GIInger predicts homologous recombination deficiency and patient response to PARPi treatment from shallow genomic profiles

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Pozzorini, Christian | Andre, Gregoire | Coletta, Tommaso | Buisson, Adrien | Bieler, Jonathan | Ferrer, Loïc | Kempfer, Rieke | Saintigny, Pierre | Harlé, Alexandre | Vacirca, Davide | Barberis, Massimo | Gilson, Pauline | Roma, Cristin | Saitta, Alexandra | Smith, Ewan | Consales Barras, Floriane | Ripol, Lucia | Fritzsche, Martin | Marques, Ana Claudia | Alkodsi, Amjad | Marin, Ray | Normanno, Nicola | Grimm, Christoph | Müllauer, Leonhard | Harter, Philipp | Pignata, Sandro | Gonzalez-Martin, Antonio | Denison, Ursula | Fujiwara, Keiichi | Vergote, Ignace | Colombo, Nicoletta | Willig, Adrian | Pujade-Lauraine, Eric | Just, Pierre-Alexandre | Ray-Coquard, Isabelle | Xu, Zhenyu

Edité par CCSD ; Cell Press -

International audience. Homologous recombination deficiency (HRD) is a predictive biomarker for poly(ADP-ribose) polymerase 1 inhibitor (PARPi) sensitivity. Routine HRD testing relies on identifying BRCA mutations, but additional HRD-positive patients can be identified by measuring genomic instability (GI), a consequence of HRD. However, the cost and complexity of available solutions hamper GI testing. We introduce a deep learning framework, GIInger, that identifies GI from HRD-induced scarring observed in low-pass whole-genome sequencing data. GIInger seamlessly integrates into standard BRCA testing workflows and yields reproducible results concordant with a reference method in a multisite study of 327 ovarian cancer samples. Applied to a BRCA wild-type enriched subgroup of 195 PAOLA-1 clinical trial patients, GIInger identified HRD-positive patients who experienced significantly extended progression-free survival when treated with PARPi. GIInger is, therefore, a cost-effective and easy-to-implement method for accurately stratifying patients with ovarian cancer for first-line PARPi treatment.

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