451
|
Shih DJH, Northcott PA, Remke M, Korshunov A, Ramaswamy V, Kool M, Luu B, Yao Y, Wang X, Dubuc AM, Garzia L, Peacock J, Mack SC, Wu X, Rolider A, Morrissy AS, Cavalli FMG, Jones DTW, Zitterbart K, Faria CC, Schüller U, Kren L, Kumabe T, Tominaga T, Shin Ra Y, Garami M, Hauser P, Chan JA, Robinson S, Bognár L, Klekner A, Saad AG, Liau LM, Albrecht S, Fontebasso A, Cinalli G, De Antonellis P, Zollo M, Cooper MK, Thompson RC, Bailey S, Lindsey JC, Di Rocco C, Massimi L, Michiels EMC, Scherer SW, Phillips JJ, Gupta N, Fan X, Muraszko KM, Vibhakar R, Eberhart CG, Fouladi M, Lach B, Jung S, Wechsler-Reya RJ, Fèvre-Montange M, Jouvet A, Jabado N, Pollack IF, Weiss WA, Lee JY, Cho BK, Kim SK, Wang KC, Leonard JR, Rubin JB, de Torres C, Lavarino C, Mora J, Cho YJ, Tabori U, Olson JM, Gajjar A, Packer RJ, Rutkowski S, Pomeroy SL, French PJ, Kloosterhof NK, Kros JM, Van Meir EG, Clifford SC, Bourdeaut F, Delattre O, Doz FF, Hawkins CE, Malkin D, Grajkowska WA, Perek-Polnik M, Bouffet E, Rutka JT, Pfister SM, Taylor MD. Cytogenetic prognostication within medulloblastoma subgroups. J Clin Oncol 2014; 32:886-96. [PMID: 24493713 DOI: 10.1200/jco.2013.50.9539] [Citation(s) in RCA: 211] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication. PATIENTS AND METHODS Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models. RESULTS Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas. CONCLUSION Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials.
Collapse
Affiliation(s)
- David J H Shih
- David J.H. Shih, Marc Remke, Vijay Ramaswamy, Betty Luu, Yuan Yao, Xin Wang, Adrian M. Dubuc, Livia Garzia, John Peacock, Stephen C. Mack, Xiaochong Wu, Adi Rolider, A. Sorana Morrissy, Florence M.G. Cavalli, Claudia C. Faria, Stephen W. Scherer, Uri Tabori, Cynthia E. Hawkins, David Malkin, Eric Bouffet, James T. Rutka, and Michael D. Taylor, Hospital for Sick Children; David J.H. Shih, Marc Remke, Vijay Ramaswamy, Yuan Yao, Xin Wang, Adrian M. Dubuc, John Peacock, Stephen C. Mack, and Michael D. Taylor, University of Toronto, Toronto; Boleslaw Lach, McMaster University, Hamilton, Ontario; Jennifer A. Chan, University of Calgary, Calgary, Alberta; Steffen Albrecht, Adam Fontebasso, and Nada Jabado, McGill University, Montreal, Quebec, Canada; Paul A. Northcott, Andrey Korshunov, Marcel Kool, David T.W. Jones, and Stefan M. Pfister, German Cancer Research Center; Stefan M. Pfister, University Hospital Heidelberg, Heidelberg; Ulrich Schüller, Ludwig-Maximilians-University, Munich; Stefan Rutkowski, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Karel Zitterbart, Masaryk University School of Medicine; Karel Zitterbart and Leos Kren, University Hospital Brno, Brno, Czech Republic; Toshihiro Kumabe and Teiji Tominaga, Tohoku University Graduate School of Medicine, Sendai, Japan; Young Shin Ra, University of Ulsan, Asan Medical Center; Ji-Yeoun Lee, Byung-Kyu Cho, Seung-Ki Kim, and Kyu-Chang Wang, Seoul National University Children's Hospital, Seoul; Shin Jung, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital and Medical School, Chonnam, South Korea; Peter Hauser and Miklós Garami, Semmelweis University, Budapest; László Bognár and Almos Klekner, University of Debrecen, Medical and Health Science Centre, Debrecen, Hungary; Shenandoah Robinson, Boston Children's Hospital; Scott L. Pomeroy, Harvard Medical School, Boston, MA; Ali G. Saad, University of Arkansas for Medical Sciences, Little
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
452
|
Schreiber JE, Gurney JG, Palmer SL, Bass JK, Wang M, Chen S, Zhang H, Swain M, Chapieski ML, Bonner MJ, Mabbott DJ, Knight SJ, Armstrong CL, Boyle R, Gajjar A. Examination of risk factors for intellectual and academic outcomes following treatment for pediatric medulloblastoma. Neuro Oncol 2014; 16:1129-36. [PMID: 24497405 DOI: 10.1093/neuonc/nou006] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this study was to prospectively examine the effects of hearing loss and posterior fossa syndrome (PFS), in addition to age at diagnosis and disease risk status, on change in intellectual and academic outcomes following diagnosis and treatment in a large sample of medulloblastoma patients. METHODS Data from at least 2 cognitive and academic assessments were available from 165 patients (ages 3-21 years) treated with surgery, risk-adapted craniospinal irradiation, and 4 courses of chemotherapy with stem cell support. Patients underwent serial evaluation of cognitive and academic functioning from baseline up to 5 years post diagnosis. RESULTS Serious hearing loss, PFS, younger age at diagnosis, and high-risk status were all significant risk factors for decline in intellectual and academic skills. Serious hearing loss and PFS independently predicted below-average estimated mean intellectual ability at 5 years post diagnosis. Patients with high-risk medulloblastoma and young age at diagnosis (<7 years) exhibited the largest drop in mean scores for intellectual and academic outcomes. CONCLUSIONS Despite a significant decline over time, intellectual and academic outcomes remained within the average range at 5 years post diagnosis for the majority of patients. Future studies should determine if scores remain within the average range at time points further out from treatment. Patients at heightened risk should be closely monitored and provided with recommendations for appropriate interventions.
Collapse
Affiliation(s)
- Jane E Schreiber
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - James G Gurney
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Shawna L Palmer
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Johnnie K Bass
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Mingjuan Wang
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Si Chen
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Hui Zhang
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Michelle Swain
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Mary L Chapieski
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Melanie J Bonner
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Donald J Mabbott
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Sarah J Knight
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Carol L Armstrong
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Robyn Boyle
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| | - Amar Gajjar
- Department of Psychology St. Jude Children's Research Hospital, Memphis, Tennessee (J.E.S., S.L.P.); Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee (J.G.G.); School of Public Health, University of Memphis, Memphis, Tennessee (J.G.G.); Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, Tennessee (J.K.B); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee (M.W., S.C., H.Z.); Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee (A.G.); Royal Children's Hospital Brisbane, Herston, Australia (M.S.); Department of Pediatric Medicine, Texas Children's Hospital, Houston, Texas (M.L.C.); Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (M.J.B.); Department of Psychology, The Hospital for Sick Children, Toronto, Canada (D.J.M.); Department of Psychology, The Royal Children's Hospital Melbourne, Victoria Australia (S.J.K.); Neuro-Oncology Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (C.L.A); Psychology Service, Sydney Children's Hospital, Randwick, Australia (R.B.)
