MYC mutation

The results of the present study suggested that druggable gene alterations may provide useful information not only in proposing alternative treatment after standard of care but also in selecting second-line targeted treatments after immunotherapy for patients with advanced HCC.

In this study, we analyzed a subset of patients from the Dallas Metastatic Breast Cancer Study comprised of patients with HR+, HER2 non-amplified, mBC who underwent treatment with a CDK4/6 inhibitor (palbociclib, ribociclib, abemaciclib) and ET, became resistant to therapy, and had ctDNA testing (n=102). There is an urgent need to develop predictive biomarkers that capture real-time changes in tumor biology. Tissue analyses from patients resistant to CDK4/6 inhibitors have demonstrated a 14%-28% expression of CCNE1, 16% of MYC mutations, and 9%-10% expression of RB mutations. In our study, we observe a lower rate of detection in ctDNA of each gene.

We concluded that both could be diagnosed as "DLBCL-NOS with MYC rearrangement" using the current pathologic classifications, 2022 International Consensus Classification (ICC) and World Health Organization Classifications of Haematolymphoid Tumors (WHO-HAEM5). This report illustrates diagnostic challenges and treatment dilemmas that may be encountered, particularly for adolescent and young adults (AYA).

Patients were excluded if they received targeted therapy, prior concurrent chemo-RT followed by durvalumab, or RT after IO discontinuation...Pembrolizumab was the most used IO agent (77%)...Our findings suggest certain gene mutations can affect radiotherapy's effect on immunotherapy efficacy in mNSCLC. Further prospective studies are needed to verify these results.

Additional potential biomarkers for the immunotherapy of UrC are mismatch repair (MMR) status and PD-L1 expression profile. In addition, combined regimens featuring targeted agents and immune checkpoint blockers might increase antitumor activity and exert better efficacy in UrC patients with specific mutational burden.

This is the first reported case of a patient with the co-existence of MM, PTC and ccRCC undergoing chemotherapy with a favorable prognosis. Herein, we suggest that such a combination may be non-random, as for mutation of BRAF might account for the co-occurrence of PTC and MM, while mutations of CCND1 and MYC cause the coexistence of MM and ccRCC. This finding may provide valuable guidance on the diagnosis and treatment of such disease, as well as the prevention of developing a second or third tumor for patients with a single primary.

Our DNA methylation analyses showed that B-PLL is heterogeneous, and cannot be epigenetically classified as CLL, MCL or MZL. Part of this B-PLL heterogeneity may be related to the presence of 2 B-PLL epitypes with potential different cell of origin, genetic mutations, transcriptional profile and clinical outcome. DNA methylation, Lymphoproliferative disorder

In this study, we identified multiple liquid biopsy factors including ctDNA and CTC-clusters at various time points, and found that these are associated with prognosis. The synergy of multiple ctDNA mutations and CTC-clusters during treatment may expand the predictive role of liquid biopsy for the monitoring of disease progression in patients MBC.

Our patient presented with an extensive, localized mass of the mandible and surrounding musculature, clinically suggestive of Ewing sarcoma or other sarcoma of soft tissue and bone. However, this small round blue cell tumor proved to be a high-grade, precursor-B non-Hodgkin lymphoma. In contrast to immature T-lineage pediatric malignancies, most precursor-B lymphoblastic malignancies manifest as leukemia.

The correlation between the profiles of genomic mutation and the oncological outcomes including overall survival, time to treatment-related neuroendocrine prostate cancer (tNEPC), and the efficacy of each sequential treatment such as androgen receptor pathway inhibitors (ARPI), docetaxel (DTX), cabazitaxel (CBZ), and platinum-based chemotherapies were evaluated. APC mutation, associated with other genomic alteration of tumor suppressor and NED, can be an important prognostic indicator in PCa patients.

