Characterisation of structural variation in breast. cancer genomes using paired-end sequencing on. the Illumina Genome Analyser

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1 Characterisation of structural variation in breast cancer genomes using paired-end sequencing on the Illumina Genome Analyser Phil Stephens Cancer Genome Project

2 Why is it important to study cancer?

3 Why is it important to study cancer? Causes of cancer How cancers develop Pathways involved

4 Why is it important to study cancer? Causes of cancer How cancers develop Pathways involved Development of tests for early detection

5 Why is it important to study cancer? Causes of cancer How cancers develop Pathways involved Development of tests for early detection New targets for anticancer drug development

6 Why is it important to study cancer? Causes of cancer How cancers develop Pathways involved Development of tests for early detection New targets for anticancer drug development Monitor whether treatment is working

7 Why is it important to study cancer? Causes of cancer How cancers develop Pathways involved Development of tests for early detection New targets for anticancer drug development Monitor whether treatment is working Personalised treatment of cancer

8 Why is it important to study cancer? Causes of cancer How cancers develop Pathways involved Development of tests for early detection New targets for anticancer drug development Monitor whether treatment is working Personalised treatment of cancer

9 Why is it important to study cancer? Causes of cancer How cancers develop Pathways involved Development of tests for early detection New targets for anticancer drug development Monitor whether treatment is working Personalised treatment of cancer

10 Challenges of studying solid tumours

11 Breast cancer spectral karyotype C/O Paul Edwards, Departments of Pathology and Oncology, University of Cambridge 73 Chromosomes, 37 structural abnormalities

12 Amplification MYC in Breast Cancer MYC Genomic location (Mb)

13 Point mutations & Indels Pre-cancerous lesion in situ cancer Invasive cancer Metastatic cancer

14 Point mutations & Indels Pre-cancerous lesion in situ cancer Invasive cancer Metastatic cancer ~20 Cancer causing mutations

15 Point mutations & Indels Pre-cancerous lesion in situ cancer Invasive cancer Metastatic cancer ~20 Cancer causing mutations 100,000 Passenger mutations

16 Pessimism around studying solid tumours

17 BRAF is an oncogene 70% of Melanoma T1799A V600E

18 BRAF is an oncogene 70% of Melanoma T1799A V600E BRAF is not important Melanoma

19 BRAF is an oncogene 70% of Melanoma T1799A V600E BRAF is not important Melanoma BRAF is not a good drug target

20 BRAF is an oncogene 70% of Melanoma T1799A V600E BRAF is not important Melanoma BRAF is not a good drug target Melanoma is too complex to treat effectively

21 Patient with malignant melanoma Courtesy of Dr Grant McArthur

22 Selective inhibitor of BRAF V600E (Plexxicon 4032) Courtesy of Dr Grant McArthur

23 Selective inhibitor of BRAF V600E (Plexxicon 4032) Before 15 days after Courtesy of Dr Grant McArthur

24 New sequencing technologies

25 Rearrangement characterisation

26 Summary of Illumina GA protocol 500bps Randomly shear DNA Size select Sequence from & ligate Illumina adaptors & amplify both ends

27 Summary of Illumina GA protocol 400 bps 37 bps 37 bps

28 Summary of Illumina GA protocol 400 bps 37 bps 37 bps Align reads to ref sequence MAQ algorithm Li Heng, Genome Res., Nov 2008

29 Correctly mapping paired end reads 400 bps 37 bps 37 bps Chromosome 11

30 Incorrectly mapping paired-end reads 400 bps 37 bps 37 bps Chromosome 11 Chromosome 8

31 PCR amplify in tumour and matched normal Somatic Germline Artefact T N T N T N

32 PCR amplify in tumour and matched normal Somatic Germline Artefact T N T N T N

33 PCR amplify in tumour and matched normal Somatic Germline Artefact T N T N T N 6 bps of microhomology at break

34 Structural variation screen 9 matched breast cancer cell lines 49.0 Gb total data 8.5 mean physical coverage

35 Illumina GA sequencing:- Broad objectives Structural variation Fusion genes Copy number changes Structure of amplicons

36 Breast cancer HCC38 spectral karyotype C/O Paul Edwards, Departments of Pathology and Oncology, University of Cambridge 73 Chromosomes, 37 structural abnormalities

