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Time for a change: considering the rights of study participants to ownership of their personal research-grade genomic data 是时候做出改变了:考虑研究参与者对其个人研究级基因组数据的所有权
Pub Date : 2018-12-31 DOI: 10.1088/2057-1739/AAF822
Alice Lu, Peter Kuhn, I. Deichaite
Determining the ownership of a patient ’ s personal genomic data is important because it impacts how data is governed and shared, which has both clinical and research implications for precision oncology. The 21st Century Cures Act enacted in December 2016 defined the ownership of clinical genomic data, but the governance of research-grade genomic data remains a hotly contested topic. The many stakeholders often have competing perspectives about ownership of raw and processed genomic data derived in research settings and how to weigh risks versus benefits of sharing this data with study participants. A growing number of research studies, policy recommendations, and ethics reviews have not been enough to influence changes in practice. Most genomic research is conducted in academia, which is guided by Institutional Review Board-approved protocols to protect study participants. The current standard is to limit the return of research-grade data to study participants, and give data ownership solely to the researchers or the research institution, since this data is not vetted for clinical purposes and is meant for research use only. However, these practices conflict not only with recommendations from peer-reviewed literature on best practices for addressing research study participants ’ needs but might indeed run counter to legal and ethical guidelines about data ownership. For example, patient-participants faced with poorly understood or incurable diseases such as certain cancers want, and could potentially benefit from, having access to their personal genomic data in this rapidly evolving field. This commentary highlights the gap between the status quo as approved by the IRB and the literature suggesting that study participants should be given access to their personal genomic data. There is an opportunity to facilitate a more effective and ethical way to collect genomic data for research use across institutions.
确定患者个人基因组数据的所有权很重要,因为它影响数据的管理和共享方式,这对精确肿瘤学具有临床和研究意义。2016年12月颁布的《21世纪治愈法案》明确了临床基因组数据的所有权,但研究级基因组数据的治理仍然是一个激烈争论的话题。许多利益相关者通常对研究环境中获得的原始和处理过的基因组数据的所有权以及如何权衡与研究参与者共享这些数据的风险与收益有不同的看法。越来越多的研究、政策建议和伦理审查不足以影响实践中的变化。大多数基因组研究是在学术界进行的,由机构审查委员会批准的协议指导,以保护研究参与者。目前的标准是限制将研究级数据返回给研究参与者,并将数据所有权完全授予研究人员或研究机构,因为这些数据未经临床目的审查,仅用于研究用途。然而,这些做法不仅与同行评议文献中关于解决研究参与者需求的最佳做法的建议相冲突,而且可能确实违反了有关数据所有权的法律和道德准则。例如,在这个快速发展的领域中,面对知之甚少或无法治愈的疾病(如某些癌症)的患者参与者希望获得他们的个人基因组数据,并且可能从中受益。这篇评论强调了IRB批准的现状与建议研究参与者应该获得其个人基因组数据的文献之间的差距。有机会促进一种更有效和道德的方式来收集跨机构研究使用的基因组数据。
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引用次数: 0
Meeting report: The physics of life—merging clinical, biological and physical sciences approaches for cancer research 会议报告:癌症研究中融合生命的临床、生物和物理科学方法的物理学
Pub Date : 2018-09-19 DOI: 10.1088/2057-1739/AADF5D
Kat Arney
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引用次数: 0
Changing cell mechanics—a precondition for malignant transformation of oral squamous carcinoma cells 改变细胞机制——口腔鳞状癌细胞恶性转化的先决条件
Pub Date : 2018-06-27 DOI: 10.1088/2057-1739/aac72d
F. Meinhoevel, R. Stange, J. Schnauss, M. Sauer, J. Kaes, T. Remmerbach
Oral squamous cell carcinomas (OSCC) are the 6th most common cancer and the diagnosis is often belated for a curative treatment. The reliable and early differentiation between healthy and diseased cells is the main aim of this study in order to improve the quality of the treatment and to understand tumour pathogenesis. Here, the optical stretcher is used to analyse mechanical properties of cells and their potential to serve as a marker for malignancy. Stretching experiments revealed for the first time that cells of primary OSCCs were deformed by 2.9 % rendering them softer than cells of healthy mucosa which were deformed only by 1.9 %. Furthermore, the relaxation behaviour of the cells revealed that these malignant cells exhibit a faster contraction than their benign counterparts. This suggests that deformability as well as relaxation behaviour can be used as distinct parameters to evaluate emerging differences between these benign and malignant cells. Since many studies in cancer research are performed with cancer cell lines rather than primary cells, we have compared the deformability and relaxation of both types, showing that long time culturing leads to softening of cells. The higher degree of deformability and relaxation behaviour can enable cancer cells to traverse tissue emphasizing that changes in cell architecture may be a potential precondition for malignant transformation. Respecting the fact that even short culture times have an essential effect on the significance of the results, the use of primary cells for further research is recommended. The distinction between malignant and benign cells would enable an early confirmation of cancer diagnoses by testing cell samples of suspect oral lesions.
口腔鳞状细胞癌(OSCC)是癌症中第六常见的癌症,其诊断往往迟于治疗。本研究的主要目的是在健康和患病细胞之间进行可靠和早期的分化,以提高治疗质量并了解肿瘤的发病机制。在这里,光学拉伸器用于分析细胞的机械特性及其作为恶性肿瘤标志物的潜力。拉伸实验首次显示,原代OSCCs的细胞变形2.9%,使其比仅变形1.9%的健康粘膜的细胞更软。此外,细胞的松弛行为表明,这些恶性细胞比良性细胞表现出更快的收缩。这表明,可变形性和松弛行为可以作为不同的参数来评估这些良性和恶性细胞之间出现的差异。由于癌症研究中的许多研究是用癌症细胞系而不是原代细胞进行的,我们比较了这两种类型的变形性和松弛性,表明长时间培养会导致细胞软化。更高程度的可变形性和松弛行为可以使癌症细胞穿过组织,强调细胞结构的变化可能是恶性转化的潜在先决条件。考虑到即使是短的培养时间也会对结果的重要性产生重要影响,建议使用原代细胞进行进一步研究。通过检测可疑口腔病变的细胞样本,恶性细胞和良性细胞之间的区别将使癌症诊断得到早期确认。
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引用次数: 8
Heterogeneous radiotherapy dose-outcomes response in parotid glands 腮腺异质放疗剂量-结果反应
Pub Date : 2018-06-18 DOI: 10.1088/2057-1739/AAC8EA
H. Clark, S. Thomas, S. Reinsberg, V. Moiseenko, A. Hovan, Jonn Wu
Parotid glands are treated clinically as though the distribution of functional burden were homogeneous. Radiotherapy treatments are planned using whole parotid mean dose to predict risk of salivary dysfunction. Recent progress has identified specific parotid non-homogeneities by demonstrating the existence of regional, bath-and-shower, and dose-volume effects. In this and shape within the parotid while also accounting for differing parotid morphology across the population. Exact adjacency is forfeited in order to reduce travel when the parotid contour is deformed. This results in robustness to contouring perturbations. The segmentation order was chosen to be straightforward to apply clinically.
腮腺在临床上的治疗,好像功能负担的分布是均匀的。放射治疗计划使用整个腮腺的平均剂量来预测唾液功能障碍的风险。最近的进展通过证明区域、沐浴和淋浴以及剂量-体积效应的存在,确定了腮腺的特异性非均质性。在腮腺内的形状同时也解释了不同人群的腮腺形态。当腮腺轮廓变形时,为了减少行程,放弃了精确的邻接。这导致了对轮廓扰动的鲁棒性。分割顺序的选择是为了直接应用于临床。
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引用次数: 5
Clonal diversity revealed by morphoproteomic and copy number profiles of single prostate cancer cells at diagnosis. 诊断时单个前列腺癌细胞的形态蛋白组和拷贝数图谱揭示了克隆多样性。
Pub Date : 2018-03-01 Epub Date: 2018-01-16 DOI: 10.1088/2057-1739/aaa00b
Paymaneh D Malihi, Michael Morikado, Lisa Welter, Sandy T Liu, Eric T Miller, Radu M Cadaneanu, Beatrice S Knudsen, Michael S Lewis, Anders Carlsson, Carmen Ruiz Velasco, Anand Kolatkar, Mariam Rodriguez-Lee, Isla P Garraway, James Hicks, Peter Kuhn

