 i alterations in matched tumor tissue and circulating cell free dna in patients with prostate cancer in a real world setting
topic metastatic prostate cancer
BRCA
PARP inhibitor
cancer evolution
cfDNA
next-generation sequencing
url https://www.mdpi.com/2227-9059/10/12/3170
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