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Despite recent advances in cancer therapy, options for central nervous system metastasis (CM) remain limited and patient outcomes are dismal. The lack of tumor models that reflect the heterogeneity and complexity of human CM tumors is a barrier to understanding the underlying biology and to developing novel therapies. Here, we report the development and characterization of 39 patient derived xenograft (PDX) models of CM tumors with histological subtypes representing the disease spectrum. The PDX models successfully grew both in the flank and brains of mice, and retained their histology regardless of the site of implantation. Brain metastasis also formed in 5/12 models after intra-cardiac injection. Multi-omic analysis of the PDX tumor and the patient-matched CM tumor showed that PDXs largely retained the molecular profiles of the tumor from which they were derived, including the retention of aberrations in key driver genes and signaling pathways. PDXs differed primarily from the ungrafted patient tumors by a downregulation in immunity-related pathways, which was expected due to the use of an immuno-compromised host, arguing for the validity of using the flank as a site of implantation. Integrated analysis of mutations and gene expression changes in CM revealed an upregulation of neuronal signaling and DNA damage response, and downregulation of calcium signaling and inflammation. We also assessed the clonal evolution of the PDX from the original patient CM by tracing variant allele frequencies in copy number neutral regions. We found that the PDX tumors were heterogeneous and comprised of multiple tumor clones that were either unique or in common with the original tumor, and displayed evidence of clonal expansion. Two PDXs that underwent phylogeny assessment showed evidence of minor clone expansion. One such PDX was a tumor from a Her2+ breast cancer (CM13), which largely did not molecularly resemble its matched patient tumor but was confirmed to have some shared expressed variants. The PDX was nearly copy number neutral, which included loss of the Her2 amplicon, and had few mutations compared with its parent tumor. Most noteworthy, is that CM13 displayed unique molecular patterns, aggressive growth and was highly metastatic in vivo. From the flank, it led to multiple metastases, including micrometastasis in the brain. This suggests that minor clone takeover may confer tumor aggressiveness and potentiate brain metastasis. The large and diverse repertoire of PDXs developed and characterized in this study provides a new set of tools that will help deepen our understanding of CM and improve preclinical testing for CM therapies. Our data also show that expansion of minor clones could confer aggressive tumor behavior and may be important in tumor evolution in PDX models and human cancers. Citation Format: Ben Yi Tew, Christophe Legendre, Tim Triche, Gerald C. Gooden, Kyle N. Johnson, Rae Anne Martinez, Emanuel F. Petricoin, Mariaelena Pierobon, Joyce O'Shaughnessy, Cindy Osborne, Mark A. Schroeder, Daniel J. Ma, Mark Bernstein, Jann N. Sarkaria, Steven A. Toms, Bodour Salhia. Development and characterization of patient derived xenografts from central nervous system metastasis reveal minor clone expansion linked with aggressive tumor behavior [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 991.

Metastasis to the central nervous system (CNS) remains a major cause of mortality and morbidity in patients with systemic cancer. However, the mechanistic interactions of the neural niche with disseminated tumors cells in CNS metastases (CM) are still poorly understood. To better understand the cross-talk between the neural niche and metastatic tumors, we generated five different patient-derived cell lines (PDCs) originating from surgically resected CM. To assess the genetic and epigenetic characteristics of each PDC, DNA and RNA sequencing, and DNA methylation analysis was performed. Non-tumoral PDCs revealed normal copy number profiles, and retention of germline mutations as seen in patient-matched germline DNA. In contrast, one PDC (CM04) resembled its patient tumor, showing numerous copy number and somatic alterations. RNA-seq and DNA methylation analysis demonstrated that non-tumoral PDCs highly resembled each other, suggestive of a common cell of origin. Additionally, PDCs revealed gene expression signatures associated with cancer associated fibroblasts, epithelial to mesenchymal transition, and mesenchymal stem cells. Further in vivo studies demonstrated that CM04 cells were tumorigenic, whereas non-tumoral PDC (CM08) cells were unable to form tumors in mice. However, CM04:CM08 mixed tumors were significantly smaller than CM04 only tumors and revealed induction of a fibrotic response by immunohistochemistry. These data offer the first evidence that CNS metastasis-associated stromal cells (cMASCs) produce a collagen and fibronectin-rich extracellular matrix constituting a protective host response, which impedes growth of tumor cells. The therapeutic potential of these cells merits further exploration. Citation Format: Christophe Legendre, Gerald C. Gooden, Kyle N. Johnson, Rae Anne Martinez, Mark Bernstein, Jennifer Glen, Jeffrey Kiefer, Aleksander Hinek, Steven A. Toms, Bodour Salhia. Human mesodermal-derived CNS metastasis-associated stromal cells induce a fibrotic response to limit tumor growth [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4336. doi:10.1158/1538-7445.AM2017-4336

Although several improvements in the management of breast cancer(BC) have been made, an estimated 90% of BC related deaths are due to the development of distant metastasis to organs such as lung, bone, liver, and brain. Numerous studies suggest that cell-free (cf)DNA methylation could serve as a useful biomarker for improving clinical management. The objective of our study was to identify novel blood-based biomarkers that can be used to predict BC patients at high risk of distant metastasis. For the first time we performed paired-end whole genome bisulfite sequencing (WGBS) using 15 ng of cf plasma DNA from three pools of samples which included metastatic BC to various organs (M, n = 40), breast cancer free survivors (BCF n = 40) and healthy individuals (H, n = 40). Sequences were aligned using the bismark tool and data analysis was conducted using the R package methylKit to identify base-pair resolution DNA methylation differences between groups. A minimum of 5 reads in each group, delta beta values ≥0.2 and p values Citation Format: Christophe Legendre, Gerald C. Gooden, Kyle N. Johnson, Rae Anne Martinez, Bodour Salhia. Whole genome bisulfite sequencing from plasma of patients with metastatic breast cancer identifies putative biomarkers. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3825. doi:10.1158/1538-7445.AM2015-3825