The Efficacy of Immunotherapy and Clinical Utility of Comprehensive Genomic Profiling in Adenoid Cystic Carcinoma of Head and Neck
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Characterization on the C-CAT Database
2.2. Patient Population and Characterization at Tokyo Medical and Dental University (TMDU)
2.3. Comprehensive Genomic Profiling (CGP) Analysis
2.4. Expert Panel Discussion
2.5. Efficacy Evaluation of ICI Therapy
2.6. Biomarker Assessment
3. Results
3.1. Comprehensive Patient Population and Genetic Characterization of CGP in C-CAT Data
3.2. Outcomes of ICI Therapy in C-CAT Data
3.3. Outcomes of ICI Therapy and Sequencing Results in TMDU
3.4. Case Presentation (Case No.3 in Table 5A,B)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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(A) | ||||||||||
n (%) | Best response | ORR | DCR | |||||||
CR | PR | SD | PD | NE | ||||||
All patients | 59 (100) | 2 (3) | 3 (5) | 26 (44) | 11 (19) | 17 (29) | 5 (8) | 31 (53) | ||
TMB | 59 (100) | |||||||||
Low (≤5) | 54 (92) | 2 (4) | 3 (6) | 23 (43) | 10 (19) | 16 (31) | 5/54 (9) | 28/54 (52) | ||
Intermediate (5–10) | 4 (7) | 0 (0) | 0 (0) | 2 (50) | 1 (25) | 1 (25) | 0/4 (0) | 2/4 (50) | ||
High (>10) | 1 (2) | 0 (0) | 0 (0) | 1 (100) | 0 (0) | 0 (0) | 0/1 (0) | 1/1 (100) | ||
(B) | ||||||||||
n (%) | Age (y) | Outcome (%) | ||||||||
Median | Range | ORR | DCR | |||||||
All patients | 59 (100) | 61 | 34–77 | 5/59 (8) | 31/59 (53) | |||||
Male | 27 (46) | 60 | 36–77 | 2/27 (7) | 15/27 (56) | |||||
Female | 32 (54) | 62 | 34–77 | 3/32 (9) | 16/32 (50) |
(A) | ||||||||
n (%) | Best response | ORR | DCR | |||||
CR | PR | SD | PD | NE | ||||
All patients | 28 (100) | 1 (4) | 1 (4) | 8 (29) | 7 (25) | 11 (39) | 2 (7) | 10 (36) |
TMB | 28 (100) | |||||||
Low (≤5) | 25 (89) | 1 (4) | 1 (4) | 6 (24) | 7 (28) | 10 (40) | 2/25 (8) | 8/25 (32) |
Intermediate (5–10) | 3 (11) | 0 (0) | 0 (0) | 2 (67) | 0 (0) | 1 (33) | 0/0 (0) | 2/3 (67) |
High (>10) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0/0 (0) | 0/0 (0) |
(B) | ||||||||
n (%) | Best response | ORR | DCR | |||||
CR | PR | SD | PD | NE | ||||
All patients | 31 (100) | 1 (3) | 2 (6) | 18 (58) | 4 (13) | 6 (19) | 3 (10) | 21 (68) |
TMB | 31 (100) | |||||||
Low (≤5) | 29 (90) | 1 (3) | 2 (7) | 17 (59) | 3 (10) | 6 (21) | 3/29 (11) | 20/29 (69) |
Intermediate (5–10) | 1 (7) | 0 (0) | 0 (0) | 0 (0) | 1 (100) | 0 (0) | 0/1 (0) | 0/1 (0) |
High (>10) | 1 (4) | 0 (0) | 0 (0) | 1 (100) | 0 (0) | 0 (0) | 0/1 (0) | 1/1 (100) |
n | Best Response (%) | ORR | DCR | |||||
---|---|---|---|---|---|---|---|---|
CR | PR | SD | PD | NE | ||||
NOTCH1 | 13 | 0 (0) | 0 (0) | 6 (46) | 3 (23) | 4 (30) | 0/13 (0) | 6/13 (46) |
BRAF | 4 | 0 (0) | 0 (0) | 2 (50) | 0 (0) | 2 (50) | 0/4 (0) | 2/4 (50) |
KDM6A | 5 | 0 (0) | 0 (0) | 1 (20) | 1 (20) | 3 (60) | 0/5 (0) | 1/5 (20) |
MYB * | 5 | 1 (20) | 1 (20) | 0 (0) | 2 (40) | 1 (20) | 2/5 (40) | 2/5 (40) |
Case No. | Age(yr)/Gender | Tumor Mutational Burden | Immune Checkpoint Inhibitor | Treatment Line | Best Response |
---|---|---|---|---|---|
1 | 53/F | 5.04 mut/Mb | Pembrolizumab | 1st line | CR |
2 | 55/M | 0 mut/Mb | Nivolumab | 2nd line | CR |
3 | 63/M | 2 mut/Mb | Pembrolizumab | 1st line | PR |
4 | 62/F | 1.26 mut/Mb | Pembrolizumab | 2nd line | PR |
5 | 34/F | 1 mut/Mb | Nivolumab | 3rd line | PR |
(A) | ||||||
Case No. | Age(yr)/Gender | Primary site | Tumor Mutational Burden | Combined positive score | Immune checkpoint inhibitor | Best Response |
1 | 57/M | Mandibular gingival | 1.26 mut/Mb | 2–3% | Pembrolizumab | SD |
2 | 61/M | Palate | 1.26 mut/Mb | 1–3% | Pembrolizumab | PD |
3 | 70/M | Submandibular gland | 1.26 mut/Mb | 1–3% | Pembrolizumab | SD |
4 | 49/F | Submandibular gland | 2.52 mut/Mb | 1–5% | Pembrolizumab | SD |
(B) | ||||||
Case No. | Genomic Findings | |||||
1 | NOTCH1 S990fs*34,H1544fs*66 U2AF1 S34F | |||||
2 | TP53 R273C | |||||
3 | BRAF G469A EP300 R202* MLL2 G61fs*69 MYB-NFIB fusion MYB rearrangement intron 14 NOTCH1 H2428fs*6 TERT promoter -124C>T TP53 C176W-subclonal | |||||
4 | RPTOR D1101Y TERT promoter -124C>T CEBPA P222T CARD11 L601P,T670M SPEN R3403H |
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Naito, T.; Noji, R.; Kugimoto, T.; Kuroshima, T.; Tomioka, H.; Fujiwara, S.; Suenaga, M.; Harada, H.; Kano, Y. The Efficacy of Immunotherapy and Clinical Utility of Comprehensive Genomic Profiling in Adenoid Cystic Carcinoma of Head and Neck. Medicina 2023, 59, 2111. https://doi.org/10.3390/medicina59122111
Naito T, Noji R, Kugimoto T, Kuroshima T, Tomioka H, Fujiwara S, Suenaga M, Harada H, Kano Y. The Efficacy of Immunotherapy and Clinical Utility of Comprehensive Genomic Profiling in Adenoid Cystic Carcinoma of Head and Neck. Medicina. 2023; 59(12):2111. https://doi.org/10.3390/medicina59122111
Chicago/Turabian StyleNaito, Takahiro, Rika Noji, Takuma Kugimoto, Takeshi Kuroshima, Hirofumi Tomioka, Shun Fujiwara, Mitsukuni Suenaga, Hiroyuki Harada, and Yoshihito Kano. 2023. "The Efficacy of Immunotherapy and Clinical Utility of Comprehensive Genomic Profiling in Adenoid Cystic Carcinoma of Head and Neck" Medicina 59, no. 12: 2111. https://doi.org/10.3390/medicina59122111