Life is the translation of the
information in the genome
into the phenotype of the
organism:
The organism ‚computes‘ this
phenotype from its genotype,
given a specific environment
?                Genome                            !




    (PentiumV)          (neuronal net visualisation)

                 Phenotype
Lehrach
The Problem

World wide ~12 million new cancer cases/year
Cure rates for many common forms of cancer have
hardly changed over the last decades
Even the most advanced targeted therapies are
typically only effective for a small fraction of the
patients
Pharma development costs have dramatically
increased, while the number of new drugs keeps
dropping
Global Cancer Burden (millions)

                        2008      2030
New cases               12.5      26.4
Deaths                   7.6      17.1
Alive with cancer       28.0      80.0
                                  Boyle and Levin, 2009
Colon Cancer
                             (K-ras wild type)



        S
        U
        R
        V
        I
        V
        A
        L




                            Time in months
                                                           Zalcberg et al, NEJM 2008
Many colon cancer patients with tumors without K-ras
wild type will respond positively to treatment with EGFR
receptor anatagonists
Colon Cancer
                                   Mutated K-ras



           S
           U
           R
           V
           I
           V
           A
           L




                                    Time in months               Zalcberg et al, NEJM 2008
Patients with tumors with K-ras mutations do not: a 30000 Euro
treatment will show no effect on the tumor (but will cause
significant side effects on the patient)
Der Anfang: 1973
Publication of Draft Version




     International Human Genome                         Celera
              Consortium

                         30th September 2010, Brussel
Genome$
                    2010 $1-7K (CGI)
                    human genome
Factors of
 10 since
   2005
              2004: $400M (ABI)

 ------
Moore’s law     2000: $3 billion
1.5x/yr for
electronics



                                       10
The 1000 genomes project:
   a catalogue of human
       polymorphism
created using next generation
         sequencing
International Cancer Genome
        Consortium (ICGC)
            Pancreas        Breast Cancer
                                                        Liver
                                 Pedriatic Gastric
                                             cancer     Cancer
                                 Cancer
                            Liver                       (Viral)
        Glioblastoma and
                            (alcohol) /
         Ovarian Cancer CLL
                            Breast
           (The Cancer                    Oral cavity
                            Cancer
         Genome Atlas)                    cancer



                                                    Pancreas
2 EU
funded
consortia
Sequencing Capacities
                    at the MPI-MG




                    5 x Illumina GAII
                                                                 3 x 454/FLX




                                                                    1 x Polonator
                                                                        G007
                         5 x SOLiD


The MPI-MG is the largest second generation sequencing centre on the
continent, technology, which will be directly transferred to Alacris Theranostics
Christoph Wierling
                                Hanahan / Weinberg Cancer Model




 Weinberg, The Biology of Cancer (2007) Garland Science
Lehrach
Lehrach
Lehrach
Proof of Concept

Dr. Schlag with the first patient’s tumor
Patient 1 Genome Sequencing
                                        Amount
              Sample       Type         sequenced
              Blood        Whole Genome  90 Gb
              Tumor        Whole Genome 120 Gb
              Blood        Exome        997 Mb
              Tumor        Exome        892 Mb

         Ca. 30x genome coverage for high-confidence scoring of mutations

• Heterogenous tumor with > 40,000 somatic mutations, mostly passengers !

Ca. 1,000 mutations in expressed proteins, mostly changing one amino acid

• One known cancer activating mutation: BRAF(V600E) observed
  in 50% of melanomas but not sufficient to promote tumorigenesis

Another 5 mutations in expressed genes model components for instance in PDGFD,
PRKCB, SCRF1.... but the mutations effects are unknown :
being modeled for three possibilities (neutral,activating or loss of function)

Identification of NOVEL driver mutations which will be implemented in the model)
Whole Genome Sequence
                                   provides virtual karyotype

(Example for tumor Chr.9) Identification of a large deletion of chr. 9
   Gene Deletion                   CDKN2A Cyclin-dependent kinase inhibitor 2A (ARF)
                                    CDKN2B Cyclin-dependent kinase 4 inhibitor B



                                                    Amount of DNA per Mb shown for
                                                    blood (red) and tumor (blue)




                                                    Ratio of reads (blood/tissue).



