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10 “genome hackers”
mostly engineers (statistics)

42 scientists
technicians, geneticists, clinicians

>100 people
hardware engineers,
mathematicians, molecular biologists
Next Generation
Epigenetic Profiling

Wim Van Criekinge
12th december, Uppsala (SE)
Overview
Epigenetics
– Introduction
– Methylation & Oncology
– Biomarkers
MDxHealth
– NEXT-GENeration Epigenetic Biomarkers
– PharmacoDX: Methylation Based Biomarkers
for Predictive and Prognostic Use
The genome is just the start …
Defining Epigenetics
Genome
DNA




Chromatin

Epigenome

Gene Expression

Phenotype




Reversible changes in gene
expression/function
Without changes in DNA
sequence
Can be inherited from
precursor cells
Allows to integrate intrinsic
with environmental signals
(including diet)
DNA Methylation Differentiates Totipotent Embryonic
Stem Cells from Unipotent Adult Stem Cells

Alex Meissner, Henry Stewart Talks
Reprogramming the DNA methylome

Paula Vertino, Henry Stewart Talks
Transgenerational inheritence
Actionable
Epigenome
250 different cell types

Epigenetic (meta)information = stem cells
Cellular programming

Epigenetic (meta)information = stem cells
Outside
Oncology ?
Historically,
Cancer Was Considered
to be Driven Mostly by Genetic Changes
GENETIC

 Mutations in p53
Example:
Replication errors

 Activating mutations in RAS
 Mutations or amplifications of the

X X

HER-2 gene

Altered
DNA sequence

 Chromosomal translocations in
Altered
DNA/mRNA/proteins

Oncogenesis

myeloid cells and the generation of
the BCR-ABL fusion protein

Tumor
Epigenetic Changes are
Important in Causing Cancer
GENETIC

EPIGENETIC

Example:
Chromatin modification errors

Example:
Replication errors
X X

Altered
chromatin structure

Altered
DNA sequence
Altered
DNA/mRNA/proteins

Oncogenesis

Altered levels of
mRNA/proteins

Tumor
Example of Methylation
vs Mutation: Colon & Breast Cancer
120

100

80

Dx

60

40

CDx

20

0

Methylated

Mutated
Source: Schuebel et al 2007

76-100 51-75

21-50

1-20
MGMT Biology
O6 Methyl-Guanine
Methyl Transferase
Essential DNA Repair Enzyme
Removes alkyl groups from damaged
guanine bases
Healthy individual:
- MGMT is an essential DNA repair enzyme
Loss of MGMT activity makes individuals susceptible
to DNA damage and prone to tumor development
Glioblastoma patient on alkylator chemotherapy:
- Patients with MGMT promoter methylation show
have longer PFS and OS with the use of alkylating
agents as chemotherapy
MGMT Promoter
Methylation Predicts
Benefit form DNA-Alkylating Chemotherapy
Post-hoc subgroup analysis of Temozolomide Clinical trial with primary
glioblastoma patients show benefit for patients with MGMT promoter methylation
25

Median Overall Survival

21.7 months

20
15

plus
temozolomide
12.7 months
radiotherapy

10
radiotherapy

5
0
Non-Methylated
MGMT Gene

Methylated
MGMT Gene

Adapted from Hegi et al.
NEJM 2005
352(10):1036-8.
Study with 207 patients
Overview
Epigenetics
– Introduction
– Methylation & Oncology
– Biomarkers
MDxHealth
– NEXT-GENeration Epigenetic Biomarkers
Can we rediscover MGMT ?
What does the epigenome look like ?
….
MBD_Seq
Condensed Chromatin

DNA Sheared

DNA Sheared

Immobilized
Methyl Binding Domain
MBD_Seq
Immobilized
Methyl binding domain

MgCl2

Next Gen Sequencing
GA Illumina: 100 million reads
Quality evaluation of Methyl Binding Domain
based kits for enrichment DNA-methylation
sequencing

De Meyer et al (2013)
Plos One

Confidential Information | ©2013 MDxHealth Inc. All rights reserved.
Quality evaluation of Methyl Binding Domain based
kits for enrichment DNA-methylation sequencing

Confidential Information | ©2013 MDxHealth Inc. All rights reserved.
MBD_Seq
MGMT = dual core
Genome-wide methylation
…. by next generation sequencing
# markers

