studying ghanaian cancer genomes using cell-free dna

1
Studying Ghanaian cancer genomes using cell-free DNA Purpose Methods Conclusion 9th Annual Symposium on Global Cancer Research, ASGCR, 2021 • Breast cancer is among the leading cause of death among Ghanaian women, where there is more frequent early onset diagnosis and late presentation compared to European populations 1 . • Analysis of cancer-related mutations in circulating tumor DNA (ctDNA) from cell-free DNA (cfDNA) that is shed into the bloodstream by tumor cells could be transformative to the African continent and provide new molecular insights as well as early detection strategies 2 . • Here, we detected circulating tumor DNA (ctDNA) and copy number profiles from peripheral blood of newly diagnosed breast cancer pa- tients in Ghana, Africa. Samuel Terkper Ahuno 1,2 , Anna-Lisa Doebley 3,4 , Thomas U. Ahearn 5 , Joel Yarney 6 , , Nicholas Titiloye 7 , Nancy Hamel 8 , Ernest Adjei 7 , Joe-Nat Clegg- Lamptey 6 , Lawrence Edusei 6 , Baffour Awuah 7 , Xiaoyu Song 8,9 , Verne Vander- puye 6 , Mustapha Abubakar 5 , Maire Duggan 11 , Daniel Stover 12,13 , Kofi Nyarko 14 , John M S Bartlet 15 , Francis Aitpillah 7 , Daniel Ansong 16 , Kevin L Gardner 17 , Felix Andy Boateng7, Anne M. Bowcock 2,10,18,19 , Carlos Caldas 20 , Wil- liam D. Foulkes 8,21,22 , Seth Wiafe 23 , Beatrice Wiafe-Addai 24 , Montserrat Garcia-Closas 5 , Alexander Kwarteng 1,25 , Gavin Ha 4*^ ,Jonine D. Figueroa 5,26*^ , Paz Polak 2,10,18*^ , on behalf of the Ghana Breast Health Study Team Results Figure 3: ctDNA fractions and patho-clinical characteristics Lorem ipsum p = 1 p = 0.91 Tumor_Fraction_ULPS Tumor_Fraction_30xWGS 2 3 2 3 0 10 20 30 0 10 20 30 Stage ctDNA fractions / % ctDNA fractions by stage ctDNA fraction (WGS - 30x): 1.8% P15 ER+/PR-/HER2- GU ctDNA fraction (WGS - 30x): 24.3% P01 ER-/PR-/HER2- G3 1.5 0 -1 1.5 0 -1 Copy neutral Deletion Gain Amplification 1 2 3 4 5 6 7 8 11 12 13 15 16 17 18 19 20 21 22 X 14 10 9 Chromosome ZNF703 (CN=6) MYC (CN=5) ZNF703 (CN=5) TERT (CN=4) Copy number (log2 ratio) R = 0.99 p = 5.4e−09 0 10 20 30 0 10 20 30 ctDNA fraction 0.1x ULPS / (%) ctDNA fraction 30x WGS / (%) Scatter plots of Tumor fractions (TFx) 0.1x & 30x WGS (n=12) (Pearson) 0 5 10 15 20 25 Luminal A 2.28% [0.56% − 4.71%] Luminal B 5.78% [5.78% − 5.78%] HER2−enriched 2.38% [1.19% − 3.57%] TNBC/basal 12.3% [9.38% − 13.2%] Molecular subtypes by Immunohistochemistry staining ctDNA fractions / % ctDNA fractions by subtypes sequenced at 0.1x WGS/ULPS Acknowledgement Authors information 1 Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi; 2 Departments of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York; 3 Molecular and Cellular Biology Program, University of Washington, Seattle, Washington, United States of Ameri- ca; 4 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; 5 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD; 6 Korle Bu Teaching Hospital, Accra, Ghana; 7 Komfo Anokye Teaching Hospital, Kumasi, Ghana; 8 Research Institute of the McGill University Health Centre, Montréal, QC, Canada; 9 Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; 10 Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA ; 11 Department of Pathology and Laboratory Medicine, University of Cal- gary, Calgary, AB, Canada; 12 Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA; 13 Division of Medical Oncology, Com- prehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA; 14 University of Ghana, Accra, Ghana; 15 Ontario Institute for Cancer Re- search, Toronto, Ontario, Canada; 16 Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 17 Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY 10027, USA; 18 Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York; 19 Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York; 20 Cancer Research UK Cam- bridge Centre, Cambridge, UK; 21 Lady Davis Institute and Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada; 22 Program in Cancer Genetics, De- partments of Oncology and Human Genetics, McGill University, Montréal, QC, Canada; 23 Loma Linda University, School of Public Health, Loma Linda, CA; 24 Peace and Love Hospital, Kumasi, Ghana; 25 Kumasi Center for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana; 26 Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, United Kingdom; * equal contribution; ^ corresponding authors: [email protected], [email protected]. paz.po- [email protected] Our data provide evidence that ctDNA-based genomic studies are possible using standardised prospective collections of blood and tumour tissues from low and middle-income countries (LMIC). Our analysis provides a framework for future molecular oncology studies in LMICs including Africa, for cancer etiology, surveillance, early detection and precision medicine clinical trials Cancer Genome Analysis On The Cloud Ghanaian women (n =15) with suspicion of breast cancer from Ghana Breast Health Study (GBHS) Figure 2: Genome-Wide copy number profiles 0.1x Whole Genome Sequencing (WGS) 30x Whole Genome Sequencing (WGS) cfDNA extraction Bioinformatics Analysis; Data processing (GATK) ctDNA fractions & Copy Number (IchorCNA) p = 0.65 0 10 20 30 50 years and above (5.90% [3.53%−10.9%]) < 50 years (5.51% [2.80%−6.18%]) Age at dignosis (years) ctDNA fractions / % ctDNA fractions by age sequenced at 0.1x WGS/ULPS p = 1 0 10 20 30 50 years and above (3.96% [2.54%−10.2%]) < 50 years (5.6% [2.45%−7.34%]) Age at dignosis (years) ctDNA fractions / % ctDNA fractions by age sequenced at 30x WGS 0 5 10 15 20 25 Luminal A 2.22% [2.03% − 4.77%] Luminal B 7.07% [7.07% − 7.07%] HER2−enriched 3.02% [2.55% − 3.49%] TNBC/basal 11.7% [8.66% − 14.5%] Tumor subtypes by Immunohistochemistry staining ctDNA fractions / % ctDNA fractions by subtypes sequenced at 30x WGS Genome-Wide copy number profiles Figure 4: High correla- tion between 0.1x WGS and 30x WGS ctDNA fractions Figure 1: cfDNA study design Figure 5: TNBCs have higher ctDNA fractions Figure 6: ctDNA fractions by tumor stage Figure 7: ctDNA fractions by age at diagnosis Email: [email protected]

