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Archive for the ‘CANCER BIOLOGY & Innovations in Cancer Therapy’ Category


New Mutant KRAS Inhibitors Are Showing Promise in Cancer Clinical Trials: Hope For the Once ‘Undruggable’ Target

Curator: Stephen J. Williams, Ph.D.

The November 1st issue of Science highlights a series of findings which give cancer researchers some hope in finally winning a thirty year war with the discovery of drugs that target KRAS, one of the most commonly mutated oncogenes  (25% of cancers), and thought to be a major driver of tumorigenesis. Once considered an undruggable target, mainly because of the smooth surface with no obvious pockets to fit a drug in, as well as the plethora of failed attempts to develop such an inhibitor, new findings with recently developed candidates, highlighted in this article and other curated within, are finally giving hope to researchers and oncologists who have been hoping for a clinically successful inhibitor of this once considered elusive target.

 

For a great review on development of G12C KRas inhibitors please see Dr. Hobb’s and Channing Der’s review in Cell Selective Targeting of the KRAS G12C Mutant: Kicking KRAS When It’s Down

Figure 1Mechanism of Action of ARS853 showing that the inhibitors may not need bind to the active conformation of KRAS for efficacy

Abstract: Two recent studies evaluated a small molecule that specifically binds to and inactivates the KRAS G12C mutant. The new findings argue that the perception that mutant KRAS is persistently frozen in its active GTP-bound form may not be accurate.

 

Although the development of the KRASG12C-specific inhibitor, compound 12 (Ostrem et al., 2013), was groundbreaking, subsequent studies found that the potency of compound 12 in cellular assays was limited (Lito et al., 2016, Patricelli et al., 2016). A search for more-effective analogs led to the development of ARS853 (Patricelli et al., 2016), which exhibited a 600-fold increase of its reaction rate in vitro over compound 12 and cellular activities in the low micromolar range.

 

A Summary and more in-depth curation of the Science article is given below:

After decades, progress against an ‘undruggable’ cancer target

Summary

Cancer researchers are making progress toward a goal that has eluded them for more than 30 years: shrinking tumors by shutting off a protein called KRAS that drives growth in many cancer types. A new type of drug aimed at KRAS made tumors disappear in mice and shrank tumors in lung cancer patients, two companies report in papers published this week. It’s not yet clear whether the drugs will extend patients’ lives, but the results are generating a wave of excitement. And one company, Amgen, reports an unexpected bonus: Its drug also appears to stimulate the immune system to attack tumors, suggesting it could be even more powerful if paired with widely available immunotherapy treatments.

Jocelyn Kaiser. After decades, progress against an ‘undruggable’ cancer target. Science  01 Nov 2019: Vol. 366, Issue 6465, pp. 561 DOI: 10.1126/science.366.6465.561

The article highlights the development of three inhibitors: by Wellspring Biosciences, Amgen, and Mirati Therapeutics.

Wellspring BioSciences

 

In 2013, Dr. Kevan Shokat’s lab at UCSF discovered a small molecule that could fit in the groove of the KRAS mutant G12C.  The G12C as well as the G12D is a common mutation found in KRAS in cancers. KRAS p.G12C mutations predominate in NSCLC comprising 11%–16% of lung adenocarcinomas (45%–50% of mutant KRAS is p.G12C) (Campbell et al., 2016; Jordan et al., 2017), as well as 1%–4% of pancreatic and colorectal adenocarcinomas, respectively (Bailey et al., 2016; Giannakis et al., 2016).  This inhibitor was effective in shrinking, in mouse studies conducted by Wellspring Biosciences,  implanted tumors containing this mutant KRAS.

 

See Wellspring’s news releases below:

March, 2016 – Publication – Selective Inhibition of Oncogenic KRAS Output with Small Molecules Targeting the Inactive State

February, 2016 – Publication – Allele-specific inhibitors inactivate mutant KRAS G12C by a trapping mechanism

Amgen

 

Amgen press release on AMG510 Clinical Trial at ASCO 2019

 

THOUSAND OAKS, Calif., June 3, 2019 /PRNewswire/ — Amgen (NASDAQ: AMGN) today announced the first clinical results from a Phase 1 study evaluating investigational AMG 510, the first KRASG12C inhibitor to reach the clinical stage. In the trial, there were no dose-limiting toxicities at tested dose levels. AMG 510 showed anti-tumor activity when administered as a monotherapy in patients with locally-advanced or metastatic KRASG12C mutant solid tumors. These data are being presented during an oral session at the 55th Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago.

“KRAS has been a target of active exploration in cancer research since it was identified as one of the first oncogenes more than 30 years ago, but it remained undruggable due to a lack of traditional small molecule binding pockets on the protein. AMG 510 seeks to crack the KRAS code by exploiting a previously hidden groove on the protein surface,” said David M. Reese, M.D., executive vice president of Research and Development at Amgen. “By irreversibly binding to cysteine 12 on the mutated KRAS protein, AMG 510 is designed to lock it into an inactive state. With high selectivity for KRASG12C, we believe investigational AMG 510 has high potential as both a monotherapy and in combination with other targeted and immune therapies.”

