Prognostic impact of ATM mutations in patients with metastatic colorectal cancer

Sci Rep. 2019 Feb 27;9(1):2858. doi: 10.1038/s41598-019-39525-3.

Abstract

Tumors bearing homologous recombination deficiency are extremely sensitive to DNA double strand breaks induced by several chemotherapeutic agents. ATM gene, encoding a protein involved in DNA damage response, is frequently mutated in colorectal cancer (CRC), but its potential role as predictive and prognostic biomarker has not been fully investigated. We carried out a multicenter effort aimed at defining the prognostic impact of ATM mutational status in metastatic CRC (mCRC) patients. Mutational profiles were obtained by means of next-generation sequencing. Overall, 35 out of 227 samples (15%) carried an ATM mutation. At a median follow-up of 56.6 months, patients with ATM mutated tumors showed a significantly longer median overall survival (OS) versus ATM wild-type ones (64.9 vs 34.8 months; HR, 0.50; 95% CI, 0.29-0.85; P = 0.01). In the multivariable model, ATM mutations confirmed the association with longer OS (HR, 0.57; 95% CI, 0.33-0.98; P = 0.04). The prognostic impact of ATM mutations was independent from TP53 mutational status and primary tumor location. High heterogeneity score for ATM mutations, possibly reflecting the loss of wild-type allele, was associated with excellent prognosis. In conclusion, we showed that ATM mutations are independently associated with longer OS in patients with mCRC.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Ataxia Telangiectasia Mutated Proteins / genetics*
  • Colorectal Neoplasms* / genetics
  • Colorectal Neoplasms* / mortality
  • Colorectal Neoplasms* / pathology
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mutation*
  • Neoplasm Proteins / genetics*
  • Survival Rate

Substances

  • Neoplasm Proteins
  • ATM protein, human
  • Ataxia Telangiectasia Mutated Proteins