Safety of the Breast Cancer Adjuvant Radiotherapy in Ataxia-Telangiectasia Mutated Variant Carriers

Cancers (Basel). 2024 Apr 5;16(7):1417. doi: 10.3390/cancers16071417.

Abstract

The Ataxia-Telangiectasia Mutated (ATM) gene is implicated in DNA double-strand break repair. Controversies in clinical radiosensitivity remain known for monoallelic carriers of the ATM pathogenic variant (PV). An evaluation of the single-nucleotide polymorphism (SNP) rs1801516 (G-A) showed different results regarding late subcutaneous fibrosis after breast radiation therapy (RT). The main objective of this study was to evaluate acute and late toxicities in carriers of a rare ATM PV or predicted PV and in carriers of minor allele A of rs1801516 facing breast RT. Fifty women with localized breast cancer treated with adjuvant RT between 2000 and 2014 at Institut Curie were selected. Acute and late toxicities in carriers of a rare PV or predicted PV (n= 9), in noncarriers (n = 41) and in carriers of SNP rs1801516 (G-A) (n = 8), were examined. The median age at diagnosis was 53 years old and 82% of patients had an invasive ductal carcinoma and 84% were at clinical stage I-IIB. With a median follow-up of 13 years, no significant difference between carriers and noncarriers was found for acute toxicities (p > 0.05). The same results were observed for late toxicities without an effect from the rs1801516 genotype on toxicities. No significant difference in acute or late toxicities was observed between rare ATM variant carriers and noncarriers after breast RT for localized breast cancer.

Keywords: ATM; SNP; breast neoplasm; pathogenic variant; radiation therapy; radio-induced toxicities; rs1801516.

Grants and funding

Financial support for GENESIS was provided by the Ligue Nationale contre le Cancer (3 grants: PRE05/DSL and PRE07/DSL to D. Stoppa-Lyonnet; PRE11/NA to N. Andrieu), the French National Institute of Cancer (INCa, Grant b2008-029/LL-LC) and the comprehensive cancer center SiRIC (Site de Recherche Intégrée sur le Cancer: Grant INCa-DGOS-4654) to N. Andrieu. Sequencing data: France Génomique to F. Lesueur and CNRGH. Financial support for CoF-AT was provided by Inserm and Ministère de la Recherche (01P0751–01P0752–01P0753–01P0754–01P0755), Electricité de France (conseil scientifique de Radioprotection d’EDF, grant EP 2002–03, EP 2004-03 RB 2016–22), Fondation de France (grants 2001009761 and 2005011201), La Ligue (grants PRE04/NA, PRE07/NA and PRE2015 LNCC/NA), La Ligue Comité du Maine et Loire, MGEN Union, ITMO Santé Publique d’AVIESAN (grant AAP12-COH-110), Institut Curie (CEST NC2013-015) and Institut National du Cancer (grant INCa-9578). This work has been also supported by the Fondation ARC pour la recherche sur le cancer (www.fondation-arc.org; accessed on 1 January 2003) (Grant ARCPGA2022120005732_6344).