                                                    SNPs unique to blood (red), unique
                                                    to tissue (blue). The higher number
                                                    of blood-specific SNPs shows that
                                                    this haplotype was lost in tumor
Patient 1 Transcriptome Sequencing

                     New protocol with RNA fragmentation
Run/lane nb                         Sample            Total.number_unique_hits
091211_EAS451_1                     Tumor                            28 859 047
091211_EAS451_2                     Tumor                            29 373 327
091211_EAS451_3                     Tumor                            29 456 853
091211_EAS451_4                     Control                          30 461 674
091211_EAS451_5                     Control                          29 622 024
                  Standard protocol with cDNA fragmentation
Run/lane nb                         Sample            Total.number_unique_hits
091113_EAS451_5                     Tumor                            21 995 533
091113_EAS451_6                     Tumor                            21 919 636
090522_EAS451_7                     Tumor                            11 277 659
090714_EAS451_1                     Stem cells‐CD133+                16 468 893
090714_EAS451_2                     Stem cells‐CD133‐                21 808 807
091106_EAS451_6                     Control                          24 766 112



   Tumor tissues and stem cells + control melanocyte sequenced
Cross-validated
                      homozygous SNP



                  Heterozygous exome SNP (in
                  splicing region) looks as
                  homozygous in transcriptome




ENSG00000115756
MAT2A



Pat1




Melanocytes
The model of patient 1
Finding a Patient 1 Specific
                                                                                Optimal Drug Treatment


                                                           Round 1
              Single Drugs




                                                             Round 2
       Double Drugs




                                                               Round 3
Triple Drugs




                                                                     Round 4
                                              Quad Drugs




                                                                       Round 5
                                       Fiver Drugs




                                                                                            MYC
                             Conc. Optimization




                                                                         Round 6




                                                                                                      Drugs / Drug Combinations
                                                               Various Modell Components
    Stepwise optimisation of the therapy for an individual patient
Lehrach
Detection of environmental effects
A) ‘mutagen fingerprints’
B) Statistically significant increase in specific molecular subtypes
C)Mechanistic predictions (e.g. tumor promoters)
D)In-silico tumor formation?
Modeling the effects of mutations, which affect response to EGFR inhibitors
• PacBio has been quoted that, by
  2013, their technology will be
  able to give a ‘raw’ human
  genome sequence in less than 3
  min, and a complete high-
  quality sequence in just 15 min
Modelling the response of cancer stem
cells?
Cancer, a curable disease?


The ‚red Queen‘ approach to cancer
treatment: Modelling cancer
progression.
Cancer, a chronic disease‘
IT Future of Medicine
      Setting the Scene
Market
“NEW YORK, Dec. 8, 2010 /PRNewswire/ -- Spending on healthcare
  among the OECD (i) countries and BRIC nations of Brazil, Russia, India
  and China will grow by 51 percent between 2010 and 2020, amounting to
  a cumulative total of more than $71 trillion, according to estimates from
  PwC's Health Research Institute. Health spending in these areas is rising
  faster than gross domestic product, magnifying gaps in budget deficits and
  spurring governments to look to the private sector for ways to get a better
  value for taxpayers' money.”
“Worldwide IT Spending outperformed expectations in 2010, reaching $1.5
  Trillion”, according to IDC's Worldwide Black Book from February 09,
  2011 08:03 AM Eastern Time
12 Million new cancer cases every year ~1 genome/second?
Computing requirements:
Sequence analysis: 100 cores ~1 day/genome: 1e7 core seconds
Modelling: 1000 conditions, 1000 positions in the body, 1000 MC runs, 1000 core seconds/run:
10e12 core seconds
1 Blue Gene L: ~10e5 cores (up to 65,536 nodes with 2 Power PC processors)
~1 Blue Gene L equivalent per patient?
Storage:
~1 Terabyte per genome
30-100 Exabytes for data storage for all cancer patients?
Multi-Zetabytes to Yottabytes for ITFoM?
As of May 2009, the size of the world's total digital content has been roughly estimated to be 500
billion Gigabytes (500 Exabytes) (From the Wiki Exabyte entry)
Metabolomics
NMR-based metabolomics



                             +

     Metabolic fingerprint
24 Partners
Relations to Infrastructures


European Sequencing and
Genotyping Infrastructure



  ISBE                                                           Integrated Structural
                                                                Biology Infrastructure




Infrastructure for Systems
     Biology – Europe

                                                          Partnership for Advanced
                                                           Computing in Europe




                                                 Jülich Supercomputing Centre
The project outcomes will enable the prediction of health,
  disease, therapy and its effects for individual patients
  and through application in the clinic will change the
  future of medicine.

