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Lee SG, Evans G, Stephen M, Goren R, Bondy M, Goodman S. Medulloblastoma and other neoplasms in patients with heterozygous germline SUFU variants: A scoping review. Am J Med Genet A 2024; 194:e63496. [PMID: 38282294 DOI: 10.1002/ajmg.a.63496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 01/30/2024]
Abstract
In 2002, heterozygous suppressor of fused variants (SUFU+/-) in the germline were described to have a tumor suppressor role in the development of pediatric medulloblastoma (MB). Other neoplasms associated with pathologic germline SUFU+/- variants have also been described among patients with basal cell nevus syndrome (BCNS; BCNS is also known as Gorlin syndrome, nevoid basal cell carcinoma [BCC] syndrome or Gorlin-Goltz syndrome; OMIM 109400), an autosomal-dominant cancer predisposition syndrome. The phenotype of patients with germline SUFU+/- variants is very poorly characterized due to a paucity of large studies with long-term follow-up. As such, there is a clinical need to better characterize the spectrum of neoplasms among patients with germline SUFU+/- variants so that clinicians can provide accurate counseling and optimize tumor surveillance strategies. The objective of this study is to perform a scoping review to map the evidence on the rate of medulloblastoma and to describe the spectrum of other neoplasms among patients with germline SUFU+/- variants. A review of all published literature in PubMed (MEDLINE), EMBASE, Cochrane, and Web of Science were searched from the beginning of each respective database until October 9, 2021. Studies of pediatric and adult patients with a confirmed germline SUFU+/- variant who were evaluated for the presence of any neoplasm (benign or malignant) were included. There were 176 patients (N = 30 studies) identified with a confirmed germline SUFU+/- variant who met inclusion criteria. Data were extracted from two cohort studies, two case-control studies, 18 case series, and eight case reports. The median age at diagnosis of a germline SUFU+/- variant was 4.5 years where 44.4% identified as female and 13.4% of variants were de novo. There were 34 different neoplasms (benign and malignant) documented among patients with confirmed germline SUFU+/- variants, and the most common were medulloblastoma (N = 59 patients), BCC (N = 21 patients), and meningioma (N = 19 patients). The median age at medulloblastoma diagnosis was 1.42 years (range 0.083-3; interquartile range 1.2). When data were available for these three most frequent neoplasms (N = 95 patients), 31 patients (32.6%) had neither MB, BCC nor meningioma; 51 patients (53.7%) had one of medulloblastoma or BCC or meningioma; eight patients (8.4%) had two of medulloblastoma or BCC or meningioma, and five patients (5.3%) had medulloblastoma and BCC and meningioma. This is the first study to synthesize the data on the frequency and spectrum of neoplasms specifically among patients with a confirmed germline SUFU+/- variant. This scoping review is a necessary step forward in optimizing evidence-based tumor surveillance strategies for medulloblastoma and estimating the risk of other neoplasms that could impact patient outcomes.
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Affiliation(s)
- Stephanie G Lee
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Gareth Evans
- Division of Evolution, Infection and Genomic Science, Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester NHS Foundation Trust, Manchester, UK
| | - Maddie Stephen
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Goren
- Queen's School of Medicine, Queens University, Kingston, Ontario, Canada
| | - Melissa Bondy
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California, USA
| | - Steven Goodman
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California, USA
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Serpieri V, D’Abrusco F, Dempsey JC, Cheng YHH, Arrigoni F, Baker J, Battini R, Bertini ES, Borgatti R, Christman AK, Curry C, D'Arrigo S, Fluss J, Freilinger M, Gana S, Ishak GE, Leuzzi V, Loucks H, Manti F, Mendelsohn N, Merlini L, Miller CV, Muhammad A, Nuovo S, Romaniello R, Schmidt W, Signorini S, Siliquini S, Szczałuba K, Vasco G, Wilson M, Zanni G, Boltshauser E, Doherty D, Valente EM. SUFU haploinsufficiency causes a recognisable neurodevelopmental phenotype at the mild end of the Joubert syndrome spectrum. J Med Genet 2022; 59:888-894. [PMID: 34675124 PMCID: PMC9411896 DOI: 10.1136/jmedgenet-2021-108114] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/29/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Joubert syndrome (JS) is a recessively inherited ciliopathy characterised by