| |
Collapse
|
453
|
Lindsey JC, Schwalbe EC, Potluri S, Bailey S, Williamson D, Clifford SC. TERT promoter mutation and aberrant hypermethylation are associated with elevated expression in medulloblastoma and characterise the majority of non-infant SHH subgroup tumours. Acta Neuropathol 2014; 127:307-9. [PMID: 24337442 DOI: 10.1007/s00401-013-1225-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 11/28/2013] [Accepted: 11/29/2013] [Indexed: 12/25/2022]
Affiliation(s)
- Janet C Lindsey
- Northern Institute for Cancer Research, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | | | | | | | | | | |
Collapse
|
454
|
Medulloblastoma Down Under 2013: a report from the third annual meeting of the International Medulloblastoma Working Group. Acta Neuropathol 2014; 127:189-201. [PMID: 24264598 PMCID: PMC3895219 DOI: 10.1007/s00401-013-1213-7] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/08/2013] [Indexed: 12/13/2022]
Abstract
Medulloblastoma is curable in approximately 70 % of patients. Over the past decade, progress in improving survival using conventional therapies has stalled, resulting in reduced quality of life due to treatment-related side effects, which are a major concern in survivors. The vast amount of genomic and molecular data generated over the last 5–10 years encourages optimism that improved risk stratification and new molecular targets will improve outcomes. It is now clear that medulloblastoma is not a single-disease entity, but instead consists of at least four distinct molecular subgroups: WNT/Wingless, Sonic Hedgehog, Group 3, and Group 4. The Medulloblastoma Down Under 2013 meeting, which convened at Bunker Bay, Australia, brought together 50 leading clinicians and scientists. The 2-day agenda included focused sessions on pathology and molecular stratification, genomics and mouse models, high-throughput drug screening, and clinical trial design. The meeting established a global action plan to translate novel biologic insights and drug targeting into treatment regimens to improve outcomes. A consensus was reached in several key areas, with the most important being that a novel classification scheme for medulloblastoma based on the four molecular subgroups, as well as histopathologic features, should be presented for consideration in the upcoming fifth edition of the World Health Organization’s classification of tumours of the central nervous system. Three other notable areas of agreement were as follows: (1) to establish a central repository of annotated mouse models that are readily accessible and freely available to the international research community; (2) to institute common eligibility criteria between the Children’s Oncology Group and the International Society of Paediatric Oncology Europe and initiate joint or parallel clinical trials; (3) to share preliminary high-throughput screening data across discovery labs to hasten the development of novel therapeutics. Medulloblastoma Down Under 2013 was an effective forum for meaningful discussion, which resulted in enhancing international collaborative clinical and translational research of this rare disease. This template could be applied to other fields to devise global action plans addressing all aspects of a disease, from improved disease classification, treatment stratification, and drug targeting to superior treatment regimens to be assessed in cooperative international clinical trials.
Collapse
|
455
|
Pambid MR, Berns R, Adomat HH, Hu K, Triscott J, Maurer N, Zisman N, Ramaswamy V, Hawkins CE, Taylor MD, Dunham C, Guns E, Dunn SE. Overcoming resistance to Sonic Hedgehog inhibition by targeting p90 ribosomal S6 kinase in pediatric medulloblastoma. Pediatr Blood Cancer 2014; 61:107-15. [PMID: 23940083 DOI: 10.1002/pbc.24675] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/03/2013] [Indexed: 01/08/2023]
Abstract
BACKGROUND Molecular subtyping has allowed for the beginning of personalized treatment in children suffering from medulloblastoma (MB). However, resistance inevitably emerges against these therapies, particularly in the Sonic Hedgehog (SHH) subtype. We found that children with SHH subtype have the worst outcome underscoring the need to identify new therapeutic targets. PROCEDURE High content screening of a 129 compound library identified agents that inhibited SHH MB growth. Lead molecular target levels, p90 ribosomal S6 kinase (RSK) were characterized by immunoblotting and qRT-PCR. Comparisons were made to human neural stem cells (hNSC). Impact of inhibiting RSK with the small molecule BI-D1870 or siRNA was assessed in growth assays (monolayer, neurosphere, and soft agar). NanoString was used to detect RSK in a cohort of 66 patients with MB. To determine BI-D1870 pharmacokinetics/pharmacodynamics, 100 mg/kg was I.P. injected into mice and tissues were collected at various time points. RESULTS Daoy, ONS76, UW228, and UW426 MB cells were exquisitely sensitive to BI-D1870 but unresponsive to SHH inhibitors. Anti-tumor growth corresponded with inactivation of RSK in MB cells. BI-D1870 had no effect on hNSCs. Inhibiting RSK with siRNA or BI-D1870 suppressed growth, induced apoptosis, and sensitized cells to SHH agents. Notably, RSK expression is correlated with SHH patients. In mice, BI-D1870 was well-tolerated and crossed the blood-brain barrier (BBB). CONCLUSIONS RSK inhibitors are promising because they target RSK which is correlated with SHH patients as well as cause high levels of apoptosis to only MB cells. Importantly, BI-D1870 crosses the BBB, acting as a scaffold for development of more long-lived RSK inhibitors.
Collapse
Affiliation(s)
- Mary Rose Pambid
- Department of Pediatrics, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
456
|
Remke M, Ramaswamy V, Peacock J, Shih DJH, Koelsche C, Northcott PA, Hill N, Cavalli FMG, Kool M, Wang X, Mack SC, Barszczyk M, Morrissy AS, Wu X, Agnihotri S, Luu B, Jones DTW, Garzia L, Dubuc AM, Zhukova N, Vanner R, Kros JM, French PJ, Van Meir EG, Vibhakar R, Zitterbart K, Chan JA, Bognár L, Klekner A, Lach B, Jung S, Saad AG, Liau LM, Albrecht S, Zollo M, Cooper MK, Thompson RC, Delattre OO, Bourdeaut F, Doz FF, Garami M, Hauser P, Carlotti CG, Van Meter TE, Massimi L, Fults D, Pomeroy SL, Kumabe T, Ra YS, Leonard JR, Elbabaa SK, Mora J, Rubin JB, Cho YJ, McLendon RE, Bigner DD, Eberhart CG, Fouladi M, Wechsler-Reya RJ, Faria CC, Croul SE, Huang A, Bouffet E, Hawkins CE, Dirks PB, Weiss WA, Schüller U, Pollack IF, Rutkowski S, Meyronet D, Jouvet A, Fèvre-Montange M, Jabado N, Perek-Polnik M, Grajkowska WA, Kim SK, Rutka JT, Malkin D, Tabori U, Pfister SM, Korshunov A, von Deimling A, Taylor MD. TERT promoter mutations are highly recurrent in SHH subgroup medulloblastoma. Acta Neuropathol 2013; 126:917-29. [PMID: 24174164 PMCID: PMC3830749 DOI: 10.1007/s00401-013-1198-2] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 10/15/2013] [Indexed: 11/27/2022]
Abstract
Telomerase reverse transcriptase (TERT) promoter mutations were recently shown to drive telomerase activity in various cancer types, including medulloblastoma. However, the clinical and biological implications of TERT mutations in medulloblastoma have not been described. Hence, we sought to describe these mutations and their impact in a subgroup-specific manner. We analyzed the TERT promoter by direct sequencing and genotyping in 466 medulloblastomas. The mutational distributions were determined according to subgroup affiliation, demographics, and clinical, prognostic, and molecular features. Integrated genomics approaches were used to identify specific somatic copy number alterations in TERT promoter-mutated and wild-type tumors. Overall, TERT promoter mutations were identified in 21 % of medulloblastomas. Strikingly, the highest frequencies of TERT mutations were observed in SHH (83 %; 55/66) and WNT (31 %; 4/13) medulloblastomas derived from adult patients. Group 3 and Group 4 harbored this alteration in <5 % of cases and showed no association with increased patient age. The prognostic implications of these mutations were highly subgroup-specific. TERT mutations identified a subset with good and poor prognosis in SHH and Group 4 tumors, respectively. Monosomy 6 was mostly restricted to WNT tumors without TERT mutations. Hallmark SHH focal copy number aberrations and chromosome 10q deletion were mutually exclusive with TERT mutations within SHH tumors. TERT promoter mutations are the most common recurrent somatic point mutation in medulloblastoma, and are very highly enriched in adult SHH and WNT tumors. TERT mutations define a subset of SHH medulloblastoma with distinct demographics, cytogenetics, and outcomes.
