pu putativ ive mole olecular bi biomarker for or tes estic - PowerPoint PPT Presentation

XIS IST pr promoter meth thylatio ion status as as pu putativ ive mole olecular bi biomarker for or tes estic icula lar ger erm cel cell l tum tumors João oão Lob Lobo Sand ndra ra Nu Nunes, nes, Vera ra Gon Gonçal alves, es, Dani niel ela a Barro rros-Silva, a, Annet nette e va van der r Berg, rg, Ad Gi Gillis, Le Leend endert rt HJ Looi Looijen jenga ga, Carm rmen en Jeró róni nimo, Rui Henr enriqu que 11 th September 2019 No conflicts of interest

Early Resistance diagnosis (T)GCTs: challenges Prognosis Fertility preservation Response Targeted Epigenetics to therapy treatment BIOMARKERS Dev. Biology Lobo et al. Hum Pathol 2018

(T)GCTs are developmental cancers “Germ cell tumors are at the crossroads between developmental biology and cancer" Lobo et al. Int J Mol Sci 2019; Oosterhuis & Looijenga, Nat Rev Cancers 2019;

Development & (T)GCT biomarkers “ Developmental biology as a driver for uncovering novel disease biomarkers" Almstrup and Lobo et al. (submitted)

XIST = X-inactive specific transcript (lncRNA, Xq13.2) X-chromosome inactivation Lobo et al. (submitted)

XIST = X-inactive specific transcript (lncRNA, Xq13.2) X-chromosome inactivation NOT EXPRESSED EXPRESSED EXPRESSED METHYLATED DEMETHYLATED DEMETHYLATED Lobo et al. (submitted)

Looijenga et al. Am J Pathol 1997 Rationale XIST expression in TGCTs XIST and TGCTs (++Seminomas) XIST promoter (++region IV) consistently demethylated in TGCTs , (++Seminomas) No demethylated fragments in somatic male cancers Kawakami et al. Lancet 2004

Cancer survivors and fertility Young-adults Overall good prognosis Long-term treatment side effects Costa and Lobo et al. Epigenomics 2017

Spermatogenesis assessment JOHNSEN’S SCORE Laborious Subjective (low reproducibility) Invasive (biopsy)

XIST and spermatogenesis Rationale XIST is expressed (=demethylated) in the testis (spermatogenesis) around the time of entering meiosis This process of XIST activation in spermatogenesis is regulated by METHYLATION Richler et al. Nat Genet 1992

250 TGCTs (tumor 54 testicular 4 (T)GCT cell lines components) parenchyma (JS) Aims and Methodology To explore the role of (de)methylated XIST promoter as a Samples Bisulfite candidate biomarker (2005- treatment 2017) (Zymo kit) For TGCTs DNA qMSP extraction (ABI 7500 For spermatogenesis status (Norgen RT PCR kit/PC8) System) Same primer set reported by Kawakami et al

Mixed TGCTs Validation of the series Case Case Case Case 59 59 271 271 TE SE SE EC

XIST methylated fragment – TGCTs XIST promoter (de)methylation

XIST demethylated fragment – TGCTs XIST promoter (de)methylation

XIST demethylated fragment – TGCTs XIST promoter (de)methylation

XIST demethylated fragment – Cell lines XIST promoter (de)methylation High Resolution Melting (HRM) analyses

XIST demethylated fragment - spermatogenesis XIST promoter (de)methylation

XIST demethylated fragment - spermatogenesis XIST promoter (de)methylation Context Sensitivity (%) Specificity (%) JS≥4 vs JS<4 75.7 100

Testicular germ cell tumors Conclusions and perspectives Early (differential) diagnosis To explore the role of (de)methylated XIST promoter as a candidate biomarker Follow-up Especially for Seminoma For TGCTs Spermatogenesis status For spermatogenesis status Improve selection of patients for TESE or other Non-invasively? fertility preservation techniques

Liquid biopsies XIST promoter: ongoing work Detection of TGCTs in liquid Upfront assessment of male biopsies (serum/plasma) patients’ fertility (semen samples) Patient monitoring HRM – High-resolution melting

Ethics approval: CES IPO 1/2018 Doctoral Grant: SFRH/BD/132751/2017 Project Funding: POCI-01-0145-FEDER-29043 IPO Porto The Netherlands Department of Pathology Urology Clinic Ângelo Rodrigues Jorge Oliveira PMC Utrecht (Group Looijenga) Paula Lopes Joaquina Maurício Ad Gillis Mariana Cantante Isaac Braga Annette van den Berg Rita Guimarães Rachita Lahri Department of Epidemiology Dennis Timmerman Luís Antunes Cancer Biology & Epigenetics Group Vera Gonçalves Erasmus MC Rotterdam & LEPO Supervising team: Daniela Barros Silva Wolter Oosterhuis Rui Henrique Sandra Nunes Lambert Dorssers Carmen Jerónimo Hans Stoop Leendert Looijenga Willem Boellaard

Thank you for your attention!