Tumor heterogeneity is prevalent in both treatment-naïve and end-stage metastatic castration-resistant prostate cancer (PCa), and may contribute to the broad range of clinical presentation, treatment response, and disease progression. To characterize molecular heterogeneity associated with de novo metastatic PCa, multiplatform single cell profiling was performed using high definition single cell analysis (HD-SCA). HD-SCA enabled morphoproteomic and morphogenomic profiling of single cells from touch preparations of tissue cores (prostate and bone marrow biopsies) as well as liquid samples (peripheral blood and bone marrow aspirate). Morphology, nuclear features, copy number alterations, and protein expression were analyzed. Tumor cells isolated from prostate tissue touch preparation (PTTP) and bone marrow touch preparation (BMTP) as well as metastatic tumor cells (MTCs) isolated from bone marrow aspirate were characterized by morphology and cytokeratin expression. Although peripheral blood was examined, circulating tumor cells were not definitively observed. Targeted proteomics of PTTP, BMTP, and MTCs revealed cell lineage and luminal prostate epithelial differentiation associated with PCa, including co-expression of EpCAM, PSA, and PSMA. Androgen receptor expression was highest in MTCs. Hallmark PCa copy number alterations, including PTEN and ETV6 deletions and NCOA2 amplification, were observed in cells within the primary tumor and bone marrow biopsy samples. Genomic landscape of MTCs revealed to be a mix of both primary and bone metastatic tissue. This multiplatform analysis of single cells reveals several clonal origins of metastatic PCa in a newly diagnosed, untreated patient with polymetastatic disease. This case demonstrates that real-time molecular profiling of cells collected through prostate and bone marrow biopsies is feasible and has the potential to elucidate the origin and evolution of metastatic tumor cells. Altogether, biological and genomic data obtained through longitudinal biopsies can be used to reveal the properties of PCa and can impact clinical management.

