Abstract Background: Epithelial ovarian cancer (EOC), commonly known as ovarian cancer (OvCa), is the deadliest gynecological malignancy. High tumor expression of either NR3C1 mRNA (encoding the glucocorticoid receptor or GR) or GR protein (IHC) are associated with poor overall survival (OS) in patients (pts) with advanced stage OvCa. We hypothesized that high GR expression and associated GR transcriptional activity favor OvCa cell survival and chemotherapy resistance, thereby reducing OS. Here we investigated whether a GR transcriptome-based gene signature (GR-sig) would be a better prognosticator than tumor NR3C1 mRNA expression alone. Methods: mRNAs up- or downregulated >1.5 fold after glucocorticoid treatment (Dex) in one or both cultured OvCa cell lines (OVSAHO and HEYA8) were defined as differentially expressed genes (DEGs). DEGs were then identified in n=1247 unique OvCa microarrays from 15 publicly available Gene Expression Omnibus (GEO) datasets with matched pt OS (training set). We then used the OS data to train a Cox proportional hazards model. The “best subset selection” (BeSS) algorithm and bootstrap sampling identified those GR-regulated DEGs whose tumor mRNA expression correlated most significantly with pt OS, creating a GR-sig “risk score.” Subsequently, all n=522 microarray and n=374 RNA-seq publicly available samples from the OvCa TCGA were used as two independent validation sets. Microarray and RNA-seq data were normalized using the MAS5 and FPKM-UQ algorithms respectively. The two validation sets were independently stratified relative to the median training set risk score into low- and high-risk score groups. To examine the prognostic ability of NR3C1 mRNA expression alone, the median training set NR3C1 expression value was used to stratify validation set pts into low- and high-expression groups. In all cases, OS was estimated by the Kaplan-Meier method. Results: We identified n=2288 protein-coding DEGs in one or both cell lines. Of these genes, n=1251 were expressed in each GEO microarray sample (training set). A 10-gene GR-signature (GR-Sig) was then identified using the BeSS algorithm and bootstrap sampling, yielding a median training set risk score of 1.02. In both the microarray and RNA-seq validation datasets, the 10-gene GR-sig risk score was associated with significant OS differences between low- and high-risk score groups (microarray p = 0.018; RNA-seq p = 0.00049). In contrast, the OS difference between low- and high- NR3C1 mRNA expression groups did not reach significance (microarray p = 0.12; RNA-seq p = 0.28). Conclusion: In this retrospective analysis, a 10-gene GR-sig derived from OvCa GR-regulated DEGs performed better as a prognosticator than NR3C1 mRNA expression alone. Prospective application of the GR-sig may be useful in stratifying patients for treatment response with novel agents in OvCa clinical trials. Citation Format: Ananth V. Panchamukhi, Lei Huang, Eleanore P. Gray, Yuanhang Liu, Manisha Taya, Jennifer T. Veneris, Xiaonan Hou, S John Weroha, Balázs Győrffy, Gini F. Fleming, Chen Wang, Suzanne D. Conzen. Development of a prognostic ovarian cancer gene signature based on glucocorticoid receptor transcriptional activity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4739.
