Multiomics modeling of the immunome, transcriptome, microbiome, proteome and metabolome adaptations during human pregnancy.

MotivationMultiple biological clocks govern a healthy pregnancy. These biological mechanisms produce immunologic, metabolomic, proteomic, genomic and microbiomic adaptations during the course of pregnancy. Modeling the chronology of these adaptations during full-term pregnancy provides the frameworks for future studies examining deviations implicated in pregnancy-related pathologies including preterm birth and preeclampsia.ResultsWe performed a multiomics analysis of 51 samples from 17 pregnant women, delivering at term. The datasets included measurements from the immunome, transcriptome, microbiome, proteome and metabolome of samples obtained simultaneously from the same patients. Multivariate predictive modeling using the Elastic Net (EN) algorithm was used to measure the ability of each dataset to predict gestational age. Using stacked generalization, these datasets were combined into a single model. This model not only significantly increased predictive power by combining all datasets, but also revealed novel interactions between different biological modalities. Future work includes expansion of the cohort to preterm-enriched populations and in vivo analysis of immune-modulating interventions based on the mechanisms identified.Availability and implementationDatasets and scripts for reproduction of results are available through: https://nalab.stanford.edu/multiomics-pregnancy/.Supplementary informationSupplementary data are available at Bioinformatics online

Metabolomics for mitochondrial and cancer studies

AbstractMetabolomics, a high-throughput global metabolite analysis, is a burgeoning field, and in recent times has shown substantial evidence to support its emerging role in cancer diagnosis, cancer recurrence, and prognosis, as well as its impact in identifying novel cancer biomarkers and developing cancer therapeutics. Newly evolving advances in disease diagnostics and therapy will further facilitate future growth in the field of metabolomics, especially in cancer, where there is a dire need for sensitive and more affordable diagnostic tools and an urgency to develop effective therapies and identify reliable biomarkers to predict accurately the response to a therapy. Here, we review the application of metabolomics in cancer and mitochondrial studies and its role in enabling the understanding of altered metabolism and malignant transformation during cancer growth and metastasis. The recent developments in the area of metabolic flux analysis may help to close the gap between clinical metabolomics research and the development of cancer metabolome. In the era of personalized medicine with more and more patient specific targeted therapies being used, we need reliable, dynamic, faster, and yet sensitive biomarkers both to track the disease and to develop and evolve therapies during the course of treatment. Recent advances in metabolomics along with the novel strategies to analyze, understand, and construct the metabolic pathways opens this window of opportunity in a very cost-effective manner. This article is part of a Special Issue entitled: Bioenergetics of Cancer

Optimising outcomes for potentially resectable pancreatic cancer through personalised predictive medicine : the application of complexity theory to probabilistic statistical modeling

