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Published on: April 29, 2014
Molecular Landscape of ERBB2/ERBB3 Mutated Colorectal Cancer
Jonathan M Loree1, Ann M Bailey2, Amber M Johnson2
1Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Background:
Despite growing therapeutic relevance of ERBB2 amplifications in colorectal cancer (CRC), little is known about ERBB2/ERBB3 mutations. We aimed to characterize these subsets of CRC.
Methods:
We performed a retrospective analysis of 419 CRC patients from MD Anderson (MDACC) and 619 patients from the Nurses' Health Study (NHS)/Health Professionals Follow-Up Study (HPFS) with tissue sequencing, clinicopathologic, mutational, and consensus molecular subtype (CMS) profiles of ERBB2/ERBB3 mutant patients. A third cohort of 1623 CRC patients with ctDNA assays characterized the ctDNA profile of ERBB2 mutants. All statistical tests were two-sided.
Results:
ERBB2 mutations occurred in 4.1% (95% confidence interval [CI] = 2.4% to 6.4%), 5.8% (95% CI = 4.1% to 8.0%), and 5.1% (95% CI = 4.0% to 6.2%) of MDACC, NHS/HPFS, and ctDNA patients, respectively. ERBB3 mutations occurred in 5.7% (95% CI = 3.7% to 8.4%, 95% CI = 4.0% to 7.8%) of patients in both tissue cohorts. Age, stage, and tumor location were not associated with either mutation. Microsatellite instability (MSI) was associated with ERBB2 (odds ratio [OR] = 5.98, 95% CI = 2.47 to 14.49, P < .001; OR = 5.13, 95% CI = 2.38 to 11.05, P < .001) and ERBB3 mutations (OR = 3.48, 95% CI = 1.51 to 8.02, P = .002; OR = 3.40, 95% CI = 1.05 to 10.96, P = .03) in both tissue cohorts. Neither gene was associated with TP53, APC, KRAS, NRAS, or BRAF mutations in tissue. However, PIK3CA mutations were strongly associated with ERBB2 mutations in all three cohorts (OR = 3.68, 95% CI = 1.83 to 7.41, P = .001; OR = 2.25, 95% CI = 1.11 to 4.58, P = .02; OR = 2.11, 95% CI = 1.25 to 3.58, P = .004) and ERBB3 mutations in the MDACC cohort (OR = 13.26, 95% CI = 5.27 to 33.33, P < .001). ERBB2 (P = 0.08) and ERBB3 (P = .008) mutations were associated with CMS1 subtype. ERBB2 (hazard ratio [HR] = 1.82, 95% CI = 1.23 to 4.03, P = .009), but not ERBB3 (HR = 0.88, 95% CI = 0.45 to 1.73, P = .73), mutations were associated with worse overall survival.
Conclusions:
MSI and PIK3CA mutations are associated with ERBB2/ERBB3 mutations. Co-occurring PIK3CA mutations may represent a second hit to oncogenic signaling that needs consideration when targeting ERBB2/ERBB3.
Insights
ERBB2 and ERBB3 mutations are found in colorectal cancer (CRC) and are associated with microsatellite instability and PIK3CA mutations. ERBB2 mutations correlate with worse overall survival in CRC patients.
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- Growing therapeutic relevance of ERBB2 amplifications in colorectal cancer (CRC).
- Limited understanding of ERBB2/ERBB3 mutations in CRC.
Purpose of the Study:
- To characterize ERBB2 and ERBB3 mutations in colorectal cancer.
- To investigate associations between these mutations and clinicopathologic features, molecular subtypes, and survival outcomes.
Main Methods:
- Retrospective analysis of three CRC cohorts (MD Anderson, NHS/HPFS, ctDNA).
- Tissue sequencing, clinicopathologic, mutational, and consensus molecular subtype (CMS) profiling.
- ctDNA assays for ERBB2 mutants.
Main Results:
- ERBB2 mutations observed in 5.1%-5.8% and ERBB3 in 5.7% of CRC patients.
- Microsatellite instability (MSI) and PIK3CA mutations significantly associated with ERBB2/ERBB3 mutations.
- ERBB2 mutations linked to CMS1 subtype and worse overall survival.
- ERBB3 mutations associated with CMS1 subtype but not survival.
Conclusions:
- MSI and PIK3CA mutations are key correlates of ERBB2/ERBB3 mutations in CRC.
- Co-occurring PIK3CA mutations may influence oncogenic signaling pathways targeted in ERBB2/ERBB3-mutant CRC.
- These findings highlight potential therapeutic strategies for specific CRC subsets.
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