Collapse
Affiliation(s)
- Marc Remke
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Vijay Ramaswamy
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - John Peacock
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - David J. H. Shih
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Christian Koelsche
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paul A. Northcott
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nadia Hill
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
| | - Florence M. G. Cavalli
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
| | - Marcel Kool
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Xin Wang
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Stephen C. Mack
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Mark Barszczyk
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
| | - A. Sorana Morrissy
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
| | - Xiaochong Wu
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
| | - Sameer Agnihotri
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
| | - Betty Luu
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
| | - David T. W. Jones
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Livia Garzia
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
| | - Adrian M. Dubuc
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Nataliya Zhukova
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
| | - Robert Vanner
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
| | - Johan M. Kros
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Pim J. French
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Erwin G. Van Meir
- Departments of Neurosurgery and Hematology and Medical Oncology, School of Medicine and Winship Cancer Institute, Emory University, Atlanta, GA USA
| | - Rajeev Vibhakar
- Department of Pediatrics, University of Colorado Denver, Aurora, CO USA
| | - Karel Zitterbart
- Department of Pediatric Oncology, School of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Jennifer A. Chan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB Canada
| | - László Bognár
- Department of Neurosurgery, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary
| | - Almos Klekner
- Department of Neurosurgery, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary
| | - Boleslaw Lach
- Division of Anatomical Pathology, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON Canada
| | - Shin Jung
- Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital and Medical School, Chonnam, South Korea
| | - Ali G. Saad
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Linda M. Liau
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | | | - Massimo Zollo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, University of Naples, Naples, Italy
- CEINGE Biotecnologie Avanzate, Naples, Italy
| | - Michael K. Cooper
- Department of Neurology, Vanderbilt Medical Center, Nashville, TN USA
| | - Reid C. Thompson
- Department of Neurological Surgery, Vanderbilt Medical Center, Nashville, TN USA
| | - Oliver O. Delattre
- Laboratoire de Génétique et Biologie des Cancers, Institut Curie, Paris, France
| | - Franck Bourdeaut
- Laboratoire de Génétique et Biologie des Cancers, Institut Curie, Paris, France
| | - François F. Doz
- Department of Pediatric Oncology, Institut Curie and University Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Miklós Garami
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Peter Hauser
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Carlos G. Carlotti
- Department of Surgery and Anatomy, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Timothy E. Van Meter
- Pediatric Hematology-Oncology, School of Medicine, Virginia Commonwealth University, Richmond, VA USA
| | - Luca Massimi
- Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy
| | - Daniel Fults
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT USA
| | - Scott L. Pomeroy
- Department of Neurology, Harvard Medical School, Children’s Hospital Boston, Boston, ME USA
| | - Toshiro Kumabe
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Young Shin Ra
- Department of Neurosurgery, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Jeffrey R. Leonard
- Division of Pediatric Neurosurgery, Department of Neurosurgery, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, MO USA
| | - Samer K. Elbabaa
- Division of Pediatric Neurosurgery, Department of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - Jaume Mora
- Developmental Tumor Biology Laboratory, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Joshua B. Rubin
- Departments of Pediatrics, Anatomy and Neurobiology, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, MO USA
| | - Yoon-Jae Cho
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA USA
| | | | | | - Charles G. Eberhart
- Departments of Pathology, Ophthalmology and Oncology, John Hopkins University School of Medicine, Baltimore, MD USA
| | - Maryam Fouladi
- Division of Oncology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH USA
| | | | - Claudia C. Faria
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children and The Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, ON Canada
- Division of Neurosurgery, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte EPE, Lisbon, Portugal
| | - Sidney E. Croul
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Annie Huang
- Division of Haematology and Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON Canada
| | - Eric Bouffet
- Division of Haematology and Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON Canada
| | - Cynthia E. Hawkins
- Department of Pathology, The Hospital for Sick Children, Toronto, ON Canada
| | - Peter B. Dirks
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children and The Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, ON Canada
| | - William A. Weiss
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA
| | - Ulrich Schüller
- Center for Neuropathology and Prion Research, University of Munich, Munich, Germany
| | - Ian F. Pollack
- Department of Neurological Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA USA
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - David Meyronet
- Neuro-oncology and Neuro-inflammation Team, Inserm U1028, CNRS UMR 5292, Neuroscience Center, University Lyon 1, 69000 Lyon, France
- Hospices Civils de Lyon, Centre de Pathologie et de Neuropathologie Est, Lyon, 69003 France
| | - Anne Jouvet
- Neuro-oncology and Neuro-inflammation Team, Inserm U1028, CNRS UMR 5292, Neuroscience Center, University Lyon 1, 69000 Lyon, France
- Hospices Civils de Lyon, Centre de Pathologie et de Neuropathologie Est, Lyon, 69003 France
| | - Michelle Fèvre-Montange
- Centre de Recherche en Neurosciences, INSERM U1028, CNRS UMR5292, Université de Lyon, Lyon, France
| | - Nada Jabado
- Division of Experimental Medicine, McGill University, Montreal, QC Canada
| | - Marta Perek-Polnik
- Department of Oncology, The Children’s Memorial Health Institute, Warsaw, Poland
| | | | - Seung-Ki Kim
- Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children’s Hospital, Seoul, Korea
| | - James T. Rutka
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children and The Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, ON Canada
| | - David Malkin
- Division of Haematology and Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON Canada
| | - Uri Tabori
- Division of Haematology and Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON Canada
| | - Stefan M. Pfister
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, University Hospital Heidelberg, Heidelberg, Germany
| | - Andrey Korshunov
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael D. Taylor
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON Canada
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
- Division of Neurosurgery, Department of Surgery, The Hospital for Sick Children and The Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, ON Canada
| |
Collapse
|
457
|
|
458
|
