Article
作者: Di Francesco, M. Emilia ; Holla, Vijaykumar ; Lazar, Alexander J. ; Sanchez, Nora S. ; Smith, Graeme C.M. ; Shaw, Kenna Rael ; Lillo, Giorgia ; Yap, Timothy A. ; Marszalek, Joseph R. ; Liu, Chiu-Yi ; Tse, Wai Yiu ; Carroll, Christopher L. ; Gheeya, Jinesh S. ; Giuliani, Virginia ; Le, Hung ; Machado, Annette A. ; Piscitello, Desiree ; Kyewalabye, Keith ; Elinati, Elias ; McGrail, Daniel J. ; Geck Do, Mary K. ; Wani, Khalida M. ; Vellano, Christopher P. ; Grinkevich, Vera ; Yang, Dong ; Feng, Ningping ; Geo, Lerin ; Kopetz, Scott E. ; Johnson, Michael G. ; Goswamy, Rohit Vivek ; Johnson, Timothy I. ; Majithiya, Jayesh ; Armstrong, Lucy ; Pilié, Patrick G. ; Ranzani, Marco ; Neves, Joana ; Heffernan, Timothy P. ; Jones, Philip ; Robinson, Helen M.R. ; Wang, Wei-Lien ; Rajendra, Eeson ; Lively, Sarah ; Bristow, Christopher A. ; Campbell, Erick ; Bardenhagen, Jennifer P. ; Ma, XiaoYan ; Luzarraga, Marina Roy ; Boursier, Marie ; Ngoi, Natalie Y.L. ; Likhatcheva, Maria ; Meric-Bernstam, Funda
Purpose::Mutations in the ATM gene are common in multiple cancers, but clinical studies of therapies targeting ATM-aberrant cancers have yielded mixed results. Refinement of ATM loss of function (LOF) as a predictive biomarker of response is urgently needed.
Experimental Design::We present the first disclosure and preclinical development of a novel, selective ATR inhibitor, ART0380, and test its antitumor activity in multiple preclinical cancer models. To refine ATM LOF as a predictive biomarker, we performed a comprehensive pan-cancer analysis of ATM variants in patient tumors and then assessed the ATM variant-to-protein relationship. Finally, we assessed a novel ATM LOF biomarker approach in retrospective clinical data sets of patients treated with platinum-based chemotherapy or ATR inhibition.
Results::ART0380 had potent, selective antitumor activity in a range of preclinical cancer models with differing degrees of ATM LOF. Pan-cancer analysis identified 10,609 ATM variants in 8,587 patient tumors. Cancer lineage–specific differences were seen in the prevalence of deleterious (Tier 1) versus unknown/benign (Tier 2) variants, selective pressure for loss of heterozygosity, and concordance between a deleterious variant and ATM loss of protein (LOP). A novel ATM LOF biomarker approach that accounts for variant classification, relationship to ATM LOP, and tissue-specific penetrance significantly enriched for patients who benefited from platinum-based chemotherapy or ATR inhibition.
Conclusions::These data help to better define ATM LOF across tumor types in order to optimize patient selection and improve molecularly targeted therapeutic approaches for patients with ATM LOF cancers.