Genomic correlates of response to immune checkpoint therapies in clear cell renal cell carcinoma

D Miao, CA Margolis, W Gao, MH Voss, W Li… - Science, 2018 - science.org
D Miao, CA Margolis, W Gao, MH Voss, W Li, DJ Martini, C Norton, D Bossé, SM Wankowicz
Science, 2018science.org
Immune checkpoint inhibitors targeting the programmed cell death 1 receptor (PD-1)
improve survival in a subset of patients with clear cell renal cell carcinoma (ccRCC). To
identify genomic alterations in ccRCC that correlate with response to anti–PD-1
monotherapy, we performed whole-exome sequencing of metastatic ccRCC from 35
patients. We found that clinical benefit was associated with loss-of-function mutations in the
PBRM1 gene (P= 0.012), which encodes a subunit of the PBAF switch-sucrose …
Immune checkpoint inhibitors targeting the programmed cell death 1 receptor (PD-1) improve survival in a subset of patients with clear cell renal cell carcinoma (ccRCC). To identify genomic alterations in ccRCC that correlate with response to anti–PD-1 monotherapy, we performed whole-exome sequencing of metastatic ccRCC from 35 patients. We found that clinical benefit was associated with loss-of-function mutations in the PBRM1 gene (P = 0.012), which encodes a subunit of the PBAF switch-sucrose nonfermentable (SWI/SNF) chromatin remodeling complex. We confirmed this finding in an independent validation cohort of 63 ccRCC patients treated with PD-1 or PD-L1 (PD-1 ligand) blockade therapy alone or in combination with anti–CTLA-4 (cytotoxic T lymphocyte-associated protein 4) therapies (P = 0.0071). Gene-expression analysis of PBAF-deficient ccRCC cell lines and PBRM1-deficient tumors revealed altered transcriptional output in JAK-STAT (Janus kinase–signal transducers and activators of transcription), hypoxia, and immune signaling pathways. PBRM1 loss in ccRCC may alter global tumor-cell expression profiles to influence responsiveness to immune checkpoint therapy.
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