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Page 1: Studying Ghanaian cancer genomes using cell-free DNA

Studying Ghanaian cancer genomes using cell-free DNA

Purpose

MethodsConclusion

9th Annual Symposium on Global Cancer Research, ASGCR, 2021

• Breast cancer is among the leading cause of death among Ghanaian women, where there is more frequent early onset diagnosis and late presentation compared to European populations1.

• Analysis of cancer-related mutations in circulating tumor DNA (ctDNA) from cell-free DNA (cfDNA) that is shed into the bloodstream by tumor cells could be transformative to the African continent and provide new molecular insights as well as early detection strategies2.

• Here, we detected circulating tumor DNA (ctDNA) and copy number profiles from peripheral blood of newly diagnosed breast cancer pa-tients in Ghana, Africa.

Samuel Terkper Ahuno1,2, Anna-Lisa Doebley3,4, Thomas U. Ahearn5, Joel Yarney6, , Nicholas Titiloye7, Nancy Hamel8, Ernest Adjei7, Joe-Nat Clegg- Lamptey6, Lawrence Edusei6 , Baffour Awuah7, Xiaoyu Song8,9, Verne Vander-puye6, Mustapha Abubakar5, Maire Duggan11, Daniel Stover12,13, Kofi Nyarko14, John M S Bartlet15, Francis Aitpillah7, Daniel Ansong16, Kevin L Gardner17, Felix Andy Boateng7, Anne M. Bowcock2,10,18,19, Carlos Caldas20, Wil-

liam D. Foulkes8,21,22, Seth Wiafe23, Beatrice Wiafe-Addai24, Montserrat Garcia-Closas5, Alexander Kwarteng1,25, Gavin Ha4*^,Jonine D. Figueroa5,26*^, Paz Polak2,10,18*^, on behalf of the Ghana Breast Health Study Team

Results

Figure 3: ctDNA fractions and patho-clinical characteristics

Lorem ipsum

p = 1 p = 0.91

Tumor_Fraction_ULPS Tumor_Fraction_30xWGS

2 3 2 30

10

20

30

0

10

20

30

Stage

ctD

NA

fract

ions

/ %

ctDNA fractions by stage

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2GBR05132_1000kb

Copy

Numb

er (lo

g2 ra

tio)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 20 22 X

Tumor Fraction: 0.01815, Ploidy: 2.27

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−2

−1

0

1

2GBR05352_1000kb

Copy

Numb

er (lo

g2 ra

tio)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 20 22 X

Tumor Fraction: 0.2427, Ploidy: 2.99Subclone Fraction: 0.421, Frac. Genome Subclonal: 0.07, Frac. CNA Subclonal: 0.12

ctDNA fraction (WGS - 30x): 1.8% P15 ER+/PR-/HER2- GU

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−2

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0

1

2GBR05352_1000kb

Copy

Numb

er (lo

g2 ra

tio)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 20 22 X

Tumor Fraction: 0.2427, Ploidy: 2.99Subclone Fraction: 0.421, Frac. Genome Subclonal: 0.07, Frac. CNA Subclonal: 0.12