PI3K/mTOR dual inhibition, PI3Kalpha inhibitor, AKT inhibitor, FGFR inhibitor, ALK/IGF1R inhibitor, CDK4/6 inhibitor, BCl2 inhibitor, WEE1 inhibitor, ATR inhibitor, DNA-PK inhibitor, AT2AR inhibitor, Mcl-1 inhibitor, MEK1/2 inhibitor, EZH2 inhibitor, HDAC inhibitor, CDK9 inhibitor, DNMT3 inhibitor, BRD4/BET inhibitor, JAK2 inhibitor, CXCR4 inhibitor, FAK inhibitor, BTK inhibitor, eribulin, & VEGFR2/ PDGFR/FGFR or VEGFR2/c-MET/Axl triple blockage might be effective on TW2.6 and reverse treatment refractoriness, maybe through the inhibition of mesenchymal transformation, pRB, & PI3K/AKT /mTOR signaling and the modulation of stemness & PD1/PDL1 pathway...All cell lines will be tried to be categorized as TCGA subtypes for the reference of future drug combinations.Cell linesSCC25KBSASCAL27FaDuSCC15SCC9SCC4TW2.6Differ- entiationWellPoorPoorPoorPoorWellWellWellWell, but rapidly replicated, with high hyper-diploidy & complex rearrangementsHPV statusHPV 16/18HPV18--HPV 16/18--HPV 6/11-EGFR statusMediumLowHighHighMediumHighLowMedium to highUnknownDocetaxel sensitivity+++++++++++++ to +++++-+Cisplatin sensitivity+++++++++++++- to +-- to +5-FU sensitivity+++++++++++-+ to ++-- to +Afatinib sensitivity+++- to +-+++++ to +++++++++-Polo-like kinase Inhibitor sensitivity+++++++++++++ to +++- to +-- to +VEGFR2 Inhibitor sensitivity----+++++--++PI3K/ mTOR inhibitorAll cell lines sensitiveCDK4/6 Inhibitor response+++- to ++++++ to +++++++++++++ to +++Western blotsWeak p-AKT & VEGF-A, mild PDL1 and BMI-1, Gli-1(+)Weak p-AKT, mild PDL1 and strong VEGF-A & BMI-1, p16(+)Moderate p-AKT & BMI-1, high PDL1, mild VEGF-AHigh p-AKT & VEGF-A, mild PDL1 & BMI-1High VEGF-A, moderate p-AKT & PDL1, weak BMI-1, Gli-1(+)Weak p-AKT & VEGF-A, mild PDL1 & BMI-1Weak p-AKT, VEGF-A, & BMI-1, moderate PDL1Moderate p-AKT & VEGF-A, strong BMI-1, mild PDL1, Gli-1(+)High p-AKT, PDL1, & VEGF-A and moderate BMI-1NGSCCND1 gain, CDKN2A deletion, FRG1 mutation, HGF mutation, p53 mutation, ATR mutation, SMO mutation, RUNX1T1 mutationSTK11 mutation, PDGFRA mutation, IGF1 mutation, BCOR mutation, EGFR mutation, NOTCH1 mutation, MET mutation, IKZF1 mutation, NFKB1 mutation, DPYD mutation, FGFR4 mutation, BRCA1 mutation, MSH2 mutation, DNMT3A mutationKRAS mutation, MDM2 mutation, TMB-H, AXIN1 loss, RAD51D mutation, NOTCH1/2 mutation, ERBB4 mutation, PALB2 mutation, p53 mutation, POLE mutation, CASP8 mutation, BRCA2 mutation, RNF43 mutation, LRP1B mutation, MET mutationCDKN2A deletion, EGFR amplification, SMAD4 mutation, TMB-H, LRP1B mutation, APC mutation, CASP8 mutation, CREBBP mutation, PIK3CG mutation, NRAS mutation, ABL1 mutation, FGF23 mutation, HGF mutation, ATRX mutation, p53 mutation, ERBB2 mutation, ROS1 mutation, EP300 mutation, NRAS mutation, CDKN1A mutation, KDM6A mutation, FLT4 