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Plasma DNA End-Motif Profiling as a Fragmentomic Marker in Cancer, Pregnancy, and Transplantation [Research Briefs]

Plasma DNA fragmentomics is an emerging area of research covering plasma DNA sizes, end points, and nucleosome footprints. In the present study, we found a significant increase in the diversity of plasma DNA end motifs in patients with hepatocellular carcinoma (HCC). Compared with patients without HCC, patients with HCC showed a preferential pattern of 4-mer end motifs. In particular, the abundance of plasma DNA motif CCCA was much lower in patients with HCC than in subjects without HCC. The aberrant end motifs were also observed in patients with other cancer types, including colorectal cancer, lung cancer, nasopharyngeal carcinoma, and head and neck squamous cell carcinoma. We further observed that the profile of plasma DNA end motifs originating from the same organ, such as the liver, placenta, and hematopoietic cells, generally clustered together. The profile of end motifs may therefore serve as a class of biomarkers for liquid biopsy in oncology, noninvasive prenatal testing, and transplantation monitoring.

Significance:

Plasma DNA molecules originating from the liver, HCC and other cancers, placenta, and hematopoietic cells each harbor a set of characteristic plasma DNA end motifs. Such markers carry tissue-of-origin information and represent a new class of biomarkers in the nascent field of fragmentomics.

This article is highlighted in the In This Issue feature, p. 627




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Pan-Cancer Efficacy of Vemurafenib in BRAFV600-Mutant Non-Melanoma Cancers [Research Briefs]

BRAFV600 mutations occur in a wide range of tumor types, and RAF inhibition has become standard in several of these cancers. Despite this progress, BRAFV600 mutations have historically been considered a clear demonstration of tumor lineage context–dependent oncogene addiction, based predominantly on the insensitivity to RAF inhibition in colorectal cancer. However, the true broader activity of RAF inhibition pan-cancer remains incompletely understood. To address this, we conducted a multicohort "basket" study of the BRAF inhibitor vemurafenib in non-melanoma BRAFV600 mutation–positive solid tumors. In total, 172 patients with 26 unique cancer types were treated, achieving an overall response rate of 33% and median duration of response of 13 months. Responses were observed in 13 unique cancer types, including historically treatment-refractory tumor types such as cholangiocarcinoma, sarcoma, glioma, neuroendocrine carcinoma, and salivary gland carcinomas. Collectively, these data demonstrate that single-agent BRAF inhibition has broader clinical activity than previously recognized.

Significance:

These data suggest that BRAFV600 mutations lead to oncogene addiction and are clinically actionable in a broad range of non-melanoma cancers, including tumor types in which RAF inhibition is not currently considered standard of care.

See related commentary by Ribas and Lo, p. 640.

This article is highlighted in the In This Issue feature, p. 627




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Clinical Research Slows as COVID-19 Surges [News in Brief]

As the COVID-19 pandemic worsens, the clinical cancer community is grappling with how to continue providing access to experimental but potentially lifesaving therapies while keeping immunocompromised patients safe. To that end, cancer centers are making changes to their clinical trial programs, while pharmaceutical companies are deciding how—or whether—trials should continue.




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Protein Instability Is Targetable in Mismatch Repair-Deficient Tumors [Research Watch]

Mismatch repair (MMR)–deficient tumors exhibit proteome-wide protein instability and aggregation.




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COVID-19 Challenges Basic Researchers [News in Brief]

As COVID-19 continues to surge, cancer scientists engaged in basic research face unique challenges. At centers throughout the United States, investigators are confronting difficult decisions about which experiments to continue, while securing supplies and creating contingency plans for a complete shutdown.