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−2

−1

0

1

2GBR05352_1000kb

Copy

Numb

er (lo

g2 ra

tio)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 20 22 X

Tumor Fraction: 0.2427, Ploidy: 2.99Subclone Fraction: 0.421, Frac. Genome Subclonal: 0.07, Frac. CNA Subclonal: 0.12

ctDNA fraction (WGS - 30x): 24.3% P01 ER-/PR-/HER2- G3 1.5

0

-1

1.5

0

-1

Copy neutral Deletion Gain Amplification

1 2 3 4 5 6 7 8 11 12 13 15 16 1718

1920

2122

X14109Chromosome

ZNF703 (CN=6)MYC (CN=5)

ZNF703 (CN=5)TERT (CN=4)

Cop

y nu

mbe

r (l

og2

ratio

)

R = 0.99p = 5.4e−09

0

10

20

30

0 10 20 30ctDNA fraction 0.1x ULPS / (%)

ctD

NA

fract

ion

30x

WG

S / (

%)

Scatter plots of Tumor fractions (TFx) 0.1x & 30x WGS (n=12) (Pearson)

0

5

10

15

20

25

Luminal A 2.28%[0.56% − 4.71%]

Luminal B 5.78%[5.78% − 5.78%]

HER2−enriched2.38% [1.19% −

3.57%]

TNBC/basal12.3% [9.38% −

13.2%]Molecular subtypes by Immunohistochemistry staining

ctD

NA

fra

ctio

ns

/ %

ctDNA fractions by subtypes sequenced at 0.1x WGS/ULPS

Acknowledgement

Authors information1Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi; 2Departments of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York; 3Molecular and Cellular Biology Program, University of Washington, Seattle, Washington, United States of Ameri-ca; 4Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; 5Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD; 6Korle Bu Teaching Hospital, Accra, Ghana; 7Komfo Anokye Teaching Hospital, Kumasi, Ghana; 8Research Institute of the McGill University Health Centre, Montréal, QC, Canada; 9Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; 10Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA ; 11Department of Pathology and Laboratory Medicine, University of Cal-gary, Calgary, AB, Canada;12Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA; 13Division of Medical Oncology, Com-prehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA; 14University of Ghana, Accra, Ghana; 15Ontario Institute for Cancer Re-search, Toronto, Ontario, Canada; 16Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 17Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY 10027, USA; 18Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York; 19Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York;20Cancer Research UK Cam-bridge Centre, Cambridge, UK; 21Lady Davis Institute and Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada; 22Program in Cancer Genetics, De-partments of Oncology and Human Genetics, McGill University, Montréal, QC, Canada; 23Loma Linda University, School of Public Health, Loma Linda, CA;24Peace and Love Hospital, Kumasi, Ghana; 25Kumasi Center for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana; 26Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, United Kingdom; *equal contribution; ^corresponding authors: [email protected], [email protected]. [email protected]

Our data provide evidence that ctDNA-based genomic studies are possible using standardised prospective collections of blood and tumour tissues from low and middle-income countries (LMIC).

Our analysis provides a framework for future molecular oncology studies in LMICs including Africa, for cancer etiology, surveillance, early detection and precision medicine clinical trials

Cancer Genome Analysis On The Cloud

Ghanaian women (n =15) with suspicion of breast

cancer from Ghana Breast Health Study (GBHS)

Figure 2: Genome-Wide copy number profiles

0.1x Whole Genome Sequencing (WGS)30x Whole Genome Sequencing (WGS)

cfDNA extraction

Bioinformatics Analysis;Data processing (GATK)

ctDNA fractions & Copy Number (IchorCNA)

p = 0.65

0

10

20

30

50 years andabove (5.90%

[3.53%−10.9%])

< 50 years(5.51%

[2.80%−6.18%])Age at dignosis (years)

ctD

NA

fra

ctio

ns

/ %

ctDNA fractions by age sequenced at 0.1x WGS/ULPS

p = 1

0

10

20

30

50 years andabove (3.96%

[2.54%−10.2%])

< 50 years (5.6%[2.45%−7.34%])

Age at dignosis (years)

ctD

NA

frac

tions

/ %

ctDNA fractions by age sequenced at 30x WGS

0

5

10

15

20

25

Luminal A 2.22%[2.03% − 4.77%]

Luminal B 7.07%[7.07% − 7.07%]

HER2−enriched3.02% [2.55% −

3.49%]

TNBC/basal 11.7%[8.66% − 14.5%]

Tumor subtypes by Immunohistochemistry staining

ctD

NA

fra

ctio

ns

/ %

ctDNA fractions by subtypes sequenced at 30x WGS

Genome-Wide copy number profiles

Figure 4: High correla-tion between 0.1x WGS

and 30x WGS ctDNA fractions

Figure 1: cfDNA study design

Figure 5: TNBCs have higher ctDNA fractions

Figure 6: ctDNA fractions by tumor stage

Figure 7: ctDNA fractions by age at diagnosis

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