Survival outcomes for pancreatic cancer remain poor. Surgical resection with adjuvant therapy is the only potentially curative treatment, but for many people surgery is of limited benefit. Neoadjuvant therapy has emerged as an alternative treatment pathway however the evidence base surrounding the treatment of potentially resectable pancreatic cancer is highly heterogeneous and fraught with uncertainty and controversy. This research seeks to engage with conjunctive theorising by avoiding simplification and abstraction to draw on different kinds of data from multiple sources to move research towards a theory that can build a rich picture of pancreatic cancer management pathways as a complex system. The overall aim is to move research towards personalised realistic medicine by using personalised predictive modeling to facilitate better decision making to achieve the optimisation of outcomes. This research is theory driven and empirically focused from a complexity perspective. Combining operational and healthcare research methodology, and drawing on influences from complementary paradigms of critical realism and systems theory, then enhancing their impact by using Cilliers’ complexity theory ‘lean ontology’, an open-world ontology is held and both epistemic reality and judgmental relativity are accepted. The use of imperfect data within statistical simulation models is explored to attempt to expand our capabilities for handling the emergent and uncertainty and to find other ways of relating to complexity within the field of pancreatic cancer research. Markov and discrete-event simulation modelling uncovered new insights and added a further dimension to the current debate by demonstrating that superior treatment pathway selection depended on individual patient and tumour factors. A Bayesian Belief Network was developed that modelled the dynamic nature of this complex system to make personalised prognostic predictions across competing treatments pathways throughout the patient journey to facilitate better shared clinical decision making with an accuracy exceeding existing predictive models.Survival outcomes for pancreatic cancer remain poor. Surgical resection with adjuvant therapy is the only potentially curative treatment, but for many people surgery is of limited benefit. Neoadjuvant therapy has emerged as an alternative treatment pathway however the evidence base surrounding the treatment of potentially resectable pancreatic cancer is highly heterogeneous and fraught with uncertainty and controversy. This research seeks to engage with conjunctive theorising by avoiding simplification and abstraction to draw on different kinds of data from multiple sources to move research towards a theory that can build a rich picture of pancreatic cancer management pathways as a complex system. The overall aim is to move research towards personalised realistic medicine by using personalised predictive modeling to facilitate better decision making to achieve the optimisation of outcomes. This research is theory driven and empirically focused from a complexity perspective. Combining operational and healthcare research methodology, and drawing on influences from complementary paradigms of critical realism and systems theory, then enhancing their impact by using Cilliers’ complexity theory ‘lean ontology’, an open-world ontology is held and both epistemic reality and judgmental relativity are accepted. The use of imperfect data within statistical simulation models is explored to attempt to expand our capabilities for handling the emergent and uncertainty and to find other ways of relating to complexity within the field of pancreatic cancer research. Markov and discrete-event simulation modelling uncovered new insights and added a further dimension to the current debate by demonstrating that superior treatment pathway selection depended on individual patient and tumour factors. A Bayesian Belief Network was developed that modelled the dynamic nature of this complex system to make personalised prognostic predictions across competing treatments pathways throughout the patient journey to facilitate better shared clinical decision making with an accuracy exceeding existing predictive models

From Correlation to Causality: Does Network Information improve Cancer Outcome Prediction?

Motivation: Disease progression in cancer can vary substantially between patients. Yet, patients often receive the same treatment. Recently, there has been much work on predicting disease progression and patient outcome variables from gene expression in order to personalize treatment options. A widely used approach is high-throughput experiments that aim to explore predictive signature genes which would provide identification of clinical outcome of diseases. Microarray data analysis helps to reveal underlying biological mechanisms of tumor progression, metastasis, and drug-resistance in cancer studies. Despite first diagnostic kits in the market, there are open problems such as the choice of random gene signatures or noisy expression data. The experimental or computational noise in data and limited tissue samples collected from patients might furthermore reduce the predictive power and biological interpretability of such signature genes. Nevertheless, signature genes predicted by different studies generally represent poor similarity; even for the same type of cancer. Integration of network information with gene expression data could provide more efficient signatures for outcome prediction in cancer studies. One approach to deal with these problems employs gene-gene relationships and ranks genes using the random surfer model of Google's PageRank algorithm. Unfortunately, the majority of published network-based approaches solely tested their methods on a small amount of datasets, questioning the general applicability of network-based methods for outcome prediction. Methods: In this thesis, I provide a comprehensive and systematically evaluation of a network-based outcome prediction approach -- NetRank - a PageRank derivative -- applied on several types of gene expression cancer data and four different types of networks. The algorithm identifies a signature gene set for a specific cancer type by incorporating gene network information with given expression data. To assess the performance of NetRank, I created a benchmark dataset collection comprising 25 cancer outcome prediction datasets from literature and one in-house dataset. Results: NetRank performs significantly better than classical methods such as foldchange or t-test as it improves the prediction performance in average for 7%. Besides, we are approaching the accuracy level of the authors' signatures by applying a relatively unbiased but fully automated process for biomarker discovery. Despite an order of magnitude difference in network size, a regulatory, a protein-protein interaction and two predicted networks perform equally well. Signatures as published by the authors and the signatures generated with classical methods do not overlap -- not even for the same cancer type -- whereas the network-based signatures strongly overlap. I analyze and discuss these overlapping genes in terms of the Hallmarks of cancer and in particular single out six transcription factors and seven proteins and discuss their specific role in cancer progression. Furthermore several tests are conducted for the identification of a Universal Cancer Signature. No Universal Cancer Signature could be identified so far, but a cancer-specific combination of general master regulators with specific cancer genes could be discovered that achieves the best results for all cancer types. As NetRank offers a great value for cancer outcome prediction, first steps for a secure usage of NetRank in a public cloud are described. Conclusion: Experimental evaluation of network-based methods on a gene expression benchmark dataset suggests that these methods are especially suited for outcome prediction as they overcome the problems of random gene signatures and noisy expression data. Through the combination of network information with gene expression data, network-based methods identify highly similar signatures over all cancer types, in contrast to classical methods that fail to identify highly common gene sets across the same cancer types. In general allows the integration of additional information in gene expression analysis the identification of more reliable, accurate and reproducible biomarkers and provides a deeper understanding of processes occurring in cancer development and progression.:1 Definition of Open Problems 2 Introduction 2.1 Problems in cancer outcome prediction 2.2 Network-based cancer outcome prediction 2.3 Universal Cancer Signature 3 Methods 3.1 NetRank algorithm 3.2 Preprocessing and filtering of the microarray data 3.3 Accuracy 3.4 Signature similarity 3.5 Classical approaches 3.6 Random signatures 3.7 Networks 3.8 Direct neighbor method 3.9 Dataset extraction 4 Performance of NetRank 4.1 Benchmark dataset for evaluation 4.2 The influence of NetRank parameters 4.3 Evaluation of NetRank 4.4 General findings 4.5 Computational complexity of NetRank 4.6 Discussion 5 Universal Cancer Signature 5.1 Signature overlap – a sign for Universal Cancer Signature 5.2 NetRank genes are highly connected and confirmed in literature 5.3 Hallmarks of Cancer 5.4 Testing possible Universal Cancer Signatures 5.5 Conclusion 6 Cloud-based Biomarker Discovery 6.1 Introduction to secure Cloud computing 6.2 Cancer outcome prediction 6.3 Security analysis 6.4 Conclusion 7 Contributions and Conclusion

