Biology subjects

Dietlein, F.

Publications and source records attributed to Dietlein, F..

6 recordsLinked to original sources

bioRxiv2025

Multi-modal characterization of transcriptional programs that drive metastatic cascades to solid sites and ascites in ovarian cancer

Ovarian high-grade serous carcinoma (HGSC) is characterized by extensive intra-peritoneal dissemination and tumor heterogeneity. In the metastatic cascade, tumors utilize several transcriptional programs to translocate and survive in distant tissues. Here, we analyzed multi-modal, real-world data from 350 tumor samples across 160 patients with HGSC to identify transcriptional programs that drive intra-peritoneal metastasis and heterogeneity. We identified nine transcriptional programs, including those regulating epithelial-mesenchymal transition and immune modulation and cytoskeletal reorganization, which shape distinct metastatic trajectories to solid and ascitic environments and are associated to treatment response. Our results reveal pronounced intra-patient transcriptional heterogeneity, which in some cases surpassed inter-patient heterogeneity, highlighting the importance of multi-site sampling for accurate prognostication and combinatorial treatments in HGSC. Our extensive characterization offers novel insights into intra-peritoneal metastasis with significant prognostic implications, reveals histomorphological biomarkers for patient stratification and paves the way for innovative therapeutic strategies aimed at impairing cancer cell adaptability and limiting metastasis.

cancer biology↗

bioRxiv2022

Mutational footprint of platinum chemotherapy in a secondary thyroid cancer

Although papillary thyroid carcinoma (PTC) is the most frequent endocrine tumor with a generally excellent prognosis, a patient developed a clinically aggressive PTC eleven years after receiving platinum chemotherapy for ovarian endometrioid adenocarcinoma. Germline and somatic analyses of multi-temporal and multi-regional molecular profiles indicated that ovarian and thyroid tumors did not share common genetic alterations. PTC tumors had driver events associated with aggressive PTC behavior, an RBPMS-NTRK3 fusion and a TERT promoter mutation. Spatial and temporal genomic heterogeneity analysis indicated a close link between anatomical locations and molecular patterns of PTC. Mutational signature analyses demonstrated a molecular footprint of platinum exposure, and that aggressive molecular drivers of PTC were linked to prior platinum-associated mutagenesis. This case provides a direct association between platinum chemotherapy exposure and secondary solid tumor evolution, in specific aggressive thyroid carcinoma, and suggests that uniform clinical assessments for secondary PTC after platinum chemotherapy may warrant further evaluation.

genomics↗

bioRxiv2021

Examining Batch Effect in Histopathology as a Distributionally Robust Optimization Problem

Computer vision (CV) approaches applied to digital pathology have informed biological discovery and development of tools to help inform clinical decision-making. However, batch effects in the images have the potential to introduce spurious confounders and represent a major challenge to effective analysis and interpretation of these data. Standard methods to circumvent learning such confounders include (i) application of image augmentation techniques and (ii) examination of the learning process by evaluating through external validation (e.g., unseen data coming from a comparable dataset collected at another hospital). Here, we show that the source site of a histopathology slide can be learned from the image using CV algorithms in spite of image augmentation, and we explore these source site predictions using interpretability tools. A CV model trained using Empirical Risk Minimization (ERM) risks learning this source-site signal as a spurious correlate in the weak-label regime, which we abate by using a training method with abstention. We find that a patch based classifier trained using abstention outperformed a model trained using ERM by 9.9, 10 and 19.4% F1 in the binary classification tasks of identifying tumor versus normal tissue in lung adenocarcinoma, Gleason score in prostate adenocarcinoma, and tumor tissue grade in clear cell renal cell carcinoma, respectively, at the expense of up to 80% coverage (defined as the percent of tiles not abstained on by the model). Further, by examining the areas abstained by the model, we find that the model trained using abstention is more robust to heterogeneity, artifacts and spurious correlates in the tissue. Thus, a method trained with abstention may offer novel insights into relevant areas of the tissue contributing to a particular phenotype. Together, we suggest using data augmentation methods that help mitigate a digital pathology models reliance on potentially spurious visual features, as well as selecting models that can identify features truly relevant for translational discovery and clinical decision support.

