Tumor Fusion Burden as a Hallmark of Immune Infiltration in Prostate Cancer.

Prostate cancer is the second leading cause of cancer-related death in men. Despite having a relatively lower tumor mutational burden than most tumor types, multiple gene fusions such as TMPRSS2:ERG have been characterized and linked to more aggressive disease. Individual tumor samples have been found to contain multiple fusions, and it remains unknown whether these fusions increase tumor immunogenicity. Here, we investigated the role of fusion burden on the prevalence and expression of key molecular and immune effectors in prostate cancer tissue specimens that represented the different stages of disease progression and androgen sensitivity, including hormone-sensitive and castration-resistant prostate cancer. We found that tumor fusion burden was inversely correlated with tumor mutational burden and not associated with disease stage. High fusion burden correlated with high immune infiltration, PD-L1 expression on immune cells, and immune signatures, representing activation of T cells and M1 macrophages. High fusion burden inversely correlated with immune-suppressive signatures. Our findings suggest that high tumor fusion burden may be a more appropriate biomarker than tumor mutational burden in prostate cancer, as it more closely associates with immunogenicity, and suggests that tumors with high fusion burden could be potential candidates for immunotherapeutic agents.

Application of pharmacogenomics and bioinformatics to exemplify the utility of human ex vivo organoculture models in the field of precision medicine.

Here we describe a collaboration between industry, the National Health Service (NHS) and academia that sought to demonstrate how early understanding of both pharmacology and genomics can improve strategies for the development of precision medicines. Diseased tissue ethically acquired from patients suffering from chronic obstructive pulmonary disease (COPD), was used to investigate inter-patient variability in drug efficacy using ex vivo organocultures of fresh lung tissue as the test system. The reduction in inflammatory cytokines in the presence of various test drugs was used as the measure of drug efficacy and the individual patient responses were then matched against genotype and microRNA profiles in an attempt to identify unique predictors of drug responsiveness. Our findings suggest that genetic variation in CYP2E1 and SMAD3 genes may partly explain the observed variation in drug response.

A novel system for the investigation of microvascular dysfunction including vascular permeability and flow-mediated dilatation in pressurised human arteries.

INTRODUCTION: Adverse drug reactions may be manifested through changes in microvascular function (e.g. angioedema) or by subtle modification of the mechanisms controlling vascular tone, such as flow-mediated dilatation. Until now the early detection of such adverse drug reactions has been hampered by the lack of a predictive in vitro model. This in vitro model can be utilised to test potential effect of drugs on the normal responses of the vascular system. METHODS: The PM-1, a new automated perfusion myograph, allows detection of the external and internal dimensions of tubular biological structures and regulates both the intraluminal pressure and flow independently. Drugs can be infused intraluminally or extraluminally (by adding to the bathing solution) to determine effects on constriction, relaxation or modulation of vascular tone. The novel imaging system also facilitates the measurement of vascular permeability using dyes introduced intraluminally into the vessel. RESULTS: To assess effects on flow-mediated dilatation we increased flow rate in pressurised human subcutaneous arteries (<500mum diameter) in the absence and presence of various drugs. Increasing flow from 0.04ml/min to 0.3ml/min resulted in a 39+/-3% relaxation of a U46619 pre-constriction (10(-6)M). This was enhanced in the presence of Ivermectin and inhibited in the presence of 100microM L-NAME (316+/-169% and 16+/-1% respectively).To assess effects on vascular permeability we infused albumin-bound Evans blue dye through the lumen of human subcutaneous arteries as a marker, in the absence and presence of a modulatory drug. Infusion of thrombin (0.5units/ml) through the vessel lumen caused an 11.8% increase in vessel permeability compared to vehicle infusion. CONCLUSION: The development of the PM-1 allows new drugs to be tested in relevant human or animal tissues at an early stage allowing crucial go/no-go decisions to be made early in development and giving a more complete picture of the overall effects of test compounds on vascular function.