Knowledge Management Approaches for predicting Biomarker and Assessing its Impact on Clinical Trials

The recent success of companion diagnostics along with the increasing regulatory pressure for better identification of the target population has created an unprecedented incentive for the drug discovery companies to invest into novel strategies for stratified biomarker discovery. Catching with this trend, trials with stratified biomarker in drug development have quadrupled in the last decade but represent a small part of all Interventional trials reflecting multiple co-developmental challenges of therapeutic compounds and companion diagnostics. To overcome the challenge, varied knowledge management and system biology approaches are adopted in the clinics to analyze/interpret an ever increasing collection of OMICS data. By semi-automatic screening of more than 150,000 trials, we filtered trials with stratified biomarker to analyse their therapeutic focus, major drivers and elucidated the impact of stratified biomarker programs on trial duration and completion. The analysis clearly shows that cancer is the major focus for trials with stratified biomarker. But targeted therapies in cancer require more accurate stratification of patient population. This can be augmented by a fresh approach of selecting a new class of biomolecules i.e. miRNA as candidate stratification biomarker. miRNA plays an important role in tumorgenesis in regulating expression of oncogenes and tumor suppressors; thus affecting cell proliferation, differentiation, apoptosis, invasion, angiogenesis. miRNAs are potential biomarkers in different cancer. However, the relationship between response of cancer patients towards targeted therapy and resulting modifications of the miRNA transcriptome in pathway regulation is poorly understood. With ever-increasing pathways and miRNA-mRNA interaction databases, freely available mRNA and miRNA expression data in multiple cancer therapy have created an unprecedented opportunity to decipher the role of miRNAs in early prediction of therapeutic efficacy in diseases. We present a novel SMARTmiR algorithm to predict the role of miRNA as therapeutic biomarker for an anti-EGFR monoclonal antibody i.e. cetuximab treatment in colorectal cancer. The application of an optimised and fully automated version of the algorithm has the potential to be used as clinical decision support tool. Moreover this research will also provide a comprehensive and valuable knowledge map demonstrating functional bimolecular interactions in colorectal cancer to scientific community. This research also detected seven miRNA i.e. hsa-miR-145, has-miR-27a, has- miR-155, hsa-miR-182, hsa-miR-15a, hsa-miR-96 and hsa-miR-106a as top stratified biomarker candidate for cetuximab therapy in CRC which were not reported previously. Finally a prospective plan on future scenario of biomarker research in cancer drug development has been drawn focusing to reduce the risk of most expensive phase III drug failures