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Defining an embryonal rhabdomyosarcoma endotype [RESEARCH ARTICLE]

Rhabdomyosarcoma (RMS) is the most common childhood soft-tissue sarcoma. The largest subtype of RMS is embryonal rhabdomyosarcoma (ERMS) and accounts for 53% of all RMS. ERMS typically occurs in the head and neck region, bladder, or reproductive organs and portends a promising prognosis when localized; however, when metastatic the 5-yr overall survival rate is ~43%. The genomic landscape of ERMS demonstrates a range of putative driver mutations, and thus the recognition of the pathological mechanisms driving tumor maintenance should be critical for identifying effective targeted treatments at the level of the individual patients. Here, we report genomic, phenotypic, and bioinformatic analyses for a case of a 3-yr-old male who presented with bladder ERMS. Additionally, we use an unsupervised agglomerative clustering analysis of RNA and whole-exome sequencing data across ERMS and undifferentiated pleomorphic sarcoma (UPS) tumor samples to determine several major endotypes inferring potential targeted treatments for a spectrum of pediatric ERMS patient cases.




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Comparative single-cell RNA sequencing (scRNA-seq) reveals liver metastasis-specific targets in a patient with small intestinal neuroendocrine cancer [RESEARCH REPORT]

Genomic analysis of a patient's tumor is the cornerstone of precision oncology, but it does not address whether metastases should be treated differently. Here we tested whether comparative single-cell RNA sequencing (scRNA-seq) of a primary small intestinal neuroendocrine tumor to a matched liver metastasis could guide the treatment of a patient's metastatic disease. Following surgery, the patient was put on maintenance treatment with a somatostatin analog. However, the scRNA-seq analysis revealed that the neuroendocrine epithelial cells in the liver metastasis were less differentiated and expressed relatively little SSTR2, the predominant somatostatin receptor. There were also differences in the tumor microenvironments. RNA expression of vascular endothelial growth factors was higher in the primary tumor cells, reflected by an increased number of endothelial cells. Interestingly, vascular expression of the major VEGF receptors was considerably higher in the liver metastasis, indicating that the metastatic vasculature may be primed for expansion and susceptible to treatment with angiogenesis inhibitors. The patient eventually progressed on Sandostatin, and although consideration was given to adding an angiogenesis inhibitor to her regimen, her disease progression involved non-liver metastases that had not been characterized. Although in this specific case comparative scRNA-seq did not alter treatment, its potential to help guide therapy of metastatic disease was clearly demonstrated.




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RNA sequencing profiles and diagnostic signatures linked with response to ramucirumab in gastric cancer [RESEARCH REPORT]

Gastric cancer (GC) is the fifth-ranked cancer type by associated mortality. The proportion of early diagnosis is low, and most patients are diagnosed at the advanced stages. First-line therapy standardly includes fluoropyrimidines and platinum compounds with trastuzumab for HER2-positive cases. For recurrent disease, there are several alternative options including ramucirumab, a monoclonal therapeutic antibody that inhibits VEGF-mediated tumor angiogenesis by binding with VEGFR2, alone or in combination with other cancer drugs. However, overall response rate following ramucirumab or its combinations is 30%–80% of the patients, suggesting that personalization of drug prescription is needed to increase efficacy of treatment. We report here original tumor RNA sequencing profiles for 15 advanced GC patients linked with data on clinical response to ramucirumab or its combinations. Three genes showed differential expression in the tumors for responders versus nonresponders: CHRM3, LRFN1, and TEX15. Of them, CHRM3 was up-regulated in the responders. Using the bioinformatic platform Oncobox we simulated ramucirumab efficiency and compared output model results with actual tumor response data. An agreement was observed between predicted and real clinical outcomes (AUC ≥ 0.7). These results suggest that RNA sequencing may be used to personalize the prescription of ramucirumab for GC and indicate potential molecular mechanisms underlying ramucirumab resistance. The RNA sequencing profiles obtained here are fully compatible with the previously published Oncobox Atlas of Normal Tissue Expression (ANTE) data.




