Results: 372 veterans from 81 sites underwent NGS sequencing of their prostate tumors (n=311) or cfDNA (n=61). Tumors from 165 (44%) were found to have mutations (allelic ratio ≥5%) in 47 genes. Of 372, 62 harbored mutations in TP53 (17%), 9 in NOTCH1 (2%), 16 in PTEN (4%), 16 in AR (4%), 13 in ATM (4%), 11 in BRCA2 (3%), 2 in MSH2 (0.5%), 1 in NBN (0.3%), and 1 in PALB2 (0.3%). 7 men (1.8%) had adequate tumor, but no identifiable somatic mutations. NPOP findings were compared to the existing databases SU2C/PCF (of metastatic biopsies in metastatic castration resistant disease) and TCGA (of primary tumors in localized disease), see table. Findings will be updated at presentation.
Conclusions: The VA NPOP has been successfully implemented, and prostate tumors from veterans were found to carry potentially actionable mutations, including BRCA2 and ATM, for which there are precision treatment trials. The program will be expanded and will facilitate more diverse and equitable distribution of access to precision oncology diagnostics and therapeutic opportunities, in alignment with the Cancer Moonshot Initiative. (e.g. VA-ABCD clinicaltrials.gov; NCT02985021).
Authors: Alexandra Sokolova, Heather H. Cheng, Bradley J Hintze, Michael J. Kelley, Neil L Spector, Jill Duffy, Julie Ann Lynch, Matthew Rettig, Robert B. Montgomery
Author Affiliations: University of Washington, Seattle, WA; VA National Oncology Program, Durham, NC; Department of Veterans Affairs, Durham, NC; VA Health Care System, Salt Lake City, UT; VA Greater Los Angeles Health Care System, Los Angeles, CA
Source: Sokolova A, Cheng H, Hintze B, et al. "The Veterans Health Administration Precision Oncology Program for Advanced Prostate Cancer Patients: Expanding tumor NGS opportunities to a broader patient population." J Clin Oncol. 37, no. 7_suppl (March 01, 2019) 193-193.