The Phase 1, first-in-human, open-label multicenter study enrolled 35 patients with various tumor types (14 non-small cell lung cancer [NSCLC], 19 colorectal cancer [CRC] and two other). Eligible patients were heavily pretreated with at least two or more prior lines of treatment, consistent with their tumor type and stage of disease. 

Canon, J., Rex, K., Saiki, A.Y. et al. The clinical KRAS(G12C) inhibitor AMG 510 drives anti-tumour immunity. Nature 575, 217–223 (2019) doi:10.1038/s41586-019-1694-1

Besides blocking tumor growth, AMG510 appears to stimulate T cells to attack the tumor, thus potentially supplying a two pronged attack to the tumor, inhibiting oncogenic RAS and stimulating anti-tumor immunity.

 

Mirati Therapeutics

 

Mirati’s G12C KRAS inhibitor (MRTX849) is being investigated in a variety of solid malignancies containing the KRAS mutation.

 

For recent publication on results in lung cancer see Patricelli M.P., et al. Cancer Discov. 2016; (Published online January 6, 2016)

For more information on Mirati’s KRAS G12C inhibitor see https://www.mirati.com/pipeline/kras-g12c/

 

KRAS G12C Inhibitor (MRTX849)

Study 849-001 – Phase 1b/2 of single agent MRTX849 for solid tumors with KRAS G12C mutation

Phase 1b/2 clinical trial of single agent MRTX849 in patients with advanced solid tumors that have a KRAS G12C mutation.

See details for this study at clinicaltrials.gov

 

Additional References:

Allele-specific inhibitors inactivate mutant KRAS G12C by a trapping mechanism.

Lito P et al. Science. (2016)

Targeting KRAS Mutant Cancers with a Covalent G12C-Specific Inhibitor.

Janes MR et al. Cell. (2018)

Potent and Selective Covalent Quinazoline Inhibitors of KRAS G12C.

Zeng M et al. Cell Chem Biol. (2017)

Campbell, J.D., Alexandrov, A., Kim, J., Wala, J., Berger, A.H., Pedamallu, C.S., Shukla, S.A., Guo, G., Brooks, A.N., Murray, B.A., et al.; Cancer Genome Atlas Research Network (2016). Distinct patterns of somatic genome alterations in lung adenocarcinomas and squamous cell carcinomas. Nat. Genet.48, 607–616

Jordan, E.J., Kim, H.R., Arcila, M.E., Barron, D., Chakravarty, D., Gao, J., Chang, M.T., Ni, A., Kundra, R., Jonsson, P., et al. (2017). Prospective comprehensive molecular characterization of lung adenocarcinomas for efficient patient matching to approved and emerging therapies. Cancer Discov. 7, 596–609.

Bailey, P., Chang, D.K., Nones, K., Johns, A.L., Patch, A.M., Gingras, M.C., Miller, D.K., Christ, A.N., Bruxner, T.J., Quinn, M.C., et al.; Australian Pancreatic Cancer Genome Initiative (2016). Genomic analyses identify molecular subtypes of pancreatic cancer. Nature 531, 47–52.

Giannakis, M., Mu, X.J., Shukla, S.A., Qian, Z.R., Cohen, O., Nishihara, R., Bahl, S., Cao, Y., Amin-Mansour, A., Yamauchi, M., et al. (2016). Genomic correlates of immune-cell infiltrates in colorectal carcinoma. Cell Rep. 15, 857–865.

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Reporter and Curator: Dr. Sudipta Saha, Ph.D.

 

One of the most contagious diseases known to humankind, measles killed an average of 2.6 million people each year before a vaccine was developed, according to the World Health Organization. Widespread vaccination has slashed the death toll. However, lack of access to vaccination and refusal to get vaccinated means measles still infects more than 7 million people and kills more than 100,000 each year worldwide as reported by WHO. The cases are on the rise, tripling in early 2019 and some experience well-known long-term consequences, including brain damage and vision and hearing loss. Previous epidemiological research into immune amnesia suggests that death rates attributed to measles could be even higher, accounting for as much as 50 percent of all childhood mortality.

 

Over the last decade, evidence has mounted that the measles vaccine protects in two ways. It prevents the well-known acute illness with spots and fever and also appears to protect from other infections over the long term by giving general boost to the immune system. The measles virus can impair the body’s immune memory, causing so-called immune amnesia. By protecting against measles infection, the vaccine prevents the body from losing or “forgetting” its immune memory and preserves its resistance to other infections. Researchers showed that the measles virus wipes out 11% to 73% of the different antibodies that protect against viral and bacterial strains a person was previously immune to like from influenza to herpes virus to bacteria that cause pneumonia and skin infections.

 

This study at Harvard Medical School and their collaborators is the first to measure the immune damage caused by the virus and underscores the value of preventing measles infection through vaccination. The discovery that measles depletes people’s antibody repertoires, partially obliterating immune memory to most previously encountered pathogens, supports the immune amnesia hypothesis. It was found that those who survive measles gradually regain their previous immunity to other viruses and bacteria as they get re-exposed to them. But because this process may take months to years, people remain vulnerable in the meantime to serious complications of those infections and thus booster shots of routine vaccines may be required.