肿瘤异质性在治疗无效和晚期转移性去势抵抗性前列腺癌(PCa)中都很普遍,这可能是导致临床表现、治疗反应和疾病进展范围广泛的原因之一。为了描述与新发转移性前列腺癌相关的分子异质性,我们使用高清单细胞分析(HD-SCA)进行了多平台单细胞分析。HD-SCA 能够对来自组织核(前列腺和骨髓活检组织)和液体样本(外周血和骨髓穿刺液)的单细胞进行形态蛋白组学和形态发生组学分析。对形态、核特征、拷贝数改变和蛋白质表达进行了分析。从前列腺组织切片制备物(PTTP)和骨髓切片制备物(BMTP)中分离出的肿瘤细胞以及从骨髓穿刺液中分离出的转移性肿瘤细胞(MTCs)通过形态学和细胞角蛋白的表达进行了定性。虽然对外周血进行了检查,但并未明确观察到循环肿瘤细胞。PTTP、BMTP 和 MTCs 的靶向蛋白质组学显示了与 PCa 相关的细胞系和管腔前列腺上皮分化,包括 EpCAM、PSA 和 PSMA 的共表达。雄激素受体的表达在 MTC 中最高。在原发肿瘤细胞和骨髓活检样本中观察到了标志性的 PCa 拷贝数改变,包括 PTEN 和 ETV6 缺失以及 NCOA2 扩增。MTCs 的基因组图谱显示,它是原发组织和骨转移组织的混合体。这种对单个细胞的多平台分析揭示了一名新诊断的、未经治疗的多转移性 PCa 患者的多个转移性 PCa 克隆起源。该病例表明,对通过前列腺和骨髓活检收集到的细胞进行实时分子分析是可行的,而且有可能阐明转移性肿瘤细胞的起源和演变。总之,通过纵向活检获得的生物和基因组数据可用来揭示 PCa 的特性,并对临床治疗产生影响。
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引用次数: 0
Multiplex protein detection on circulating tumor cells from liquid biopsies using imaging mass cytometry. 利用成像质谱仪对液体活检中的循环肿瘤细胞进行多重蛋白质检测。
Pub Date : 2018-03-01 Epub Date: 2018-01-16 DOI: 10.1088/2057-1739/aaa013
Erik Gerdtsson, Milind Pore, Jana-Aletta Thiele, Anna Sandström Gerdtsson, Paymaneh D Malihi, Rafael Nevarez, Anand Kolatkar, Carmen Ruiz Velasco, Sophia Wix, Mohan Singh, Anders Carlsson, Amado J Zurita, Christopher Logothetis, Akil A Merchant, James Hicks, Peter Kuhn