mutationCCND1 gain, CDKN2A deletion, FLCN mutation, TMB-H, LRP1B mutation, SMAD4 loss, SF3B1 mutation, FAT1 mutation, VHL mutation, NOTCH3 mutation, EPHA5 mutation, p53 mutation, ERCC2 mutationCCND1 gain, EGFR amplification, SMO mutation, ATR mutation, FAT1 loss, NTRK1 mutation, KMT2D mutation, p53 mutation, NOTCH3 mutationCDKN2A deletion, AXIN2 amplification, SMAD3 loss, HRAS mutation, ATR mutation, NF1 mutation. IGF1R mutation, FLCN mutation, KEAP1 mutation, ASXL1 mutation, PMS2 mutationCCND1 gain, NF1 loss, LRP1B mutation, NSD1 mutation, KMT2D mutation, p53 mutation, EPHA2 mutationFAT1 loss, CCND3/FGF10 amplification, PIK3CA H1047R mutation, STK11 mutation, RICTOR/FLCN amplification, VEGF-A amplification , TSC2 mutation, EPHB1 mutation, MAP2K4 mutation, KDM5A mutation, PDGFRB mutation, SETD2 mutation, RPTOR mutation, APC mutation, DDR2 mutation, ATM mutation, MDM2 mutation, p53 mutation, CDK12 mutation, HRAS mutation, MYC mutation, CDK8 mutation, ARID1B lossOutcomesBest; like TCGA CL (HPV+) subtypeLike TCGA basal subtype, but responded to particular treatments eachBasalBasalLike TCGA mesen-chymal subtype (HPV+)Like TCGA CL(HPV-) subtype, different characters between these 3 cell linesCL(HPV-) subtypeCL(HPV-) subtypeWorse; like TCGA EMT subtype (HPV-)Potential treatmentsAll sensitive maybe; Hedgehog inhibitor , HGF/c-MET inhibitor, and I/O could be tried(1) Taxane, cisplatin, PLKi (2) mTORi (3) IGF1Ri, METi, PDGFRi, FGFRi (4) Epigenetics (5) I/O(1) Taxane, cisplatin, 5-FU, PLKi (2) CDK4/6i (3) I/O (4) DDRi (5) KRASi, METi, HERi (6) p53 reactivator and MDM2/Mcl-1 inhibitor(1) Taxane, cisplatin, 5-FU, PLKi (2) CDK4/6i (3) Mild EGFRi response (4) I/O (5) NRASi, FGFRi, HGF/c-METi/ROS1i/HERi (6) p53 reactivator/DDRi/Epigenetics(1) Cisplatin, 5-FU (2) EGFRi and VEGFR2i (3) Weak to PLKi & CDK4/6i (4) I/O (5) mTORi (6) Ephi (7) DDR/Epigenetics (8) p53 reactivator (9) HIFi(1) Taxane and PLKi (2) EGFRi, VEGFR2i, CDK4/6i (3) NTRKi (4) Hedgehog inhibitor (5) DDRi, epigenetics,& p53 reactivator(1) Taxane &5-FU (2) EGFRi (3) HRASi (4) DDRi/Epigenetics (5) I/O (6) IGF1Ri (7) mTORi(1) EGFRi (2) CDK4/6i (3) I/O (4) Epigenetics (5) Ephi (6) p53 reactivator(1) CDK4/6 inhibitor (2) Multi-targeted VEGFR TKI (3) PI3K/AKT/mTOR inhibitor (4) ICIs combination (5) p53 reactivator/ DDR interventions/Epigenetics (6) Dasatinib, HRASi, EphB1/B4 interventions Further NGS analysis may translate these HNSCC cell lines to represent TCGA subtypes for the reference of future drug combinations, esp... Further NGS analysis may translate these HNSCC cell lines to represent TCGA subtypes for the reference of future drug combinations, esp. immunotherapy, basic/translational research, and animal models. LRP1B will be a potential ICIs efficacy biomarker in HNSCC.

