Colonoscopy screening is an effective intervention for identifying and removing precursor lesions for colorectal cancer (CRC). CRC has declined in incidence by 30% in the U.S. during the twenty years since adoption of colonoscopy screening that has enabled physicians to detect and remove polyps, the precursor lesion for CRC. While colonoscopy allows for observation of the endoscopic appearance of polyps by the practitioner and histological evaluation by pathologists, those measures of diagnostic scrutiny fall short of defining polyp properties that predict which lesions are most likely to transition through molecular events that commit a polyp to progress to cancer. Though the majority of CRC arises through malignant transformation of an adenomatous polyp, only 5% of those polyps progress to cancer. Currently, best practice protocols cannot discriminate between polyps containing molecular features leading to cancer from polyps that are likely to remain benign. In response to Provocative question #14, we seek to determine what the definable properties of CRC are, by comparing a polyp that has cancer from one that does not. Without a better understanding of the biological basis for polyp progression to cancer at the molecular level, physicians and patients approach decisions about treatment options without complete information about factors that predict the risk that polyps will transition to cancer. These studies propose to identify molecular features of polyps that differentiate the clinical behavior of given lesions so that optimal treatment opportunities can be determined for individual patients in the context of the probability that their polyps will progress to cancer. Recent studies utilizing molecular analysis f the genome, mRNA and micro RNA transcriptome or methylome (GTM) have attempted to depict the molecular features of carcinogenesis by studying independent polyps and cancer from different individuals.
The first aim of this research will compare the molecular changes found in polyp tissue sets from individual patients with cancer adjacent polyps versus cancer-free polyps similar in terms of size, histology and degree of dysplasia.
The second aim will refine the profiles of molecular features discovered in aim one by testing those refined profiles on a hundred sets of polyps in order to condense profile sets to affordable, accurate diagnostic panels of molecular progression. Finally, these profiles will be validated in a thousand sets of patient polyps to predict cancer progression risk in the clinical setting. The goals of this application are to develop an affordable, refined set of GTM events that answer fundamental questions about the molecular events that occur in polyps that have begun transformation to CRC compared to those that have not. These studies address a critical need to expand the base of knowledge upon which physicians and patients can make best case practice decisions for patients at risk for colorectal polyp transformation and progressive malignancy leading to invasive, metastatic colorectal cancer.

Public Health Relevance

In the US, CRC incidence has declined with uptake in colonoscopy for early detection and removal of polyps, the precursor lesion, can stop a cancer from developing, but in spite of this, CRC remains the second leading cause of cancer death in the United States. One third of people who undergo screening colonoscopy will have adenomatous polyps, but less than 5% of the time do these polyps develop into cancer. Why does one polyp develop into cancer while another does not? In this application we will identify which genetic, mRNA expression and genetic methylation patterns will distinguish a polyp that has already transformed into cancer from one that has not.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA170357-03
Application #
8678878
Study Section
Special Emphasis Panel (ZCA1-SRLB-9 (M1))
Program Officer
Thurin, Magdalena
Project Start
2012-09-18
Project End
2017-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
3
Fiscal Year
2014
Total Cost
$368,382
Indirect Cost
$136,695
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905
Hale, Vanessa L; Jeraldo, Patricio; Mundy, Michael et al. (2018) Synthesis of multi-omic data and community metabolic models reveals insights into the role of hydrogen sulfide in colon cancer. Methods 149:59-68
Mouchli, Mohamad A; Singh, Siddharth; Boardman, Lisa et al. (2018) Natural History of Established and De Novo Inflammatory Bowel Disease After Liver Transplantation for Primary Sclerosing Cholangitis. Inflamm Bowel Dis 24:1074-1081
Druliner, Brooke R; Wang, Panwen; Bae, Taejeong et al. (2018) Molecular characterization of colorectal adenomas with and without malignancy reveals distinguishing genome, transcriptome and methylome alterations. Sci Rep 8:3161
Druliner, Brooke R; Ruan, Xiaoyang; Sicotte, Hugues et al. (2018) Early genetic aberrations in patients with sporadic colorectal cancer. Mol Carcinog 57:114-124
Hale, Vanessa L; Chen, Jun; Johnson, Stephen et al. (2017) Shifts in the Fecal Microbiota Associated with Adenomatous Polyps. Cancer Epidemiol Biomarkers Prev 26:85-94
Rashtak, Shahrooz; Ruan, Xiaoyang; Druliner, Brooke R et al. (2017) Peripheral Neutrophil to Lymphocyte Ratio Improves Prognostication in Colon Cancer. Clin Colorectal Cancer 16:115-123.e3
Li, Jian; Dittmar, Rachel L; Xia, Shu et al. (2017) Cell-free DNA copy number variations in plasma from colorectal cancer patients. Mol Oncol 11:1099-1111
Li, Mulin Jun; Li, Miaoxin; Liu, Zipeng et al. (2017) cepip: context-dependent epigenomic weighting for prioritization of regulatory variants and disease-associated genes. Genome Biol 18:52
Mouchli, Mohamad A; Singh, Siddharth; Loftus Jr, Edward V et al. (2017) Risk Factors and Outcomes of De Novo Cancers (Excluding Nonmelanoma Skin Cancer) After Liver Transplantation for Primary Sclerosing Cholangitis. Transplantation 101:1859-1866
Druliner, Brooke R; Ruan, Xiaoyang; Johnson, Ruth et al. (2016) Time Lapse to Colorectal Cancer: Telomere Dynamics Define the Malignant Potential of Polyps. Clin Transl Gastroenterol 7:e188

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