Molecular analysis of circulating and disseminated tumor cells (CTCs/DTCs) has great potential as a means for continuous evaluation of prognosis and treatment efficacy in near-real time through minimally invasive liquid biopsies. To realize this potential, however, methods for molecular analysis of these rare cells must be developed and validated. Here, we describe the integration of imaging mass cytometry (IMC) using metal-labeled antibodies as implemented on the Fluidigm Hyperion Imaging System into the workflow of the previously established High Definition Single Cell Analysis (HD-SCA) assay for liquid biopsies, along with methods for image analysis and signal normalization. Using liquid biopsies from a metastatic prostate cancer case, we demonstrate that IMC can extend the reach of CTC characterization to include dozens of protein biomarkers, with the potential to understand a range of biological properties that could affect therapeutic response, metastasis and immune surveillance when coupled with simultaneous phenotyping of thousands of leukocytes.

循环和播散肿瘤细胞(CTCs/DTCs)的分子分析作为一种通过微创液体活检近实时连续评估预后和治疗效果的手段,具有巨大的潜力。然而,要实现这一潜力,必须开发并验证对这些罕见细胞进行分子分析的方法。在这里,我们介绍了使用金属标记抗体的成像质控细胞仪(IMC)在 Fluidigm Hyperion 成像系统上的应用,以及图像分析和信号归一化的方法。通过使用转移性前列腺癌病例的液体活检,我们证明了 IMC 能将 CTC 特征描述的范围扩大到数十种蛋白质生物标记物,并能同时对数千个白细胞进行表型,从而了解可能影响治疗反应、转移和免疫监视的一系列生物特性。
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引用次数: 0
Secondary use of electronic medical records for clinical research: Challenges and Opportunities. 电子病历在临床研究中的二次使用:挑战与机遇。
Pub Date : 2018-03-01 Epub Date: 2018-02-12 DOI: 10.1088/2057-1739/aaa905
Wen-Wai Yim, Amanda J Wheeler, Catherine Curtin, Todd H Wagner, Tina Hernandez-Boussard

With increasingly ubiquitous electronic medical record (EMR) implementation accelerated by the adoption of the HITECH Act, there is much interest in the secondary use of collected data to improve outcomes and promote personalized medicine. A plethora of research has emerged using EMRs to investigate clinical research questions and assess variations in both treatments and outcomes. However, whether because of genuine complexities of modeling disease physiology or because of practical problems regarding data capture, data accuracy, and data completeness, the state of current EMR research is challenging and gives rise to concerns regarding study accuracy and reproducibility. This work explores challenges in how different experimental design decisions can influence results using a specific example of breast cancer patients undergoing excision and reconstruction surgeries from EMRs in an academic hospital and the Veterans Health Administration (VHA) We discuss emerging strategies that will mitigate these limitations, including data sharing, application of natural language processing, and improved EMR user design.