Ramaswamy V, Remke M, Bouffet E, Faria CC, Perreault S, Cho YJ, Shih DJ, Luu B, Dubuc AM, Northcott PA, Schüller U, Gururangan S, McLendon R, Bigner D, Fouladi M, Ligon KL, Pomeroy SL, Dunn S, Triscott J, Jabado N, Fontebasso A, Jones DTW, Kool M, Karajannis MA, Gardner SL, Zagzag D, Nunes S, Pimentel J, Mora J, Lipp E, Walter AW, Ryzhova M, Zheludkova O, Kumirova E, Alshami J, Croul SE, Rutka JT, Hawkins C, Tabori U, Codispoti KET, Packer RJ, Pfister SM, Korshunov A, Taylor MD. Recurrence patterns across medulloblastoma subgroups: an integrated clinical and molecular analysis. Lancet Oncol 2013; 14:1200-7. [PMID: 24140199 PMCID: PMC3953419 DOI: 10.1016/s1470-2045(13)70449-2] [Citation(s) in RCA: 286] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recurrent medulloblastoma is a therapeutic challenge because it is almost always fatal. Studies have confirmed that medulloblastoma consists of at least four distinct subgroups. We sought to delineate subgroup-specific differences in medulloblastoma recurrence patterns. METHODS We retrospectively identified a discovery cohort of all recurrent medulloblastomas at the Hospital for Sick Children (Toronto, ON, Canada) from 1994 to 2012 (cohort 1), and established molecular subgroups using a nanoString-based assay on formalin-fixed paraffin-embedded tissues or frozen tissue. The anatomical site of recurrence (local tumour bed or leptomeningeal metastasis), time to recurrence, and survival after recurrence were assessed in a subgroup-specific manner. Two independent, non-overlapping cohorts (cohort 2: samples from patients with recurrent medulloblastomas from 13 centres worldwide, obtained between 1991 and 2012; cohort 3: samples from patients with recurrent medulloblastoma obtained at the NN Burdenko Neurosurgical Institute [Moscow, Russia] between 1994 and 2011) were analysed to confirm and validate observations. When possible, molecular subgrouping was done on tissue obtained from both the initial surgery and at recurrence. RESULTS Cohort 1 consisted of 30 patients with recurrent medulloblastomas; nine with local recurrences, and 21 with metastatic recurrences. Cohort 2 consisted of 77 patients and cohort 3 of 96 patients with recurrent medulloblastoma. Subgroup affiliation remained stable at recurrence in all 34 cases with available matched primary and recurrent pairs (five pairs from cohort 1 and 29 pairs from cohort 2 [15 SHH, five group 3, 14 group 4]). This finding was validated in 17 pairs from cohort 3. When analysed in a subgroup-specific manner, local recurrences in cohort 1 were more frequent in SHH tumours (eight of nine [89%]) and metastatic recurrences were more common in group 3 and group 4 tumours (17 of 20 [85%] with one WNT, p=0·0014, local vs metastatic recurrence, SHH vs group 3 vs group 4). The subgroup-specific location of recurrence was confirmed in cohort 2 (p=0·0013 for local vs metastatic recurrence, SHH vs group 3 vs group 4,), and cohort 3 (p<0·0001). Treatment with craniospinal irradiation at diagnosis was not significantly associated with the anatomical pattern of recurrence. Survival after recurrence was significantly longer in patients with group 4 tumours in cohort 1 (p=0·013) than with other subgroups, which was confirmed in cohort 2 (p=0·0075), but not cohort 3 (p=0·70). INTERPRETATION Medulloblastoma does not change subgroup at the time of recurrence, reinforcing the stability of the four main medulloblastoma subgroups. Significant differences in the location and timing of recurrence across medulloblastoma subgroups have potential treatment ramifications. Specifically, intensified local (posterior fossa) therapy should be tested in the initial treatment of patients with SHH tumours. Refinement of therapy for patients with group 3 or group 4 tumours should focus on metastases.
Collapse
Affiliation(s)
- Vijay Ramaswamy
- Division of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Marc Remke
- Division of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Bouffet
- Division of Pediatric Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Claudia C. Faria
- Division of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
- Division of Neurosurgery, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal
| | | | - Yoon-Jae Cho
- Department of Neurology, Stanford University, Palo Alto, CA, USA
| | - David J. Shih
- Division of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Betty Luu
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Adrian M. Dubuc
- Division of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Paul A. Northcott
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ulrich Schüller
- Center for Neuropathology, Ludwig-Maximilians-University, Munich, Germany
| | - Sridharan Gururangan
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
| | - Roger McLendon
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
| | - Darell Bigner
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
| | - Maryam Fouladi
- Division of Hematology/Oncology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Keith L. Ligon
- Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, and Boston Children's Hospital, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Scott L. Pomeroy
- Department of Neurology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Sandra Dunn
- Division of Hematology/Oncology, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Joanna Triscott
- Division of Hematology/Oncology, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Nada Jabado
- Division of Pediatric Hematology/Oncology, Montreal Children's Hospital, Montreal, PQ, Canada
| | - Adam Fontebasso
- Division of Pediatric Hematology/Oncology, Montreal Children's Hospital, Montreal, PQ, Canada
| | - David T. W. Jones
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marcel Kool
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias A. Karajannis
- Division of Pediatric Hematology/Oncology, NYU Langone Medical Center, New York, NY, USA
| | - Sharon L. Gardner
- Division of Pediatric Hematology/Oncology, NYU Langone Medical Center, New York, NY, USA
| | - David Zagzag
- Departments of Pathology and Neurosurgery, NYU Langone Medical Center, New York, NY, USA
| | - Sofia Nunes
- Unidade de Neuro-Oncologia Pediátrica, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - José Pimentel
- Laboratory of Neuropathology, Department of Neurology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon, Portugal
| | - Jaume Mora
- Department of Oncology, Hospital Sant Joan de Deu de Barcelona, Barcelona, Spain
| | - Eric Lipp
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
| | | | - Marina Ryzhova
- Department of Neuropathology, NN Burdenko Neurosurgical Institute, Moscow, Russia
| | - Olga Zheludkova
- Department of Pediatric Neurooncology, Dmitry Rogachev Federal Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Ella Kumirova
- Department of Pediatric Neurooncology, Dmitry Rogachev Federal Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Jad Alshami
- Division of Pediatric Hematology/Oncology, Montreal Children's Hospital, Montreal, PQ, Canada
| | - Sidney E. Croul
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - James T. Rutka
- Division of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Cynthia Hawkins
- Division of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Uri Tabori
- Division of Pediatric Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| | - Kari-Elise T. Codispoti
- Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, Washington, DC, USA
| | - Roger J. Packer
- Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, Washington, DC, USA
| | - Stefan M. Pfister
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heidelberg University Hospital, Department of Pediatric Hematology and Oncology, Heidelberg, Germany
| | - Andrey Korshunov
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center, and Department of Neuropathology, University of Heidelberg, Heidelberg, Germany
| | - Michael D. Taylor
- Division of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada
| |
Collapse
|
459
|
|
460
|
Abstract
Since its discovery as an oncogene carried by the avian acute leukemia virus MC29 in myelocytomatosis (Roussel et al. 1979) and its cloning (Vennstrom et al. 1982), c-MYC (MYC), as well as its paralogs MYCN and MYCL1, has been shown to play essential roles in cycling progenitor cells born from proliferating zones during embryonic development, and in all proliferating cells after birth. MYC deletion induces cell-cycle exit or cell death, depending on the cell type and milieu, whereas MYC and MYCN amplification or overexpression promotes cell proliferation and occurs in many cancers. Here, we review the relationship of MYC family proteins to the four molecularly distinct medulloblastoma subgroups, discuss the possible roles MYC plays in each of these subgroups and in the developing cells of the posterior fossa, and speculate on possible therapeutic strategies targeting MYC.