congenital ocular motor apraxia (COMA), developmental delay (DD), intellectual disability, ataxia, multiorgan involvement, and a unique cerebellar and brainstem malformation. Over 40 JS-associated genes are known with a diagnostic yield of 60%-75%.In 2018, we reported homozygous hypomorphic missense variants of the SUFU gene in two families with mild JS. Recently, heterozygous truncating SUFU variants were identified in families with dominantly inherited COMA, occasionally associated with mild DD and subtle cerebellar anomalies. METHODS We reanalysed next generation sequencing (NGS) data in two cohorts comprising 1097 probands referred for genetic testing of JS genes. RESULTS Heterozygous truncating and splice-site SUFU variants were detected in 22 patients from 17 families (1.5%) with strong male prevalence (86%), and in 8 asymptomatic parents. Patients presented with COMA, hypotonia, ataxia and mild DD, and only a third manifested intellectual disability of variable severity. Brain MRI showed consistent findings characterised by vermis hypoplasia, superior cerebellar dysplasia and subtle-to-mild abnormalities of the superior cerebellar peduncles. The same pattern was observed in two out of three tested asymptomatic parents. CONCLUSION Heterozygous truncating or splice-site SUFU variants cause a novel neurodevelopmental syndrome encompassing COMA and mild JS, which likely represent overlapping entities. Variants can arise de novo or be inherited from a healthy parent, representing the first cause of JS with dominant inheritance and reduced penetrance. Awareness of this condition will increase the diagnostic yield of JS genetic testing, and allow appropriate counselling about prognosis, medical monitoring and recurrence risk.
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Affiliation(s)
| | - Fulvio D’Abrusco
- Department of Molecular Medicine, University of Pavia, Pavia, Lombardia, Italy
| | - Jennifer C Dempsey
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Yong-Han Hank Cheng
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Filippo Arrigoni
- Neuroimaging Lab, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Janice Baker
- Genomics and Genetic Medicine Department, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Roberta Battini
- Unit of Child Neuropsychiatry, IRCCS Foundation Stella Maris, Calambrone, Toscana, Italy,Department of Clinical ad Experimental Medicine, University of Pisa, Pisa, Italy
| | - Enrico Silvio Bertini
- Laboratory of Molecular Medicine, Unit of Muscular and Neurodegenerative Diseases, Department of Neuroscience, Bambino Gesu Children's Hospital, IRCCS, Rome, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Angela K Christman
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Cynthia Curry
- Department of Pediatrics, Stanford University, Stanford, California, USA,Division of Medical Genetics, Department of Pediatrics, University of California San Francisco, Fresno, California, USA,University Pediatric Specialists, Fresno, California, USA
| | - Stefano D'Arrigo
- Department of Developmental Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Joel Fluss
- Department of Women, Children and Adolescents, Geneva University Hospitals, Geneva, Switzerland
| | - Michael Freilinger
- Department of Paediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Simone Gana
- Neurogenetics Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Gisele E Ishak
- Department of Neuroradiology, University of Washington School of Medicine, Seattle, Washington, USA,Pediatric Radiology, Seattle Children’s Hospital, Seattle, Washington, USA
| | - Vincenzo Leuzzi
- Department of Human Neuroscience, University of Rome La Sapienza, Roma, Lazio, Italy
| | - Hailey Loucks
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Filippo Manti
- Department of Human Neuroscience, University of Rome La Sapienza, Roma, Lazio, Italy
| | - Nancy Mendelsohn
- Complex Health Solutions, United Healthcare, Minneapolis, Minnesota, USA
| | - Laura Merlini
- Department of Pediatric Radiology, Geneva University Hospitals Children's Hospital, Geneva, Switzerland
| | - Caitlin V Miller
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA
| | - Ansar Muhammad
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland,Depatment of Ophtalmology, University of Lausanne, Jules Gonin Eye Hospital, Lausanne, Switzerland,Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland
| | - Sara Nuovo
- Department of Experimental Medicine, University of Rome La Sapienza, Rome, Lazio, Italy
| | - Romina Romaniello
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Wolfgang Schmidt
- Center for Anatomy and Cell Biology, Neuromuscular Research Department, Medical University of Vienna, Vienna, Austria
