Abstract 6429: Proteogenomic and observational evidence implicate ANGPTL4 as a potential therapeutic target for colorectal cancer prevention
Bibliographic record
Abstract
Abstract Background: Preclinical, observational, and genetic epidemiological evidence implicate circulating lipids in cancer development. The role of approved and emerging lipid-perturbing medications in cancer risk is unclear. Patients and Methods: We employed cis-Mendelian randomization (MR) and colocalization to evaluate the role of 5 lipid-perturbing drug targets (ANGPTL3, ANGPTL4, APOC3, CETP, PCSK9) in risk of 5 cancers (breast, colorectal, head and neck, ovarian, prostate) in up to 319, 661 cases and 348, 078 controls. We further triangulated findings using direct measures of pre-diagnostic protein targets in case-cohort analyses in the European Prospective Investigation into cancer and Nutrition (EPIC). To gain mechanistic insight into the role of ANGPTL4 in carcinogenesis, we examined the impact of the ANGPTL4 p.E40K loss-of-function variant on differential gene expression in normal colon tissue in the BarcUVa-Seq project. Finally, we evaluated the association of ANGPTL4 gene expression in colon tumor tissue with all-cause mortality in The Cancer Genome Atlas (TCGA). Results: In analysis of 78, 473 cases and 107, 143 controls, genetically-proxied circulating ANGPTL4 inhibition was associated with a reduced risk of colorectal cancer (OR per SD decrease: 0.76, 95% CI 0.66-0.89, P = 5.52 x 10-4, colocalization posterior probability = 0.83). This association was replicated in the EPIC cohort using pre-diagnostic circulating ANGPTL4 concentrations in 977 incident colorectal cancer cases and 4, 080 sub-cohort members (HR per log10 decrease: 0.92, 95% CI 0.85-0.99, P = 0.02). In gene set enrichment analysis of differential gene expression in 445 normal colon tissue samples, ANGPTL4 loss-of-function was associated with down-regulation of several biological pathways implicated in cancer (FDR P < 0.05), including those involved in cellular proliferation, epithelial-to-mesenchymal transition, and bile acid metabolism. In analysis of 465 colon cancer patients, lower ANGPTL4 expression in tumor tissue was associated with reduced risk of all-cause mortality (HR per log2 decrease: 0.85, 95% CI 0.73-0.99; P = 0.04). There was little evidence of association of genetically-proxied inhibition of ANGPTL4 or other lipid targets with the other cancer outcomes evaluated. Conclusion: Our integrative proteogenomic and observational analyses suggest a protective role of lower circulating ANGPTL4 concentrations in colorectal cancer risk. These findings support further evaluation of ANGPTL4, an emerging drug target for hypertriglyceridemia, as a potential therapeutic target for colorectal cancer prevention. Citation Format: James Yarmolinsky, Matthew A. Lee, Evelyn Lau, Ferran Moratalla-Navarro, Emma E. Vincent, Ruifang Li-Gao, Patrick C. Rensen, Ko Willems van Dijk, Kostas K. Tsilidis, Apiwat Sangphukieo, Elmira Ebrahimi, Jochen Hampe, Loic Le Marchand, Franzel J. van Duijnhoven, Kala Visvanathan, Michael O. Woods, Marcela Guevara, Sabina Sieri, Giovanna Masala, Keren Papier, Shama Virani, Tom Dudding, Abbas Dehghan, Dennis Wang, Victor Moreno, Marc J. Gunter, Ioanna Tzoulaki. Proteogenomic and observational evidence implicate ANGPTL4 as a potential therapeutic target for colorectal cancer prevention [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6429.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".