  For more information:
  Website: http://www.itfom.eu
  Email: info@itfom.eu
  Twitter: @itfom
  Facebook: I.T. Future of Medicine
  LinkedIn: IT Future of Medicine

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Lehrach

  • 1. Life is the translation of the information in the genome into the phenotype of the organism: The organism ‚computes‘ this phenotype from its genotype, given a specific environment
  • 2. ? Genome ! (PentiumV) (neuronal net visualisation) Phenotype
  • 4. The Problem World wide ~12 million new cancer cases/year Cure rates for many common forms of cancer have hardly changed over the last decades Even the most advanced targeted therapies are typically only effective for a small fraction of the patients Pharma development costs have dramatically increased, while the number of new drugs keeps dropping
  • 5. Global Cancer Burden (millions) 2008 2030 New cases 12.5 26.4 Deaths 7.6 17.1 Alive with cancer 28.0 80.0 Boyle and Levin, 2009
  • 6. Colon Cancer (K-ras wild type) S U R V I V A L Time in months Zalcberg et al, NEJM 2008 Many colon cancer patients with tumors without K-ras wild type will respond positively to treatment with EGFR receptor anatagonists
  • 7. Colon Cancer Mutated K-ras S U R V I V A L Time in months Zalcberg et al, NEJM 2008 Patients with tumors with K-ras mutations do not: a 30000 Euro treatment will show no effect on the tumor (but will cause significant side effects on the patient)
  • 9. Publication of Draft Version International Human Genome Celera Consortium 30th September 2010, Brussel
  • 10. Genome$ 2010 $1-7K (CGI) human genome Factors of 10 since 2005 2004: $400M (ABI) ------ Moore’s law 2000: $3 billion 1.5x/yr for electronics 10
  • 11. The 1000 genomes project: a catalogue of human polymorphism created using next generation sequencing
  • 12. International Cancer Genome Consortium (ICGC) Pancreas Breast Cancer Liver Pedriatic Gastric cancer Cancer Cancer Liver (Viral) Glioblastoma and (alcohol) / Ovarian Cancer CLL Breast (The Cancer Oral cavity Cancer Genome Atlas) cancer Pancreas 2 EU funded consortia
  • 13. Sequencing Capacities at the MPI-MG 5 x Illumina GAII 3 x 454/FLX 1 x Polonator G007 5 x SOLiD The MPI-MG is the largest second generation sequencing centre on the continent, technology, which will be directly transferred to Alacris Theranostics
  • 14. Christoph Wierling Hanahan / Weinberg Cancer Model Weinberg, The Biology of Cancer (2007) Garland Science
  • 18. Proof of Concept Dr. Schlag with the first patient’s tumor
  • 19. Patient 1 Genome Sequencing Amount Sample Type sequenced Blood Whole Genome 90 Gb Tumor Whole Genome 120 Gb Blood Exome 997 Mb Tumor Exome 892 Mb Ca. 30x genome coverage for high-confidence scoring of mutations • Heterogenous tumor with > 40,000 somatic mutations, mostly passengers ! Ca. 1,000 mutations in expressed proteins, mostly changing one amino acid • One known cancer activating mutation: BRAF(V600E) observed in 50% of melanomas but not sufficient to promote tumorigenesis Another 5 mutations in expressed genes model components for instance in PDGFD, PRKCB, SCRF1.... but the mutations effects are unknown : being modeled for three possibilities (neutral,activating or loss of function) Identification of NOVEL driver mutations which will be implemented in the model)
  • 20. Whole Genome Sequence provides virtual karyotype (Example for tumor Chr.9) Identification of a large deletion of chr. 9 Gene Deletion CDKN2A Cyclin-dependent kinase inhibitor 2A (ARF) CDKN2B Cyclin-dependent kinase 4 inhibitor B Amount of DNA per Mb shown for blood (red) and tumor (blue) Ratio of reads (blood/tissue). SNPs unique to blood (red), unique to tissue (blue). The higher number of blood-specific SNPs shows that this haplotype was lost in tumor
