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Systematic identification of cancer driving signaling pathways based on mutual exclusivity of genomic alterations

Recent cancer genome studies have identified numerous genomic alterations in cancer genomes. It is hypothesized that only a fraction of these genomic alterations drive the progression of cancer - often called driver mutations. Current sample sizes for cancer studies, often in the hundreds, are sufficient to detect pivotal drivers solely based on their high frequency of alterations. In cases where the alterations for a single function are distributed among multiple genes of a common pathway, however, single gene alteration frequencies might not be statistically significant. In such cases, we expect to observe that most samples are altered in only one of those alternative genes because additional alterations would not convey an additional selective advantage to the tumor. This leads to a mutual exclusion pattern of alterations, that can be exploited to identify these groups.\n\nWe developed a novel method for the identification of sets of mutually exclusive gene alterations in a signaling network. We scan the groups of genes with a common downstream effect, using a mutual exclusivity criterion that makes sure that each gene in the group significantly contributes to the mutual exclusivity pattern. We have tested the method on all available TCGA cancer genomics datasets, and detected multiple previously unreported alterations that show significant mutual exclusivity and are likely to be driver events.

Cancer Biology

Integrative Genome-wide Analysis of the Determinants of RNA Splicing in Kidney Renal Clear Cell Carcinoma

We present a genome-wide analysis of splicing patterns of 282 kidney renal clear cell carcinoma patients in which we integrate data from whole-exome sequencing of tumor and normal samples, RNA-seq and copy number variation. We proposed a scoring mechanism to compare splicing patterns in tumor samples to normal samples in order to rank and detect tumor-specific isoforms that have a potential for new biomarkers. We identified a subset of genes that show introns only observable in tumor but not in normal samples, ENCODE and GEUVADIS samples. In order to improve our understanding of the underlying genetic mechanisms of splicing variation we performed a large-scale association analysis to find links between somatic or germline variants with alternative splicing events. We identified 915 cis- and trans-splicing quantitative trait loci (sQTL) associated with changes in splicing patterns. Some of these sQTL have previously been associated with being susceptibility loci for cancer and other diseases. Our analysis also allowed us to identify the function of several COSMIC variants showing significant association with changes in alternative splicing. This demonstrates the potential significance of variants affecting alternative splicing events and yields insights into the mechanisms related to an array of disease phenotypes.

Cancer Biology

CGMD: An integrated database of Cancer Genes and Markers

Cancer is a dysregulation of apoptosis process a programmed cell death through which the cell number is tightly regulated. Many factors affect apoptosis including tumor genes (TGs). Moreover, several researchers identified TGs and demonstrated their functions in various types of tumors or normal samples. Surprisingly, it has also been indicated that the expression of tumor markers in the development of cancer type is also one of the important target sites for clinical applications. Therefore, integrating tumor genes and tumor markers with experimental evidences might definitely provide valuable information for further investigation of TGs and their crosstalk in cancer. To achieve this objective, we developed a database known as Cancer Gene Marker Database (CGMD) which integrates cancer genes and markers based on experimental background. The major goal of CGMD is to provide: 1) systemic treatment approaches and advancements of different cancer treatments in present scenario; 2) Pooling of different genes and markers with their molecular characterization and involvements in different pathways; 3) Free availability of CGMD at www.cgmd.in. The database consists of 309 genes plus 206 markers and also includes sequences of a list of 40 different human cancers and moreover, all the characterized markers have detailed descriptions in appropriate manner. CGMD extraction is collective and informative by using web resources like National Cancer Institute (NCI) and National Center for Biotechnology Information (NCBI), UniProtKB, KEGG and EMBOSS. CGMD provides updated literature regarding different cancer annotations and their detail molecular descriptions such as CpG islands, promoters, exons of cancer genes and their active sites, physico-chemical properties and also systematically represented the domains of characterized proteins.