37 Breast cancer HCC38 (Triple neg) 238 somatic structural variants

38 Breast cancer HCC38 (Triple neg) somatic structural variants Patterns of variation 0

39 What are these structural variants doing?

40 Copy number ~160 kb copy number increase Chromosome 3 position (Mb)

41 Copy number 164 kb tandem duplication T N Chromosome 3 position (Mb)

42 Copy number 164 kb tandem duplication Chromosome 3 position (Mb) SLC26A6/PRKAR2A in frame fusion gene SLC26A6 PRKAR2A (Exons 1-17) (Exons 4-11) 5 UTR 3 UTR

43 Copy number 164 kb tandem duplication Genomic PCR bps T N T N Chromosome 3 position (Mb) SLC26A6/PRKAR2A in frame fusion gene SLC26A6 PRKAR2A (Exons 1-17) (Exons 4-11) 5 UTR 3 UTR

44 Copy number 164 kb tandem duplication Genomic PCR bps T N T N Chromosome 3 position (Mb) SLC26A6/PRKAR2A in frame fusion gene FISH confirmation of tandem duplication SLC26A6 PRKAR2A (Exons 1-17) (Exons 4-11) 5 UTR 3 UTR

45 bps T N RT-PCR

46 bps T N RT-PCR

47 bps T N RT-PCR

48 bps T N RT-PCR Predicted 914 amino acid fusion protein MGLADASGPRDTQALLSATQAMDLRRRDYHMERPLLNQEHLEELGRWGSAPRTHQWRTWLQCSRARAYALLLQHLPVLVWLPRYPVRDWLLGDLLSGL SVAIMQLPQGLAYALLAGLPPVFGLYSSFYPVFIYFLFGTSRHISVGTFAVMSVMVGSVTESLAPQALNDSMINETARDAARVQVASTLSVLVGLFQVGLGLIH FGFVVTYLSEPLVRGYTTAAAVQVFVSQLKYVFGLHLSSHSGPLSLIYTVLEVCWKLPQSKVGTVVTAAVAGVVLVVVKLLNDKLQQQLPMPIPGELLTLIGAT GISYGMGLKHRFEVDVVGNIPAGLVPPVAPNTQLFSKLVGSAFTIAVVGFAIAISLGKIFALRHGYRVDSNQELVALGLSNLIGGIFQCFPVSCSMSRSLVQEST GGNSQVAGAISSLFILLIIVKLGELFHDLPKAVLAAIIIVNLKGMLRQLSDMRSLWKANRADLLIWLVTFTATILLNLDLGLVVAVIFSLLLVVVRTQMPHYSVLGQ VPDTDIYRDVAEYSEAKEVRGVKVFRSSATVYFANAEFYSDALKQRCGVDVDFLISQKKKLLKKQEQLKLKQLQKEEKLRKQAASPKGASVSINVNTSLEDMR SNNVEDCKMVIHPKTDEQRCRLQEACKDILLFKNLDQEQLSQVLDAMFERIVKADEHVIDQGDDGDNFYVIERGTYDILVTKDNQTRSVGQYDNRGSFGEL ALMYNTPRAATIVATSEGSLWGLDRVTFRRIIVKNNAKKRKMFESFIESVPLLKSLEVSERMKIVDVIGEKIYKDGERIITQGEKADSFYIIESGEVSILIRSRTKSN KDGGNQEVEIARCHKGQYFGELALVTNKPRAASAYAVGDVKCLVMDVQAFERLLGPCMDIMKRNISHYEEQLVKMFGSSVDLGNLGQStop

49 Five expressed in frame fusion genes 2 generated by tandem duplications 3 generated by large inversions

50 Very small rearrangements:- below the resolution of copy number graphs

51 Very small rearrangements:- below the resolution of copy number graphs T N 5 kb tandem duplication, spanned by 4 reads TNRC15:- In frame duplication exons 14 & 15

52 Different patterns of structural variation are emerging from other breast cancers

53 Patterns of somatic structural variation HCC38 HCC1937 HCC1954 Triple Neg BRCA1 null ERBB2 Positive

54 Patterns of somatic structural variation HCC38 HCC1937 HCC1954 Triple Neg BRCA1 null ERBB2 Positive

55 Patterns of somatic structural variation HCC38 HCC1937 HCC1954 Triple Neg BRCA1 null ERBB2 Positive

56 Copy number Complex patterns of structural variation Solexa copy number:- chromosome 6

57 Copy number Complex patterns of structural variation Tandem Duplication Solexa copy number:- chromosome 6

58 Copy number Complex patterns of structural variation Tandem Duplication Deletion & Tandem Duplication Solexa copy number:- chromosome 6

