Relevant Degree Programs
Graduate Student Supervision
Doctoral Student Supervision
Dissertations completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest dissertations.
The full abstract for this thesis is available in the body of the thesis, and will be available when the embargo expires.
Emerging evidence that the interplay between tumour cells and reactive immune cells has profound impact on tumour development, evolution and progression inspired the field of cancer research for the last decade. It has become apparent that the evolutionary pressure exerted by the immune system leads to the evolution of various mechanisms by which tumour cells escape immune surveillance. These often include somatically acquired genetic alterations, resulting in disturbed expression of surface molecules or an altered chemokine/cytokine milieu. B cells play an important role in the adaptive immune response and are potent antigen-presenting cells with high expression of major histocompatibility complexes (MHC) I and II. Multiple studies have reported on defective antigen presentation pathways in malignant lymphomas, however, many of the underlying genetic alterations are largely unexplored.Herein, we applied next generation sequencing techniques and fluorescence in situ hybridization to explore the landscape of genetic alterations in CIITA, the master transcriptional regulator of MHC class II, in various B cell lymphomas and to determine the spectrum of rearrangement partner genes. The functional impact of these mutations on MHC class II expression and the composition of the tumour microenvironment were subsequently evaluated in cell line model systems, and by immunohistochemistry performed on primary lymphoma specimens. Finally, we integrated our findings with patient outcomes to ascertain the clinical impact.We discovered that genomic rearrangements and coding sequence mutations in CIITA are frequent across B cell lymphoma subtypes and can result in diminished MHC class II expression, coinciding with a lower abundance of CD4- and CD8-positive T cells in the tumour microenvironment. We identified that at least some of the genetic alterations are likely a byproduct of AID-mediated somatic hypermutation, as evidenced by the co-occurrence of mutations in the non-coding region of CIITA intron 1. In addition, we described novel translocations involving a broad spectrum of rearrangement partner genes and intra-chromosomal structural variants.In summary, we established CIITA genetic alterations as a frequent immune escape strategy exploited by a variety of malignant B cell lymphomas. These mutations resulted in reduced MHC class II expression and altered microenvironment composition.
B-cell lymphomas are lymphoid neoplasms derived from mature B lymphocytes at various stages of B-cell development. Advances in sequencing have contributed to decoding the genomic landscapes underlying many subtypes of B-cell lymphomas. However, it remains unclear why some B-cell lymphoma patients suffer from disease progression. A major factor contributing to disease progression is tumour heterogeneity, a consequence of branched evolutionary processes, and microenvironment heterogeneity leading to variation in the composition and properties of non-malignant cells infiltrating and surrounding the cancer. A thorough characterization of these forms of diversity in B-cell lymphomas and their association with disease progression has not been undertaken. As such, the overarching hypothesis of this thesis is that uncharacterized inter-tumour, intra-tumour, and tumour microenvironment heterogeneity impacts disease progression in B-cell lymphomas. In particular, this thesis is focused on studying these types of heterogeneity in three subtypes of B-cell lymphomas and their implications on disease progression. First, I explored inter-tumour heterogeneity in primary specimens of diffuse large B-cell lymphoma patients. I identified novel RCOR1 deletions and their corresponding transcriptional signature in a subset of patients that stratified patients into good and poor outcome following first-line treatment. Secondly, I explored intra-tumour heterogeneity in histologically transformed and early progressed follicular lymphoma patients using serial samples of their primary and transformed/progressed specimens. Through the inference of clonal dynamic patterns, I revealed divergent evolution patterns and identified novel genes underlying these distinct clinical end points. Thirdly, I explored tumour microenvironment (TME) heterogeneity in classical Hodgkin lymphoma relapse patients through serial sampling of primary pretreatment and relapse specimens. I demonstrated how specific TME dynamic patterns can inform on treatment failure. Moreover, I derived a novel, clinically applicable prognostic model (RHL30), based on the TME composition at relapse that predicts response to second-line treatment.Collectively, the work in this thesis constitutes a step forward in our characterization of tumour and microenvironment heterogeneity in B-cell lymphomas and its association with disease progression. The results presented here will aid in the determination of precise therapeutic approaches for individual lymphoma patients.
