<i>LRP1B</i> mutations are associated with favorable outcomes to immune checkpoint inhibitors across multiple cancer types.

dc.contributor.author

Brown, Landon C

dc.contributor.author

Tucker, Matthew D

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Sedhom, Ramy

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Schwartz, Eric B

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Zhu, Jason

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Kao, Chester

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Labriola, Matthew K

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Gupta, Rajan T

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Marin, Daniele

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Wu, Yuan

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Gupta, Santosh

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Zhang, Tian

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Harrison, Michael R

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George, Daniel J

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Alva, Ajjai

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Antonarakis, Emmanuel S

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Armstrong, Andrew J

dc.date.accessioned

2021-04-01T19:10:53Z

dc.date.available

2021-04-01T19:10:53Z

dc.date.issued

2021-03

dc.date.updated

2021-04-01T19:10:51Z

dc.description.abstract

Background

Low-density lipoprotein receptor-related protein 1b (encoded by LRP1B) is a putative tumor suppressor, and preliminary evidence suggests LRP1B-mutated cancers may have improved outcomes with immune checkpoint inhibitors (ICI).

Methods

We conducted a multicenter, retrospective pan-cancer analysis of patients with LRP1B alterations treated with ICI at Duke University, Johns Hopkins University (JHU) and University of Michigan (UM). The primary objective was to assess the association between overall response rate (ORR) to ICI and pathogenic or likely pathogenic (P/LP) LRP1B alterations compared with LRP1B variants of unknown significance (VUS). Secondary outcomes were the associations with progression-free survival (PFS) and overall survival (OS) by LRP1B status.

Results

We identified 101 patients (44 Duke, 35 JHU, 22 UM) with LRP1B alterations who were treated with ICI. The most common tumor types by alteration (P/LP vs VUS%) were lung (36% vs 49%), prostate (9% vs 7%), sarcoma (5% vs 7%), melanoma (9% vs 0%) and breast cancer (3% vs 7%). The ORR for patients with LRP1B P/LP versus VUS alterations was 54% and 13%, respectively (OR 7.5, 95% CI 2.9 to 22.3, p=0.0009). P/LP LRP1B alterations were associated with longer PFS (HR 0.42, 95% CI 0.26 to 0.68, p=0.0003) and OS (HR 0.62, 95% CI 0.39 to 1.01, p=0.053). These results remained consistent when excluding patients harboring microsatellite instability (MSI) and controlling for tumor mutational burden (TMB).

Conclusions

This multicenter study shows significantly better outcomes with ICI therapy in patients harboring P/LP versus VUS LRP1B alterations, independently of TMB/MSI status. Further mechanistic and prospective validation studies are warranted.
dc.identifier

jitc-2020-001792

dc.identifier.issn

2051-1426

dc.identifier.issn

2051-1426

dc.identifier.uri

https://hdl.handle.net/10161/22508

dc.language

eng

dc.publisher

BMJ

dc.relation.ispartof

Journal for immunotherapy of cancer

dc.relation.isversionof

10.1136/jitc-2020-001792

dc.subject

genetic markers

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immunotherapy

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lung neoplasms

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prostatic neoplasms

dc.title

LRP1B mutations are associated with favorable outcomes to immune checkpoint inhibitors across multiple cancer types.

dc.type

Journal article

duke.contributor.orcid

Labriola, Matthew K|0000-0003-0919-9864

duke.contributor.orcid

Gupta, Rajan T|0000-0002-2984-5010

duke.contributor.orcid

Wu, Yuan|0000-0001-8925-555X

duke.contributor.orcid

Zhang, Tian|0000-0001-8914-3531

duke.contributor.orcid

Harrison, Michael R|0000-0003-3776-8892

duke.contributor.orcid

Armstrong, Andrew J|0000-0001-7012-1754

pubs.begin-page

e001792

pubs.end-page

e001792

pubs.issue

3

pubs.organisational-group

School of Medicine

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Duke Cancer Institute

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Medicine, Medical Oncology

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Duke

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Institutes and Centers

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Medicine

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Clinical Science Departments

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Medicine, General Internal Medicine

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Surgery

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Pharmacology & Cancer Biology

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Surgery, Urology

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Basic Science Departments

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Radiology, Abdominal Imaging

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Radiology

pubs.organisational-group

Biostatistics & Bioinformatics

pubs.publication-status

Published

pubs.volume

9

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