Abstract 6614: Small cell lung cancer (SCLC) at recurrence has a “colder” tumor microenvironment than primary SCLC according to gene expression profiling
Abstract Recent studies have described the tumor microenvironment and the key transcription factors in untreated small cell lung cancer (SCLC), but less is known about the salient features in recurrent SCLC (rSCLC). This information could provide valuable insight about the effectiveness of second and later line therapies. In this study, we compared transcriptome profiles (by RNA-seq) of rSCLC against untreated primaries (pSCLC). rSCLC samples (n=23) were obtained from frozen biopsies in patients enrolled in our MC1923 (NCT04607954) phase 2 clinical trial whose disease progressed after chemoimmunotherapy. The pSCLC group (n=73) included publicly available data from fresh frozen primary tumors after surgical resections. Normalized expression data were used in immune deconvolution and gene set enrichment analysis (GSEA) in molecular signature database. Additional GSEA included gene sets describing ASCL1 (A), NEUROD1 (N), ASCL1 and NEUROD1 (AN), and POU2F3 (P) transcription factor activities which are used for subtyping of SCLC. Immune deconvolutions by multiple software algorithms suggested depletion of immune infiltrates in rSCLC compared with pSCLC including dendritic cells, B cells, CD8+ T cells, and M1 macrophages. Furthermore, we found decreased chemotaxis and increased apoptosis of dendritic cells, reduced TNF signaling, and reduced lymphocyte co-stimulation in rSCLC by GSEA. Additionally, in comparisons with pSCLC, rSCLC tumors had significantly lower enrichment scores for POU2F3 activity, representing the SCLC-P subtype (p < 0.007). Importantly, the SCLC-P was recently reported to be more immune inflamed than the other A, N, and AN subtypes. Altogether, our analyses provide strong evidence that the tumor microenvironment of rSCLC is significantly more immunosuppressed and with reduced immune cell infiltrates compared to pSCLC. Developing therapeutic strategies aimed at “warming” the tumor microenvironment and enhancing anti-tumor immune activity in ongoing multimodal therapies of recurrent SCLC will likely provide significant benefits to patients. Citation Format: Farhad Kosari, Mohamed Ali, Sarah H. Johnson, Alex Adjei, Julian R. Molina, Aaron S. Mansfield, Anastasios Dimou, Kaushal Parikh, Mohamed Shanshal, Katherine E. Smith, Ailsa G. Luce, Anna J. Schwecke, Janet Lensing, Ying-Chun Lo, John C. Cheville, George Vasmatzis, Konstantinos Leventakos. Small cell lung cancer (SCLC) at recurrence has a “colder” tumor microenvironment than primary SCLC according to gene expression profiling [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6614.
Abstract 2035: Clinical-immunological correlates in platinum resistant or refractory ovarian cancer patients treated with chimeric oncolytic adenovirus encoding TNFa and IL-2 (TILT-123) in combination with pembrolizumab
Abstract Background: Ad5/3-E2F-D24-hTNFa-IRES-hIL-2 (TILT-123) is an oncolytic adenovirus armed with TNFa and IL-2. The cytokine pairing demonstrated superior tumor immunomodulation in preclinical studies. Subsequent studies supported evaluation of TILT-123 in PROTA, a phase 1 study of TILT-123 in combination with pembrolizumab in platinum resistant or refractory ovarian cancer patients. Biomarker analysis is ongoing. Experimental procedures: In this phase 1a dose escalation trial (NCT05271318), 15 patients received an initial single intravenous dose of TILT-123 ranging from 3x1011 to 4x1012 VPs, followed by intratumoural and/or intraperitoneal injections ranging from 1x1011 to 5x1011 VPs. Patients also received i.v. pembrolizumab (200mg) every three weeks starting on day 36. The primary endpoint was safety by day 92, while efficacy by RECIST1.1 and overall survival (OS) were secondary endpoints. Collection of tumour biopsies and blood, including PBMCs and serum, enabled evaluation of MoA and identification of preliminary biomarkers. Summary of data: ORR was 7.1% in evaluable patients (1/14). Disease control rate was 64% in evaluable patients (n = 14) and median OS was 190 days (n =15). Patients with disease control and no disease control by 92 achieved a median OS of 571 days and 138 days respectively. Correlations of complete blood count with differential to OS (n =15) and imaging response (n = 14) revealed a greater drop in lymphocyte count after treatment, as well as baseline lymphocyte count positively correlated with OS and disease control (PR/SD vs PD). Correlation of prothrombin INR to OS revealed patients with a slower blood-clotting rate at baseline and post-treatment positively correlated with OS. Analysis of anti-adenovirus neutralizing antibody (nAb) titer revealed 77% of all patients were positive for nAbs prior to treatment. All patients developed nAbs in blood and ascites (ascites n = 3). Patients presenting with nAbs at baseline achieved longer OS than those not positive. Additionally, a higher titer post-treatment positively correlated with OS and disease control. Percentage and fold change increase in IgM expression on plasma cells on day 36 positively correlated with OS. In addition, a higher expression of IgM on the surface of plasma cells at baseline was observed in patients achieving disease control. Conclusion: These preliminary results identify a key role of circulating lymphocyte re-distribution and humoral immune response as markers of treatment benefit. Initial phenotyping implicates IgM producing plasma cells as a potentially relevant immune cell population. Additionally we observed a correlation between the coagulation cascade and OS. Citation Format: James H. Clubb, Matthew Block, Johanna Mäenpää, Victor Arias, Mirte van der Heijden, Santeri Pakola, Dafne C. Quixabeira, Tatiana Kudling, Elise Jirovec, Lyna Haybout, Tuomo Alanko, Daniel Adamo, Susan Ramadan, Jorma Sormunen, Juha Kononen, Michael J. Chisamore, Julia W. Cohen, Nadena Singh, John Goldfinch, Suvi Sorsa, Riikka Havunen, Claudia Kistler, João M. Santos, Víctor Cervera-Carrascon, Akseli Hemminki. Clinical-immunological correlates in platinum resistant or refractory ovarian cancer patients treated with chimeric oncolytic adenovirus encoding TNFa and IL-2 (TILT-123) in combination with pembrolizumab [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 2035.
