In Vivo Testing of Novel Drug Combinations for Pediatric Soft Tissue Sarcomas

项目总结 尽管我们对儿童软组织肉瘤的病因了解取得了进展 (STS)，20多年来，这些疾病的总体存活率没有显著改善。为 患有复发性疾病的儿童，存活率低于30%，而长期存活的人数有所增加 与他们接受的根治疗法相关的疾病负担。因此，我们的目标是 研究小组的目标是通过整合基础设施，提高性病患儿的生存和生活质量， 翻译和临床研究。在过去的10年里，我们已经同意了STS和其他固体 肿瘤患者捐献组织原位移植免疫低下小鼠发育 原位患者来源异种移植物(O-PDX)。我们的O-PDX已用于体外高密度脂蛋白 使用标准化的临床前I、II、III期范例进行药物筛选和体内试验。 横纹肌肉瘤(RMS)是儿童最常见的性传播疾病，基因组研究表明 罕见的克隆性相关细胞亚群可以在治疗中幸存下来，并有助于疾病复发。 随后使用转录、表观遗传学和蛋白质组数据进行的综合分析表明，RMS 肿瘤保留了其发育起源的谱系特异性转录和表观遗传特征。 最近，单细胞和单核RNA-seq(sc/snRNA-seq)和体内谱系追踪 表明细胞克隆可以通过其正常的发育程序进行过渡。的确，单身- 细胞ATAC-seq表明，细胞和发育阶段特异的超级增强子活性是 与基因表达的克隆性变化相关。化疗消除了大部分 增殖的肿瘤细胞群，存活的休眠肿瘤细胞迅速扩张和再... 建立他们的发育等级，这会导致疾病复发。这是一个引人注目的例子。 STS内复杂的细胞内在和外在信号以及STS之间错综复杂的联系 儿童癌症的发育和致癌途径。在这项提案中，我们将在体内进行 使用我们的STS O-PDX模型每年测试8-10种药物。最引人注目的途径是 发育激酶通路(AIM 1)、细胞应激通路(AIM 2)和G2/M细胞周期检查点 (目标3)。将测试新的药物组合以及包括常规药物在内的药物组合 以化疗为标准的护理。将特别强调消除中的所有克隆 肿瘤通过减少疾病复发来提高存活率。

PROJECT SUMMARY Despite the advances made in our understanding of the etiology of pediatric soft tissue sarcomas (STS), the overall survival of those diseases has not significantly improved in over 2 decades. For children with recurrent disease, survival is below 30%, and long-term survivors have an increased burden of disease associated with the curative therapies they received. Therefore, the goal of our research team is to improve the survival and quality of life of children with STS by integrating basic, translational, and clinical research. For the past 10 years, we have consented STS and other solid tumor patients to donate tissue for orthotopic implantation into immunocompromised mice to develop orthotopic patient derived xenografts (O-PDXs). Our O-PDXs have been used for ex vivo high- throughput drug screening and in vivo testing using a standardized preclinical phase I, II, III paradigm. Rhabdomyosarcoma (RMS) is the most common STS in children and genomic studies have shown that rare subsets of clonally related cells can survive treatment and contribute to disease recurrence. Subsequent integrated analyses using transcriptomic, epigenetic and proteomic data showed that RMS tumors retain lineage-specific transcriptional and epigenetic signatures of their developmental origins. More recently, single cell and single nucleus RNA-seq (sc/snRNA-seq) and in vivo lineage-tracing showed that clones of cells can transition through their normal developmental programs. Indeed, single- cell ATAC-seq demonstrated that the cell- and developmental stage–specific super-enhancer activity is correlated with those clonal changes in gene expression. Chemotherapy eliminates the most proliferative tumor cell populations, and the surviving dormant tumor cells rapidly expand and re- establish their developmental hierarchy, which leads to disease recurrence. This is a striking example of the complex cell-intrinsic and -extrinsic signaling within STS and the intricate connection between developmental and oncogenic pathways in childhood cancer. In this proposal, we will perform in vivo testing for 8-10 drugs per year using our STS O-PDX models. The most compelling pathways are developmental kinase pathways (Aim 1), cell stress pathways (Aim 2) and G2/M cell cycle checkpoints (Aim 3). Novel drug combinations will be tested as well as those that include conventional chemotherapy for standard of care. Particular emphasis will be placed on eliminating all the clones in the tumor to improve survival by reducing disease recurrence.