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Ref Type | Journal Article | ||||||||||||
PMID | (35948633) | ||||||||||||
Authors | Zingg D, Bhin J, Yemelyanenko J, Kas SM, Rolfs F, Lutz C, Lee JK, Klarenbeek S, Silverman IM, Annunziato S, Chan CS, Piersma SR, Eijkman T, Badoux M, Gogola E, Siteur B, Sprengers J, de Klein B, de Goeij-de Haas RR, Riedlinger GM, Ke H, Madison R, Drenth AP, van der Burg E, Schut E, Henneman L, van Miltenburg MH, Proost N, Zhen H, Wientjens E, de Bruijn R, de Ruiter JR, Boon U, de Korte-Grimmerink R, van Gerwen B, Féliz L, Abou-Alfa GK, Ross JS, van de Ven M, Rottenberg S, Cuppen E, Chessex AV, Ali SM, Burn TC, Jimenez CR, Ganesan S, Wessels LFA, Jonkers J | ||||||||||||
Title | Truncated FGFR2 is a clinically actionable oncogene in multiple cancers. | ||||||||||||
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Abstract Text | Somatic hotspot mutations and structural amplifications and fusions that affect fibroblast growth factor receptor 2 (encoded by FGFR2) occur in multiple types of cancer1. However, clinical responses to FGFR inhibitors have remained variable1-9, emphasizing the need to better understand which FGFR2 alterations are oncogenic and therapeutically targetable. Here we apply transposon-based screening10,11 and tumour modelling in mice12,13, and find that the truncation of exon 18 (E18) of Fgfr2 is a potent driver mutation. Human oncogenomic datasets revealed a diverse set of FGFR2 alterations, including rearrangements, E1-E17 partial amplifications, and E18 nonsense and frameshift mutations, each causing the transcription of E18-truncated FGFR2 (FGFR2ΔE18). Functional in vitro and in vivo examination of a compendium of FGFR2ΔE18 and full-length variants pinpointed FGFR2-E18 truncation as single-driver alteration in cancer. By contrast, the oncogenic competence of FGFR2 full-length amplifications depended on a distinct landscape of cooperating driver genes. This suggests that genomic alterations that generate stable FGFR2ΔE18 variants are actionable therapeutic targets, which we confirmed in preclinical mouse and human tumour models, and in a clinical trial. We propose that cancers containing any FGFR2 variant with a truncated E18 should be considered for FGFR-targeted therapies. |
Molecular Profile | Treatment Approach |
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Gene Name | Source | Synonyms | Protein Domains | Gene Description | Gene Role |
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Therapy Name | Drugs | Efficacy Evidence | Clinical Trials |
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Drug Name | Trade Name | Synonyms | Drug Classes | Drug Description |
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Gene | Variant | Impact | Protein Effect | Variant Description | Associated with drug Resistance |
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FGFR2 | E768* | nonsense | gain of function - predicted | FGFR2 E768* results in a premature truncation of the Fgfr2 protein at amino acid 768 of 821 (UniProt.org). E768* is predicted to lead to a gain of Fgfr2 protein function as a corresponding mouse variant (E673*) activates FGFR2 signaling and promotes colony formation in cell culture, and leads to tumor formation in a mouse model (PMID: 35948633). | |
FGFR2 | L776Rfs*6 | frameshift | gain of function - predicted | FGFR2 L776Rfs*6 indicates a shift in the reading frame starting at amino acid 776 and terminating six residues downstream causing a premature truncation of the 821 amino acid Fgfr2 protein (UniProt.org). L776Rfs*6 is predicted to lead to a gain of Fgfr2 protein function as a corresponding mouse variant (L681Rfs*6) promotes colony formation in cell culture and leads to tumor formation in a mouse model (PMID: 35948633). | |
FGFR2 | P781* | nonsense | gain of function - predicted | FGFR2 P781* results in a premature truncation of the Fgfr2 protein at amino acid 781 of 821 (UniProt.org). P781* is predicted to lead to a gain of Fgfr2 protein function as a corresponding mouse variant (P686*) promotes colony formation in cell culture and leads to tumor formation in a mouse model (PMID: 35948633). | |
FGFR2 | S782Rfs*3 | frameshift | gain of function - predicted | FGFR2 S782Rfs*3 indicates a shift in the reading frame starting at amino acid 776 and terminating 6 residues downstream causing a premature truncation of the 821 amino acid Fgfr2 protein (UniProt.org). S782Rfs*3 is predicted to lead to a gain of Fgfr2 protein function as a corresponding mouse variant (S687Rfs*3) promotes colony formation in cell culture and leads to tumor formation in a mouse model (PMID: 35948633). | |
FGFR2 | S789* | nonsense | gain of function - predicted | FGFR2 S789* results in a premature truncation of the Fgfr2 protein at amino acid 789 of 821 (UniProt.org). S789* is predicted to lead to a gain of Fgfr2 protein function as a corresponding mouse variant (S694*) promotes colony formation in cell culture and leads to tumor formation in a mouse model (PMID: 35948633). | |
FGFR2 | S792Ffs*4 | frameshift | unknown | FGFR2 S792Ffs*4 indicates a shift in the reading frame starting at amino acid 792 and terminating four residues downstream causing a premature truncation of the 821 amino acid Fgfr2 protein (UniProt.org). S792Ffs*4 (corresponding to S697Ffs*4 in a mouse isoform) leads to limited increase in FGFR2 signaling and colony formation in cell culture but promotes tumor formation in a mouse model (PMID: 35948633), and therefore, its effect on Fgfr2 protein function is unknown. | |