Collapse
Affiliation(s)
- Martine F Roussel
- Department of Tumor Cell Biology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105
| | | |
Collapse
|
461
|
Molecular insights into brain tumors: ready for translation into novel treatment strategies? Curr Opin Neurol 2013; 26:678-80. [PMID: 24152816 DOI: 10.1097/wco.0000000000000038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
462
|
Jäger N, Schlesner M, Jones DTW, Raffel S, Mallm JP, Junge KM, Weichenhan D, Bauer T, Ishaque N, Kool M, Northcott PA, Korshunov A, Drews RM, Koster J, Versteeg R, Richter J, Hummel M, Mack SC, Taylor MD, Witt H, Swartman B, Schulte-Bockholt D, Sultan M, Yaspo ML, Lehrach H, Hutter B, Brors B, Wolf S, Plass C, Siebert R, Trumpp A, Rippe K, Lehmann I, Lichter P, Pfister SM, Eils R. Hypermutation of the inactive X chromosome is a frequent event in cancer. Cell 2013; 155:567-81. [PMID: 24139898 PMCID: PMC3898475 DOI: 10.1016/j.cell.2013.09.042] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 08/02/2013] [Accepted: 09/20/2013] [Indexed: 11/26/2022]
Abstract
Mutation is a fundamental process in tumorigenesis. However, the degree to which the rate of somatic mutation varies across the human genome and the mechanistic basis underlying this variation remain to be fully elucidated. Here, we performed a cross-cancer comparison of 402 whole genomes comprising a diverse set of childhood and adult tumors, including both solid and hematopoietic malignancies. Surprisingly, we found that the inactive X chromosome of many female cancer genomes accumulates on average twice and up to four times as many somatic mutations per megabase, as compared to the individual autosomes. Whole-genome sequencing of clonally expanded hematopoietic stem/progenitor cells (HSPCs) from healthy individuals and a premalignant myelodysplastic syndrome (MDS) sample revealed no X chromosome hypermutation. Our data suggest that hypermutation of the inactive X chromosome is an early and frequent feature of tumorigenesis resulting from DNA replication stress in aberrantly proliferating cells. X chromosome has up to 4× more mutations than the autosomes in female cancer genomes Hypermutations only affect the inactive X chromosome X hypermutation involves somatic point mutations and indels, but not germline mutations No X hypermutation is found in clonal expansions of normal or premalignant cells
Collapse
Affiliation(s)
- Natalie Jäger
- Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
463
|
Whittier KL, Boese EA, Gibson-Corley KN, Kirby PA, Darbro BW, Qian Q, Ingram WJ, Robertson T, Remke M, Taylor MD, O’Dorisio MS. G-protein coupled receptor expression patterns delineate medulloblastoma subgroups. Acta Neuropathol Commun 2013; 1:66. [PMID: 24252460 PMCID: PMC3893540 DOI: 10.1186/2051-5960-1-66] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 10/01/2013] [Indexed: 12/02/2022] Open
Abstract
Background Medulloblastoma is the most common malignant brain tumor in children. Genetic profiling has identified four principle tumor subgroups; each subgroup is characterized by different initiating mutations, genetic and clinical profiles, and prognoses. The two most well-defined subgroups are caused by overactive signaling in the WNT and SHH mitogenic pathways; less is understood about Groups 3 and 4 medulloblastoma. Identification of tumor subgroup using molecular classification is set to become an important component of medulloblastoma diagnosis and staging, and will likely guide therapeutic options. However, thus far, few druggable targets have emerged. G-protein coupled receptors (GPCRs) possess characteristics that make them ideal targets for molecular imaging and therapeutics; drugs targeting GPCRs account for 30-40% of all current pharmaceuticals. While expression patterns of many proteins in human medulloblastoma subgroups have been discerned, the expression pattern of GPCRs in medulloblastoma has not been investigated. We hypothesized that analysis of GPCR expression would identify clear subsets of medulloblastoma and suggest distinct GPCRs that might serve as molecular targets for both imaging and therapy. Results Our study found that medulloblastoma tumors fall into distinct clusters based solely on GPCR expression patterns. Normal cerebellum clustered separately from the tumor samples. Further, two of the tumor clusters correspond with high fidelity to the WNT and SHH subgroups of medulloblastoma. Distinct over-expressed GPCRs emerge; for example, LGR5 and GPR64 are significantly and uniquely over-expressed in the WNT subgroup of tumors, while PTGER4 is over-expressed in the SHH subgroup. Uniquely under-expressed GPCRs were also observed. Our key findings were independently validated using a large international dataset. Conclusions Our results identify GPCRs with potential to act as imaging and therapeutic targets. Elucidating tumorigenic pathways is a secondary benefit to identifying differential GPCR expression patterns in medulloblastoma tumors.
Collapse
|
464
|
Plass C, Pfister SM, Lindroth AM, Bogatyrova O, Claus R, Lichter P. Mutations in regulators of the epigenome and their connections to global chromatin patterns in cancer. Nat Rev Genet 2013; 14:765-80. [DOI: 10.1038/nrg3554] [Citation(s) in RCA: 315] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
465
|
Lee RS, Roberts CWM. Rhabdoid tumors: an initial clue to the role of chromatin remodeling in cancer. Brain Pathol 2013; 23:200-5. [PMID: 23432645 DOI: 10.1111/bpa.12021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 12/29/2012] [Indexed: 12/25/2022] Open
Abstract
The discovery of biallelic, inactivating SMARCB1 mutations in rhabdoid tumors (RTs) over a decade ago represented the first recognized link between chromatin remodeling and tumor suppression. SMARCB1 is a core subunit of the SWI/SNF chromatin remodeling complex, and the recent emergence of frequent mutations in genes that encode subunits of this complex across a wide variety of cancers suggests that perturbation of this chromatin remodeling complex constitutes a key driver of cancer formation. Despite the highly aggressive nature of RTs, they are genetically simple cancers that appear to lack chromosomal instability and contain very few mutations. Indeed, the mutation rate in RTs is among the lowest of all cancers sequenced, with loss of SMARCB1 as essentially the sole recurrent event. Given the genetic simplicity of this disease, understanding the chromatin dysregulation caused by SMARCB1 loss may provide more general insight into how epigenetic alterations can contribute to oncogenic transformation and may reveal opportunities for targeted therapy not only of RT but also the variety of other SWI/SNF mutant cancers.
