Association between FGFR1 copy numbers, MAP3K1 mutations, and survival in axillary node-positive, hormone receptor-positive, and HER2-negative early breast cancer in the PACS04 and METABRIC studies

Dimitri Carene, Alicia Tran-Dien, Jérôme Lemonnier, Florence Dalenc, Christelle Levy, Jean Yves Pierga, William Jacot, Jean Luc Canon, Catherine Richon, Ludovic Lacroix, Christophe Caux, Fabrice André, Stefan Michiels

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    Abstract

    Purpose: Hormone receptor-positive (HR+) and human epidermal growth factor receptor 2 negative (HER2−) early breast cancer (BC) is the most prevalent BC subtype with substantial biological heterogeneity. Although clinicopathological (CP) characteristics have a clear prognostic value, additional biomarkers could refine survival prediction and guide treatment decision. Methods: Copy number aberrations and somatic driver mutations were obtained with OncoScan CGH array and sequencing of 36 genes on HR+/HER2− node-positive early BC patients treated with chemotherapy from the PACS04 trial. We built a two-gene genomic score (GS) associated with distant disease-free survival (DDFS), whose prognostic value was assessed on the external METABRIC data (n = 1413) using overall survival (OS) and breast cancer-specific survival (BCSS). Results: In the PACS04 trial (n = 327), the median follow-up for DDFS (65 events) was 9.6 years. FGFR1 amplifications (HR Amplification = 2.44, 95% CI [1.25; 4.76], p = 0.009) and MAP3K1 mutations (HR Mutation = 0.10, [0.01; 0.78], p = 0.03) were associated with DDFS beyond CP characteristics. A prognostic GS combining FGFR1 amplifications and MAP3K1 mutations added more information to CP model (χDDFS2 = 12.97, pDDFS < 0.001 and χOS2 = 11.52, pOS < 0.001). In the METABRIC study (n = 1413), FGFR1 amplifications (HR Amplification = 2.00 [1.40; 2.87], p < 0.001) and MAP3K1 mutations (HR Mutation = 0.58 [0.41; 0.83], p = 0.003) were significantly associated with BCSS beyond CP characteristics. The prognostic GS added significant prognostic information to CP model (χBCSSS2 = 15.39, pBCSS < 0.001 and χOS2 = 5.62, pOS = 0.02). Conclusion: In axillary node-positive, HR+, and HER2− early BC, amplifications of FGFR1 gene were strongly associated with increased risk for distant disease, while mutations of MAP3K1 gene were significantly associated with decreased risk.

    Original languageEnglish
    Pages (from-to)387-401
    Number of pages15
    JournalBreast Cancer Research and Treatment
    Volume179
    Issue number2
    DOIs
    Publication statusPublished - 1 Jan 2020

    Keywords

    • Biomarkers
    • Breast cancer (BC)
    • Copy number aberrations (CNA)
    • Cox regression
    • Mutations

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