59 Copy number Complex patterns of structural variation t(6;7) translocation 10 8 Tandem Duplication t(6;7) translocation Deletion & Tandem Duplication Solexa copy number:- chromosome 6

60 Copy number Complex patterns of structural variation 10 8 t(6;7) translocation Tandem Duplication Inversion & Tandem Duplication & t(6;7) translocation t(6;7) translocation Deletion & Tandem Duplication Solexa copy number:- chromosome 6

61 Copy number Complex patterns of structural variation t(6;7) translocation Tandem Duplication Inversion & Tandem Duplication & t(6;7) translocation Inversion & Tandem Duplication & t(6;7) translocation t(6;7) translocation Deletion & Tandem Duplication Solexa copy number:- chromosome 6

62 Copy number Complex patterns of structural variation t(6;7) translocation Tandem Duplication Complex Complex Inversion & Tandem Duplication & t(6;7) translocation Inversion & Tandem Duplication & t(6;7) translocation t(6;7) translocation Deletion & Tandem Duplication Solexa copy number:- chromosome 6

63 Summary of breast cancer cell line data 9 breast cancer cell lines 1152 somatic rearrangements 16 In-frame fusion genes (15/16 expressed)

64 Structural variation screen on 15 primary breast cancers 2 Luminal A 2 Luminal B 3 Basal like 2 BRCA1 neg 2 BRCA2 neg 3 ERBB2 + 1 Lobular 66.6 Gb total data 7.4 mean physical coverage

65 199 somatic structural variants Triple negative

66 Triple negative somatic structural variants Patterns of variation

67 Triple negative somatic structural variants Patterns of variation

68 ERRB2 positive somatic structural variants Patterns of variation

69 ERRB2 positive somatic structural variants Patterns of variation

70 Luminal B expression somatic structural variants Patterns of variation

71 Invasive lobular carcinoma somatic structural variant Patterns of variation

72 Novel expressed in frame fusion gene

73 Novel expressed in frame fusion gene 16.8 Mb inversion

74 Novel expressed in frame fusion gene 16.8 Mb inversion

75 Novel expressed in frame fusion gene 16.8 Mb inversion

76 Novel expressed in frame fusion gene 16.8 Mb inversion

77 Novel expressed in frame fusion gene 16.8 Mb inversion

78 Novel expressed in frame fusion gene 16.8 Mb inversion

79 Novel expressed in frame fusion gene 16.8 Mb inversion

80 Very small rearrangements T N 3 kb deletion RB1:- Deletion Exon 13

81 Summary of primary breast cancer data 15 primary breast cancers 1014 Somatic rearrangements 10 In-frame fusion genes (5 expressed)

82 How do we identify the driver mutations?

83 How do we identify the driver mutations? 139 genes rearranged in more than one sample

84 How do we identify the driver mutations? 139 genes rearranged in more than one sample 22 gene fusions ~300 primary breast cancers FISH cdna PCR (Jorge Reis-Filho) (John Foekins)

85 Whole exome sequencing (Agilent Sure Select)

86 Whole exome sequencing (Agilent Sure Select) Shear genomic DNA, ligate Illumina adaptors Hybridise to baits that span exons & wash Sequence form both ends

87 Breast cancer samples (28 total) 21 x ER + HER2 6 x ER + HER2 + 3 x triple neg

88 Substitutions in known cancer genes PD3995a AKT1 E17K PD3995a NF1 G-1T PD3994a PIK3CA N345K PD3989a PIK3CA E545K PD3856a PIK3CA H1047R PD3857a PIK3CA H1047R PD3888a PIK3CA H1047R PD3983a PIK3CA H1047R PD3985a PIK3CA H1047R PD3992a PIK3CA H1047R PD3996a PTEN Y27D PD3991a TP53 G245S PD4002a TP53 H179Y PD3987a TP53 Y220C PD3986a TP53 G+1A PD3985a TP53 R306X

89 High confidence Indels Sample Gene Mutation PD3849a CDH1 V193X PD3984a MAP2K4 V151X PD3992a MAP2K4 I81X PD3989a PTEN L370X

