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      Novel analytical methods to interpret large sequencing data from small sample sizes

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          Abstract

          Background

          Targeted therapies have greatly improved cancer patient prognosis. For instance, chronic myeloid leukemia is now well treated with imatinib, a tyrosine kinase inhibitor. Around 80% of the patients reach complete remission. However, despite its great efficiency, some patients are resistant to the drug. This heterogeneity in the response might be associated with pharmacokinetic parameters, varying between individuals because of genetic variants. To assess this issue, next-generation sequencing of large panels of genes can be performed from patient samples. However, the common problem in pharmacogenetic studies is the availability of samples, often limited. In the end, large sequencing data are obtained from small sample sizes; therefore, classical statistical analyses cannot be applied to identify interesting targets. To overcome this concern, here, we described original and underused statistical methods to analyze large sequencing data from a restricted number of samples.

          Results

          To evaluate the relevance of our method, 48 genes involved in pharmacokinetics were sequenced by next-generation sequencing from 24 chronic myeloid leukemia patients, either sensitive or resistant to imatinib treatment. Using a graphical representation, from 708 identified polymorphisms, a reduced list of 115 candidates was obtained. Then, by analyzing each gene and the distribution of variant alleles, several candidates were highlighted such as UGT1A9, PTPN22, and ERCC5. These genes were already associated with the transport, the metabolism, and even the sensitivity to imatinib in previous studies.

          Conclusions

          These relevant tests are great alternatives to inferential statistics not applicable to next-generation sequencing experiments performed on small sample sizes. These approaches permit to reduce the number of targets and find good candidates for further treatment sensitivity studies.

          Electronic supplementary material

          The online version of this article (10.1186/s40246-019-0235-1) contains supplementary material, which is available to authorized users.

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          Most cited references22

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          European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013.

          Advances in chronic myeloid leukemia treatment, particularly regarding tyrosine kinase inhibitors, mandate regular updating of concepts and management. A European LeukemiaNet expert panel reviewed prior and new studies to update recommendations made in 2009. We recommend as initial treatment imatinib, nilotinib, or dasatinib. Response is assessed with standardized real quantitative polymerase chain reaction and/or cytogenetics at 3, 6, and 12 months. BCR-ABL1 transcript levels ≤10% at 3 months, 10% at 6 months and >1% from 12 months onward define failure, mandating a change in treatment. Similarly, partial cytogenetic response (PCyR) at 3 months and complete cytogenetic response (CCyR) from 6 months onward define optimal response, whereas no CyR (Philadelphia chromosome-positive [Ph+] >95%) at 3 months, less than PCyR at 6 months, and less than CCyR from 12 months onward define failure. Between optimal and failure, there is an intermediate warning zone requiring more frequent monitoring. Similar definitions are provided for response to second-line therapy. Specific recommendations are made for patients in the accelerated and blastic phases, and for allogeneic stem cell transplantation. Optimal responders should continue therapy indefinitely, with careful surveillance, or they can be enrolled in controlled studies of treatment discontinuation once a deeper molecular response is achieved.
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            Rank products: a simple, yet powerful, new method to detect differentially regulated genes in replicated microarray experiments.

            One of the main objectives in the analysis of microarray experiments is the identification of genes that are differentially expressed under two experimental conditions. This task is complicated by the noisiness of the data and the large number of genes that are examined simultaneously. Here, we present a novel technique for identifying differentially expressed genes that does not originate from a sophisticated statistical model but rather from an analysis of biological reasoning. The new technique, which is based on calculating rank products (RP) from replicate experiments, is fast and simple. At the same time, it provides a straightforward and statistically stringent way to determine the significance level for each gene and allows for the flexible control of the false-detection rate and familywise error rate in the multiple testing situation of a microarray experiment. We use the RP technique on three biological data sets and show that in each case it performs more reliably and consistently than the non-parametric t-test variant implemented in Tusher et al.'s significance analysis of microarrays (SAM). We also show that the RP results are reliable in highly noisy data. An analysis of the physiological function of the identified genes indicates that the RP approach is powerful for identifying biologically relevant expression changes. In addition, using RP can lead to a sharp reduction in the number of replicate experiments needed to obtain reproducible results.
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              Pharmacogenomics in the clinic.

              After decades of discovery, inherited variations have been identified in approximately 20 genes that affect about 80 medications and are actionable in the clinic. And some somatically acquired genetic variants direct the choice of 'targeted' anticancer drugs for individual patients. Current efforts that focus on the processes required to appropriately act on pharmacogenomic variability in the clinic are moving away from discovery and towards implementation of an evidenced-based strategy for improving the use of medications, thereby providing a cornerstone for precision medicine.
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                Author and article information

                Contributors
                florence.lichou@gmail.com
                s.orazio@bordeaux.unicancer.fr
                stephanie.dulucq@chu-bordeaux.fr
                G.Etienne@bordeaux.unicancer.fr
                M.Longy@bordeaux.unicancer.fr
                christophe.hubert@u-bordeaux.fr
                alexis.groppi@u-bordeaux.fr
                A.Monnereau@bordeaux.unicancer.fr
                francois-xavier.mahon@u-bordeaux.fr
                (+33) 5 57 57 10 51 , beatrice.turcq@u-bordeaux.fr
                Journal
                Hum Genomics
                Hum. Genomics
                Human Genomics
                BioMed Central (London )
                1473-9542
                1479-7364
                30 August 2019
                30 August 2019
                2019
                : 13
                : 41
                Affiliations
                [1 ]ISNI 0000 0001 2106 639X, GRID grid.412041.2, Laboratory of Mammary and Leukaemic Oncogenesis, Inserm U1218 ACTION, Bergonié Cancer Institute, , University of Bordeaux, ; 146 rue Léo Saignat, bâtiment TP 4ème étage, case 50, 33076 Bordeaux, France
                [2 ]ISNI 0000 0001 2106 639X, GRID grid.412041.2, Team EPICENE, Inserm U1219 BPH, Bergonié Cancer Institute, , University of Bordeaux, ; Bordeaux, France
                [3 ]ISNI 0000 0001 2106 639X, GRID grid.412041.2, Inserm U1211 MRGM, , University of Bordeaux, ; Bordeaux, France
                [4 ]ISNI 0000 0001 2106 639X, GRID grid.412041.2, The Bordeaux Bioinformatics Center (CBiB), , University of Bordeaux, ; Bordeaux, France
                Article
                235
                10.1186/s40246-019-0235-1
                6717342
                31470908
                cca6db40-565d-471d-9c48-cf3046fc2adb
                © The Author(s). 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 April 2019
                : 19 August 2019
                Funding
                Funded by: La Fondation ARC
                Award ID: PGA120140200913
                Categories
                Primary Research
                Custom metadata
                © The Author(s) 2019

                Genetics
                chronic myeloid leukemia,next-generation sequencing,pharmacogenetics,small sample size,statistics,factorial correspondence analysis,hierarchical clustering on principal components,rank products

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