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Paired analysis of tumor mutation burden calculated by targeted deep sequencing panel and whole exome sequencing in non-small cell lung cancer

  • Park, Sehhoon (Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Chung (Geninus Inc.) ;
  • Ku, Bo Mi (Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Minjae (Geninus Inc.) ;
  • Park, Woong-Yang (Geninus Inc.) ;
  • Kim, Nayoung K.D. (Geninus Inc.) ;
  • Ahn, Myung-Ju (Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2021.03.31
  • Accepted : 2021.06.02
  • Published : 2021.07.31

Abstract

Owing to rapid advancements in NGS (next generation sequencing), genomic alteration is now considered an essential predictive biomarkers that impact the treatment decision in many cases of cancer. Among the various predictive biomarkers, tumor mutation burden (TMB) was identified by NGS and was considered to be useful in predicting a clinical response in cancer cases treated by immunotherapy. In this study, we directly compared the lab-developed-test (LDT) results by target sequencing panel, K-MASTER panel v3.0 and whole-exome sequencing (WES) to evaluate the concordance of TMB. As an initial step, the reference materials (n = 3) with known TMB status were used as an exploratory test. To validate and evaluate TMB, we used one hundred samples that were acquired from surgically resected tissues of non-small cell lung cancer (NSCLC) patients. The TMB of each sample was tested by using both LDT and WES methods, which extracted the DNA from samples at the same time. In addition, we evaluated the impact of capture region, which might lead to different values of TMB; the evaluation of capture region was based on the size of NGS and target sequencing panels. In this pilot study, TMB was evaluated by LDT and WES by using duplicated reference samples; the results of TMB showed high concordance rate (R2 = 0.887). This was also reflected in clinical samples (n = 100), which showed R2 of 0.71. The difference between the coding sequence ratio (3.49%) and the ratio of mutations (4.8%) indicated that the LDT panel identified a relatively higher number of mutations. It was feasible to calculate TMB with LDT panel, which can be useful in clinical practice. Furthermore, a customized approach must be developed for calculating TMB, which differs according to cancer types and specific clinical settings.

Keywords

Acknowledgement

This study was supported by Bristol Myers Squibb. The biospecimens of this study were provided by Samsung Medical Center BioBank (2019-0029).

