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Chapter 2 - University of British Columbia

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utilized for early detection purposes as well as a target for therapeutic intervention [70-72],<br />

emphasizing its key role in cancer.<br />

In lung cancer, a number <strong>of</strong> specific genes such as CDKN2A (or p16), RASSF1A, and MGMT<br />

have shown to harbour increased promoter methylation [73]. While many <strong>of</strong> these methylation<br />

events were discovered using single locus assays, recent advances have allowed for the high<br />

throughput analysis <strong>of</strong> 1000s <strong>of</strong> genes in a single experiment [74-79]. As such, applications <strong>of</strong><br />

these high throughput approaches in lung cancer are likely to identify novel methylated genes.<br />

Similar to array CGH analysis, though many methylated genes are likely to be identified, it will<br />

be important to validate if these alterations affect downstream gene expression.<br />

1.5 Current level <strong>of</strong> integrative analysis<br />

At the time this thesis started, there were a small number <strong>of</strong> whole genome integrative studies<br />

which primarily focused on the integration <strong>of</strong> gene dosage and gene expression. In fact, the<br />

majority <strong>of</strong> the integrative analysis would be done at single locus level such as the examination<br />

<strong>of</strong> gene dosage and expression <strong>of</strong> HER2 (ERBB2) oncogene in breast cancer [80]. Moreover,<br />

there were a limited number <strong>of</strong> gene dosage or gene expression studies in lung cancer.<br />

However, from recent studies involving multiple cancer types, including lung cancer, it has been<br />

shown that anywhere between 20% and 60% <strong>of</strong> genes in regions <strong>of</strong> copy number change also<br />

exhibit a concerted change in gene expression [52, 81-84]. Conversely, when the proportion <strong>of</strong><br />

differential expression associated with gene dosage alteration was examined, it was found that<br />

only 11% <strong>of</strong> the observed differential expression could be attributed to high level DNA copy<br />

number change [83]. Thus, it is clear that gene dosage alterations are responsible for only a<br />

part <strong>of</strong> the overall dysregulated gene expression and that other mechanisms are likely involved.<br />

1.6 Need for an integrative approach to study lung cancer<br />

As discussed earlier, a gene such as CDKN2A has been shown to be inactivated by both gene<br />

dosage loss and increased promoter methylation. Thus, it is very likely that when examining a<br />

7

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