Collapse
Affiliation(s)
- Ryan S Lee
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | | |
Collapse
|
466
|
Jones DTW, Northcott PA, Kool M, Pfister SM. The role of chromatin remodeling in medulloblastoma. Brain Pathol 2013; 23:193-9. [PMID: 23432644 DOI: 10.1111/bpa.12019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 12/29/2012] [Indexed: 12/19/2022] Open
Abstract
The unexpectedly high frequency and universality of alterations to the chromatin machinery is one of the most striking themes emerging from the current deluge of cancer genomics data. Medulloblastoma (MB), a malignant pediatric brain tumor, is no exception to this trend, with a wealth of recent studies indicating multiple alterations at all levels of chromatin processing. MB is typically now regarded as being composed of four major molecular entities (WNT, SHH, Group 3 and Group 4), which vary in their clinical and biological characteristics. Similarities and differences across these subgroups are also reflected in the specific chromatin modifiers that are found to be altered in each group, and each new cancer genome sequence or microarray profile is adding to this important knowledge base. These data are fundamentally changing our understanding of tumor developmental pathways, not just for MB but also for cancer as a whole. They also provide a new class of targets for the development of rational, personalized therapeutic approaches. The mechanisms by which these chromatin remodelers are dysregulated in MB, and the consequences both for future basic research and for translation to the clinic, will be examined here.
Collapse
Affiliation(s)
- David T W Jones
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | | |
Collapse
|
467
|
Wang X, Ramaswamy V, Remke M, Mack SC, Dubuc AM, Northcott PA, Taylor MD. Intertumoral and Intratumoral Heterogeneity as a Barrier for Effective Treatment of Medulloblastoma. Neurosurgery 2013; 60 Suppl 1:57-63. [DOI: 10.1227/01.neu.0000430318.01821.6f] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
468
|
Gerges N, Fontebasso AM, Albrecht S, Faury D, Jabado N. Pediatric high-grade astrocytomas: a distinct neuro-oncological paradigm. Genome Med 2013; 5:66. [PMID: 23906214 PMCID: PMC3979088 DOI: 10.1186/gm470] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Brain tumors are the leading cause of cancer-related death in children. High-grade astrocytomas (HGAs), in particular, are lethal in children across all ages. Integrative genome-wide analyses of the tumor's genome, transcriptome and epigenome, using next-generation sequencing technologies and genome-wide DNA methylation arrays, have provided valuable breakthroughs in our understanding of the pathogenesis of HGAs across all ages. Recent profiling studies have provided insight into the epigenetic nature of gliomas in young adults and HGAs in children, particularly with the identification of recurrent gain-of-function driver mutations in the isocitrate dehydrogenase 1 and 2 genes (IDH1/2) and the epigenetic influence of their oncometabolite 2-hydroxyglutarate, as well as mutations in the histone 3 variant 3 gene (H3F3A) and loss-of-function mutations in the histone 3 lysine 36 trimethyltransferase gene (SETD2). Mutations in H3F3A result in amino acid substitutions at residues thought to directly (K27M) or indirectly (G34R/V) affect histone post-translational modifications, suggesting they have the capacity to affect the epigenome in a profound manner. Here, we review recent genomic studies, and discuss evidence supporting the molecular characterization of pediatric HGAs to complement traditional approaches, such as histology of resected tumors. We also describe newly identified molecular mechanisms and discuss putative therapeutic approaches for HGAs specific to pediatrics, highlighting the necessity for the evolution of HGA disease management approaches.
Collapse
Affiliation(s)
- Noha Gerges
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3
| | - Adam M Fontebasso
- Division of Experimental Medicine, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3
| | - Steffen Albrecht
- Department of Pathology, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada, H3H1P3
| | - Damien Faury
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3
| | - Nada Jabado
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3 ; Division of Experimental Medicine, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3
| |
Collapse
|
469
|
Natarajan S, Li Y, Miller EE, Shih DJ, Taylor MD, Stearns TM, Bronson RT, Ackerman SL, Yoon JK, Yun K. Notch1-induced brain tumor models the sonic hedgehog subgroup of human medulloblastoma. Cancer Res 2013; 73:5381-90. [PMID: 23852537 DOI: 10.1158/0008-5472.can-13-0033] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
While activation of the Notch pathway is observed in many human cancers, it is unknown whether elevated Notch1 expression is sufficient to initiate tumorigenesis in most tissues. To test the oncogenic potential of Notch1 in solid tumors, we expressed an activated form of Notch1 (N1ICD) in the developing mouse brain. N1ICD;hGFAP-cre mice were viable but developed severe ataxia and seizures, and died by weaning age. Analysis of transgenic embryo brains revealed that N1ICD expression induced p53-dependent apoptosis. When apoptosis was blocked by genetic deletion of p53, 30% to 40% of N1ICD;GFAP-cre;p53(+/-) and N1ICD;GFAP-cre;p53(-/-) mice developed spontaneous medulloblastomas. Interestingly, N1ICD-induced medulloblastomas most closely resembled the sonic hedgehog subgroup of human medulloblastoma at the molecular level. Surprisingly, N1ICD-induced tumors do not maintain high levels of the Notch pathway gene expression, except for Notch2, showing that initiating oncogenic events may not be decipherable by analyzing growing tumors in some cases. In summary, this study shows that Notch1 has an oncogenic potential in the brain when combined with other oncogenic hits, such as p53 loss, and provides a novel mouse model of medulloblastoma. Cancer Res; 73(17); 5381-90. ©2013 AACR.