90 High confidence Indels Sample Gene Mutation PD3849a CDH1 V193X PD3984a MAP2K4 V151X PD3992a MAP2K4 I81X PD3989a PTEN L370X PD3995a GATA3 N352X PD3988a GATA3 N352X PD4004a GATA3 Read through

91 Novel cancer genes

92 Novel cancer genes Integrating rearrangement and exome data 2 novel pathways deregulated in a large proportion of ER pos breast cancer

93 Potential applications in healthcare

94 Personalised Haematology Risk stratification Therapy duration Prediction of relapse Tumour cells Time (months)

95 Tumour-specific rearrangements

96 Plasma DNA Normal tissues Cancer DNA with tumour-specific mutation

97 Work flow Identify tumour-specific rearrangements from cancer DNA 2 weeks ~ 2,500

98 Work flow Identify tumour-specific rearrangements from cancer DNA 2 weeks ~ 2,500 Design & test quantitative assay for rearrangements 1 week 250

99 Work flow Identify tumour-specific rearrangements from cancer DNA 2 weeks ~ 2,500 Design & test quantitative assay for rearrangements Extract DNA from plasma (10-20mL blood sample) 1 week 250 ½ day 50

100 Work flow Identify tumour-specific rearrangements from cancer DNA 2 weeks ~ 2,500 Design & test quantitative assay for rearrangements Extract DNA from plasma (10-20mL blood sample) 1 week 250 ½ day 50 Quantify tumour DNA ½ day 50

101 Assay design

102 Detecting 1 copy of tumour genome

103 Serial measurements

104 Potential healthcare applications Monitoring tumour response to therapy in real-time Reduce toxicity, prevent drug wastage

105 Potential healthcare applications Monitoring tumour response to therapy in real-time Reduce toxicity, prevent drug wastage Identifying disease relapse before clinically evident Pre-emptive therapy

106 Potential healthcare applications Monitoring tumour response to therapy in real-time Reduce toxicity, prevent drug wastage Identifying disease relapse before clinically evident Pre-emptive therapy Choosing intensity of adjuvant therapy based on risk stratification

107 Potential healthcare applications Monitoring tumour response to therapy in real-time Reduce toxicity, prevent drug wastage Identifying disease relapse before clinically evident Pre-emptive therapy Choosing intensity of adjuvant therapy based on risk stratification Surrogate marker of cell kill in early phase clinical trials

108 Potential healthcare applications 100 Breast cancers 100 Colorectal cancers 100 Osteosarcomas

109 Conclusions Paired-end sequencing is an effective tool for characterising structural variation in complex cancer genomes

110 Conclusions Paired-end sequencing is an effective tool for characterising structural variation in complex cancer genomes The average breast cancer has ~ 100 somatic structural variants

111 Conclusions Paired-end sequencing is an effective tool for characterising structural variation in complex cancer genomes The average breast cancer has ~ 100 somatic structural variants The average breast cancer has ~1.0 expressed in-frame fusion gene

112 Conclusions Paired-end sequencing is an effective tool for characterising structural variation in complex cancer genomes The average breast cancer has ~ 100 somatic structural variants The average breast cancer has ~1.0 expressed in-frame fusion gene Exome sequencing will unveil a multitude of novel drug targets in the next few years

113 Conclusions Paired-end sequencing is an effective tool for characterising structural variation in complex cancer genomes The average breast cancer has ~ 100 somatic structural variants The average breast cancer has ~1.0 expressed in-frame fusion gene Exome sequencing will unveil a multitude of novel drug targets in the next few years That personalised cancer care is on the horizon

114 Conclusions Paired-end sequencing is an effective tool for characterising structural variation in complex cancer genomes The average breast cancer has ~ 100 somatic structural variants The average breast cancer has ~1.0 expressed in-frame fusion gene Exome sequencing will unveil a multitude of novel drug targets in the next few years That personalised cancer care is on the horizon, and if you are wealthy enough, already here!

115

SUPPLEMENTARY INFORMATION

SUPPLEMENTARY INFORMATION doi: 1.138/nature8645 Physical coverage (x haploid genomes) 11 6.4 4.9 6.9 6.7 4.4 5.9 9.1 7.6 125 Neither end mapped One end mapped Chimaeras Correct Reads (million ns) 1 75 5 25 HCC1187 HCC1395 HCC1599

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