 

VirScan detects antiviral and antibacterial antibodies in the blood that result from current or past encounters with viruses and bacteria, giving an overall snapshot of the immune system. Researchers gathered blood samples from unvaccinated children during a 2013 measles outbreak in the Netherlands and used VirScan to measure antibodies before and two months after infection in 77 children who’d contracted the disease. The researchers also compared the measurements to those of 115 uninfected children and adults. Researchers found a striking drop in antibodies from other pathogens in the measles-infected children that clearly suggested a direct effect on the immune system resembling measles-induced immune amnesia.

 

Further tests revealed that severe measles infection reduced people’s overall immunity more than mild infection. This could be particularly problematic for certain categories of children and adults, the researchers said. The present study observed the effects in previously healthy children only. But, measles is known to hit malnourished children much harder, the degree of immune amnesia and its effects could be even more severe in less healthy populations. Inoculation with the MMR (measles, mumps, rubella) vaccine did not impair children’s overall immunity. The results align with decades of research. Ensuring widespread vaccination against measles would not only help prevent the expected 120,000 deaths that will be directly attributed to measles this year alone, but could also avert potentially hundreds of thousands of additional deaths attributable to the lasting damage to the immune system.

 

References:

 

https://hms.harvard.edu/news/inside-immune-amnesia?utm_source=Silverpop

 

https://science.sciencemag.org/content/366/6465/599

 

www.who.int/immunization/newsroom/measles-data-2019/en/

 

https://www.ncbi.nlm.nih.gov/pubmed/20636817

 

https://www.ncbi.nlm.nih.gov/pubmed/27157064

 

https://www.ncbi.nlm.nih.gov/pubmed/30797735

 

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DISCOVER BRIGHAM | NOVEMBER 7, 2019, 10AM – 6PM

#DISCOVERBRIGHAM

@pharma_BI

@AVIVA1950

 Aviva Lev-Ari, PhD, RN will be attending and will cover presentations in real time

ABOUT BRIGHAM RESEARCH

Discover Brigham is hosted by the Brigham Research Institute (BRI), under the umbrella of Brigham Health. Launched in 2005, the BRI’s mission is to accelerate discoveries that improve human health by bridging the gaps between science, communication and funding. The BRI’s resources help to foster groundbreaking interdepartmental and interdisciplinary research. They provide a voice for the research community and raise the profile of Brigham Research.

Speakers

http://www.discoverbrigham.org/speakers/

 

AGENDA

http://www.discoverbrigham.org/agenda/

ASK A QUESTION WITH SLI.DO!

DO YOU WANT TO SUBMIT A QUESTION TO A SPEAKER OF A SESSION? YOU CAN DO IT THROUGH SLI.DO!

2. ENTER THE EVENT CODE: DB19. THEN HIT JOIN!
3. PICK THE SESSION YOU WANT TO ASK A QUESTION. THEN ASK YOUR QUESTION!
4. YOUR QUESTION WILL BE REVIEWED AND MAY BE FORWARDED TO THE CHAIR TO ASK THE SPEAKER(S).

IT WORKS ON ANY DEVICE, YOU DO NOT NEED TO INSTALL ANYTHING!

 

Registration will open at 9:00 AM and will be located throughout the hospital including

  • Schlager Atrium (formerly known as Cabot Atrium, 45 Francis Street Lobby),
  • Schuster Lobby (75 Francis Street Entrance),
  • Shapiro Cardiovascular Center (70 Francis Street Entrance), and the
  • Hale Building for Transformative Medicine (HBTM) 1st Floor (60 Fenwood Road).

 

Click here for directions to these locations.  

NAVIGATING THE BRIGHAM IS EASIER THAN EVER

Need directions to a clinic, conference room, public space, or help assisting someone who looks lost?

Try our browser-based wayfinding tool and mobile app, BWH Maps,
which provides real-time location tracking and directions in the hospital.

Look for BWH Maps on the Apple App Store and Google Play Store,
or visit maps.brighamandwomens.org.

REGISTRATION LOCATIONS

Please visit one of the registration desks listed below to check-in, receive your badge, and collect any necessary materials. Registration will begin starting at 9:00 AM at each of the locations below.

 

Click on each location below for directions. 

  • SCHLAGER ATRIUM, FORMERLY KNOWN AS CABOT ATRIUM (45 FRANCIS ST. LOBBY)
  • SCHUSTER LOBBY (75 FRANCIS ST. LOBBY)
  • CARL J. AND RUTH SHAPIRO
    CARDIOVASCULAR CENTER
  • HALE BUILDING FOR
    TRANSFORMATIVE MEDICINE

SESSION LOCATIONS

Below you will find directions to each of the session locations.

MARSHALL A. WOLF CONFERENCE ROOM

HALE BUILDING FOR TRANSFORMATIVE MEDICINE

SESSION ROOM

FROM 60 FENWOOD ROAD:
Enter at 60 Fenwood Rd lobby entrance.

STAIRS:
Take the lobby staircase to the 2nd floor. Walk past the balcony overlooking the atrium and take the stairs on the left (Stair 2) to the 3rd floor. Once on the 3rd floor, exit the stairwell and take a right. The room is to your right through the double glass door, straight ahead.

