Detection, Characterization, and Inhibition of FGFR-TACC Fusions in IDH Wild-type Glioma

  • Clin Cancer Res. 2015 Jul 15;21(14):3307-17. doi: 10.1158/1078-0432.CCR-14-2199.
Anna Luisa Di Stefano  1 Alessandra Fucci  2 Veronique Frattini  2 Marianne Labussiere  3 Karima Mokhtari  4 Pietro Zoppoli  2 Yannick Marie  5 Aurelie Bruno  3 Blandine Boisselier  3 Marine Giry  3 Julien Savatovsky  6 Mehdi Touat  7 Hayat Belaid  8 Aurelie Kamoun  9 Ahmed Idbaih  10 Caroline Houillier  11 Feng R Luo  12 Jean-Charles Soria  7 Josep Tabernero  13 Marica Eoli  14 Rosina Paterra  14 Stephen Yip  15 Kevin Petrecca  16 Jennifer A Chan  17 Gaetano Finocchiaro  14 Anna Lasorella  18 Marc Sanson  19 Antonio Iavarone  20
Affiliations
  • 1. Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, Paris, France. AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2, Paris, France. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
  • 2. Institute for Cancer Genetics, Columbia University Medical Center, New York, New York.
  • 3. Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, Paris, France.
  • 4. Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, Paris, France. AP-HP, Groupe Hospitalier Pitié Salpêtrière, Laboratoire de Neuropathologie R Escourolle, Paris, France. AP-HP Onconeurothèque, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
  • 5. Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, Paris, France. Institut du Cerveau et de la Moelle épinière (ICM), Plateforme de Génotypage Séquençage, Paris, France.
  • 6. Fondation Ophtalmologique A. de Rothschild, Paris, France.
  • 7. Drug Development Department, Gustave Roussy Cancer Center, Paris, France.
  • 8. AP-HP, Groupe Hospitalier Pitié Salpêtrière, Department of Neurosurgery, Paris, France.
  • 9. Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, Paris, France.
  • 10. Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, Paris, France. AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2, Paris, France.
  • 11. AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2, Paris, France.
  • 12. Janssen Pharmaceutical Companies of Johnson and Johnson, Titusville, New Jersey.
  • 13. Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain.
  • 14. Fondazione I.R.C.C.S Istituto Neurologico C. Besta, Milan, Italy.
  • 15. Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
  • 16. Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
  • 17. University of Calgary, Calgary, Canada.
  • 18. Institute for Cancer Genetics, Columbia University Medical Center, New York, New York. Department of Pediatrics and Pathology, Columbia University Medical Center, New York, New York.
  • 19. Sorbonne Universités UPMC Univ Paris 06, INSERM CNRS, U1127, UMR 7225, ICM, Paris, France. AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Neurologie 2, Paris, France. AP-HP Onconeurothèque, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. [email protected] [email protected].
  • 20. Institute for Cancer Genetics, Columbia University Medical Center, New York, New York. Department of Neurology and Pathology, Columbia University Medical Center, New York, New York. [email protected] [email protected].
Abstract

Purpose: Oncogenic fusions consisting of Fibroblast Growth Factor receptor (FGFR) and TACC are present in a subgroup of glioblastoma (GBM) and Other human cancers and have been proposed as new therapeutic targets. We analyzed frequency and molecular features of FGFR-TACC fusions and explored the therapeutic efficacy of inhibiting FGFR kinase in GBM and grade II and III glioma.

Experimental design: Overall, 795 gliomas (584 GBM, 85 grades II and III with wild-type and 126 with IDH1/2 mutation) were screened for FGFR-TACC breakpoints and associated molecular profile. We also analyzed expression of the FGFR3 and TACC3 components of the fusions. The effects of the specific FGFR Inhibitor JNJ-42756493 for FGFR3-TACC3-positive glioma were determined in preclinical experiments. Two patients with advanced FGFR3-TACC3-positive GBM received JNJ-42756493 and were assessed for therapeutic response.

Results: Three of 85 IDH1/2 wild-type (3.5%) but none of 126 IDH1/2-mutant grade II and III gliomas harbored FGFR3-TACC3 fusions. FGFR-TACC rearrangements were present in 17 of 584 GBM (2.9%). FGFR3-TACC3 fusions were associated with strong and homogeneous FGFR3 immunostaining. They are mutually exclusive with IDH1/2 mutations and EGFR amplification, whereas they co-occur with CDK4 amplification. JNJ-42756493 inhibited growth of glioma cells harboring FGFR3-TACC3 in vitro and in vivo. The two patients with FGFR3-TACC3 rearrangements who received JNJ-42756493 manifested clinical improvement with stable disease and minor response, respectively.

Conclusions: RT-PCR Sequencing is a sensitive and specific method to identify FGFR-TACC-positive patients. FGFR3-TACC3 fusions are associated with uniform intratumor expression of the fusion protein. The clinical response observed in the FGFR3-TACC3-positive patients treated with an FGFR Inhibitor supports clinical studies of FGFR inhibition in FGFR-TACC-positive patients.