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The diagnostic challenges and clinical course of a myeloid/lymphoid neoplasm with eosinophilia and ZBTB20-JAK2 gene fusion presenting as B-lymphoblastic leukemia [RESEARCH REPORT]

We report the diagnostic challenges and the clinical course of a patient with an extraordinary presentation of B-lymphoblastic leukemia (B-ALL) with eosinophilia. We identified a novel ZBTB20-JAK2 gene fusion as a chimeric RNA transcript using the Archer platform. This gene fusion from the same patient was recently identified by Peterson et al. (2019) at the genomic level using a different sequencing technology platform. The configuration of this gene fusion predicts the production of a kinase-activating JAK2 fusion protein, which would normally lead to a diagnosis of Philadelphia chromosome–like B-ALL (Ph-like B-ALL). However, the unusual presentation of eosinophilia led us to demonstrate the presence of this gene fusion in nonlymphoid hematopoietic cells by fluorescence in situ hybridization (FISH) studies with morphologic correlation. Therefore, we believe this disease, in fact, represents blast crisis arising from an underlying myeloid neoplasm with JAK2 rearrangements. This case illustrates the difficulty in differentiating Ph-like B-ALL and myeloid/lymphoid neoplasm with eosinophilia and gene rearrangements (MLN-EGR) in blast crisis. As currently defined, the diagnosis of MLN-EGR relies on the hematologic presentations and the identification of marker gene fusions (including PCM1-JAK2, ETV6-JAK2, and BCR-JAK2). However, these same gene fusions, when limited to B-lymphoblasts, also define Ph-like B-ALL. Yet, our case does not conform to either condition. Therefore, the assessment for lineage restriction of gene rearrangements to reflect the pathophysiologic difference between B-ALL and MLN-EGR in blast crisis is likely a more robust diagnostic approach and allows the inclusion of MLN-EGR with novel gene fusions.




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The tale of two genes: from next-generation sequencing to phenotype [RESEARCH REPORT]

An 18-yr-old man with a history of intellectual disability, craniofacial dysmorphism, seizure disorder, and obesity was identified to carry a de novo, pathogenic variant in ASXL1 (c.4198G>T; p.E1400X) associated with the diagnosis of Bohring–Opitz syndrome based on exome sequencing. In addition, he was identified to carry a maternally inherited and likely pathogenic variant in MC4R (c.817C>T; p.Q273X) associated with monogenic obesity. Dual genetic diagnosis occurs in 4%–6% of patients and results in unique clinical phenotypes that are a function of tissue-specific gene expression, involved pathways, clinical expressivity, and penetrance. This case highlights the utility of next-generation sequencing in patients with an unusual combination of clinical presentations for several pillars of precision medicine including (1) diagnosis, (2) prognosis and outcome, (3) management and therapy, and (4) utilization of resources.




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Functional characterization of two rare BCR-FGFR1+ leukemias [RESEARCH REPORT]

8p11 myeloproliferative syndrome (EMS) represents a unique World Health Organization (WHO)-classified hematologic malignancy defined by translocations of the FGFR1 receptor. The syndrome is a myeloproliferative neoplasm characterized by eosinophilia and lymphadenopathy, with risk of progression to either acute myeloid leukemia (AML) or T- or B-lymphoblastic lymphoma/leukemia. Within the EMS subtype, translocations between breakpoint cluster region (BCR) and fibroblast growth factor receptor 1 (FGFR1) have been shown to produce a dominant fusion protein that is notoriously resistant to tyrosine kinase inhibitors (TKIs). Here, we report two cases of BCR–FGFR1+ EMS identified via RNA sequencing (RNA-seq) and confirmed by fluorescence in situ hybridization (FISH). Sanger sequencing revealed that both cases harbored the exact same breakpoint. In the first case, the patient presented with AML-like disease, and in the second, the patient progressed to B-cell acute lymphoblastic leukemia (B-ALL). Additionally, we observed that that primary leukemia cells from Case 1 demonstrated sensitivity to the tyrosine kinase inhibitors ponatinib and dovitinib that can target FGFR1 kinase activity, whereas primary cells from Case 2 were resistant to both drugs. Taken together, these results suggest that some but not all BCR–FGFR1 fusion positive leukemias may respond to TKIs that target FGFR1 kinase activity.