Collapse
|
470
|
Hovestadt V, Remke M, Kool M, Pietsch T, Northcott PA, Fischer R, Cavalli FMG, Ramaswamy V, Zapatka M, Reifenberger G, Rutkowski S, Schick M, Bewerunge-Hudler M, Korshunov A, Lichter P, Taylor MD, Pfister SM, Jones DTW. Robust molecular subgrouping and copy-number profiling of medulloblastoma from small amounts of archival tumour material using high-density DNA methylation arrays. Acta Neuropathol 2013; 125:913-6. [PMID: 23670100 PMCID: PMC3661908 DOI: 10.1007/s00401-013-1126-5] [Citation(s) in RCA: 220] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 05/04/2013] [Indexed: 01/06/2023]
Affiliation(s)
- Volker Hovestadt
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Marc Remke
- Program in Developmental and Stem Cell Biology and The Arthur and Sonja Labatt Brain Tumour Research Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
- Division of Neurosurgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON Canada
| | - Marcel Kool
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Torsten Pietsch
- Department of Neuropathology, University of Bonn Medical Centre, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany
| | - Paul A. Northcott
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Roger Fischer
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Florence M. G. Cavalli
- Program in Developmental and Stem Cell Biology and The Arthur and Sonja Labatt Brain Tumour Research Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON Canada
| | - Vijay Ramaswamy
- Program in Developmental and Stem Cell Biology and The Arthur and Sonja Labatt Brain Tumour Research Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
- Division of Neurosurgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON Canada
| | - Marc Zapatka
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Guido Reifenberger
- Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Matthias Schick
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Melanie Bewerunge-Hudler
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Andrey Korshunov
- Department of Neuropathology, University of Heidelberg, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Peter Lichter
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Michael D. Taylor
- Program in Developmental and Stem Cell Biology and The Arthur and Sonja Labatt Brain Tumour Research Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
- Division of Neurosurgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON Canada
| | - Stefan M. Pfister
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
| | - David T. W. Jones
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| |
Collapse
|
471
|
Dykhuizen EC, Hargreaves DC, Miller EL, Cui K, Korshunov A, Kool M, Pfister S, Cho YJ, Zhao K, Crabtree GR. BAF complexes facilitate decatenation of DNA by topoisomerase IIα. Nature 2013; 497:624-7. [PMID: 23698369 PMCID: PMC3668793 DOI: 10.1038/nature12146] [Citation(s) in RCA: 200] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 04/03/2013] [Indexed: 12/19/2022]
Abstract
Recent exon-sequencing studies of human tumours have revealed that subunits of BAF (mammalian SWI/SNF) complexes are mutated in more than 20% of all human malignancies, but the mechanisms involved in tumour suppression are unclear. BAF chromatin-remodelling complexes are polymorphic assemblies that use energy provided by ATP hydrolysis to regulate transcription through the control of chromatin structure and the placement of Polycomb repressive complex 2 (PRC2) across the genome. Several proteins dedicated to this multisubunit complex, including BRG1 (also known as SMARCA4) and BAF250a (also known as ARID1A), are mutated at frequencies similar to those of recognized tumour suppressors. In particular, the core ATPase BRG1 is mutated in 5-10% of childhood medulloblastomas and more than 15% of Burkitt's lymphomas. Here we show a previously unknown function of BAF complexes in decatenating newly replicated sister chromatids, a requirement for proper chromosome segregation during mitosis. We find that deletion of Brg1 in mouse cells, as well as the expression of BRG1 point mutants identified in human tumours, leads to anaphase bridge formation (in which sister chromatids are linked by catenated strands of DNA) and a G2/M-phase block characteristic of the decatenation checkpoint. Endogenous BAF complexes interact directly with endogenous topoisomerase IIα (TOP2A) through BAF250a and are required for the binding of TOP2A to approximately 12,000 sites across the genome. Our results demonstrate that TOP2A chromatin binding is dependent on the ATPase activity of BRG1, which is compromised in oncogenic BRG1 mutants. These studies indicate that the ability of TOP2A to prevent DNA entanglement at mitosis requires BAF complexes and suggest that this activity contributes to the role of BAF subunits as tumour suppressors.
Collapse
Affiliation(s)
- Emily C Dykhuizen
- Howard Hughes Medical Institute, Stanford University School of Medicine, Stanford, California 94305, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
472
|
MicroRNA 22 regulates cell cycle length in cerebellar granular neuron precursors. Mol Cell Biol 2013; 33:2706-17. [PMID: 23671190 DOI: 10.1128/mcb.00338-13] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
During cerebellum development, Sonic hedgehog (Shh)-induced proliferation of cerebellar granular neuronal precursors (CGNPs) is potently inhibited by bone morphogenetic proteins (BMPs). We have previously reported the upregulation of TIEG-1 and Mash1, two antimitotic factors that modulate MYCN transcription and N-Myc activity, in response to BMP2. To gain further insight into the BMP antimitotic mechanism, we used microRNA (miRNA) arrays to compare the miRNAs of CGNPs proliferating in response to Shh with those of CGNPs treated with Shh plus BMP2. The array analysis revealed that miRNA 11 (miR-22) levels significantly increased in cells treated with BMP2. Additionally, in P7 mouse cerebellum, miR-22 distribution mostly recapitulated the combination of BMP2 and BMP4 expression patterns. Accordingly, in CGNP cultures, miR-22 overexpression significantly reduced cell proliferation, whereas miR-22 suppression diminished BMP2 antiproliferative activity. In contrast to BMP2, miR-22 did not induce neural differentiation but instead significantly increased cell cycle length. Consistent with the central role played by N-myc on CGNP proliferation, Max was revealed as a direct target of miR-22, and miR-22 expression caused a significant reduction of Max protein levels and N-myc/Max-dependent promoter activity. Therefore, we conclude that, in addition to the previously described mechanisms, miR-22 plays a specific role on downstream BMPs through cerebellum growth.
Collapse
|
473
|
Snuderl M, Batista A, Kirkpatrick ND, Ruiz de Almodovar C, Riedemann L, Walsh EC, Anolik R, Huang Y, Martin JD, Kamoun W, Knevels E, Schmidt T, Farrar CT, Vakoc BJ, Mohan N, Chung E, Roberge S, Peterson T, Bais C, Zhelyazkova BH, Yip S, Hasselblatt M, Rossig C, Niemeyer E, Ferrara N, Klagsbrun M, Duda DG, Fukumura D, Xu L, Carmeliet P, Jain RK. Targeting placental growth factor/neuropilin 1 pathway inhibits growth and spread of medulloblastoma. Cell 2013; 152:1065-76. [PMID: 23452854 DOI: 10.1016/j.cell.2013.01.036] [Citation(s) in RCA: 149] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 06/09/2012] [Accepted: 01/18/2013] [Indexed: 10/27/2022]
Abstract
Medulloblastoma is the most common pediatric malignant brain tumor. Although current therapies improve survival, these regimens are highly toxic and are associated with significant morbidity. Here, we report that placental growth factor (PlGF) is expressed in the majority of medulloblastomas, independent of their subtype. Moreover, high expression of PlGF receptor neuropilin 1 (Nrp1) correlates with poor overall survival in patients. We demonstrate that PlGF and Nrp1 are required for the growth and spread of medulloblastoma: PlGF/Nrp1 blockade results in direct antitumor effects in vivo, resulting in medulloblastoma regression, decreased metastasis, and increased mouse survival. We reveal that PlGF is produced in the cerebellar stroma via tumor-derived Sonic hedgehog (Shh) and show that PlGF acts through Nrp1-and not vascular endothelial growth factor receptor 1-to promote tumor cell survival. This critical tumor-stroma interaction-mediated by Shh, PlGF, and Nrp1 across medulloblastoma subtypes-supports the development of therapies targeting PlGF/Nrp1 pathway.
Collapse
Affiliation(s)
- Matija Snuderl
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
474
|
|
475
|
Rood BR, Leprince D. Deciphering HIC1 control pathways to reveal new avenues in cancer therapeutics. Expert Opin Ther Targets 2013; 17:811-27. [PMID: 23566242 DOI: 10.1517/14728222.2013.788152] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The tumor suppressor gene HIC1 (Hypermethylated in Cancer 1), which encodes a transcriptional repressor with multiple partners and multiple targets, is epigenetically silenced but not mutated in tumors. HIC1 has broad biological roles during normal development and is implicated in many canonical processes of cancer such as control of cell growth, cell survival upon genotoxic stress, cell migration, and motility. AREAS COVERED The HIC1 literature herein discussed includes its discovery as a candidate tumor suppressor gene hypermethylated or deleted in many human tumors, animal models establishing it as tumor suppressor gene, its role as a sequence-specific transcriptional repressor recruiting several chromatin regulatory complexes, its cognate target genes, and its functional roles in normal tissues. Finally, this review discusses how its loss of function contributes to the early steps in tumorigenesis. EXPERT OPINION Given HIC1's ability to direct repressive complexes to sequence-specific binding sites associated with its target genes, its loss results in specific changes in the transcriptional program of the cell. An understanding of this program through identification of HIC1's target genes and their involvement in feedback loops and cell process regulation will yield the ability to leverage this knowledge for therapeutic translation.