Cancer Biology

Tissue-specific cancer paradox and mutation rates

Some genes have ubiquitous expression patterns in an individuals cells, thus a paradox exists whereby mutations in such genes are only strongly associated with cancers of specific tissues. As these genes are ubiquitously expressed in the bodys cells and thereby have functions in -potentially- all tissue types, then surely their resulting defects would manifest as cancers in all tissues?\n\nWe hypothesize that the different susceptibility to mutations could explain the tissue-specific paradox for cancer.

Cancer Biology

Integrative Analysis of Transcriptome Variation in Uterine Carcinosarcoma and Comparison to Sarcoma and Endometrial Carcinoma

Large-scale cancer genomics has made a huge impact onto cancer research. It has allowed the characterization of tumor types in an unprecedented depth. More recent studies target the joint analysis of multiple tumor types to gain insight into similarities and differences on a molecular level. Here we present an analysis of Uterine Carcinosarcoma. The histological similarities to sarcomas and carcinomas warrants an in-depth analysis to Uterine Endometrial Carcinoma as well as Sarcomas and we have used data from The Cancer Genome Atlas to understand transcriptome similarities and differences between these tumor types. We have performed a differential transcriptome analysis of Uterine Carinosarcoma to Uterine samples from GTEx to find genes with tumor specific splicing or expression patterns, which may not only be of interest for a deeper mechanistic understanding of the development and progression of Uterine Carcinosarcoma, but may also be potential tumor markers. Similarities and differences to Sarcomas and Endometrial Carcinomas present new opportunities for the development of new and targeted drug therapies. Finally we have also studied genetic determinants of gene expression and splicing changes and identified germline variants that explain expression and splicing differences between individuals. This analysis demonstrates the opportunities of integrative comparative analysis between multiple tumor types.

Cancer Biology

Estimating stem cell fractions in hierarchically organized tumors

Cancers arise as a result of genetic and epigenetic alterations. These accumulate in cells during the processes of tissue development, homeostasis and repair. Many tumor types are hierarchically organized and driven by a sub-population of cells often called cancer stem cells. Cancer stem cells are uniquely capable of recapitulating the tumor and can be highly resistant to radio-and chemotherapy treatment. We investigate tumor growth patterns from a theoretical standpoint and show how significant changes in pre-and post-therapy tumor dynamics are tied to the dynamics of cancer stem cells. We identify two characteristic growth regimes of a tumor population that can be leveraged to estimate cancer stem cell fractions in vivo using simple linear regression. Our method is a mathematically exact result, parameter free and does not require any microscopic knowledge of the tumor properties. A more accurate quantification of the direct link between the sub-population driving tumor growth and treatment response promises new ways to individualize treatment strategies.\n\nSignificance StatementUnder the cancer stem cell hypothesis a tumor population is driven by a fraction of self-renewing cancer stem cells. Absolute and relative size of this population in human cancers at any stage of the disease remains unknown. We formulate a mathematical model that describes the tumor cell populations growth dynamics and response to therapy. This allows to estimate cancer stem cell fraction from longitudinal measurements of tumor size (often available from imaging). Such estimates are critical because treatment outcome and risk of relapse depend on the tumors capacity to self-renew. Ideally, by tailoring patient treatment strategies based on the relative abundance of cancer stem cells could lead to radically different therapeutic regime and to the successful eradication of the disease.

Cancer Biology

Edge effects in game theoretic dynamics of spatially structured tumours

BackgroundAnalysing tumour architecture for metastatic potential usually focuses on phenotypic differences due to cellular morphology or specific genetic mutations, but often ignore the cells position within the heterogeneous substructure. Similar disregard for local neighborhood structure is common in mathematical models.\n\nMethodsWe view the dynamics of disease progression as an evolutionary game between cellular phenotypes. A typical assumption in this modeling paradigm is that the probability of a given phenotypic strategy interacting with another depends exclusively on the abundance of those strategies without regard local heterogeneities. We address this limitation by using the Ohtsuki-Nowak transform to introduce spatial structure to the go vs. grow game.\n\nResultsWe show that spatial structure can promote the invasive (go) strategy. By considering the change in neighbourhood size at a static boundary - such as a blood-vessel, organ capsule, or basement membrane - we show an edge effect that allows a tumour without invasive phenotypes in the bulk to have a polyclonal boundary with invasive cells. We present an example of this promotion of invasive (EMT positive) cells in a metastatic colony of prostate adenocarcinoma in bone marrow.\n\nInterpretationPathologic analyses that do not distinguish between cells in the bulk and cells at a static edge of a tumour can underestimate the number of invasive cells. We expect our approach to extend to other evolutionary game models where interaction neighborhoods change at fixed system boundaries.