References

  1. Shen T, Pajaro-Van de Stadt SH, Yeat NC and Lin JC (2015) Clinical applications of next generation sequencing in cancer: from panels, to exomes, to genomes. Front Genet 6, 215 https://doi.org/10.3389/fgene.2015.00215
  2. Luthra R, Chen H, Roy-Chowdhuri S and Singh RR (2015) Next-generation sequencing in clinical molecular diagnostics of cancer: advantages and challenges. Cancers (Basel) 7, 2023-2036 https://doi.org/10.3390/cancers7040874
  3. Ettinger DS, Wood DE, Aisner DL et al (2021) NCCN Guidelines insights: non-small cell lung cancer, version 2.2021. J Natl Compr Canc Netw 19, 254-266 https://doi.org/10.6004/jnccn.2021.0013
  4. Drilon A, Wang L, Arcila ME et al (2015) Broad, hybrid capture-based next-generation sequencing identifies actionable genomic alterations in lung adenocarcinomas otherwise negative for such alterations by other genomic testing approaches. Clin Cancer Res 21, 3631-3639 https://doi.org/10.1158/1078-0432.CCR-14-2683
  5. Surrey LF, MacFarland SP, Chang F et al (2019) Clinical utility of custom-designed NGS panel testing in pediatric tumors. Genome Med 11, 32 https://doi.org/10.1186/s13073-019-0644-8
  6. Reck M, Rodriguez-Abreu D, Robinson AG et al (2016) Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer. N Engl J Med 375, 1823-1833 https://doi.org/10.1056/NEJMoa1606774
  7. Larkin J, Chiarion-Sileni V, Gonzalez R et al (2019) Five-year survival with combined nivolumab and ipilimumab in advanced melanoma. N Engl J Med 381, 1535-1546 https://doi.org/10.1056/NEJMoa1910836
  8. Alexandrov LB, Nik-Zainal S, Wedge DC et al (2013) Signatures of mutational processes in human cancer. Nature 500, 415-421 https://doi.org/10.1038/nature12477
  9. Yarchoan M, Hopkins A and Jaffee EM (2017) Tumor mutational burden and response rate to PD-1 inhibition. N Engl J Med 377, 2500-2501 https://doi.org/10.1056/NEJMc1713444
  10. Snyder A, Makarov V, Merghoub T et al (2014) Genetic basis for clinical response to CTLA-4 blockade in melanoma. N Engl J Med 371, 2189-2199 https://doi.org/10.1056/NEJMoa1406498
  11. Rizvi NA, Hellmann MD, Snyder A et al (2015) Cancer immunology. Mutational landscape determines sensitivity to PD-1 blockade in non-small cell lung cancer. Science 348, 124-128 https://doi.org/10.1126/science.aaa1348
  12. Rizvi H, Sanchez-Vega F, La K et al (2018) Molecular determinants of response to anti-programmed cell death (PD)-1 and anti-programmed death-ligand 1 (PD-L1) blockade in patients with non-small-cell lung cancer profiled with targeted next-generation sequencing. J Clin Oncol 36, 633-641
  13. Andre T, Shiu KK, Kim TW et al (2020) Pembrolizumab in microsatellite-instability-high advanced colorectal cancer. N Engl J Med 383, 2207-2218 https://doi.org/10.1056/NEJMoa2017699
  14. Marabelle A, Fakih M, Lopez J et al (2020) Association of tumour mutational burden with outcomes in patients with advanced solid tumours treated with pembrolizumab: prospective biomarker analysis of the multicohort, open-label, phase 2 KEYNOTE-158 study. Lancet Oncol 21, 1353-1365 https://doi.org/10.1016/S1470-2045(20)30445-9
  15. Chalmers ZR, Connelly CF, Fabrizio D et al (2017) Analysis of 100,000 human cancer genomes reveals the landscape of tumor mutational burden. Genome Med 9, 34 https://doi.org/10.1186/s13073-017-0424-2
  16. Le DT, Uram JN, Wang H et al (2015) PD-1 Blockade in tumors with mismatch-repair deficiency. N Engl J Med 372, 2509-2520 https://doi.org/10.1056/NEJMoa1500596
  17. Budczies J, Allgauer M, Litchfield K et al (2019) Optimizing panel-based tumor mutational burden (TMB) measurement. Ann Oncol 30, 1496-1506 https://doi.org/10.1093/annonc/mdz205
  18. Golkaram M, Zhao C, Kruglyak K, Zhang S and Bilke S (2020) The interplay between cancer type, panel size and tumor mutational burden threshold in patient selection for cancer immunotherapy. PLoS Comput Biol 16, e1008332 https://doi.org/10.1371/journal.pcbi.1008332
  19. Hong TH, Cha H, Shim JH et al (2020) Clinical advantage of targeted sequencing for unbiased tumor mutational burden estimation in samples with low tumor purity. J Immunother Cancer 8, e001199 https://doi.org/10.1136/jitc-2020-001199
  20. Shim JH, Kim HS, Cha H et al (2020) HLA-corrected tumor mutation burden and homologous recombination deficiency for the prediction of response to PD-(L)1 blockade in advanced non-small-cell lung cancer patients. Ann Oncol 31, 902-911 https://doi.org/10.1016/j.annonc.2020.04.004
  21. Heydt C, Rehker J, Pappesch R et al (2020) Analysis of tumor mutational burden: correlation of five large gene panels with whole exome sequencing. Sci Rep 10, 11387 https://doi.org/10.1038/s41598-020-68394-4
  22. Shin HT, Choi YL, Yun JW et al (2017) Prevalence and detection of low-allele-fraction variants in clinical cancer samples. Nat Commun 8, 1377 https://doi.org/10.1038/s41467-017-01470-y
  23. Kim ST, Kim KM, Kim NKD et al (2017) Clinical application of targeted deep sequencing in solid-cancer patients and utility for biomarker-selected clinical trials. Oncologist 22, 1169-1177 https://doi.org/10.1634/theoncologist.2017-0020
  24. Lee J, Kim ST, Kim K et al (2019) Tumor genomic profiling guides patients with metastatic gastric cancer to targeted treatment: the VIKTORY umbrella trial. Cancer Discov 9, 1388-1405 https://doi.org/10.1158/2159-8290.cd-19-0442
  25. Kim Y, Lee B, Shim JH et al (2019) Concurrent genetic alterations predict the progression to target therapy in EGFR-mutated advanced NSCLC. J Thorac Oncol 14, 193-202 https://doi.org/10.1016/j.jtho.2018.10.150
  26. Lee J, Shim JH, Park WY et al (2019) Rare mechanism of acquired resistance to osimertinib in Korean patients with EGFR-mutated non-small cell lung cancer. Cancer Res Treat 51, 408-412 https://doi.org/10.4143/crt.2018.138
  27. Yun JW, Bae YK, Cho SY et al (2019) Elucidation of novel therapeutic targets for acute myeloid leukemias with RUNX1-RUNX1T1 fusion. Int J Mol Sci 20, 1717 https://doi.org/10.3390/ijms20071717
  28. Park YH, Shin HT, Jung HH et al (2015) Role of HER2 mutations in refractory metastatic breast cancers: targeted sequencing results in patients with refractory breast cancer. Oncotarget 6, 32027-32038 https://doi.org/10.18632/oncotarget.5184
  29. Kim KH, Kim J, Park H et al (2020) Parallel comparison and combining effect of radiomic and emerging genomic data for prognostic stratification of non-small cell lung carcinoma patients. Thorac Cancer 11, 2542-2551 https://doi.org/10.1111/1759-7714.13568
  30. Ku BM, Bae YH, Lee KY et al (2020) Entrectinib resistance mechanisms in ROS1-rearranged non-small cell lung cancer. Invest New Drugs 38, 360-368 https://doi.org/10.1007/s10637-019-00795-3
  31. Park S, Ku BM, Jung HA et al (2020) EGFR C797S as a resistance mechanism of lazertinib in non-small cell lung cancer with EGFR T790M mutation. Cancer Res Treat 52, 1288-1290
  32. Lee HS, Kim E, Lee J et al (2021) Profiling of conditionally reprogrammed cell lines for in vitro chemotherapy response prediction of pancreatic cancer. EBioMedicine 65, 103218 https://doi.org/10.1016/j.ebiom.2021.103218
  33. Lee Y, Lee S, Sung JS et al (2021) Clinical application of targeted deep sequencing in metastatic colorectal cancer patients: actionable genomic alteration in K-MASTER project. Cancer Res Treat 53, 123-130 https://doi.org/10.4143/crt.2020.559
  34. Wu HX, Wang ZX, Zhao Q et al (2019) Tumor mutational and indel burden: a systematic pan-cancer evaluation as prognostic biomarkers. Ann Transl Med 7, 640 https://doi.org/10.21037/atm.2019.10.116
  35. Fancello L, Gandini S, Pelicci PG and Mazzarella L (2019) Tumor mutational burden quantification from targeted gene panels: major advancements and challenges. J Immunother Cancer 7, 183 https://doi.org/10.1186/s40425-019-0647-4