cancer biology↗

bioRxiv2021

Learning the mutational landscape of the cancer genome

An ongoing challenge to better understand and treat cancer is to distinguish neutral mutations, which do not affect tumor fitness, from those that provide a proliferative advantage. However, the variability of mutation rates has limited our ability to model patterns of neutral mutations and therefore identify cancer driver mutations. Here, we predict cancer-specific mutation rates genome-wide by leveraging deep neural networks to learn mutation rates within kilobase-scale regions and then refining these estimates to test for evidence of selection on combinations of mutations by comparing observed to expected mutation counts. We mapped mutation rates for 37 cancer types and used these maps to identify new putative drivers in understudied regions of the genome including cryptic alternative-splice sites, 5 untranslated regions and infrequently mutated genes. These results, available for exploration via web interface, indicate the potential for high-resolution neutral mutation models to empower further driver discovery as cancer sequencing cohorts grow.

cancer biology↗

bioRxiv2020

Clinical interpretation of integrative molecular profiles to guide precision cancer medicine

Individual tumor molecular profiling is routinely used to detect single gene-variant ("first-order") genomic alterations that may inform therapeutic actions -- for instance, a tumor with a BRAF p.V600E variant might be considered for RAF/MEK inhibitor therapy. Interactions between such first-order events (e.g., somatic-germline) and global molecular features (e.g. mutational signatures) are increasingly associated with clinical outcomes, but these "second order" alterations are not yet generally accounted for in clinical interpretation algorithms and knowledge bases. Here, we introduce the Molecular Oncology Almanac (MOAlmanac), a clinical interpretation algorithm paired with a novel underlying knowledge base to enable integrative interpretation of genomic and transcriptional cancer data for point-of-care treatment decision-making and translational hypothesis generation. We compared MOAlmanac to first-order interpretation methodology in multiple retrospective patient cohorts and observed that the inclusion of preclinical and inferential evidence as well as second-order molecular features increased the number of nominated clinical hypotheses. MOAlmanac also performed matchmaking between patient molecular profiles and cancer cell lines to further expand individualized clinical actionability. When applied to a prospective precision oncology trial cohort, MOAlmanac nominated a median of two therapies per patient and identified therapeutic strategies administered in 46% of patient profiles. Overall, we present a novel computational method to perform integrative clinical interpretation of individualized molecular profiles. MOAlmanc increases clinical actionability over conventional approaches by considering second-order molecular features and additional evidence sources, and is available as an open-source framework.

cancer biology↗

bioRxiv2018

Discovery of cancer driver genes based on nucleotide context

Many cancer genomes contain large numbers of somatic mutations, but few of these mutations drive tumor development. Current approaches to identify cancer driver genes are largely based on mutational recurrence, i.e. they search for genes with an increased number of nonsynonymous mutations relative to the local background mutation rate. Multiple studies have noted that the sensitivity of recurrence-based methods is limited in tumors with high background mutation rates, because passenger mutations dilute their statistical power. Here, we observe that passenger mutations tend to occur in characteristic nucleotide sequence contexts, while driver mutations follow a different distribution pattern determined by the location of functionally relevant genomic positions along the protein-coding sequence. To discover new cancer genes, we searched for genes with an excess of mutations in unusual nucleotide contexts that deviate from the characteristic context around passenger mutations. By applying this statistical framework to whole-exome sequencing data from 12,004 tumors, we discovered a long tail of novel candidate cancer genes with mutation frequencies as low as 1% and functional supporting evidence. Our results show that considering both the number and the nucleotide context around mutations helps identify novel cancer driver genes, particularly in tumors with high background mutation rates.

genetics↗