Cancer Biology

Dynamics of preventive and reactive cancer control using low-impact treatments

Cancer poses danger because of its unregulated growth, development of resistant subclones, and metastatic spread to vital organs. Although the major transitions in cancer development are increasingly well understood, we lack quantitative theory for how preventive measures and post-excision (reactive) treatments are predicted to affect risks of obtaining a life threatening cancer or relapse, respectively. We employ analytical and numerical models to evaluate how continuous measures such as life style changes, and certain non-targeted and targeted treatments affect both neoplastic growth and the frequency of resistant clones. We find that preventive measures can have a negligible impact on pre-cancerous lesions and yet achieve considerable reductions in risk of invasive cancer. Importantly, our model, based on realistic parameter estimates, predicts that daily cancer cell arrest levels of 0.2-0.3% produce optimal outcomes for prevention, whereas for reaction the level is 0.3-0.4%. For similar cancer cell populations, prevention outcomes are, on average, always better than reactive ones. This is because reactive measures are more likely to select for faster growing subclones with higher probabilities of resistance, highlighting the difficulty in countering relapse regardless of therapeutic impact on cancer cell populations. We discuss these results and other important mitigating factors that need to be taken into consideration in a comparative understanding of preventive versus reactive treatments.

Cancer Biology

A Pan-cancer catalogue of driver protein interaction interfaces

Despite their critical importance in maintaining the integrity of all cellular pathways, the specific role of mutations on protein-protein interaction (PPI) interfaces as cancer drivers, though known for some specific examples, has not been systematically studied. We analyzed missense somatic mutations in a pan-cancer cohort of 5,989 tumors from 23 projects of The Cancer Genome Atlas (TCGA) for enrichment on PPI interfaces using e-Driver, an algorithm to analyze the mutation pattern of specific protein regions such as PPI interfaces. We identified 128 PPI interfaces enriched in somatic cancer mutations. Our results support the notion that many mutations in well-established cancer driver genes, particularly those in critical network positions, act by altering PPI interfaces. Finally, focusing on individual interfaces we are also able to show how tumors driven by the same gene can have different behaviors, including patient outcomes, depending on whether specific interfaces are mutated or not.

Cancer Biology

Phase i trials in melanoma: A framework to translate preclinical findings to the clinic

AbstractWe present a, mathematical model driven, framework to implement virtual or imaginary clinical trials (phase i trials) that can be used to bridge the gap between preclinical studies and the clinic. The trial implementation process includes the development of an experimentally validated mathematical model, generation of a cohort of heterogeneous virtual patients, an assessment of stratification factors, and optimization of treatment strategy. We show the detailed process through application to melanoma treatment, using a combination therapy of chemotherapy and an AKT inhibitor, which was recently tested in a phase 1 clinical trial. We developed a mathematical model, composed of ordinary differential equations, based on experimental data showing that such therapies differentially induce autophagy in melanoma cells. Model parameters were estimated using an optimization algorithm that minimizes differences between predicted cell populations and experimentally measured cell numbers. The calibrated model was validated by comparing predicted cell populations with experimentally measured melanoma cell populations in twelve different treatment scheduling conditions. By using this validated model as the foundation for a genetic algorithm, we generated a cohort of virtual patients that mimics the heterogeneous combination therapy responses observed in a companion clinical trial. Sensitivity analysis of this cohort defined parameters that discriminated virtual patients having more favorable versus less favorable outcomes. Finally, the model predicts optimal therapeutic approaches across all virtual patients.\n\nOne Sentence SummaryWe propose a computational framework to implement phase i trials (virtual/imaginary yet informed clinical trials) in cancer, using an experimentally calibrated mathematical model of melanoma combination therapy, that can readily capture observed heterogeneous clinical outcomes and be used to optimize future clinical trial design.