| | - Sabrina Signorini
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Sabrina Siliquini
- Child Neuropsychiatry Unit, Paediatric Hospital G Salesi, Ancona, Italy
| | - Krzysztof Szczałuba
- Department of Medical Genetics, Warszawski Uniwersytet Medyczny, Warszawa, Poland
| | - Gessica Vasco
- Unit of Neurorehabilitation, Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Roma, Italy
| | - Meredith Wilson
- Department of Clinical Genetics, Children’s Hospital at Westmead, Sydney, New South Wales, Australia,Discipline of Genomic Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Ginevra Zanni
- Laboratory of Molecular Medicine, Unit of Muscular and Neurodegenerative Diseases, Department of Neuroscience, Bambino Gesu Children's Hospital, IRCCS, Rome, Italy
| | - Eugen Boltshauser
- Department of Pediatric Neurology (Emeritus), University Children's Hospital Zürich, Zurich, Zürich, Switzerland
| | - Dan Doherty
- Department of Pediatrics, University of Washington Center for Mendelian Genomics, WashingtonUSA,Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Enza Maria Valente
- Neurogenetics Research Centre, IRCCS Mondino Foundation, Pavia, Italy,Department of Molecular Medicine, University of Pavia, Pavia, Lombardia, Italy
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Guerrini-Rousseau L, Masliah-Planchon J, Waszak SM, Alhopuro P, Benusiglio PR, Bourdeaut F, Brecht IB, Del Baldo G, Dhanda SK, Garrè ML, Gidding CEM, Hirsch S, Hoarau P, Jorgensen M, Kratz C, Lafay-Cousin L, Mastronuzzi A, Pastorino L, Pfister SM, Schroeder C, Smith MJ, Vahteristo P, Vibert R, Vilain C, Waespe N, Winship IM, Evans DG, Brugieres L. Cancer risk and tumour spectrum in 172 patients with a germline SUFU pathogenic variation: a collaborative study of the SIOPE Host Genome Working Group. J Med Genet 2022; 59:jmedgenet-2021-108385. [PMID: 35768194 PMCID: PMC9613872 DOI: 10.1136/jmedgenet-2021-108385] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/23/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Little is known about risks associated with germline SUFU pathogenic variants (PVs) known as a cancer predisposition syndrome. METHODS To study tumour risks, we have analysed data of a large cohort of 45 unpublished patients with a germline SUFU PV completed with 127 previously published patients. To reduce the ascertainment bias due to index patient selection, the risk of tumours was evaluated in relatives with SUFU PV (89 patients) using the Nelson-Aalen estimator. RESULTS Overall, 117/172 (68%) SUFU PV carriers developed at least one tumour: medulloblastoma (MB) (86 patients), basal cell carcinoma (BCC) (25 patients), meningioma (20 patients) and gonadal tumours (11 patients). Thirty-three of them (28%) had multiple tumours. Median age at diagnosis of MB, gonadal tumour, first BCC and first meningioma were 1.5, 14, 40 and 44 years, respectively. Follow-up data were available for 160 patients (137 remained alive and 23 died). The cumulative incidence of tumours in relatives was 14.4% (95% CI 6.8 to 21.4), 18.2% (95% CI 9.7 to 25.9) and 44.1% (95% CI 29.7 to 55.5) at the age of 5, 20 and 50 years, respectively. The cumulative risk of an MB, gonadal tumour, BCC and meningioma at age 50 years was: 13.3% (95% CI 6 to 20.1), 4.6% (95% CI 0 to 9.7), 28.5% (95% CI 13.4 to 40.9) and 5.2% (95% CI 0 to 12), respectively. Sixty-four different PVs were reported across the entire SUFU gene and inherited in 73% of cases in which inheritance could be evaluated. CONCLUSION Germline SUFU PV carriers have a life-long increased risk of tumours with a spectrum dominated by MB before the age of 5, gonadal tumours during adolescence and BCC and meningioma in adulthood, justifying fine-tuned surveillance programmes.
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Affiliation(s)
- Léa Guerrini-Rousseau
- Department of Children and Adolescents Oncology, Gustave Roussy, Villejuif, France
- Team "Genomics and Oncogenesis of pediatric Brain Tumors"-Paris Saclay University, INSERM U981, VILLEJUIF, France
| | - Julien Masliah-Planchon
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Institute Curie, Paris, France
| | - Sebastian M Waszak
- Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Pediatric Research, Oslo University Hospital, Oslo, Norway
| | - Pia Alhopuro
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Patrick R Benusiglio
- Département de Génétique et Institut Universitaire de Cancérologie, Sorbonne University Faculty of Medicine Pitié-Salpêtrière Campus, Paris, France
| | - Franck Bourdeaut
- INSERM U830, Laboratory of Translational Research in Pediatric Oncology, SIREDO Pediatric Oncology Center, Institute Curie, