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Cornish, A. J.

Publications and source records attributed to Cornish, A. J..

5 recordsLinked to original sources

Whole genome sequencing of endometrial cancer identifies novel subgroups, drivers, and actionable alterations

Endometrial cancer (EC) is the most common gynaecological malignancy in high income countries, and is increasing in incidence. While molecular stratification has improved its management, precision care is hampered by incomplete characterization of the EC genome. We address this by analysis of whole genome sequencing (WGS) of 665 ECs generated by the UK Genomics England 100,000 Genome Project (100kGP). 5% of cases were associated with germline pathogenic variants in cancer genes, including BRCA1 which we confirmed predisposes to EC. We identified 107 putative coding driver genes, 35% of which had no prior established role in EC. Novel structural variants included gains of MYCN and loss of its negative regulator NEDD4.1 which were significantly mutually exclusive in copy number (CN) high tumours. Immunogenomic analysis confirmed selection for driver alterations of low immunogenicity based on patient HLA haplotype, and pervasive immune escape through multiple mechanisms. Unsupervised clustering of mutational signatures and genomic alterations identified known and novel molecular subgroups, including a CN-high subset with mutational signatures of homologous recombination deficiency (HRD) and favourable outcome. Independent prognostic value of single nucleotide variant (SNV) burden, CN burden and multiple coding drivers, along with the identification of targetable molecular alterations in over one-third of cases, underscores the promise of WGS for precision medicine in EC.

genomics↗

Identification of non-covalent inhibitors for the atypical peroxiredoxin PRDX5 as a therapeutic strategy in malignant pleural mesothelioma

Malignant pleural mesothelioma (MPM) is an aggressive asbestos-linked cancer with limited therapeutic options and a dismal 5-year survival rate of [~]5%. While aberrant production of reactive oxygen and nitrogen species (ROS/RNS) is a hallmark of MPM, targeted approaches to exploit these redox vulnerabilities remain scarce. Here, using the MOSAIC multimodal cancer patient atlas, we identify Peroxiredoxin 5 (PRDX5) as being significantly upregulated in the epithelioid subtype of MPM. We show that MPM cells exhibit enhanced resistance to nitrosative and oxidative stress compared to healthy mesothelial cells, a phenotype correlated with basal PRDX5 expression. Next, utilising a machine learning guided discovery pipeline, we identified three putative allosteric pockets in PRDX5 and conducted a virtual screen of 3.6 million compounds. High-throughput biochemical validation of 452 candidates yielded 36 non-covalent hits, including sub-micromolar inhibitors. These findings establish PRDX5 as a novel, subtype specific therapeutic target in MPM and provide a chemical framework for the development of next-generation redox-modulating oncology treatments.

cancer biology↗

Multi-modal benchmarking of the Ultima UG100 and Illumina NovaSeq sequencing platforms using clinically relevant FFPE tissues

Emerging high-throughput sequencing technologies promise lower costs and higher scalability, yet their performance on archival clinical samples remains poorly characterized. Here, we benchmarked Ultima Genomics UG100 against Illumina Novaseq platforms across single-nuclei RNA-seq (snRNA-seq), whole-transcriptome (WTS), whole-exome (WES), and whole-genome sequencing (WGS) using FFPE tissues from oncologic and immune-mediated diseases. Across matched samples, we systematically assessed data quality, coverage profiles, error spectra, variant concordance and transcriptomic reproducibility. UG100 produced highly comparable results to Illumina, capturing key oncogenic and immune-related transcripts, accurately resolving cellular composition in snRNA-seq, and maintaining sensitivity for lowly expressed genes, despite characteristic insertion-biased indels and modest differences in multi-mapping reads. Discrepancies were subtle, largely limited to pseudogene and non-coding transcripts, and did not affect pathway-level conclusions. Ultima UG100 platform prioritized high precision and reduced low-frequency artifacts, offering a cleaner but more conservative variant-calling profile compared to the more sensitive, yet noisier, Illumina/DRAGEN workflow. This multimodal, clinically oriented assessment provides the first comprehensive evaluation of UG100, demonstrating its translational utility in population-scale genomics, and highlighting the potential for emerging sequencing technologies to lower the cost of biomedical research and clinical diagnostics.