Cancer Biology

Spatial model predicts dispersal and cell turnover cause reduced intra-tumor heterogeneity

Most cancers in humans are large, measuring centimeters in diameter, composed of many billions of cells. An equivalent mass of normal cells would be highly heterogeneous as a result of the mutations that occur during each cell division. What is remarkable about cancers is their homogeneity - virtually every neoplastic cell within a large cancer contains the same core set of genetic alterations, with heterogeneity confined to mutations that have emerged after the last clonal expansions. How such clones expand within the spatially-constrained three dimensional architecture of a tumor, and come to dominate a large, pre-existing lesion, has never been explained. We here describe a model for tumor evolution that shows how short-range migration and cell turnover can account for rapid cell mixing inside the tumor. With it, we show that even a small selective advantage of a single cell within a large tumor allows the descendants of that cell to replace the precursor mass in a clinically relevant time frame. We also demonstrate that the same mechanisms can be responsible for the rapid onset of resistance to chemotherapy. Our model not only provides novel insights into spatial and temporal aspects of tumor growth but also suggests that targeting short range cellular migratory activity could have dramatic effects on tumor growth rates.

Cancer Biology

Disturbance of poised chromatin coincides with increased expression of developmental genes in cancer

Poised (bivalent or paused) chromatin comprises activating and repressing histone modifications at the same location (Voigt et al., 2013). This combination of epigenetic marks keeps genes expressed at low levels but poised for rapid activation (Margaritis and Holstege, 2008; Mikkelsen et al., 2007). Typically, DNA at poised promoters carries low levels of methylation in normal cells (Meissner et al., 2008; Roadmap Epigenomics Consortium et al., 2015), but frequently shows elevated methylation levels in cancer samples (Hinoue et al., 2012; Gal-Yam et al., 2008; Ohm et al., 2007; Rodriguez et al., 2008; Easwaran et al., 2012). Although higher levels of methylation are normally associated with transcriptional silencing, recently counter-intuitive positive correlations between methylation and expression levels have been reported for two cancer types (Hahn et al., 2014; Kretzmer et al.,). Here, we analyze one of the largest combined expression and methylation data-sets to date, comprising over 5,000 samples and demonstrate that the hypermethylation of poised chromatin in conjunction with up-regulation of the corresponding genes is a general phenomenon in cancer. This up-regulation affects developmental genes and transcription factors, including many genes implicated in cancer. From analysis of 7,000 methylation data sets, we built a universal classifier that can identify cancer samples solely from the hypermethylation status of originally poised chromatin. We reason that the alteration of the epigenetic status of poised chromatin is intimately linked to tumorigenesis.

Cancer Biology

Cancer stem cell plasticity as tumor growth promoter and catalyst of population collapse

It is increasingly argued that cancer stem cells are not a cellular phenotype but rather a transient state that cells can acquire, either through intrinsic signaling cascades or in response to environmental cues. While cancer stem cell plasticity is generally associated with increased aggressiveness and treatment resistance, we set out to thoroughly investigate the impact of different rates of plasticity on early and late tumor growth dynamics and the response to therapy. We develop an agent-based model of cancer stem cell driven tumor growth, in which plasticity is defined as a spontaneous transition between stem and non-stem cancer cell states. Simulations of the model show that plasticity can substantially increase tumor growth rate and invasion. At high rates of plasticity, however, the cells get exhausted and the tumor will undergo spontaneous remission in the long term. In a series of in silico trials we show that such remission can be facilitated through radiotherapy. The presented study suggests that stem cell plasticity has rather complex, non-intuitive implications on tumor growth and treatment response. Further theoretical, experimental and integrated studies are needed to fully decipher cancer stem cell plasticity and how it can be harnessed for novel therapeutic approaches.

