Integrative functional genomic delineation of the cascades of transcriptional changes involved in hepatocellular carcinoma progression

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Development of targeted therapeutics is still at its early stage for hepatocellular carcinoma (HCC) due to the incomplete understanding of the confounding regulations at signaling pathway level. In this investigation, gene co-expression-based networking and integrative functional genomic modeling of HCC mRNA profiles as signaling processes were employed to understand the complex signaling cascades involved in HCC development toward understanding the avenues for targeted therapeutics. Multiple sets of genes and molecular biological processes involved during HCC development were identified from this integrative analysis: (i) Loss of liver cellular features due to the reduced HNF4A & PPAR signaling in the early stages of HCC, (ii) activated inflammatory and stress signals in the cirrhosis stages and (iii) highly activated cellular proliferation with the activated E2F-MYC oncogenic signaling with the gain of embryonic liver stem cell-like features in the advanced stage tumors. Upon connecting these gene-sets with the established drug sensitivity-related gene signatures, targeted therapeutic strategies for the heterogeneous HCC conditions have been identified. PPAR agonist class of drugs for early stage HCC conditions, anti-inflammatory drugs for cirrhosis and topoisomerase inhibitors for the advanced HCC conditions were inferred. Integrative functional genomic analysis of HCC transcriptome profiles at the context of signaling pathways has defined the key molecular processes involved in HCC development. Further, the study highlights the stage-specific and pathway focused targeted therapeutics for HCC. These findings deserve extensive preclinical explorations toward the establishment of targeted therapeutics.What's new?Slow progress in the development of targeted therapies against hepatocellular carcinoma (HCC) is due largely to limitations in scientific understanding of the complex signaling pathways that underlie the disease. To advance this understanding, the authors of the present study performed integrative functional genomic analyses of transcriptome and signaling pathways in HCC, identifying three distinct molecular regulatory processes involved in disease development and progression. The processes centered generally on loss of hepatocyte-related signaling features in early HCC, activated inflammatory-stress signaling in cirrhosis, and proliferative signaling features in advanced HCC. Targeted therapeutic interventions were identified for specific HCC stages and pathways.

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