Huffman, B. M. | bioRxiv Science

bioRxiv2026

Coupled Modeling of Tumor Volume and ctDNA Dynamics in HPV-Associated Anal Squamous Cell Carcinoma

Response to anti-PD-1 immunotherapy in advanced HPV-associated anal squamous cell carcinoma (ASCC) varies and is assessed by infrequent imaging that lags behind tumor biology. Circulating tumor DNA (ctDNA) can be sampled frequently and reflects near-real-time tumor activity yet is rarely built into mechanistic models of treatment response. Using longitudinal tumor volume and HPV ctDNA from 26 patients treated with pembrolizumab, we found that baseline ctDNA scores tracked tumor burden but did not distinguish responders from non-responders, whereas ctDNA after one treatment cycle had a higher relative decrease in responders, six weeks before the next scan. We developed an ordinary differential equation model linking tumor volume to the ctDNA released by tumor cells. Sensitivity, identifiability, and model-selection analyses reduced it to two patient-specific parameters, proliferation and shedding rates, which reproduced individual volume and ctDNA trajectories, including a transient ctDNA spike at treatment onset. Proliferation was faster in non-responders. This framework supports model-based, ctDNA-guided monitoring of immunotherapy response.

cancer biology↗

bioRxiv2022

Diagnostic tool to identify and treat DNA repair deficient gastroesophageal adenocarcinomas

Background and aimsDNA repair deficiency is a common feature of cancer. Homologous recombination (HR) and nucleotide excision repair (NER) are the two most frequently disabled DNA repair pathways in solid tumors. HR deficient breast, ovarian, pancreatic and prostate cancers respond well to platinum chemotherapy and PARP inhibitors. However, the frequency of DNA repair pathway deficiency in gastric and esophageal adenocarcinoma (GEA) still lacks diagnostic and functional validation. Furthermore, whether DNA repair deficient GEA have enhanced responsiveness to platinum chemotherapy and sensitivity to PARP inhibitors is not well characterized. MethodsUsing whole exome and genome sequencing data, we measured various HR deficiency-associated mutational signatures in patient specimen of gastric, esophageal and colorectal cancer specimens and gastric cancer cell lines. Gold-standard immunofluorescence assays were used to confirm HR and NER deficiency in cancer cell lines. The relationship between PARP inhibitor treatment and tumor response was evaluated in patients with gastric cancer. Drug sensitivity was determined using standard in vitro cell culture assays. Single-cell RNA-sequencing was performed to evaluate gastric cancer response to commonly used chemotherapeutics. ResultsWe found that a significant subset of GEA, but very few colorectal tumors, show evidence of HR deficiency by mutational signature analysis (HRD score). Gastric cancer cell lines with high HRD mutational signature scores demonstrated functional HR deficiency by RAD51 assay and increased sensitivity to platinum and PARP inhibitors. There was a positive association between HRD scores and tumor response in patients with gastric cancer treated with a PARP inhibitor on a clinical trial. A gastric cancer cell line with strong sensitivity to cisplatin showed HR proficiency but exhibited NER deficiency by DDB2 proteo-probe assay. Single-cell RNA-sequencing revealed that, in addition to inducing general apoptosis, cisplatin treatment triggered ferroptosis in a NER-deficient gastric cancer, which may explain the outlier sensitivity. ConclusionA subset of upper gastrointestinal tumors have genomic features of HR and NER deficiency and therefore may be more likely to benefit from platinum chemotherapy and PARP inhibition.

cancer biology↗