1-2 million
methylation
cores

MBD_Seq

Discovery

# samples
BRCA1,
a bidirectional promoter

27
Splice variants

28
Zooming into
Exon 1

29
Zooming into
Exon 1

30
Zooming into
Exon 1

31
Where is the mC ?
GCATCGTGACTAGCGACTGATCGATGGATGCTAGCAT
GCATCGTGACTAGCGACTGATCGATGGATGCTAGCAT
GCATCGTGACTAGCGACTGATCGATGGATGCTAGCAT
25%

50%

25%

GCATCGTGACTAGCGACTGATCGATGGATGCTAGCAT
GCATCGTGACTAGCGACTGATCGATGGATGCTAGCAT
25%

50%

25%

GCATCGTGACTAGCGACTGATCGATGGATGCTAGCAT

GCATCGTGACTAGCGACTGATCGATGGATGCTAGCAT
Dense methylated needed for transcriptional silencing
Are there alleles with all three positions methylated ?
Deep Sequencing
unmethylated alleles

methylated alleles

less methylation

more methylation

GCATCGTGACTTACGACTGATCGATGGATGCTA
Deep Sequencing MGMT Heterogenic complexity
Data integration with
DEEP Sequencing, Infinium, Reactivation, (directional) Expression …
Data integration
Correlation tracks
expression

expression

Corr =-1

Corr = 1

methylation

methylation
Correlation track
in GBM @ MGMT

+1

-1
BRCA1

1
2
3
4
5
6
7
8

T47D
BT549
MCF7
MDAMB231
HS578T
NORMAL
NORMAL
NORMAL

41
9
10
11
12
13
14
15
16
17

BI T21 (BRCA1 MUT)
BI T22 (BRCA1 MUT)
BLC
BLC
BLC
BLC
BLC
BLC
BLC
13 BLC
14 BLC
15 BLC
16 BLC
17 BLC
18 BLC
19 IVM
20 DKO
Genome-wide methylation
…. by next generation sequencing
# markers

MBD_Seq

Discovery
BT_Seq
Verification

MSP
Validation

# samples
Genetics
Whole-genome
Bisulphite seq

Probes
(450-27K)

Enrichment
Targeted Panels

MSP

bp

Full genome

109

108

107

106

Confidential Information | ©2013 MDxHealth Inc. All rights reserved.

105

104

103

102

101

1
Genetics
Instrument and Assay providers

G
E
N
E
T
I
C

Whole-genome
sequencing

Enrichment seq
(Exome)

Enrichment
Targeted Panels

PCR

bp

Full genome

109

108

107

106

105

104

103

CLIA Lab service providers

Confidential Information | ©2013 MDxHealth Inc. All rights reserved.

102

101

1
Molecular Unification
E
P
I

Whole-genome
Bisulphite seq

G
E
N
E
T
I
C

Whole-genome
sequencing

Enrichment seq
(MBD, RRBS)

Probes
(450-27K)

Ultra
Deep

Enrichment
Targeted Panels

Enrichment seq
(Exome)

Enrichment
Targeted Panels

Deep
Seq
bp

Full genome

109

108

RUO

107

106

105

104

103

Sequencing

102

101

1

Clinical
236 cancer-related genes
(3,769 exons) plus 47 introns
from 19 genes often
rearranged or altered in
cancer. These genes are
known to be somatically
altered in human solid
cancers based on recent
scientific and clinical
literature.

Confidential Information | ©2013 MDxHealth Inc. All rights reserved.
PubMeth.org
Reviewed methylation database in cancer

Confidential Information | ©2013 MDxHealth Inc. All rights reserved.
Epigenetic Alterations
Associated with Cancer Therapy Response

PCFT – folate
transport (MTX)

WRN
440 cancer-related genes genes are known to
be epigenetically altered in human solid
cancers based on recent scientific and clinical
literature.
Confidential Information | ©2013 MDxHealth Inc. All rights reserved.
Molecular Unification
E
P
I

Whole-genome
Bisulphite seq

G
E
N
E
T
I
C

Whole-genome
sequencing

Enrichment seq
(MBD, RRBS)

Probes
(450-27K)

Ultra
Deep

Enrichment
Targeted Panels

Enrichment seq
(Exome)

Enrichment
Targeted Panels

Deep
Seq
bp

Full genome

109

108

RUO

107

106

105

104

103

Sequencing

102

101

1

Clinical
Acknowledgments
Geert Trooskens
Simon Denil
Klaas Mensaert
Jean-Pierre Renard
Sarah De Keulenaer
Ellen De Meester
Tim De Meyer

Wim van den Berghe

Manon Van Engeland
Jurgen Veeck

Monika Hegi
Pierre Bady
Sebastian Kurscheid

Olivier Thas
53
biobix
wvcrieki

biobix.be
bioinformatics.be

54

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