随着越来越普遍的电子病历(EMR)的实施加速了HITECH法案的通过,人们对二次使用收集的数据来改善结果和促进个性化医疗很感兴趣。大量的研究已经出现,使用电子病历来调查临床研究问题并评估治疗和结果的变化。然而,无论是由于疾病生理学建模的真正复杂性,还是由于数据捕获、数据准确性和数据完整性方面的实际问题,当前EMR研究的状态具有挑战性,并引起了对研究准确性和可重复性的担忧。本研究以一家学术医院和退伍军人健康管理局(VHA)的EMR为例,探讨了不同实验设计决策如何影响结果的挑战。我们讨论了减轻这些限制的新兴策略,包括数据共享、自然语言处理的应用和改进的EMR用户设计。
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引用次数: 13
A Brownian dynamics tumor progression simulator with application to glioblastoma. 一种应用于胶质母细胞瘤的布朗动力学肿瘤进展模拟器。
Pub Date : 2018-03-01 Epub Date: 2018-01-03 DOI: 10.1088/2057-1739/aa9e6e
Rebecca L Klank, Steven S Rosenfeld, David J Odde

Tumor progression modeling offers the potential to predict tumor-spreading behavior to improve prognostic accuracy and guide therapy development. Common simulation methods include continuous reaction-diffusion (RD) approaches that capture mean spatio-temporal tumor spreading behavior and discrete agent-based (AB) approaches which capture individual cell events such as proliferation or migration. The brain cancer glioblastoma (GBM) is especially appropriate for such proliferation-migration modeling approaches because tumor cells seldom metastasize outside of the central nervous system and cells are both highly proliferative and migratory. In glioblastoma research, current RD estimates of proliferation and migration parameters are derived from computed tomography or magnetic resonance images. However, these estimates of glioblastoma cell migration rates, modeled as a diffusion coefficient, are approximately 1-2 orders of magnitude larger than single-cell measurements in animal models of this disease. To identify possible sources for this discrepancy, we evaluated the fundamental RD simulation assumptions that cells are point-like structures that can overlap. To give cells physical size (~10 μm), we used a Brownian dynamics approach that simulates individual single-cell diffusive migration, growth, and proliferation activity via a gridless, off-lattice, AB method where cells can be prohibited from overlapping each other. We found that for realistic single-cell parameter growth and migration rates, a non-overlapping model gives rise to a jammed configuration in the center of the tumor and a biased outward diffusion of cells in the tumor periphery, creating a quasi-ballistic advancing tumor front. The simulations demonstrate that a fast-progressing tumor can result from minimally diffusive cells, but at a rate that is still dependent on single-cell diffusive migration rates. Thus, modeling with the assumption of physically-grounded volume conservation can account for the apparent discrepancy between estimated and measured diffusion of GBM cells and provide a new theoretical framework that naturally links single-cell growth and migration dynamics to tumor-level progression.

肿瘤进展模型提供了预测肿瘤扩散行为的潜力,以提高预后准确性并指导治疗发展。常见的模拟方法包括捕获平均时空肿瘤扩散行为的连续反应扩散(RD)方法和捕获单个细胞事件(如增殖或迁移)的基于离散试剂的(AB)方法。脑癌症胶质母细胞瘤(GBM)特别适用于这种增殖迁移建模方法,因为肿瘤细胞很少转移到中枢神经系统之外,并且细胞具有高度增殖和迁移性。在胶质母细胞瘤研究中,目前对增殖和迁移参数的RD估计来自计算机断层扫描或磁共振图像。然而,这些以扩散系数建模的胶质母细胞瘤细胞迁移率的估计值比该疾病动物模型中的单细胞测量值大大约1-2个数量级。为了确定这种差异的可能来源,我们评估了基本的RD模拟假设,即细胞是可以重叠的点状结构。为了给出细胞的物理尺寸(~10μm),我们使用了布朗动力学方法,该方法通过无网格、脱离晶格的AB方法模拟单个单细胞的扩散迁移、生长和增殖活动,其中可以禁止细胞相互重叠。我们发现,对于真实的单细胞参数生长和迁移率,非重叠模型会在肿瘤中心产生堵塞配置,并在肿瘤外围产生细胞的偏置向外扩散,从而产生准弹道推进肿瘤前沿。模拟表明,快速进展的肿瘤可能是由最小扩散细胞引起的,但其速度仍取决于单细胞扩散迁移率。因此,基于物理接地体积守恒假设的建模可以解释GBM细胞的估计扩散和测量扩散之间的明显差异,并提供一个新的理论框架,将单细胞生长和迁移动力学与肿瘤水平的进展自然联系起来。
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引用次数: 18
Epithelial and mesenchymal prostate cancer cell population dynamics on a complex drug landscape. 上皮和间充质前列腺癌细胞在复杂药物环境下的种群动态。
Pub Date : 2017-12-01 Epub Date: 2017-08-30 DOI: 10.1088/2057-1739/aa83bf
Ke-Chih Lin, Gonzalo Torga, Amy Wu, Joshua D Rabinowitz, Wesley J Murray, James C Sturm, Kenneth J Pienta, Robert Austin

