Multi-Omics Marker Analysis Enables Early Prediction of Breast Tumor Progression

Haifeng Xu; Tonje Lien; Helga Bergholtz; Thomas Fleischer; Lounes Djerroudi; Anne Vincent-Salomon; Therese Sørlie; Tero Aittokallio

doi:10.3389/fgene.2021.670749

Multi-Omics Marker Analysis Enables Early Prediction of Breast Tumor Progression

Front Genet. 2021 Jun 3:12:670749. doi: 10.3389/fgene.2021.670749. eCollection 2021.

Authors

Haifeng Xu^{1

2}, Tonje Lien¹, Helga Bergholtz¹, Thomas Fleischer¹, Lounes Djerroudi³, Anne Vincent-Salomon³, Therese Sørlie¹, Tero Aittokallio^{1

2

4}

Affiliations

¹ Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
² Oslo Centre for Biostatistics and Epidemiology (OCBE), University of Oslo, Oslo, Norway.
³ Institut Curie, Ensemble Hospitalier, Pôle de Médecine Diagnostique et Théranostique, Département de Pathologie, Paris, France.
⁴ Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.

Abstract

Ductal carcinoma in situ (DCIS) is a preinvasive form of breast cancer with a highly variable potential of becoming invasive and affecting mortality of the patients. Due to the lack of accurate markers of disease progression, many women with detected DCIS are currently overtreated. To distinguish those DCIS cases who are likely to require therapy from those who should be left untreated, there is a need for robust and predictive biomarkers extracted from molecular or genetic profiles. We developed a supervised machine learning approach that implements multi-omics feature selection and model regularization for the identification of biomarker combinations that could be used to distinguish low-risk DCIS lesions from those with a higher likelihood of progression. To investigate the genetic heterogeneity of disease progression, we applied this approach to 40 pure DCIS and 259 invasive breast cancer (IBC) samples profiled with genome-wide transcriptomics, DNA methylation, and DNA copy number variation. Feature selection using the multi-omics Lasso-regularized algorithm identified both known genes involved in breast cancer development, as well as novel markers for early detection. Even though the gene expression-based model features led to the highest classification accuracy alone, methylation data provided a complementary source of features and improved especially the sensitivity of correctly classifying DCIS cases. We also identified a number of repeatedly misclassified DCIS cases when using either the expression or methylation markers. A small panel of 10 gene markers was able to distinguish DCIS and IBC cases with high accuracy in nested cross-validation (AU-ROC = 0.99). The marker panel was not specific to any of the established breast cancer subtypes, suggesting that the 10-gene signature may provide a subtype-agnostic and cost-effective approach for breast cancer detection and patient stratification. We further confirmed high accuracy of the 10-gene signature in an external validation cohort (AU-ROC = 0.95), profiled using distinct transcriptomic assay, hence demonstrating robustness of the risk signature.

Keywords: breast cancer; disease progression; early detection; machine learning; risk signature.