FGFR2 | V797* | nonsense | unknown | FGFR2 V797* results in a premature truncation of the Fgfr2 protein at amino acid 797 of 821 (UniProt.org). V797* (corresponding to V702* in a mouse isoform) leads to limited increase in FGFR2 signaling and colony formation in cell culture but promotes tumor formation in a mouse model (PMID: 35948633), and therefore, its effect on Fgfr2 protein function is unknown. | |
FGFR2 | Y769* | nonsense | gain of function - predicted | FGFR2 Y769* results in a premature truncation of the Fgfr2 protein at amino acid 769 of 821 (UniProt.org). Y769* is predicted to lead to a gain of Fgfr2 protein function as a corresponding mouse variant (Y674*) promotes colony formation in cell culture and leads to tumor formation in a mouse model (PMID: 35948633). | |
FGFR2 | Y812* | nonsense | unknown | FGFR2 Y812* results in a premature truncation of the Fgfr2 protein at amino acid 812 of 821 (UniProt.org). Y812* (corresponding to Y717* in a mouse isoform) leads to limited increase in FGFR2 signaling and colony formation in cell culture but promotes tumor formation in a mouse model (PMID: 35948633), and therefore, its effect on Fgfr2 protein function is unknown. |
Molecular Profile | Indication/Tumor Type | Response Type | Therapy Name | Approval Status | Evidence Type | Efficacy Evidence | References |
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FGFR2 E768* | breast cancer | predicted - sensitive | Pemigatinib | Preclinical - Cell culture | Actionable | In a preclinical study, Pemazyre (pemigatinib) inhibited growth of mouse mammary epithelial cells expressing FGFR2 E673* (corresponding to E768* in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 P781* | breast cancer | predicted - sensitive | Pemigatinib | Preclinical - Cell culture | Actionable | In a preclinical study, Pemazyre (pemigatinib) inhibited growth of mouse mammary epithelial cells expressing FGFR2 P686* (corresponding to P781* in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 L776Rfs*6 | breast cancer | predicted - sensitive | Pemigatinib | Preclinical - Cell culture | Actionable | In a preclinical study, Pemazyre (pemigatinib) inhibited growth of mouse mammary epithelial cells expressing FGFR2 L681Rfs*6 (corresponding to L776Rfs*6 in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 L776Rfs*6 | breast cancer | predicted - sensitive | Fexagratinib | Preclinical - Cell culture | Actionable | In a preclinical study, AZD4547 inhibited growth of mouse mammary epithelial cells expressing FGFR2 L681Rfs*6 (corresponding to L776Rfs*6 in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 C382R | breast cancer | predicted - sensitive | Pemigatinib | Preclinical - Cell culture | Actionable | In a preclinical study, Pemazyre (pemigatinib) inhibited growth of mouse mammary epithelial cells expressing FGFR2 C287R (corresponding to C382R in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 C382R | breast cancer | predicted - sensitive | Fexagratinib | Preclinical - Cell culture | Actionable | In a preclinical study, AZD4547 inhibited growth of mouse mammary epithelial cells expressing FGFR2 C287R (corresponding to C382R in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 E768* | breast cancer | predicted - sensitive | Infigratinib | Preclinical - Cell culture | Actionable | In a preclinical study, Truseltiq (infigratinib) inhibited growth of mouse mammary epithelial cells expressing FGFR2 E673* (corresponding to E768* in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 E768* | breast cancer | predicted - sensitive | Zoligratinib | Preclinical - Cell culture | Actionable | In a preclinical study, Debio 1347 inhibited growth of mouse mammary epithelial cells expressing FGFR2 E673* (corresponding to E768* in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 E768* | breast cancer | predicted - sensitive | Fexagratinib | Preclinical | Actionable | In a preclinical study, AZD4547 inhibited FGFR2 signaling and growth in mouse mammary epithelial cells expressing FGFR2 E673* (corresponding to E768* in human) in culture and inhibited tumor growth in an orthotopic model (PMID: 35948633). | 35948633 |
FGFR2 P781* | breast cancer | predicted - sensitive | Fexagratinib | Preclinical - Cell culture | Actionable | In a preclinical study, AZD4547 inhibited growth of mouse mammary epithelial cells expressing FGFR2 P686* (corresponding to P781* in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 Y769* | breast cancer | predicted - sensitive | Pemigatinib | Preclinical - Cell culture | Actionable | In a preclinical study, Pemazyre (pemigatinib) inhibited growth of mouse mammary epithelial cells expressing FGFR2 Y674* (corresponding to Y769* in human) in culture (PMID: 35948633). | 35948633 |
FGFR2 Y769* | breast cancer | predicted - sensitive | Fexagratinib | Preclinical - Cell culture | Actionable | In a preclinical study, AZD4547 inhibited growth of mouse mammary epithelial cells expressing FGFR2 Y674* (corresponding to Y769* in human) in culture (PMID: 35948633). | 35948633 |