ELEVATOR:
Take S Elevator to 3rd floor. Take a right out of the elevator. The room is past the stairwell, on your right through the double glass doors.

HALE VTC 02006B CONFERENCE ROOM

HALE BUILDING FOR TRANSFORMATIVE MEDICINE

OVERFLOW ROOM FOR MARSHALL A. WOLF CONFERENCE ROOM

FROM 60 FENWOOD ROAD:
Enter at 60 Fenwood Rd lobby entrance.

STAIRS:
Take the lobby staircase to the 2nd floor. The conference room will be on your right near the display monitor.

ELEVATOR:
Enter at 60 Fenwood Rd main entrance and take the S Elevator to the 2nd floor. Once you exit the elevator, take a right and walk past the balcony overlooking the atrium and the conference room will be straight ahead near the display monitor.

ZINNER BREAKOUT ROOM

CARL J. AND RUTH SHAPIRO CARDIOVASCULAR CENTER

SESSION ROOM

FROM 70 FRANCIS STREET:
The Zinner Breakout Room is located in the Carl J. and Ruth Shapiro Cardiovascular Center at 70 Francis Street, Boston, MA. Upon entering the building at the street level, walk straight towards the escalators in the rear of the building. The Zinner Conference Center is located on your right; the Breakout room is through the large doors on the left.

ZINNER BOARDROOM

CARL J. AND RUTH SHAPIRO CARDIOVASCULAR CENTER

OVERFLOW ROOM FOR ZINNER BREAKOUT ROOM

FROM 70 FRANCIS STREET:
The Zinner Boardroom is located in the Carl J. and Ruth Shapiro Cardiovascular Center at 70 Francis Street, Boston, MA. Upon entering the building at the street level, walk straight towards the escalator, keeping to the left side of the building. The Conference Center is located on your right; the Boardroom is through the large doors on the back wall.

BORNSTEIN FAMILY AMPHITHEATER

MAIN PIKE, 45 FRANCIS STREET LOBBY

SESSION ROOM

FROM 45 FRANCIS STREET:
Coming from 45 Francis Street lobby, walk towards the Main Pike (2nd floor hallway). Then take left on the Main Pike, 2nd door on right.

AGENDA

10:00 AM – 11:00 AM

Opening remarks

Elizabeth G. Nabel, MD, President Brigham Health, Prof. Medicine @HarvardMed

  • 8th event since 2012
  • show casing amazing research
  • Open to the Public: Patients, Families to educate
  • 90 Posters
  • Health equity perspective as DNA of the Brigham
  • Learn a new idea, meet someone new, create a new idea

Keynote Introduction

David Bates, MD @DBatesSafety

KEYNOTE

KYU RHEE, MD, MPP, VICE PRESIDENT & CHIEF HEALTH OFFICER, IBM CORPORATION & IBM WATSON HEALTH

MAIN PIKE, 45 FRANCIS STREET LOBBY
  • Partnership BWH & IBM WATSON
  • Big data of claims from providers to payers
  • Waiting rookms in Healthcare delivery
  • Government: ACA
  • AI Spring is here, no more Winter for AI
  • Health disparities, salaries, sexual orientation – improving health of populations
  • Science & Security
  • Red Hat – data security – big data statoscope
  • Healthcare Culture & Technology Culture: IBM & Amazon hire healthcare professionals
  • Cost: Burnout, managing population health,
  • Reduce physicians burnout
  • Culture Tech – Competition by IBM’s Project Debater

11:15 AM – 12:50 PM

1:00 – 1:50 PM

FROM 70 FRANCIS STREET:
The Zinner Breakout Room is located in the Carl J. and Ruth Shapiro Cardiovascular Center at 70 Francis Street, Boston, MA. Upon entering the building at the street level, walk straight towards the escalators in the rear of the building. The Zinner Conference Center is located on your right; the Breakout room is through the large doors on the left.

Aaron Goldman
HaeLin Jang
Greog K. Gerber
  • Microbiome – Bacteria and Fungus therapies – computational tools for applications on microbiome
  • Diagnostics
  • Microbiome in early childhood
  • temporal variability during adulthood
  • host disease bacteriptherapeutics: C-Diff
  • Bugs as drugs
  • Gnotobiotic mice model for c-Diff in mice
  • MDSINE – Microbial dynamin model interaction model
  • cancer microbiome: Bacteria causing cancer, cancer changing the bacteria environment

 

Jeff Karp BENG PhD @MrJeffKarp

  • tissue based patch to seal open foramane ovale. Project remained in Academic settings however
  • GLUE component was commercialized
  • bioinspiration from living organs in Nature, slugs
  1. Viscose secretions
  2. Hydrophobic secretions and snails and sand castle worms

1:00 – 1:50 PM

Lina Matta, PharmD
Joji Suzuki, MD
Lisa WIchmann
Kevin Elias, MD
Daiva Braunfelds,MBA HPH
Elizabeth Cullen, MS

