Bresalier, Robert S.

Abstract Given the morbidity and mortality associated with colorectal cancer, novel biomarkers are clearly warranted, especially for early detection, particularly for advanced adenomas. An earlier 1317-plex aptamer-based proteomic screen of stool proteins revealed 92 proteins to be significantly elevated in CRC stool, with the most discriminatory proteins being MMP9, haptoglobin, myeloperoxidase, fibrinogen, and adiponectin (PMID: 34117903). Results from a recent 2000-plex proteomic screen of CRC stools are detailed below, while a 11,000-plex aptamer based proteomic screen is in progress. Comprehensive proteomic screening revealed 116 proteins to be differentially expressed in CRC stool compared to control stool, with 45 being elevated 2-fold or higher. 37 of these proteins were ELISA validated in 3 independent cohorts. Stool MMP-8, MMP-9, Hemoglobin, PGRP-S, Haptoglobin, Myeloperoxidase and Fibrinogen emerged as being most discriminatory for distinguishing CRC from healthy controls (AUC: 0.91-0.95), while Stool Fibrinogen, MMP-9, Hemoglobin, MMP-8, and PGRP-S best distinguished advanced adenoma from healthy control (HC) stool, with stool Fibrinogen topping the list with an ROC AUC value of 0.86, as detailed in Table 1. Functional pathway analysis revealed a significant over-representation of pathways related to anti-oxidant activity, integrin/receptor binding, cytokines, blood coagulation, and lipoprotein biosynthesis in patients with CRC compared to HC. Nuclear Factor IC (NFIC) and IKZF2 were identified as key regulators of the molecular cascades over-represented in CRC. Stool Fibrinogen, MMP-8, MMP-9, PGRP-S, Haptoglobin, and Myeloperoxidase emerge as promising biomarkers for distinguishing CRC/advanced adenomas/healthy stools, outperforming Hemoglobin. Thus, comprehensive proteomics and independent ELISA validation have uncovered novel stool biomarkers for identifying CRC and advanced adenomas, that warrant further head to head comparison against current diagnostic tests. Citation Format: Chandra Mohan, Kamala Vanarsa, Jessica Castillo, Robert Bresalier, Nicholas Chia. 11,000-plex aptamer based proteomics of colorectal cancer stools for the discovery of novel disease biomarkers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1845.

AbstractThis article reviews progress in chemopreventive drug development, especially data and concepts that are new since the 2002 AACR report on treatment and prevention of intraepithelial neoplasia. Molecular biomarker expressions involved in mechanisms of carcinogenesis and genetic progression models of intraepithelial neoplasia are discussed and analyzed for how they can inform mechanism-based, molecularly targeted drug development as well as risk stratification, cohort selection, and end-point selection for clinical trials. We outline the concept of augmenting the risk, mechanistic, and disease data from histopathologic intraepithelial neoplasia assessments with molecular biomarker data. Updates of work in 10 clinical target organ sites include new data on molecular progression, significant completed trials, new agents of interest, and promising directions for future clinical studies. This overview concludes with strategies for accelerating chemopreventive drug development, such as integrating the best science into chemopreventive strategies and regulatory policy, providing incentives for industry to accelerate preventive drugs, fostering multisector cooperation in sharing clinical samples and data, and creating public-private partnerships to foster new regulatory policies and public education.