Introduction Patients with diffuse large B-cell lymphoma (DLBCL) are generally treated in the frontline setting with a standard immunochemotherapy regimen (R-CHOP), but for the 30-40% of patients who develop relapsed disease (relapsed-refractory DLBCL, rrDLBCL), prognosis is generally poor...The frequent observation of deletions affecting HNRNPD points to an under-appreciated role of RNA-binding proteins in DLBCL relapse. Recurrent deletions of IRF2 could further explain immune evasion observed in rrDLBCL.

However, the poor clinical outcomes in patients with both MYC and TP53 abnormalities call for potential therapeutic strategies. KeyWords:relapsed/refractory DLBCL,MYC,TP53 ,CAR T-cell therapy

She presented 2 weeks later with worsening neck pain and dyspnea where was admitted to the ICU for airway watch and started on dexamethasone 40 mg with R‐EPOCH chemotherapy...TP53 mutation has been associated with tumor aggressiveness in follicular, poorly differentiated, and anaplastic thyroid cancers and can be synergistic with MYC mutation in aggressive B cell lymphoma. Further research is needed on the role this mutation plays in the pathogenesis of thyroid lymphoma.

M1, high Gleason score, and IDC-P pathology represent higher HRD scores in PCa. Tumors with IDC-P might have different driven mechanisms for high HRD scores than non-IDC-P. HRD score displayed prognostic value in this aggressive prostate cancer cohort.

Interestingly, despite the fact that APOBEC3A, APOBEC3B and APOBEC3G caused c-MYC mutations when overexpressed in HEK293T cells, a mutational enrichment in eBL tumors was only detected in AID motifs. This suggests that even though the EBV- and P. falciparum-directed immune response triggers the expression and activity of several AID/APOBEC members, only the upregulation of AID has oncogenic consequences, while the induction of the APOBEC3 subfamily may primarily have immunoprotective functions.

Conclusions : Tumors with IDC-P might have different driven mechanisms for high HRD scores than non-IDC-P. Alternative treatment should be considered for PCa patients with high HRD scores.

P2, N=0, Withdrawn, Weill Medical College of Cornell University | N=30 --> 0 | Not yet recruiting --> Withdrawn

Pathway enrichment analysis revealed that epigenetic modifiers and NOTCH pathway (4 cases each) were the most recurrently affected. Two out of 20 cases were classified as N1 according to LymphGen (Wright, 2020) algorithm while the rest remained undetermined.The mutational profile of pediatric PTLD-BL is similar to that observed in IC patients whereas PTLD-DLBCL are less complex than their counterpart in IC children and present a very heterogeneous mutational landscape with enrichment in NOTCH pathway mutations.

The biomarkers we identified will facilitate the selection of pre-clinical in vivo tumor models and, if confirmed, even patient selection for clinical trials. The combined use of the ProLiFiler and Cancer Data Miner Platforms has the potential to accelerate and de-risk the development of anti-cancer agents.

Thus, mutants affecting MYC proteins may augment quantitative oncogenic effects on the expression of normal MYC-target genes with qualitative oncogenic effects, by which sets of cell cycle genes are abnormally targeted by MYC as B cells transition into lymphoma cells. The T58A and T58I mutations augment MYC-driven transformation by distinct mechanisms.

P2, N=30, Not yet recruiting, Weill Medical College of Cornell University | Initiation date: Sep 2021 --> Feb 2022

Certain mutations seem to be more prevalent in those with prior pelvic radiation. The lack of difference between the two cohorts may be due to an underlying history of smoking in both groups, which is a proven predictor of TMB, driving mutational burden more so than prior pelvic radiation. The higher rate of MYC and TP53 mutations in patients with prior pelvic radiation is interesting in light of MYC’s role in inhibiting urothelial carcinoma progression and TP53’s ubiquitous presence in cancer.

Conclusion : In this retrospective analysis, MYC+ pts had not different clinical characteristics compared to MYC- pts other than higher proliferative index and and more CNS involvement at diagnosis. MYC+ pts were frequently treated with iCT, this aggressive approach seemed feasible and could allow to obtain better outcome compared to standard R-CHOP treatment but further prospective studies are needed.

No studies have yet been performed investigating the genetic impact of prior radiation in bladder cancer. The higher rate of MYC mutations in patients with prior pelvic radiation is interesting in light of MYC’s role in inhibiting urothelial carcinoma progression. This coincides with our finding that patients with prior radiation also had a higher rate of MIBC.