Cancer Biology

SCT promoter methylation is a highly discriminative biomarker for lung and many other cancers

Aberrant DNA methylation has long been implicated in cancers. In this work we present a highly discriminative DNA methylation biomarker for non-small cell lung cancers and fourteen other cancers. Based on 69 NSCLC cell lines and 257 cancer-free lung tissues we identified a CpG island in SCT gene promoter which was verified by qMSP experiment in 15 NSCLC cell lines and 3 immortalized human respiratory epithelium cells. In addition, we found that SCT promoter was methylated in 23 cancer cell lines involving >10 cancer types profiled by ENCODE. We found that SCT promoter is hyper-methylated in primary tumors from TCGA lung cancer cohort. Additionally, we found that SCT promoter is methylated at high frequencies in fifteen malignancies and is not methylated in [~]1000 non-cancerous tissues across >30 organ types. Our study indicates that SCT promoter methylation is a highly discriminative biomarker for lung and many other cancers.

Cancer Biology

NADH as a cancer medicine

We propose that NADH will exert a specific kill action against some cancers. NADH is a natural metabolite. We envisage a low side effect profile and that NADH therapy will, additionally, combat the wastage and weakness of cancer patients, which can be the cause of death in some cases. Significantly, NADH can be administered orally and has already cleared clinical trials, all be it for other pathologies.\n\nBackgroundAerobic respiration consists of glycolysis in the cytoplasm and in the mitochondria: the Krebs cycle and oxidative phosphorylation (OXPHOS) [1, 2]. It requires O2 and net yields 30 ATPs from one glucose molecule. Anaerobic respiration, consisting of glycolysis only, does not require O2 but produces merely 2 ATPs from one glucose molecule. When O2 is available, normal animal cells tend to favour aerobic respiration because of its higher ATP yield.

Cancer Biology

A non-local model for cancer stem cells and the tumor growth paradox

The tumor growth paradox refers to the observation that incomplete treatment of cancers can enhance their growth. As shown here and elsewhere, the existence of cancer stem cells (CSC) can explain this effect. CSC are less sensitive to treatments, hence any stress applied to the tumor selects for CSC, thereby increasing the fitness of the tumor. In this paper we use a mathematical model to understand the role of CSC in the progression of cancer. Our model is a rather general system of integro-differential equations for tumor growth and tumor spread. Such a model has never been analysed, and we prove results on local and global existence of solutions, their uniqueness and their boundedness. We show numerically that this model exhibits the tumor growth paradox for all parameters tested. This effect becomes more relevant for small renewal rate of the CSC.

Cancer Biology

A computational modelling approach for deriving biomarkers to predict cancer risk in premalignant disease

The lack of effective biomarkers for predicting cancer risk in premalignant disease is a major clinical problem. There is a near-limitless list of candidate biomarkers and it remains unclear how best to sample the tissue in space and time. Practical constraints mean that only a few of these candidate biomarker strategies can be evaluated empirically and there is no framework to determine which of the plethora of possibilities is the most promising. Here we have sought to solve this problem by developing a theoretical platform for in silico biomarker development. We construct a simple computational model of carcinogenesis in premalignant disease and use the model to evaluate an extensive list of tissue sampling strategies and different molecular measures of these samples. Our model predicts that: (i) taking more biopsies improves prognostication, but with diminishing returns for each additional biopsy; (ii) longitudinally-collected biopsies provide slightly more prognostic information than a single biopsy collected at the latest possible time-point; (iii) measurements of clonal diversity are more prognostic than measurements of the presence or absence of a particular abnormality and are particularly robust to confounding by tissue sampling; and (iv) the spatial pattern of clonal expansions is a particularly prognostic measure. This study demonstrates how the use of a mechanistic framework provided by computational modelling can diminish empirical constraints on biomarker development.

Cancer Biology