2:00 – 2:50 PM

3:00 – 3:50 PM

David Levin
Christopher baugh
Kathryn Britton
Joanne Feinberg Goldstein
Amrita Shahani
If patient meets criteria for Home Hospital : all services are sent home.
2016 – Pilot randomized controlled trial
2017-2018 – Repeat of Pilot on larger population
2018 – High-volume single arm innovation services
2019 – studies within home hospital wtth sensors at home
2020 – continue
Operation and Research lead to innovations

Anna Krichevsky, PhD HMS Initiative for RNA Medicine

  • paradox of organismal complexity and # protein encoding genes
  • Human genome, 70% Transcriptome Non-coding RNA only 2% encode proteins
  • Non-coding RNA small, long, multifunctional
  • biogenesis of offending RNAs can be drugged
  • RNA novel therapies: RNA as a Drug,
  • Indications: Brain Tumors and AD: MicroRNA (miRNA)the smallest Glioblastoma – only 4 drugs FDA approved in 25 years miRNA – 10b inhibition kills gliomacells miR-132 most neuroprotective RNA
  • Cardiovascular

Paul Anderson, MD, PhD

  • ALS and FTD – Fronto Temporal Dimensia
  • Riluzone 1970 – anti Anti-glutamateric
  • Edarabone 2017 drugs approved – anti-oxidative
  • Andogenesis role in Motor protection from Stress Cytoplasmatic tRNA – ANdiogenin (ANG) production
  • 20 amino acids
  • 5″-tiRNAs assemble G-quadruples – G4
  • point mutationin ANG (mANG) reduce its RNanase
  • G4-containing DNA analogs of 5″-tiRNA (Ala)

Marc Feinberg, MD

  • Cardiovascular: CAD, Insulin resistence – Vascular inflammation
  • Impaired angiogenesis: post MI repair CHF
  • MiRNA therapeutics for Atherosclerosis – miR-181b: Aortic ECs Athero (mice) CAD (Human)
  • miRNA _ Liposomes injected in the vessel wall – reduction of inflammation in vessel – microRNA Group
  • monocyte – How can we increase or amintain mir-181b expression in endothelial cells?
  • LncRNA Therapeutics for vascular Senescence and Atherosclerosis – no effect on leucocyte accumulation no difference in inflammation
  • DNA-dependent protein kinase (DNA-PK)
  • Does Loss SNHG12 triggers vascular senescence in the vessel wall

 

Clemens Scherzer, MD

  • The Protein RNA Brain
  • Dopamin p
  • BRAINCODE: 64% RNA: mRNA, ncRNA,
  • cell-type-spacific putative enhancer RNAs (eRNAs)
  • eRNAs indicate active genetic switches
  • central dogma in Biology: DNA, non-coding RNA, Protein
  • Top 10 Markers
  • Neuropsychiatric Disease: Parkinson: How do genetic variants function in specific brain cells: neurons, microglia, astrocytes
  • genetic variants of neuropsychiatric diseases over-localize to active eRNA sites in dopamine neurons
  • enhancers RNA – ADHD,
  • enhacers RNA – schizoprania, bipolar, addiction – antopsychotic Vlporic acid
  • BRAINCODE Project: BWH MGH HMS

5:00 – 6:00 PM

AWARDS & RECEPTION

SPECIAL PHOTO-OP TO CELEBRATE YOU!
WE WILL TAKE A GROUP PHOTO DURING THE RECEPTION AND AWARDS CEREMONY TO CELEBRATE YOU, OUR INNOVATORS!
THE PHOTO WILL BE DISPLAYED AT THE BRIGHAM IN THE HALE BUILDING. WE HOPE YOU CAN JOIN US IN CELEBRATING YOUR ACHIEVEMENTS.

SOURCE

http://www.discoverbrigham.org/agenda/

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Deep Learning extracts Histopathological Patterns and accurately discriminates 28 Cancer and 14 Normal Tissue Types: Pan-cancer Computational Histopathology Analysis

Reporter: Aviva Lev-Ari, PhD, RN

Pan-cancer computational histopathology reveals mutations, tumor composition and prognosis

Yu Fu1, Alexander W Jung1, Ramon Viñas Torne1, Santiago Gonzalez1,2, Harald Vöhringer1, Mercedes Jimenez-Linan3, Luiza Moore3,4, and Moritz Gerstung#1,5 # to whom correspondence should be addressed 1) European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Hinxton, UK. 2) Current affiliation: Institute for Research in Biomedicine (IRB Barcelona), Parc Científic de Barcelona, Barcelona, Spain. 3) Department of Pathology, Addenbrooke’s Hospital, Cambridge, UK. 4) Wellcome Sanger Institute, Hinxton, UK 5) European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany.