  • 21. Patient 1 Transcriptome Sequencing New protocol with RNA fragmentation Run/lane nb Sample Total.number_unique_hits 091211_EAS451_1 Tumor 28 859 047 091211_EAS451_2 Tumor 29 373 327 091211_EAS451_3 Tumor 29 456 853 091211_EAS451_4 Control 30 461 674 091211_EAS451_5 Control 29 622 024 Standard protocol with cDNA fragmentation Run/lane nb Sample Total.number_unique_hits 091113_EAS451_5 Tumor 21 995 533 091113_EAS451_6 Tumor 21 919 636 090522_EAS451_7 Tumor 11 277 659 090714_EAS451_1 Stem cells‐CD133+ 16 468 893 090714_EAS451_2 Stem cells‐CD133‐ 21 808 807 091106_EAS451_6 Control 24 766 112 Tumor tissues and stem cells + control melanocyte sequenced
  • 22. Cross-validated homozygous SNP Heterozygous exome SNP (in splicing region) looks as homozygous in transcriptome ENSG00000115756
  • 24. The model of patient 1
  • 25. Finding a Patient 1 Specific Optimal Drug Treatment Round 1 Single Drugs Round 2 Double Drugs Round 3 Triple Drugs Round 4 Quad Drugs Round 5 Fiver Drugs MYC Conc. Optimization Round 6 Drugs / Drug Combinations Various Modell Components Stepwise optimisation of the therapy for an individual patient
  • 27. Detection of environmental effects A) ‘mutagen fingerprints’ B) Statistically significant increase in specific molecular subtypes C)Mechanistic predictions (e.g. tumor promoters) D)In-silico tumor formation?
  • 28. Modeling the effects of mutations, which affect response to EGFR inhibitors
  • 29. • PacBio has been quoted that, by 2013, their technology will be able to give a ‘raw’ human genome sequence in less than 3 min, and a complete high- quality sequence in just 15 min
  • 30. Modelling the response of cancer stem cells? Cancer, a curable disease? The ‚red Queen‘ approach to cancer treatment: Modelling cancer progression. Cancer, a chronic disease‘
  • 31. IT Future of Medicine Setting the Scene
  • 32. Market “NEW YORK, Dec. 8, 2010 /PRNewswire/ -- Spending on healthcare among the OECD (i) countries and BRIC nations of Brazil, Russia, India and China will grow by 51 percent between 2010 and 2020, amounting to a cumulative total of more than $71 trillion, according to estimates from PwC's Health Research Institute. Health spending in these areas is rising faster than gross domestic product, magnifying gaps in budget deficits and spurring governments to look to the private sector for ways to get a better value for taxpayers' money.” “Worldwide IT Spending outperformed expectations in 2010, reaching $1.5 Trillion”, according to IDC's Worldwide Black Book from February 09, 2011 08:03 AM Eastern Time
  • 33. 12 Million new cancer cases every year ~1 genome/second? Computing requirements: Sequence analysis: 100 cores ~1 day/genome: 1e7 core seconds Modelling: 1000 conditions, 1000 positions in the body, 1000 MC runs, 1000 core seconds/run: 10e12 core seconds 1 Blue Gene L: ~10e5 cores (up to 65,536 nodes with 2 Power PC processors) ~1 Blue Gene L equivalent per patient? Storage: ~1 Terabyte per genome 30-100 Exabytes for data storage for all cancer patients? Multi-Zetabytes to Yottabytes for ITFoM? As of May 2009, the size of the world's total digital content has been roughly estimated to be 500 billion Gigabytes (500 Exabytes) (From the Wiki Exabyte entry)
  • 34. Metabolomics NMR-based metabolomics + Metabolic fingerprint
  • 36. Relations to Infrastructures European Sequencing and Genotyping Infrastructure ISBE Integrated Structural Biology Infrastructure Infrastructure for Systems Biology – Europe Partnership for Advanced Computing in Europe Jülich Supercomputing Centre
  • 37. The project outcomes will enable the prediction of health, disease, therapy and its effects for individual patients and through application in the clinic will change the future of medicine. For more information: Website: http://www.itfom.eu Email: [email protected] Twitter: @itfom Facebook: I.T. Future of Medicine LinkedIn: IT Future of Medicine