Electrochemical Catheter Hub Operated by a Wearable Micropotentiostat Prevents Acinetobacter baumannii Infection In Vitro
ABSTRACTIntraluminal infection of central venous catheters, used for long‐term treatment, can result in central line‐associated bloodstream infection (CLABSI). These infections can be challenging to prevent and treat due to formation of biofilms within catheter lumens, which shield bacteria from the human immune response and conventional antimicrobial therapies. Preventing bacterial colonization of catheter hubs is a strategy to prevent CLABSI. To address this, we developed a nonantibiotic, animal‐ready electrochemical catheter hub (e‐catheter hub), operated by a wearable, battery‐powered micropotentiostat (MP), that internally generates tunable hypochlorous acid (HOCl) for preventing intraluminal infection. The design evaluated three different electrode materials—titanium, platinum, and gold—for HOCl generation and biocidal activity, using working and counter electrodes of the same materials and a silver/silver chloride‐plated wire as a quasi‐reference electrode. e‐catheter hubs operated by MPs at 1.5 VAg/AgCl for 3 h generated HOCl, reducing Acinetobacter baumannii ATCC‐17978 below the detection limit (average reduction of 4.40 ± 0.05 log10 CFU/mL). The efficacy of e‐catheter hubs operated by MPs in generating HOCl and achieving biocidal activity is comparable to that of a commercial potentiostat. This study represents the first step in developing a localized, nonantibiotic strategy to mitigate CLABSI risk.
Peripheral Neuropathy in Myofibrillar Myopathies (MFM) and MFM Gene-related Myopathies (P2-11.033)
BACKGROUND: Spinal cord involvement is infrequently reported in primary central nervous system vasculitis (PCNSV). This study describes the clinical findings, therapeutic responses, and outcomes of spinal cord involvement in a large cohort of patients with PCNSV. METHODS: We retrospectively studied 216 consecutive patients with PCNSV evaluated at the Mayo Clinic from 1983 to 2023. Spinal cord involvement was documented by histological examination or imaging. The clinical, laboratory, radiological, and pathological findings, along with management and outcomes, were compared between patients with and without spinal cord involvement. RESULTS: Of 216 patients, 10 (4.6%) had spinal cord involvement, with cerebral involvement in 9 cases. One patient (0.5%) had isolated spinal cord vasculitis. Histological evidence of vasculitis was found in all 10, with necrotizing vasculitis in 5 (50%). Magnetic resonance imaging showed thoracic abnormalities in 8 patients, cervical spine involvement in 2, conus medullaris involvement in 3, and cauda equina enhancement in 4. Compared with the 206 patients without spinal cord involvement, those with spinal cord vasculitis were more likely to present with paraparesis/tetraparesis ( P <0.001) and necrotizing vasculitis ( P =0.01) and less likely with hemiparesis ( P =0.006) and granulomatous vasculitis ( P =0.03). Patients with spinal cord involvement were more likely to have at least 1 relapse ( P <0.001) or more ( P <0.001). No differences between the 2 groups were observed regarding long-term remission, therapy response, and high disability scores (modified Rankin Scale score, 4–6) or death at last follow-up. Spinal cord involvement was associated with meningeal enhancement on brain imaging (odds ratio, 10.50) and the presence of lymphoma (odds ratio, 6.49), specifically Hodgkin lymphoma diagnosed simultaneously with PCNSV. Spinal involvement was negatively associated with increasing age (odds ratio, 0.64) and cerebral infarction on imaging (odds ratio, 0.08). CONCLUSIONS: Spinal cord involvement defines a distinct subset of patients with PCNSV.