Correspondence:

Dr Moritz Gerstung European Molecular Biology Laboratory European Bioinformatics Institute (EMBL-EBI) Hinxton, CB10 1SA UK. Tel: +44 (0) 1223 494636 E-mail: moritz.gerstung@ebi.ac.uk

Abstract

Pan-cancer computational histopathology reveals mutations, tumor composition and prognosis

Here we use deep transfer learning to quantify histopathological patterns across 17,396 H&E stained histopathology image slides from 28 cancer types and correlate these with underlying genomic and transcriptomic data. Pan-cancer computational histopathology (PC-CHiP) classifies the tissue origin across organ sites and provides highly accurate, spatially resolved tumor and normal distinction within a given slide. The learned computational histopathological features correlate with a large range of recurrent genetic aberrations, including whole genome duplications (WGDs), arm-level copy number gains and losses, focal amplifications and deletions as well as driver gene mutations within a range of cancer types. WGDs can be predicted in 25/27 cancer types (mean AUC=0.79) including those that were not part of model training. Similarly, we observe associations with 25% of mRNA transcript levels, which enables to learn and localise histopathological patterns of molecularly defined cell types on each slide. Lastly, we find that computational histopathology provides prognostic information augmenting histopathological subtyping and grading in the majority of cancers assessed, which pinpoints prognostically relevant areas such as necrosis or infiltrating lymphocytes on each tumour section. Taken together, these findings highlight the large potential of PC-CHiP to discover new molecular and prognostic associations, which can augment diagnostic workflows and lay out a rationale for integrating molecular and histopathological data.

SOURCE

https://www.biorxiv.org/content/10.1101/813543v1

Key points

● Pan-cancer computational histopathology analysis with deep learning extracts histopathological patterns and accurately discriminates 28 cancer and 14 normal tissue types

● Computational histopathology predicts whole genome duplications, focal amplifications and deletions, as well as driver gene mutations

● Wide-spread correlations with gene expression indicative of immune infiltration and proliferation

● Prognostic information augments conventional grading and histopathology subtyping in the majority of cancers

 

Discussion

Here we presented PC-CHiP, a pan-cancer transfer learning approach to extract computational histopathological features across 42 cancer and normal tissue types and their genomic, molecular and prognostic associations. Histopathological features, originally derived to classify different tissues, contained rich histologic and morphological signals predictive of a range of genomic and transcriptomic changes as well as survival. This shows that computer vision not only has the capacity to highly accurately reproduce predefined tissue labels, but also that this quantifies diverse histological patterns, which are predictive of a broad range of genomic and molecular traits, which were not part of the original training task. As the predictions are exclusively based on standard H&E-stained tissue sections, our analysis highlights the high potential of computational histopathology to digitally augment existing histopathological workflows. The strongest genomic associations were found for whole genome duplications, which can in part be explained by nuclear enlargement and increased nuclear intensities, but seemingly also stems from tumour grade and other histomorphological patterns contained in the high-dimensional computational histopathological features. Further, we observed associations with a range of chromosomal gains and losses, focal deletions and amplifications as well as driver gene mutations across a number of cancer types. These data demonstrate that genomic alterations change the morphology of cancer cells, as in the case of WGD, but possibly also that certain aberrations preferentially occur in distinct cell types, reflected by the tumor histology. Whatever is the cause or consequence in this equation, these associations lay out a route towards genomically defined histopathology subtypes, which will enhance and refine conventional assessment. Further, a broad range of transcriptomic correlations was observed reflecting both immune cell infiltration and cell proliferation that leads to higher tumor densities. These examples illustrated the remarkable property that machine learning does not only establish novel molecular associations from pre-computed histopathological feature sets but also allows the localisation of these traits within a larger image. While this exemplifies the power of a large scale data analysis to detect and localise recurrent patterns, it is probably not superior to spatially annotated training data. Yet such data can, by definition, only be generated for associations which are known beforehand. This appears straightforward, albeit laborious, for existing histopathology classifications, but more challenging for molecular readouts. Yet novel spatial transcriptomic44,45 and sequencing technologies46 bring within reach spatially matched molecular and histopathological data, which would serve as a gold standard in combining imaging and molecular patterns. Across cancer types, computational histopathological features showed a good level of prognostic relevance, substantially improving prognostic accuracy over conventional grading and histopathological subtyping in the majority of cancers. It is this very remarkable that such predictive It is made available under a CC-BY-NC 4.0 International license. (which was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. bioRxiv preprint first posted online Oct. 25, 2019; doi: http://dx.doi.org/10.1101/813543. The copyright holder for this preprint signals can be learned in a fully automated fashion. Still, at least at the current resolution, the improvement over a full molecular and clinical workup was relatively small. This might be a consequence of the far-ranging relations between histopathology and molecular phenotypes described here, implying that histopathology is a reflection of the underlying molecular alterations rather than an independent trait. Yet it probably also highlights the challenges of unambiguously quantifying histopathological signals in – and combining signals from – individual areas, which requires very large training datasets for each tumour entity. From a methodological point of view, the prediction of molecular traits can clearly be improved. In this analysis, we adopted – for the reason of simplicity and to avoid overfitting – a transfer learning approach in which an existing deep convolutional neural network, developed for classification of everyday objects, was fine tuned to predict cancer and normal tissue types. The implicit imaging feature representation was then used to predict molecular traits and outcomes. Instead of employing this two-step procedure, which risks missing patterns irrelevant for the initial classification task, one might directly employ either training on the molecular trait of interest, or ideally multi-objective learning. Further improvement may also be related to the choice of the CNN architecture. Everyday images have no defined scale due to a variable z-dimension; therefore, the algorithms need to be able to detect the same object at different sizes. This clearly is not the case for histopathology slides, in which one pixel corresponds to a defined physical size at a given magnification. Therefore, possibly less complex CNN architectures may be sufficient for quantitative histopathology analyses, and also show better generalisation. Here, in our proof-of-concept analysis, we observed a considerable dependence of the feature representation on known and possibly unknown properties of our training data, including the image compression algorithm and its parameters. Some of these issues could be overcome by amending and retraining the network to isolate the effect of confounding factors and additional data augmentation. Still, given the flexibility of deep learning algorithms and the associated risk of overfitting, one should generally be cautious about the generalisation properties and critically assess whether a new image is appropriately represented. Looking forward, our analyses revealed the enormous potential of using computer vision alongside molecular profiling. While the eye of a trained human may still constitute the gold standard for recognising clinically relevant histopathological patterns, computers have the capacity to augment this process by sifting through millions of images to retrieve similar patterns and establish associations with known and novel traits. As our analysis showed this helps to detect histopathology patterns associated with a range of genomic alterations, transcriptional signatures and prognosis – and highlight areas indicative of these traits on each given slide. It is therefore not too difficult to foresee how this may be utilised in a computationally augmented histopathology workflow enabling more precise and faster diagnosis and prognosis. Further, the ability to quantify a rich set of histopathology patterns lays out a path to define integrated histopathology and molecular cancer subtypes, as recently demonstrated for colorectal cancers47 .

