Genomic evidence of pre-invasive clonal expansion, dispersal and progression in bronchial dysplasia

The term ‘field cancerization’ is used to describe an epithelial surface that has a propensity to develop cancerous lesions, and in the case of the aerodigestive tract this is often as a result of chronic exposure to carcinogens in cigarette smoke 1, 2. The clinical endpoint is the development of multiple tumours, either simultaneously or sequentially in the same epithelial surface. The mechanisms underlying this process remain unclear; one possible explanation is that the epithelium is colonized by a clonal population of cells that are at increased risk of progression to cancer. We now address this possibility in a short case series, using individual genomic events as molecular biomarkers of clonality. In squamous lung cancer the most common genomic aberration is 3q amplification. We use a digital PCR technique to assess the clonal relationships between multiple biopsies in a longitudinal bronchoscopic study, using amplicon boundaries as markers of clonality. We demonstrate that clonality can readily be defined by these analyses and confirm that field cancerization occurs at a pre-invasive stage and that pre-invasive lesions and subsequent cancers are clonally related. We show that while the amplicon boundaries can be shared between different biopsies, the degree of 3q amplification and the internal structure of the 3q amplicon varies from lesion to lesion. Finally, in this small cohort, the degree of 3q amplification corresponds to clinical progression. Copyright © 2011 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd

Elucidating drivers of oral epithelial dysplasia formation and malignant transformation to cancer using RNAseq

Oral squamous cell carcinoma (OSCC) is a prevalent cancer with poor prognosis. Most OSCC progresses via a non-malignant stage called dysplasia. Effective treatment of dysplasia prior to potential malignant transformation is an unmet clinical need. To identify markers of early disease, we performed RNA sequencing of 19 matched HPV negative patient trios: normal oral mucosa, dysplasia and associated OSCC. We performed differential gene expression, principal component and correlated gene network analysis using these data. We found differences in the immune cell signatures present at different disease stages and were able to distinguish early events in pathogenesis, such as upregulation of many HOX genes, from later events, such as down-regulation of adherens junctions. We herein highlight novel coding and non-coding candidates for involvement in oral dysplasia development and malignant transformation, and speculate on how our findings may guide further translational research into the treatment of oral dysplasia

La fantasía como partera de la historia : El rey de los espinos de Marcelo Figueras

La novela El rey de los espinos (2014) del escritor argentino Marcelo Figueras se ubica en una constelación de umbrales que ofrece una figura semejante a la del caleidoscopio. Definida como "novela de aventuras" por su autor, pero tributaria tanto del género fantástico como de la ciencia ficción, arrastra a los lectores a una serie de peripecias en las que se intersectan historias y estéticas provenientes del cómic con una radiografía del mundo contemporáneo. A partir de la configuración de héroes inesperados, el texto contrapone una utopía de índole social a un presente al que ya experimentamos cotidianamente como distópico.The novel El rey de los espinos (2014) by Argentine writer Marcelo Figueras is set in a constellation of thresholds that offers a figure like that of the kaleidoscope. Defined as an "adventure novel" by its author, though a tributary of both the fantastic genre and science fiction, it draws readers into a series of adventures in which stories and aesthetics from the comic strip intersect with an X-ray of the contemporary world. From the configuration of unexpected heroes, the novel opposes a social utopia to a present that we daily experience as dystopian.La novel·la El rey de los espinos (2014) de l'escriptor argentí Marcelo Figueras s'ubica en una constel·lació de llindars que ofereix una figura semblant a la del calidoscopi. Definida com a "novel·la d'aventures" pel seu autor, però tributàriatant del gènere fantàstic com de la ciència-ficció, arrossega els lectors a una sèrie de peripècies en què s'intersequen històries i estètiques provinents del còmic amb una radiografia del món contemporani. A partir de la configuració d'herois inesperats, el text contraposa una utopia d'índole social a un present que ja experimentem quotidianament com a distòpic

A non-cell autonomous mouse model of CNS haemangioblastoma mediated by mutant KRAS

