Abstract 1165: Complementary diagnostics for precision targeting of cellular pathways

Abstract

Abstract Precision medicine aims to tailor treatment to an individual patient through understanding the molecular basis of their disease. Targeted therapies have the potential to optimize responses and minimize side effects, while also offering savings to the healthcare system through tailoring treatment and avoiding futile therapies. Regimes are usually designed through identifying DNA-level alterations in the tumour and selecting drugs tailored to that mutation. However, cancer is not a one-pathway disease: not all patients with a particular mutational profile will respond to the same treatment, and patients without a canonical pathway-activating alteration will be excluded from potentially life-saving treatment. To address this, we developed a NanoString assay that combines proteomic and transcriptomic profiling of 4 key cancer-related, actionable pathways (MAPK, PI3K, NF-κB and JAK/STAT). Using RNA-Seq data from gold standard cell lines with defined changes in each pathway we generated minimal sets of genes indicative of pathway activation, and integrated this with total and phospho protein measurements to show pathway activation levels. The combined panel was run on a series of isogenic cell lines and glioma samples with both known and unknown driving alterations. Overall, pathway activation is more variable than would be predicted based on DNA alterations alone, with alternate pathway activation emerging as a potential new target and implying that consideration of proteomic and/or transcriptomic-level information will be important for future therapeutic decision-making. Citation Format: Robert Siddaway, Liana Nobre, Monique Johnson, Scott Milos, Scott Ryall, Javal Sheth, Uri Tabori, Cynthia Hawkins. Complementary diagnostics for precision targeting of cellular pathways [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1165.