Lastly, our analyses provide It is made available under a CC-BY-NC 4.0 International license. (which was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.

bioRxiv preprint first posted online Oct. 25, 2019; doi: http://dx.doi.org/10.1101/813543.

The copyright holder for this preprint proof-of-concept for these principles and we expect them to be greatly refined in the future based on larger training corpora and further algorithmic refinements.

SOURCE

https://www.biorxiv.org/content/biorxiv/early/2019/10/25/813543.full.pdf

 

Other related articles published in this Open Access Online Scientific Journal include the following: 

 

CancerBase.org – The Global HUB for Diagnoses, Genomes, Pathology Images: A Real-time Diagnosis and Therapy Mapping Service for Cancer Patients – Anonymized Medical Records accessible to anyone on Earth

Reporter: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2016/07/28/cancerbase-org-the-global-hub-for-diagnoses-genomes-pathology-images-a-real-time-diagnosis-and-therapy-mapping-service-for-cancer-patients-anonymized-medical-records-accessible-to/

 

631 articles had in their Title the keyword “Pathology”

https://pharmaceuticalintelligence.com/?s=Pathology

 

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Cancer Genomics: Multiomic Analysis of Single Cells and Tumor Heterogeneity

Curator: Stephen J. Williams, PhD

 

scTrio-seq identifies colon cancer lineages

Single-cell multiomics sequencing and analyses of human colorectal cancer. Shuhui Bian et al. Science  30 Nov 2018:Vol. 362, Issue 6418, pp. 1060-1063

To better design treatments for cancer, it is important to understand the heterogeneity in tumors and how this contributes to metastasis. To examine this process, Bian et al. used a single-cell triple omics sequencing (scTrio-seq) technique to examine the mutations, transcriptome, and methylome within colorectal cancer tumors and metastases from 10 individual patients. The analysis provided insights into tumor evolution, linked DNA methylation to genetic lineages, and showed that DNA methylation levels are consistent within lineages but can differ substantially among clones.

Science, this issue p. 1060

Abstract

Although genomic instability, epigenetic abnormality, and gene expression dysregulation are hallmarks of colorectal cancer, these features have not been simultaneously analyzed at single-cell resolution. Using optimized single-cell multiomics sequencing together with multiregional sampling of the primary tumor and lymphatic and distant metastases, we developed insights beyond intratumoral heterogeneity. Genome-wide DNA methylation levels were relatively consistent within a single genetic sublineage. The genome-wide DNA demethylation patterns of cancer cells were consistent in all 10 patients whose DNA we sequenced. The cancer cells’ DNA demethylation degrees clearly correlated with the densities of the heterochromatin-associated histone modification H3K9me3 of normal tissue and those of repetitive element long interspersed nuclear element 1. Our work demonstrates the feasibility of reconstructing genetic lineages and tracing their epigenomic and transcriptomic dynamics with single-cell multiomics sequencing.

Fig. 1 Reconstruction of genetic lineages with scTrio-seq2.

Global SCNA patterns (250-kb resolution) of CRC01. Each row represents an individual cell. The subclonal SCNAs used for identifying genetic sublineages were marked and indexed; for details, see fig. S6B. On the top of the heatmap, the amplification or deletion frequency of each genomic bin (250 kb) of the non-hypermutated CRC samples from the TCGA Project and patient CRC01’s cancer cells are shown.

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Fig. 1 Reconstruction of genetic lineages with scTrio-seq2.