Haemangioblastoma is a rare malignancy of the CNS where vascular proliferation causes lesions due to endothelial propagation. We found that conditionally expressing mutant Kras, using Rag1-Cre, gave rise to CNS haemangioblastoma in the cortex and cerebellum in mice that present with highly vascular tumours with stromal cells similar to human haemangioblastomas. The aberrant haemangioblastoma endothelial cells do not express mutant Kras but rather the mutant oncogene is expressed in CNS interstitial cells, including neuronal cells and progeny. This demonstrates a non-cell autonomous origin of this disease that is unexpectedly induced via Rag1-Cre expression in CNS interstitial cells. This is the first time that mutant RAS has been shown to stimulate non-cell autonomous proliferation in malignancy and suggests that mutant RAS can control endothelial cell proliferation in neo-vascularisation when expressed in certain cells.This work was supported by grants from the Medical Research Council (MR/J000612/1), the Wellcome Trust (099246/Z/12/Z) and Bloodwise (12051)

KRAS-specific inhibition using a DARPin binding to a site in the allosteric lobe.

Inhibiting the RAS oncogenic protein has largely been through targeting the switch regions that interact with signalling effector proteins. Here, we report designed ankyrin repeat proteins (DARPins) macromolecules that specifically inhibit the KRAS isoform by binding to an allosteric site encompassing the region around KRAS-specific residue histidine 95 at the helix α3/loop 7/helix α4 interface. We show that these DARPins specifically inhibit KRAS/effector interactions and the dependent downstream signalling pathways in cancer cells. Binding by the DARPins at that region influences KRAS/effector interactions in different ways, including KRAS nucleotide exchange and inhibiting KRAS dimerization at the plasma membrane. These results highlight the importance of targeting the α3/loop 7/α4 interface, a previously untargeted site in RAS, for specifically inhibiting KRAS function

Pharmacological inhibition of RAS overcomes FLT3 inhibitor resistance in FLT3-ITD+ AML through AP-1 and RUNX1

\ua9 2024 The Author(s). AML is characterized by mutations in genes associated with growth regulation such as internal tandem duplications (ITD) in the receptor kinase FLT3. Inhibitors targeting FLT3 (FLT3i) are being used to treat patients with FLT3-ITD+ but most relapse and become resistant. To elucidate the resistance mechanism, we compared the gene regulatory networks (GRNs) of leukemic cells from patients before and after relapse, which revealed that the GRNs of drug-responsive patients were altered by rewiring their AP-1-RUNX1 axis. Moreover, FLT3i induces the upregulation of signaling genes, and we show that multiple cytokines, including interleukin-3 (IL-3), can overcome FLT3 inhibition and send cells back into cycle. FLT3i leads to loss of AP-1 and RUNX1 chromatin binding, which is counteracted by IL-3. However, cytokine-mediated drug resistance can be overcome by a pan-RAS inhibitor. We show that cytokines instruct AML growth via the transcriptional regulators AP-1 and RUNX1 and that pan-RAS drugs bypass this barrier

Sequential screening for lung cancer in a high-risk group: randomised controlled trial

BACKGROUND: Low-dose CT (LDCT) screening detects early stage lung cancer and reduces mortality. We proposed a sequential approach targeted to a high-risk group as a potentially efficient screening strategy. METHODS: LungSEARCH was a national multicentre randomised trial. Current/former smokers with mild/moderate COPD were allocated (1:1) to have 5 years surveillance or not. Screened participants provided annual sputum samples for cytology and cytometry, and if abnormal were offered annual LDCT and autofluorescence bronchoscopy (AFB). Those with normal sputum provided annual samples. Primary endpoint was the percentage of lung cancers diagnosed at stage I/II (non-small cell) or limited disease (small cell). RESULTS: 1568 individuals were randomised 2007-2011, from 10 UK centres. 85.2% of those screened provided an adequate baseline sputum sample. There were 42 lung cancers among 785 screened and 36 among 783 controls. 54.8% (23/42) screened versus 45.2% (14/31) controls with known staging were diagnosed with early stage disease (one-sided p=0.24). Relative risk 1.21 (95%CI 0.75-1.95) or 0.82 (95%CI 0.52-1.31) for early stage or advanced cancers respectively. Overall sensitivity for sputum (in those randomised to surveillance) was low (40.5%) and cumulative false-positive rate (FPR) 32.8%. 55% of cancers had normal sputum results throughout. Among sputum-positive individuals who had AFB, sensitivity was 45.5% and cumulative FPR 39.5%; the corresponding measures for those who had LDCT were 100% and 16.1%. CONCLUSIONS: Our sequential strategy, using sputum cytology/cytometry to select high-risk individuals for AFB and LDCT, did not lead to a clear stage shift, and did not improve the efficiency of lung cancer screening