HIV-DLBCL are enriched for MYC rearrangements, MYC mutations and generally lack BCL2 rearrangements, regardless of EBV status. Among HIV-DLBCL, tumours that are EBV-negative and EBV-positive appear to have important differences, the latter arising in context of lower CD4 count, showing frequent non-GCB origin, lower mutation burden and recurrent STAT3 mutations.

P2, N=30, Not yet recruiting, Weill Medical College of Cornell University | Initiation date: May 2021 --> Sep 2021

UK National Cancer Research Institute (NCRI) Phase 2 Study of efficacy of 1st line rituximab, cyclophosphamide, vincristine, doxorubicin, methotrexate, ifosfamide, etoposide, cytarabine (R-CODOX-M/R-IVAC) in high risk DLBCL (IPI 3-5) achieved 2 year PFS of 67.9%. R-CODOX-M/R-IVAC proved effective in DH and TH disease achieving OS of 77% at 2 year, benefit in other high risk patients was less clear. Treatment-related toxicity in the real world setting was significant; 40% of patients failed to complete all 4 cycles and treatment delays were common. The local management guideline has subsequently been modified, de-escalating treatment to R-CHOP for those without DH/TH or CNS involvement.

Of note, EBVnegative PBL cases had higher mutational and copy-number load and more frequent TP53, CARD11 and MYC mutations, whereas EBV-positive PBL tended to have more mutations affecting the JAK-STAT pathway. In conclusion, these findings further unravel the distinctive molecular heterogeneity of PBL identifying novel molecular targets and the different genetic profile of these tumors related to EBV infection.

P2, N=30, Not yet recruiting, Weill Medical College of Cornell University | N=20 --> 30 | Initiation date: Jan 2021 --> May 2021

It has been proved that cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab show limited effects for DHL or DE-DLBCL, and the rituximab plus dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin seem to be efficacious for DHL. The novel therapy is urgently needed for clinical improvement in DHL and DE-DLBCL.

P2, N=20, Not yet recruiting, Weill Medical College of Cornell University

We have identified four distinct biologic subgroups of GCB DLBCL with different survival rates, and with similarities to the genomic classifications from recent large retrospective studies of DLBCL. Patients with the DH signature but no abnormalities of TP53 (GCB2), and those lacking EZH2 mutation and BCL2 translocation (GCB4), had an excellent prognosis. However, patients with an EZB-like profile (GCB3) had an intermediate prognosis, whereas those with TP53 inactivation combined with the DH signature (GCB1) had an extremely poor prognosis.

The mutations were more frequent in double-hit lymphomas with IG as the MYC translocation partner, and were associated with higher MYC protein expression and poor patient survival. DLBCL with MYC/BCL2-DH and those with BCL2 translocation alone are most likely derived from follicular lymphoma or its precursor lesion, and acquisition of MYC pathogenic mutations may augment MYC function, resulting in aggressive clinical behaviour.

Factors related to unfavorable outcome were age >18y old, activated B-cell DLBCL profile, HGBCL, NOS, high genetic complexity, 1q21-q44 gains, 2p16/REL gains/amplifications, 19p13/CD70 homozygous deletions, and TP53 and MYC mutations. In conclusion, these findings further unravel the molecular heterogeneity of pediatric/young-adult LBCL, improve the classification of this group of tumors and provide new parameters for risk stratification.

Conclusion (1) MYCr in MM and lymphomas show different characteristics and seem to be generated by different mechanisms. (2) FISH analysis is a reliable method for the detection of MYCr in lymphoma patients, however complexity and variability of MYCr in MM patients often leads to false negative FISH results.

"This study found that ctDNA is a feasible, attractive alternative to traditional biopsies and may identify actionable mutations in older adults with breast cancer. When controlling for subtype, results from a single institution were similar to the larger multicenter cohort showing ATM and PIK3CA were more common in the older adult population. This data suggests there may be additional molecular differences between breast cancer in older compared to younger adults that warrants further investigation."