Collapse
Affiliation(s)
- Brian R Rood
- Center for Cancer and Blood Disorders, Children's National Medical Center, Division of Oncology, 111 Michigan Ave. NW, Washington, DC 20010, USA
| | | |
Collapse
|
476
|
Gutmann DH, Blakeley JO, Korf BR, Packer RJ. Optimizing biologically targeted clinical trials for neurofibromatosis. Expert Opin Investig Drugs 2013; 22:443-62. [PMID: 23425047 PMCID: PMC4009992 DOI: 10.1517/13543784.2013.772979] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The neurofibromatoses (neurofibromatosis type 1, NF1 and neurofibromatosis type 2, NF2) comprise the most common inherited conditions in which affected children and adults develop tumors of the central and peripheral nervous system. In this review, the authors discuss how the establishment of the Neurofibromatosis Clinical Trials Consortium (NFCTC) has positively impacted on the design and execution of treatment studies for individuals with NF1 and NF2. AREAS COVERED Using an extensive PUBMED search in collaboration with select NFCTC members expert in distinct NF topics, the authors discuss the clinical features of NF1 and NF2, the molecular biology of the NF1 and NF2 genes, the development and application of clinically relevant Nf1 and Nf2 genetically engineered mouse models and the formation of the NFCTC to enable efficient clinical trial design and execution. EXPERT OPINION The NFCTC has resulted in a more seamless integration of mouse preclinical and human clinical trials efforts. Leveraging emerging enabling resources, current research is focused on identifying subtypes of tumors in NF1 and NF2 to deliver the most active compounds to the patients most likely to respond to the targeted therapy.
Collapse
Affiliation(s)
- David H Gutmann
- Washington University School of Medicine, Department of Neurology and Washington University Neurofibromatosis Center, 660 South Euclid Avenue, St. Louis, MO 63110, USA.
| | | | | | | |
Collapse
|
477
|
Nör C, Sassi FA, de Farias CB, Schwartsmann G, Abujamra AL, Lenz G, Brunetto AL, Roesler R. The histone deacetylase inhibitor sodium butyrate promotes cell death and differentiation and reduces neurosphere formation in human medulloblastoma cells. Mol Neurobiol 2013; 48:533-43. [PMID: 23516101 DOI: 10.1007/s12035-013-8441-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 03/08/2013] [Indexed: 01/07/2023]
Abstract
Increasing evidence suggests that alterations in epigenetic mechanisms regulating chromatin state play a role in the pathogenesis of medulloblastoma (MB), the most common malignant brain tumor of childhood. Histone deacetylase (HDAC) inhibitors, which increase chromatin relaxation, have been shown to display anticancer activities. Here we show that the HDAC inhibitor sodium butyrate (NaB) markedly increases cell death and reduces colony formation in human MB cell lines. In addition, NaB increased the mRNA expression of Gria2, a neuronal differentiation marker, in D283 and DAOY cells and reduced the number of neurospheres in D283 cell cultures. Finally, NaB reduced the viability of D283 cells when combined with etoposide. These data show that NaB displays pronounced inhibitory effects on the survival of human MB cells and suggest that NaB might potentiate the effects of etoposide. In addition, our study suggests that HDAC inhibition might promote the neuronal differentiation of MB cells and provides the first evidence that an HDAC inhibitor might suppress the expansion or survival of MB cancer stem cells.
Collapse
Affiliation(s)
- Carolina Nör
- Cancer Research Laboratory, University Hospital Research Center (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
478
|
Wagner MJ, Maki RG. Type 1 insulin-like growth factor receptor targeted therapies in pediatric cancer. Front Oncol 2013; 3:9. [PMID: 23383402 PMCID: PMC3563098 DOI: 10.3389/fonc.2013.00009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 01/10/2013] [Indexed: 02/06/2023] Open
Abstract
Data from over 20 years ago demonstrated potential use for insulin-like growth factor (IGF) signaling modulators, specifically with IGF-1R antagonists, in a variety of pediatric and adolescent cancers, particularly in sarcomas. However, in spite of promising preclinical data, IGF-1R inhibitors have not had the success as single agents that was originally hoped for in clinical trials. Several potential mechanisms exist by which tumors are resistant to IGF-1R inhibitors. Notably, these resistance mechanisms are currently best understood in Ewing sarcoma and alveolar rhabdomyosarcoma. Various treatment schema have been proposed as a potential way to overcome this resistance. The use of IGF-1R inhibitors, mechanisms of resistance, and current ongoing clinical studies using IGF-1R inhibitors in pediatric cancers are reviewed here.
Collapse
Affiliation(s)
- Michael J Wagner
- Department of Medicine, Mount Sinai Medical Center New York, NY, USA
| | | |
Collapse
|
479
|
Castro-Gamero AM, Borges KS, Lira RC, Andrade AF, Fedatto PF, Cruzeiro GAV, Silva RB, Fontes AM, Valera ET, Bobola M, Scrideli CA, Tone LG. Chromosomal heterogeneity and instability characterize pediatric medulloblastoma cell lines and affect neoplastic phenotype. Cytotechnology 2013; 65:871-85. [PMID: 23325114 DOI: 10.1007/s10616-012-9529-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 12/20/2012] [Indexed: 01/09/2023] Open
Abstract
Chromosomal heterogeneity is a hallmark of most tumors and it can drive critical events as growth advantages, survival advantages, progression and karyotypic evolution. Medulloblastoma (MB) is the most common malignant central nervous system tumor in children. This work attempted to investigate chromosomal heterogeneity and instability profiles of two MB pediatric cell lines and their relationship with cell phenotype. We performed GTG-banding and cytokinesis-block micronucleus cytome assays, as well as morphological characterization, cell population doubling time, colony-forming efficiency, and chemo-sensitivity assays in two pediatric MB cell lines (UW402 and UW473). Both MB cells showed a high chromosomal heterogeneity. UW473 cells showed ~2 fold higher both clonal- and non-clonal chromosomal alterations than UW402 cells. Besides, UW473 showed two clonal-groups well-differentiated by ploidy level (<2n> and <4n>) and also presented a significantly higher number of chromosomal instability biomarkers. These results were associated with high morphological heterogeneity and survival advantages for UW473 and proliferation advantages for UW402 cells. Moreover, UW473 was significantly more sensitive to methotrexate, temozolomide and cisplatin while UW402 cells were more sensitive to doxorubicin. These data suggest that distinct different degrees of karyotypic heterogeneity and instability may affect neoplasic phenotype of MB cells. These findings bring new insights into cell and tumor biology.
Collapse
|