genomics↗

Histology and spatial transcriptomic integration revealed infiltration zone with specific cell composition as a prognostic hotspot in glioblastoma

BackgroundGlioblastoma (GBM), the most aggressive primary brain tumor, has a median survival of approximately 15 months. Twenty percent of patients survive beyond three years, but known clinical factors like age, performance status, resection extent, and MGMT promoter methylation status do not fully explain the observed outcomes. ObjectiveOur objective was to identify novel histology derived biomarkers associated with end-of-spectrum overall survival (OS) to provide novel biological insight with a translational potential. MethodsWe analyzed a total of 748 GBM patients from 3 different cohorts, uniquely enriched in long survivors (n=98 with overall survival (OS) > 5y including n=196 with OS[&ge;]3y), with clinical data and H&E slides obtained from the primary tumor at baseline. We propose an interpretable machine learning (ML) methodology for the discovery of histological biomarkers. Our method learned to segment each H&E slide into three distinct regions associated with long-term survival, short-term survival, and non-informative tissue. We characterized these regions by integrating unsupervised learning, nuclei segmentation, blood vessels detection, pathologist annotations, and multimodal data including spatial transcriptomics from n=31 patients of the GBM MOSAIC dataset to discover fully interpretable biomarkers. ResultsOur OS prediction model using histology and clinical data as input achieved an area under the curve (AUC) of 0.85 for the classification of patients between OS<2 and OS[&ge;]3y in external cohort validation, outperforming significantly models trained on clinical data or on histology alone (AUC of 0.76; 0.73, respectively). Two novel biomarkers were predicting poor survival: the presence of regions of lowly infiltrated white matter enriched in malignant cells with a mesenchymal-like phenotype, and lower levels of angiogenesis associated with higher hypoxia response in the main tumor regions. We also found that a subtype of immunosuppressive tumor macrophages - defined by high PLIN2 expression and lipid accumulation- is consistently enriched in histological areas predictive of poor prognosis. ConclusionOur interpretable ML methodology identified a novel prognostic impact of biological processes and cell types according to distinct tumor regions of GBM. These results pave the way for spatially-informed biomarkers to improve risk stratification and for personalized spatially-targeted therapeutic strategies. Key highlightsO_LIOur ML model identified histological biomarkers predicting prognosis independently from known clinical factors C_LIO_LIThe region of lowly infiltrated white matter enriched in malignant cells including a mesenchymal-like phenotype is predictive of poor prognosis C_LIO_LIAngiogenesis is increased in areas predictive of long survival in main non-necrotic tumor regions. C_LIO_LIThe subtype of macrophages expressing PLIN2 and associated with increased lipid metabolism was associated with poor prognosis in all GBM regions. C_LI Highlights O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=116 SRC="FIGDIR/small/681087v4_ufig1.gif" ALT="Figure 1"> View larger version (43K): org.highwire.dtl.DTLVardef@45e619org.highwire.dtl.DTLVardef@105a4b0org.highwire.dtl.DTLVardef@17f257dorg.highwire.dtl.DTLVardef@7669b4_HPS_FORMAT_FIGEXP M_FIG C_FIG

cancer biology↗

Correcting reference bias from the Illumina Isaac aligner enables analysis of cancer genomes

Estimating the fraction of cancer cells with individual somatic mutations is central to many analyses in cancer genomics, including characterisation of clonal architecture and timing of mutational events. Estimation of these cancer cell fractions (CCFs) is contingent on unbiased assessment of the fraction of reads supporting variant alleles (VAFs). We demonstrate that VAFs computed by the Illumina Isaac pipeline, used in many large-scale sequencing projects including The 100,000 Genomes Project, are biased by the preferential soft clipping of reads supporting non-reference alleles (semi-aligned reads). We show that these biased VAFs can have deleterious effects on downstream analyses reliant on unbiased CCF estimates. While Isaac bias can be corrected through realignment with alternative parameters, this is computationally intensive. We therefore developed FixVAF, a tool for removing bias introduced by soft clipping of semi-aligned reads, facilitating downstream analyses without the need for realignment. FixVAF is freely available at https://github.com/danchubb/FixVAF.\n\nContactalex.cornish@icr.ac.uk or daniel.chubb@icr.ac.uk.

bioinformatics↗