The clonal evolution theory of cancer has been recognized for decades and follows principles of Darwinian selection, in which there is selection of the fittest clones in an ecosystem that is fundamentally heterogeneous and undergoes selective pressure. Follicular lymphoma (FL) emerges as a prototypical disease in which to study clonal evolution. It is the most common indolent lymphoma and, although the median overall survival largely surpasses 10 years, patients almost invariably experience progressive disease. Furthermore, a subset of FL patients is at risk of early lymphoma-related death due to rapid progression or transformation to aggressive lymphoma. Yet, the clonal dynamics and the landscape of genomic alterations underlying progression and transformation remain to be uncovered.Herein, we applied whole genome sequencing to a discovery set of transformed, progressed and non-progressed FL cases, re-constructed clonal phylogenies, and interrogated a larger set of transformed FLs and clinical extremes by capture-based targeted sequencing. Moreover, we applied the Lymph2Cx cell-of-origin assay to determine whether molecular subtypes can be defined in transformed follicular lymphoma (TFL) by gene-expression profiling.We discovered that transformation is typically the result of drastic clonal shifts during which TFL-specific clones rapidly outcompete indolent clones. In a subset of cases, these aggressive clones can be found at low levels (
Classical Hodgkin lymphoma (HL) and primary mediastinal large B cell lymphoma (PMBCL) are related lymphomas sharing pathological, molecular and clinical characteristics. Here we discovered by next-generation sequencing recurrent somatic coding-sequence mutations in the protein tyrosine phosphatase PTPN1 and the cytokine receptor IL4R. Mutations in PTPN1 were found in 6 of 30 (20%) HL cases, in 6 of 9 (67%) HL–derived cell lines, in 17 of 77 (22%) PMBCL cases and in 1 of 3 (33%) PMBCL-derived cell lines, consisting of nonsense, missense and frameshift mutations. We demonstrate that PTPN1 mutations lead to reduced phosphatase activity and increased phosphorylation of JAK-STAT pathway members. Moreover, silencing of PTPN1 by RNA interference in HL cell line KM-H2 resulted in hyperphosphorylation and overexpression of the downstream oncogenes BCL6 and MYC. Mutations in IL4R were found in 18 of 65 (28%) PMBCL cases confirming a ‘hotspot’ missense mutation I242N in exon 8 in 11 of 18 (61%) mutated cases. Ectopic expression of the mutant I242N in HEK 293 cells showed increased activated STAT6-dependent SEAP reporter gene expression without interleukin-4 stimulation. Introduction of the mutant into Hodgkin lymphoma cell line DEV showed cytokine-independent hyperphosphorylation of JAK-STAT pathway members and upregulation of the T cell regulatory chemokine TARC (CCL17) and the B cell activation marker CD23. Our data suggest loss-of-function PTPN1 and gain-of-function IL4R mutations leading to oncogenic JAK-STAT activation as new driver alterations in lymphomagenesis with implications for future treatment strategies.
Master's Student Supervision
Theses completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest theses.
Hodgkin lymphoma (HL) is a highly curable malignancy of the pediatric population with 5-year overall survival > 96%. However, dose-intensified chemotherapy regimens in combination with radiation therapy come at a high cost in the form of long-term toxicity and morbidity. Current clinical trials aim to achieve the optimal equilibrium between high survival rates and limiting treatment-related toxicity. However, risk stratification in pediatric HL is limited to the use of clinical factors, as no robust molecular-based biomarkers for treatment outcome exist. The aim of our study was to develop an expression-based prognostic model to tailor first-line therapy in pediatric HL, and to explore biological differences between pediatric and adult HL. We obtained a training cohort of 175 patients with pre-treatment formalin-fixed paraffin-embedded tissue (FFPET) biopsies from the Children’s Oncology Group clinical trial AHOD0031, and determined expression levels of 784 genes using NanoString technology. A model for event free survival (EFS) separating patients into low- and high-risk groups was generated using Cox regression, and subsequently applied to an independent validation cohort of 71 patients enriched for events from the same trial. We developed a 9-cellular component model based on tumour microenvironment signatures to predict EFS in pediatric HL patients. Application of the model to the validation cohort identified a significant difference in 5-year EFS between high- and low-risk groups (75.7% vs. 90.5%, respectively; weighted log-rank p-value = 0.0138). Additionally, we utilized gene expression profiles of 290 pre-treatment FFPET biopsies from adult HL patients enrolled in the E2496 Intergroup trial to perform differential expression analysis and Spearman correlation between age groups. We discovered that unique microenvironment signatures are associated with age. Specifically, we revealed that eosinophil, B-cell, and mast cell signatures are more abundant in younger patients, and macrophage and stroma cell signatures are more pronounced in older patients. An expression-based prognostic model of EFS is a clinically relevant tool for pediatric HL patients allowing refinement of risk stratification at diagnosis. To investigate the utility of the 9-cellular component EFS model, future studies should incorporate the model into clinical trial designs.
The B-cell lymphomas are a heterogeneous group of disease entities arising from mature B lymphocytes and are characterized by frequent genomic rearrangements. Recurrent rearrangements involving the MHC class II transactivator CIITA and the programmed death 1 ligands PDL1 and PDL2 have been shown to contribute to an immune privilege phenotype in multiple B-cell lymphomas, with implications for novel therapeutic approaches. However, the landscape of fusion partners for these genes has not been well characterized and methods that utilize formalin-fixed paraffin-embedded (FFPE) tumour samples for breakpoint discovery have not been explored.We selected 68 B-cell lymphoma patients with known CIITA and PDL1/2 rearrangement status determined by fluorescence in situ hybridization (FISH) break-apart assays. DNA surrounding the CIITA and PDL1/2 loci was captured from FFPE tumour libraries using a hybridization-based target enrichment assay and sequenced on an Illumina HiSeq 2500. Multiple structural variant (SV) detection tools were used in an ensemble approach to generate SV predictions. We identified 35 novel translocation partners and observed translocation cluster breakpoint regions (CBRs) in CIITA, PDL1, PDL2 and the SOCS1 tumour suppressor gene downstream of CIITA. Recurrent intrachromosomal deletions, inversions and duplications were also identified in each region. Immunohistochemistry (IHC) analysis of PD-L1 and PD-L2 surface expression demonstrated that CBR translocations and a subset of intra-chromosomal rearrangements are significantly associated with increased protein expression of the respective ligand. In conjunction with published reports this suggests that distinct rearrangement types have variable functional consequences. We also report many SVs below the detection resolution of FISH, suggesting the value of a combined approach integrating FISH, capture sequencing and IHC data for characterizing genomic rearrangements in lymphomas.This study confirms the utility of a targeted sequencing approach for detecting structural variation in FFPE lymphoma tissues. Future capture designs interrogating the full set of recurrently rearranged lymphoma genes are being explored with the aim of designing a comprehensive, high-throughput and clinically relevant assay for routine profiling of rearrangement status to guide clinical decision making.