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BRAF V600E-mutated metastatic pediatric Wilms tumor with complete response to targeted RAF/MEK inhibition [RESEARCH REPORT]

Wilms tumor (WT) is the most common renal malignancy of childhood and accounts for 6% of all childhood malignancies. With current therapies, the 5-yr overall survival (OS) for children with unilateral favorable histology WT is greater than 85%. The prognosis is worse, however, for the roughly 15% of patients who relapse, with only 50%–80% OS reported in those with recurrence. Herein, we describe the extended and detailed clinical course of a rare case of a child with recurrent, pulmonary metastatic, favorable histology WT harboring a BRAF V600E mutation. The BRAF V600E mutation, commonly found in melanoma and other cancers, and previously undescribed in WT, has recently been reported by our group in a subset of epithelial-predominant WT. This patient, who was included in that series, presented with unilateral, stage 1, favorable histology WT and was treated with standard chemotherapy. Following the completion of therapy, the patient relapsed with pulmonary metastatic disease, that then again recurred despite an initial response to salvage chemotherapy and radiation. Next-generation sequencing (NGS) on the metastatic pulmonary nodule revealed a BRAF V600E mutation. After weighing the therapeutic options, a novel approach with dual BRAF/MEK inhibitor combination therapy was initiated. Complete radiographic response was observed following 4 months of therapy with dabrafenib and trametinib. At 12 months following the start of BRAF/MEK combination treatment, the patient continues with a complete response and has experienced minimal treatment-related side effects. This represents the first case, to our knowledge, of effective treatment with BRAF/MEK molecularly targeted therapy in a pediatric Wilms tumor patient.




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Tumoral and immune heterogeneity in an anti-PD-1-responsive glioblastoma: a case study [RESEARCH REPORT]

Clinical benefit of immune checkpoint blockade in glioblastoma (GBM) is rare, and we hypothesize that tumor clonal evolution and the immune microenvironment are key determinants of response. Here, we present a detailed molecular characterization of the intratumoral and immune heterogeneity in an IDH wild-type, MGMT-negative GBM patient who plausibly benefited from anti-PD-1 therapy with an unusually long 25-mo overall survival time. We leveraged multiplex immunohistochemistry, RNA-seq, and whole-exome data from the primary tumor and three resected regions of recurrent disease to survey regional tumor-immune interactions, genomic instability, mutation burden, and expression profiles. We found significant regional heterogeneity in the neoantigenic and immune landscape, with a differential T-cell signature among recurrent sectors, a uniform loss of focal amplifications in EGFR, and a novel subclonal EGFR mutation. Comparisons with recently reported correlates of checkpoint blockade in GBM and with TCGA-GBM revealed appreciable intratumoral heterogeneity that may have contributed to a differential PD-1 blockade response.




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Li-Fraumeni Exploration Consortium Data Coordinating Center: Building an Interactive Web-Based Resource for Collaborative International Cancer Epidemiology Research for a Rare Condition

Background:

The success of multisite collaborative research relies on effective data collection, harmonization, and aggregation strategies. Data Coordination Centers (DCC) serve to facilitate the implementation of these strategies. The utility of a DCC can be particularly relevant for research on rare diseases where collaboration from multiple sites to amass large aggregate datasets is essential. However, approaches to building a DCC have been scarcely documented.

Methods:

The Li-Fraumeni Exploration (LiFE) Consortium's DCC was created using multiple open source packages, including LAM/G Application (Linux, Apache, MySQL, Grails), Extraction-Transformation-Loading (ETL) Pentaho Data Integration Tool, and the Saiku-Mondrian client. This document serves as a resource for building a rare disease DCC for multi-institutional collaborative research.

Results:

The primary scientific and technological objective to create an online central repository into which data from all participating sites could be deposited, harmonized, aggregated, disseminated, and analyzed was completed. The cohort now include 2,193 participants from six contributing sites, including 1,354 individuals from families with a pathogenic or likely variant in TP53. Data on cancer diagnoses are also available. Challenges and lessons learned are summarized.