Single-cell multiomics reveals disrupted glial gene regulatory programs in Alzheimer’s disease via interpretable machine learning
ABSTRACT Recent development of single-cell technology across multiple omics platforms has provided new ways to obtain holistic views of cells to study disease pathobiology. Alzheimer’s disease (AD) is the most common form of dementia worldwide, yet the detailed understanding of its cellular and molecular mechanisms remains limited. In this study, we analyzed paired single-cell transcriptomic (scRNA-seq) and chromatin accessibility (scATAC-seq) data from the Seattle Alzheimer’s Disease Brain Cell Atlas (SEA-AD) Consortium to investigate the molecular mechanisms of AD at a cell-subpopulation-specific resolution focusing on glial cells. We benchmarked various multi-omics integration methods using diverse metrics and built an analytic workflow that enabled effective batch correction and cross-modality alignment, creating a unified cell state space. Through integrative analysis of 26 human brain samples, we uncovered AD-associated gene expression and pathway changes in glial subpopulations and highlighted important transcriptomic and epigenomic signatures via functional inference and interpretable machine learning paradigms, discovering the profound involvement of the Solute Carrier proteins (SLC) family genes in multiple glial cell types. We also identified glial cell-specific regulatory programs mediated by key transcription factors such as JUN and FOSL2 in astrocytes, the Zinc Finger (ZNF) family genes in microglia, and the SOX family of transcription factors in oligodendrocytes. Our study provides a comprehensive workflow and a high-resolution view of how glial regulatory programs are disrupted in AD. Our findings offer novel insights into disease-related changes in gene regulation and suggest potential targets for further research and therapy.
Copy Number Variation and Haplotype Analysis of 17q21.31 Reveals Increased Risk Associated with Progressive Supranuclear Palsy and Gene Expression Changes in Neuronal Cells
Abstract Background: Ovarian high-grade serous carcinomas (HGSC) comprise four distinct molecular subtypes based on mRNA expression patterns, with differential survival. Understanding risk factor associations is important to elucidate the etiology of HGSC. We investigated associations between different epidemiologic risk factors and HGSC molecular subtypes. Methods: We pooled data from 11 case–control studies with epidemiologic and tumor gene expression data from custom NanoString CodeSets developed through a collaboration within the Ovarian Tumor Tissue Analysis consortium. The PrOTYPE-validated NanoString-based 55-gene classifier was used to assign HGSC gene expression subtypes. We examined associations between epidemiologic factors and HGSC subtypes in 2,070 cases and 16,633 controls using multivariable-adjusted polytomous regression models. Results: Among the 2,070 HGSC cases, 556 (27%) were classified as C1.MES, 340 (16%) as C5.PRO, 538 (26%) as C2.IMM, and 636 (31%) as C4.DIF. The key factors, including oral contraceptive use, parity, breastfeeding, and family history of ovarian cancer, were similarly associated with all subtypes. Heterogeneity was observed for several factors. Former smoking [OR = 1.25; 95% confidence interval (CI) = 1.03, 1.51] and genital powder use (OR = 1.42; 95% CI = 1.08, 1.86) were uniquely associated with C2.IMM. History of endometriosis was associated with C5.PRO (OR = 1.46; 95% CI = 0.98, 2.16) and C4.DIF (OR = 1.27; 95% CI = 0.94, 1.71) only. Family history of breast cancer (OR = 1.44; 95% CI = 1.16, 1.78) and current smoking (OR = 1.40; 95% CI = 1.11, 1.76) were associated with C4.DIF only. Conclusions: This study observed heterogeneous associations of epidemiologic and modifiable factors with HGSC molecular subtypes. Impact: The different patterns of associations may provide key information about the etiology of the four subtypes.