Global SCNA patterns (250-kb resolution) of CRC01. Each row represents an individual cell. The subclonal SCNAs used for identifying genetic sublineages were marked and indexed; for details, see fig. S6B. On the top of the heatmap, the amplification or deletion frequency of each genomic bin (250 kb) of the non-hypermutated CRC samples

 

 

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Human gene editing continues to hold a major fascination within a biomedical and biopharmaceutical industries. It’s extraordinary potential is now being realized but important questions as to who will be the beneficiaries of such breakthrough technologies remained to be answered. The session will discuss whether gene editing technologies can alleviate some of the most challenging unmet medical needs. We will discuss how research advances often never reach minority communities and how diverse patient populations will gain access to such breakthrough technologies. It is widely recognize that there are patient voids in the population and we will explore how community health centers might fill this void to ensure that state-of-the-art technologies can reach the forgotten patient groups . We also will touch ethical questions surrounding germline editing and how such research and development could impact the community at large.

Please follow LIVE on TWITTER using the following @ handles and # hashtags:

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from The American Association for Cancer Research aacr.org:

 

AACR Congratulates Dr. William G. Kaelin Jr., Sir Peter J. Ratcliffe, and Dr. Gregg L. Semenza on 2019 Nobel Prize in Physiology or Medicine

10/7/2019

PHILADELPHIA — The American Association for Cancer Research (AACR) congratulates Fellow of the AACR Academy William G. Kaelin Jr., MDSir Peter J. Ratcliffe, MD, FRS, and AACR member Gregg L. Semenza, MD, PhD, on receiving the 2019 Nobel Prize in Physiology or Medicine for their discoveries of how cells sense and adapt to oxygen availability.

Kaelin, professor of medicine at the Dana-Farber Cancer Institute and Harvard Medical School in Boston; Ratcliffe, director of Clinical Research at the Francis Crick Institute in London; and Semenza, director of the Vascular Program at the Institute for Cell Engineering at Johns Hopkins University School of Medicine in Baltimore, are being recognized by the Nobel Assembly at the Karolinska Institute for identifying the molecular machinery that regulates the activity of genes in response to varying levels of oxygen, which is one of life’s most essential adaptive processes. Their work has provided basic understanding of several diseases, including many types of cancer, and has laid the foundation for the development of promising new approaches to treating cancer and other diseases.

Kaelin, Ratcliffe, and Semenza were previously recognized for this work with the 2016 Lasker-DeBakey Clinical Medical Research Award.

Kaelin’s research focuses on understanding how mutations affecting tumor-suppressor genes cause cancer. As part of this work, he discovered that a tumor-suppressor gene called von Hippel–Lindau (VHL) is involved in controlling the cellular response to low levels of oxygen. Kaelin’s studies showed that the VHL protein binds to hypoxia-inducible factor (HIF) when oxygen is present and targets it for destruction. When the VHL protein is mutated, it is unable to bind to HIF, resulting in inappropriate HIF accumulation and the transcription of genes that promote blood vessel formation, such as vascular endothelial growth factor (VEGF). VEGF is directly linked to the development of renal cell carcinoma and therapeutics that target VEGF are used in the clinic to treat this and several other types of cancer.

Kaelin has been previously recognized with numerous other awards and honors, including the 2006 AACR-Richard and Hinda Rosenthal Award.

Ratcliffe independently discovered that the VHL protein binds to HIF. Since then, his research has focused on the molecular interactions underpinning the binding of VHL to HIF and the molecular events that occur in low levels of oxygen, a condition known as hypoxia. Prior to his work on VHL, Ratcliffe’s research contributed to elucidating the mechanisms by which hypoxia increases levels of the hormone erythropoietin (EPO), which leads to increased production of red blood cells.

Semenza’s research, which was independent of Ratcliffe’s, identified in exquisite detail the molecular events by which the EPO gene is regulated by varying levels of oxygen. He discovered HIF and identified this protein complex as the oxygen-dependent regulator of the EPO gene. Semenza followed up this work by identifying additional genes activated by HIF, including showing that the protein complex activates the VEGF gene that is pivotal to the development of renal cell carcinoma.

The recognition of Kaelin and Semenza increases the number of AACR members to have been awarded a Nobel Prize to 70, 44 of whom are still living.

The Nobel Prize in Physiology or Medicine is awarded by the Nobel Assembly at the Karolinska Institute for discoveries of major importance in life science or medicine that have changed the scientific paradigm and are of great benefit for mankind. Each laureate receives a gold medal, a diploma, and a sum of money that is decided by the Nobel Foundation.

The Nobel Prize Award Ceremony will be Dec. 10, 2019, in Stockholm.

Please find following articles on the Nobel Prize and Hypoxia in Cancer on this Open Access Journal:

2018 Nobel Prize in Physiology or Medicine for contributions to Cancer Immunotherapy to James P. Allison, Ph.D., of the University of Texas, M.D. Anderson Cancer Center, Houston, Texas. Dr. Allison shares the prize with Tasuku Honjo, M.D., Ph.D., of Kyoto University Institute, Japan

The History, Uses, and Future of the Nobel Prize, 1:00pm – 6:00pm, Thursday, October 4, 2018, Harvard Medical School

2017 Nobel prize in chemistry given to Jacques Dubochet, Joachim Frank, and Richard Henderson  for developing cryo-electron microscopy

Tumor Ammonia Recycling: How Cancer Cells Use Glutamate Dehydrogenase to Recycle Tumor Microenvironment Waste Products for Biosynthesis

Hypoxia Inducible Factor 1 (HIF-1)[7.9]

 

 

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