Conclusions:

The methods leveraged mitigate challenges associated with successfully developing a DCC's technical infrastructure, data harmonization efforts, communications, and software development and applications.

Impact:

These methods can serve as a framework in establishing other collaborative research efforts. Data from the consortium will serve as a great resource for collaborative research to improve knowledge on, and the ability to care for, individuals and families with Li-Fraumeni syndrome.




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Further Guidance in Implementing the Standardized 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score

The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score was developed to establish a simple, standardized scoring system for researchers to quantify adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and assess its impact on cancer risk and other health-related outcomes. The aim of this commentary is to clarify potential points of ambiguity in its application, focusing on aspects related to specific subscore components (physical activity, fast foods, alcohol, and sugar-sweetened drinks), how to address different data needs due to varied data collection instruments, and future exploratory score approaches. Overall, we encourage researchers to utilize the standardized score to enhance comparability across populations and countries. Researchers who may adapt or augment the 2018 WCRF/AICR Score are strongly encouraged to provide detailed descriptions of their methods to promote transparency and reproducibility.




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Cancer Prevention Research




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Cancer Research




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Hunt through satellite images of Earth with an AI search engine

An AI search engine takes one-tenth of a second to search more than 2 billion satellite images, identifying natural or built features that look alike, such as forests or military bases




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Death researcher on pandemics and our fascination with dying

Pandemics of the past can teach us about the current one, says John Troyer, who studies how we use technology to alter the experience of death




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AI can search satellite data to find plastic floating in the sea

AI can check satellite images of the ocean and distinguish between floating materials such as seaweed or plastics, which could help clean-up efforts




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One Family’s Frantic Search to Get the Drugs to Combat COVID-19

Photo Illustration by The Daily Beast/Getty

Marissa Guale is like all too many Americans right now. Her husband and father of her two children, Raul, is on a ventilator in a hospital on Long Island, fighting for his life while sick with COVID-19. Raul, a 34-year-old nurse, likely caught the disease while working in a nursing home. When the National Institutes of Health announced an emergency use authorization for the experimental antiviral drug remdesivir, Marissa scrambled friends and family on Facebook to figure out how to get access for Raul, emailing hospital administrators, senators, and doctors. They pressed the Guale family’s case for a potentially lifesaving treatment on social media to anyone who would listen.

Her confusion about where and how to get access to the drug isn’t unique. All over the country, families, doctors, and hospitals are wondering how to get the drug and on what basis it’s being distributed. The Trump administration, which is in charge of allocation, hasn’t published any guidance on how it’s making decisions about the scarce supplies of the drug.

So who decides which hospitals get remdesivir? And what’s the most ethical way to prioritize access?

Read more at The Daily Beast.




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9 Google Tricks For Better Search Results

Google is such a powerhouse search engine that it has not only injected itself into our everyday lives, it's even a verb now. But just because we Google things a lot doesn't mean that that we do it as effectively as possible. So here are some tips to help maximise and improve your Google search results. More »
    




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NASA's next Mars rover is called Perseverance and will search for life

Out of 28,000 suggestions, NASA selected the name Perseverance for its Mars 2020 rover, which will search for signs of life on the Red Planet




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Disney Research Makes Dynamic Robots Less Wiggly, More Lifelike

A new computational method allows robotic characters to perform fast motions without excessive vibrations




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AI Agents Startle Researchers With Unexpected Hide-and-Seek Strategies

The OpenAI project demonstrated "emergent behavior" by the AI players, including surfing



  • robotics
  • robotics/artificial-intelligence

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AI Faces Speed Bumps and Potholes on Its Road From the Research Lab to Everyday Use

Rigid IT departments and job-hopping data scientists are just two of the challenges that make implementing machine learning harder than you might think



  • robotics
  • robotics/artificial-intelligence

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We're at IROS 2019 to Bring You the Most Exciting Robotics Research From Around the World

