Supplemental Material to: A genome-wide approach identifies that the aspartate metabolism pathway contributes to asparaginase sensitivity Shih-Hsiang Chen, MD1,2, Wenjian Yang, PhD1, Yiping Fan, PhD3, Gabriele Stocco, PhD1, Kristine R. Crews, PharmD1,5, Jun J. Yang, PhD1, Steven W. Paugh, PhD1, Ching-Hon Pui, MD4,5, William E. Evans, PharmD1,5, Mary V. Relling, PharmD1,5 1 Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA 2 Division of Hematology/Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan 3 Hartwell Center for Bioinformatics and Biotechnology, St Jude Children's Research Hospital, Memphis, Tennessee, USA 4 Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA 5 Department of Clinical Pharmacy, University of Tennessee, Memphis, Tennessee, USA Methods Multivariate model to predict association of asparaginase IC50 with genotypes. Random forests is an ensemble tree-based regression algorithm for performing regressions in pathwaybased analyses. Pathway analyses allow one to cluster associated SNPs in relevant genes in biologically meaningful pathways, but such analyses of grouped SNPs are subject to bias. Random forests has several positive features. One is that it uses a random selection of features (SNPs in our case) to split each node, yielding error rates that compare favorably to other regression methods and are more robust with respect to noise. It provides an unbiased estimate of the regression error as the forest is built. We used the library package RandomForest v4.5-16 from the R program (http://www.r-project.org/)1 for our analysis. The algorithm grows a large number of unpruned trees (n=10,000 in our case) using bootstrap samples from the original data and predicts out-of-bag data (the original data that are not in the bootstrap sample, approximately one-third of the original data) in each tree. The overall prediction is then calculated by averaging the predictions of all the trees. The results of this approach for the highest ranked pathway (aspartate) are presented in the main manuscript. Comparing within-trio variability to that expected from unrelated trios of individuals. We compared the observed child-parent variability in asparaginase IC50 within trios to the variability observed in randomly-chosen child-parent trios. For each family, we estimated the intra-trio variability using the following formula: (|Child IC50 – father IC50| + |Child IC50 – mother IC50|)/ (2*|mother IC50 – father IC50|). We estimated the observed average of the child-parent variability within trios across the 30 families. To estimate “child-parent” variability had the trios not consisted of families (e.g. been “random” trios), we kept the parents unchanged for each family, but randomly selected their “child” from other families. We repeated this 1000 times, i.e. we created 1000 datasets, each dataset had 30 families, and in each family the child-parents relationship was not biological. Out of 1000 permuted estimates of such “child-parent” variability, 45 had variability less than that observed, indicating that the variability in IC50 we observed within parent/child trios is somewhat lower than that expected among unrelated “parent/child” trios (p = 0.045). References: 1. Liaw A, Wiener M. Classification and regression by randomForest. RNews. 2002;2:18-22. 2. Scherf U, Ross DT, Waltham M, et al. A gene expression database for the molecular pharmacology of cancer. Nat Genet. 2000;24:236-244. 3. Stams WA, den Boer ML, Beverloo HB, et al. Sensitivity to L-asparaginase is not associated with expression levels of asparagine synthetase in t(12;21)+ pediatric ALL. Blood. 2003;101:2743-2747. 4. Stams WA, den Boer ML, Holleman A, et al. Asparagine synthetase expression is linked with L-asparaginase resistance in TEL-AML1-negative but not TEL-AML1-positive pediatric acute lymphoblastic leukemia. Blood. 2005;105:4223-4225. 5. Fine BM, Kaspers GJ, Ho M, Loonen AH, Boxer LM. A genome-wide view of the in vitro response to l-asparaginase in acute lymphoblastic leukemia. Cancer Res. 2005;65:291299. 6. Holleman A, Cheok MH, den Boer ML, et al. Gene-expression patterns in drugresistant acute lymphoblastic leukemia cells and response to treatment. N Engl J Med. 2004;351:533-542. 7. Krejci O, Starkova J, Otova B, et al. Upregulation of asparagine synthetase fails to avert cell cycle arrest induced by L-asparaginase in TEL/AML1-positive leukaemic cells. Leukemia. 2004;18:434-441. 8. Iwamoto S, Mihara K, Downing JR, Pui CH, Campana D. Mesenchymal cells regulate the response of acute lymphoblastic leukemia cells to asparaginase. J Clin Invest. 2007;117:1049-1057. 9. Estes DA, Lovato DM, Khawaja HM, Winter SS, Larson RS. Genetic alterations determine chemotherapy resistance in childhood T-ALL: modelling in stage-specific cell lines and correlation with diagnostic patient samples. Br J Haematol. 2007;139:20-30. 10. Su N, Pan YX, Zhou M, Harvey RC, Hunger SP, Kilberg MS. Correlation between asparaginase sensitivity and asparagine synthetase protein content, but not mRNA, in acute lymphoblastic leukemia cell lines. Pediatr Blood Cancer. 2008;50:274-279.