Article
作者: Smith, Graeme C.M. ; Holla, Vijaykumar ; Heffernan, Timothy P. ; Liu, Chiu-Yi ; Yap, Timothy A. ; Marszalek, Joseph R. ; Luzarraga, Marina Roy ; Sanchez, Nora S. ; Wang, Wei-Lien ; Majithiya, Jayesh ; Giuliani, Virginia ; Tse, Wai Yiu ; Kyewalabye, Keith ; Boursier, Marie ; Geo, Lerin ; Meric-Bernstam, Funda ; Ranzani, Marco ; Feng, Ningping ; Vellano, Christopher P. ; Geck Do, Mary K. ; Gheeya, Jinesh S. ; Armstrong, Lucy ; Johnson, Timothy I. ; Kopetz, Scott E. ; Campbell, Erick ; Goswamy, Rohit Vivek ; Ngoi, Natalie Y.L. ; Wani, Khalida M. ; Lively, Sarah ; McGrail, Daniel J. ; Rajendra, Eeson ; Grinkevich, Vera ; Lazar, Alexander J. ; Machado, Annette A. ; Pilié, Patrick G. ; Yang, Dong ; Bristow, Christopher A. ; Jones, Philip ; Shaw, Kenna Rael ; Johnson, Michael G. ; Le, Hung ; Ma, XiaoYan ; Piscitello, Desiree ; Elinati, Elias ; Robinson, Helen M.R. ; Neves, Joana ; Bardenhagen, Jennifer P. ; Likhatcheva, Maria ; Carroll, Christopher L. ; Lillo, Giorgia ; Di Francesco, M. Emilia
AbstractPurpose: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.