As always, our coverage will feature the coolest, weirdest, and most interesting things that we find at this massive robotics conference




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Microsoft's AI Research Draws Controversy Over Possible Disinformation Use

Microsoft's AI could enable its popular chatbot to comment on news, but critics see a tool for spreading disinformation



  • robotics
  • robotics/artificial-intelligence

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Japanese Researchers Teaching Robots to Repair Themselves

Whether for maintenance or augmentation, robots that can use tools on themselves are more independent and capable




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Search for self-improvement leads to joga

Jodian Self is hanging out with some of the biggest names in pro sports these days — all from the comfort of her south Winnipeg home. The 52-year-old former physical education ...




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Research volunteers won't be told of their coronavirus genetic risk

Half a million people taking part in the UK Biobank, which gathers genetic information for researchers to study, won't be told if they turn out to be genetically vulnerable to the coronavirus




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Researchers find way to steal data via your power supply

Unlikely to happen but interesting idea




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Coronavirus found in semen of male coronavirus patients, Chinese researchers say

The novel coronavirus has been discovered in the semen of infected male individuals, according to Chinese researchers, potentially raising the prospect that the virus could potentially be sexually transmitted.






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Why the MOSAiC Expedition's Research Is So Vital to Climate Change Research

On a ship frozen in the Arctic, scientists have spent all winter to shed light on exactly how the world is changing




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Researchers Are Learning How Asian Elephants Think—in Order to Save Them

As the pachyderms increasingly clash with farmers and villagers over disappearing land, scientists study the way the animals' minds work




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How Scientists Are Keeping Irreplaceable Research Going During the COVID-19 Pandemic

The outbreak, and the travel bans and fears that come with it, have endangered long-running research projects




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Plasma medicine research highlights antibacterial effects and potential uses

As interest in the application of plasma medicine -- the use of low-temperature plasma (LTP) created by an electrical discharge to address medical problems -- continues to grow, so does the need for research advancements proving its capabilities and potential impacts on the health care industry. Across the world, many research groups are investigating plasma medicine for applications including cancer treatment and the accelerated healing of chronic wounds, among others.




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Inspired by cheetahs, researchers build fastest soft robots yet

Inspired by the biomechanics of cheetahs, researchers have developed a new type of soft robot that is capable of moving more quickly on solid surfaces or in the water than previous generations of soft robots. The new soft robotics are also capable of grabbing objects delicately -- or with sufficient strength to lift heavy objects.




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Neutralizing antibody; new virus details to aid vaccine research

The following is a brief roundup of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.




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Belgian, U.S. scientists look to llama in search for COVID-19 treatment

A llama called Winter could prove useful in the hunt for a treatment for COVID-19, according to U.S. and Belgian scientists who have identified a tiny particle that appears to block the new coronavirus.




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Police search for man after attempted rape of woman in Hoxton

Police are searching for a man they wish to speak to following the attempted rape of a woman in north-east London street.




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Beer sales slump staggering 82 per cent amid coronavirus crisis, research shows

Live coronavirus updates here




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Police issue lockdown fines to nighttime boat trippers after helicopter scrambled to search for them

Pair in Leicestershire reprimanded for illicit weekend venture which prompted police helicopter search




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Covid-19 screening data reassuring for frontline health workers, researchers say

Infection rates among NHS workers tested for Covid-19 were no higher for those treating patients face-to-face than for staff in non-clinical roles, a new study has found.




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Earth's insect population shrinks by more than a quarter in 30 years, researchers say

Earth's insect population has shrunk by 27 per cent in the past 30 years, researchers have found.




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Flamingos 'form long-lasting friendships and some behave like married couples', new research shows

Flamingos form long-lasting friendships and some "behave like married couples", according to new research.




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Nearly 18,000 more people could die of cancer due to impact of Covid-19, researchers warn

Nearly 18,000 more people could die from cancer over the next year in England due to the impact of coronavirus, experts have warned.




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Police search for man after alleged rape in central London

Police are searching for a man in connection with an alleged rape at Embankment in central London.