We have improved our microfluidic cell culture device that generates an in vitro landscape of stress heterogeneity. We now can do continuous observations of different cancer cell lines and carry out downstream analysis of cell phenotype as a function of position on the stress landscape. We use this technology to probe adaption and evolution dynamics in prostate cancer cell metapopulations under a stress landscape of a chemotherapeutic drug (docetaxel). The utility of this approach is highlighted by analysis of heterogenous prostate cancer cell motility changes as a function of position in the stress landscape. Because the technology presented here is easily adapted to a standard epifluorescence microscope it has the potential for broad application in preclinical drug development and assays of likely drug efficacy.

我们已经改进了我们的微流体细胞培养装置,产生体外应激异质性景观。我们现在可以对不同的癌细胞系进行连续观察,并对细胞表型作为应激环境中位置的函数进行下游分析。我们使用这项技术来探索化疗药物(多西紫杉醇)应激环境下前列腺癌细胞群的适应和进化动力学。通过分析异质前列腺癌细胞运动变化作为应激环境中位置的功能,强调了这种方法的实用性。由于这里介绍的技术很容易适用于标准的荧光显微镜,因此在临床前药物开发和可能的药物功效测定中具有广泛应用的潜力。
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引用次数: 14
Evaluating the potential for maximized T cell redistribution entropy to improve abscopal responses to radiotherapy. 评估最大化T细胞再分配熵的潜力,以改善放射治疗的体外反应。
Pub Date : 2017-09-01 Epub Date: 2017-06-15 DOI: 10.1088/2057-1739/aa7269
Rachel Walker, Jonathan D Schoenfeld, Shari Pilon-Thomas, Jan Poleszczuk, Heiko Enderling

The potential for local radiation therapy to elicit systemic (abscopal) anti-tumor immune responses has been receiving a significant amount of attention over the last decade. We recently developed a mathematical framework designed to simulate the systemic dissemination of activated T cells among multiple metastatic sites. This framework allowed the identification of non-intuitive patterns of T cell redistribution after localized therapy, and offered suggestions as to the optimal site to irradiate in order to increase the magnitude of an immune-mediated abscopal response. Here, we evaluate the potential for such a framework to provide clinical decision making support to radiation oncologists. Several challenges such as efficient segmentation and delineation of multiple tumor sites on PET/CT scans, validation of model prediction performance, and effective clinical trial design remain to be addressed prior to the incorporation of such a tool in the clinical setting.

在过去的十年里,局部放射治疗引发全身(体外)抗肿瘤免疫反应的潜力已经得到了大量的关注。我们最近开发了一个数学框架,旨在模拟活化T细胞在多个转移部位的全身传播。该框架允许识别局部治疗后T细胞重新分配的非直观模式,并提供关于最佳照射部位的建议,以增加免疫介导的体外反应的大小。在这里,我们评估这种框架为放射肿瘤学家提供临床决策支持的潜力。一些挑战,如PET/CT扫描中多个肿瘤部位的有效分割和描绘,模型预测性能的验证,以及有效的临床试验设计,在将这种工具纳入临床环境之前,仍有待解决。
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引用次数: 5
期刊
Convergent science physical oncology
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