Lee Sam

Individual cancers harbor a set of genetic aberrations that can be informative for identifying rational therapies currently available or in clinical trials. We implemented a pilot study to explore the practical challenges of applying high-throughput sequencing in clinical oncology. We enrolled patients with advanced or refractory cancer who were eligible for clinical trials. For each patient, we performed whole-genome sequencing of the tumor, targeted whole-exome sequencing of tumor and normal DNA, and transcriptome sequencing (RNA-Seq) of the tumor to identify potentially informative mutations in a clinically relevant time frame of 3 to 4 weeks. With this approach, we detected several classes of cancer mutations including structural rearrangements, copy number alterations, point mutations, and gene expression alterations. A multidisciplinary Sequencing Tumor Board (STB) deliberated on the clinical interpretation of the sequencing results obtained. We tested our sequencing strategy on human prostate cancer xenografts. Next, we enrolled two patients into the clinical protocol and were able to review the results at our STB within 24 days of biopsy. The first patient had metastatic colorectal cancer in which we identified somatic point mutations in NRAS, TP53, AURKA, FAS, and MYH11, plus amplification and overexpression of cyclin-dependent kinase 8 (CDK8). The second patient had malignant melanoma, in which we identified a somatic point mutation in HRAS and a structural rearrangement affecting CDKN2C. The STB identified the CDK8 amplification and Ras mutation as providing a rationale for clinical trials with CDK inhibitors or MEK (mitogen-activated or extracellular signal-regulated protein kinase kinase) and PI3K (phosphatidylinositol 3-kinase) inhibitors, respectively. Integrative high-throughput sequencing of patients with advanced cancer generates a comprehensive, individual mutational landscape to facilitate biomarker-driven clinical trials in oncology.

Beginning with precursor lesions, aberrant DNA methylation marks the entire spectrum of prostate cancer progression. We mapped the global DNA methylation patterns in select prostate tissues and cell lines using MethylPlex-next-generation sequencing (M-NGS). Hidden Markov model-based next-generation sequence analysis identified ∼68,000 methylated regions per sample. While global CpG island (CGI) methylation was not differential between benign adjacent and cancer samples, overall promoter CGI methylation significantly increased from ~12.6% in benign samples to 19.3% and 21.8% in localized and metastatic cancer tissues, respectively (P-value < 2 × 10(-16)). We found distinct patterns of promoter methylation around transcription start sites, where methylation occurred not only on the CGIs, but also on flanking regions and CGI sparse promoters. Among the 6691 methylated promoters in prostate tissues, 2481 differentially methylated regions (DMRs) are cancer-specific, including numerous novel DMRs. A novel cancer-specific DMR in the WFDC2 promoter showed frequent methylation in cancer (17/22 tissues, 6/6 cell lines), but not in the benign tissues (0/10) and normal PrEC cells. Integration of LNCaP DNA methylation and H3K4me3 data suggested an epigenetic mechanism for alternate transcription start site utilization, and these modifications segregated into distinct regions when present on the same promoter. Finally, we observed differences in repeat element methylation, particularly LINE-1, between ERG gene fusion-positive and -negative cancers, and we confirmed this observation using pyrosequencing on a tissue panel. This comprehensive methylome map will further our understanding of epigenetic regulation in prostate cancer progression.

MOTIVATION: Despite advances in the gene annotation process, the functions of a large portion of gene products remain insufficiently characterized. In addition, the in silico prediction of novel Gene Ontology (GO) annotations for partially characterized gene functions or processes is highly dependent on reverse genetic or functional genomic approaches. To our knowledge, no prediction method has been demonstrated to be highly accurate for sparsely annotated GO terms (those associated to fewer than 10 genes). RESULTS: We propose a novel approach, information theory-based semantic similarity (ITSS), to automatically predict molecular functions of genes based on existing GO annotations. Using a 10-fold cross-validation, we demonstrate that the ITSS algorithm obtains prediction accuracies (precision 97%, recall 77%) comparable to other machine learning algorithms when compared in similar conditions over densely annotated portions of the GO datasets. This method is able to generate highly accurate predictions in sparsely annotated portions of GO, where previous algorithms have failed. As a result, our technique generates an order of magnitude more functional predictions than previous methods. A 10-fold cross validation demonstrated a precision of 90% at a recall of 36% for the algorithm over sparsely annotated networks of the recent GO annotations (about 1400 GO terms and 11,000 genes in Homo sapiens). To our knowledge, this article presents the first historical rollback validation for the predicted GO annotations, which may represent more realistic conditions than more widely used cross-validation approaches. By manually assessing a random sample of 100 predictions conducted in a historical rollback evaluation, we estimate that a minimum precision of 51% (95% confidence interval: 43-58%) can be achieved for the human GO Annotation file dated 2003. AVAILABILITY: The program is available on request. The 97,732 positive predictions of novel gene annotations from the 2005 GO Annotation dataset and other supplementary information is available at http://phenos.bsd.uchicago.edu/ITSS/. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.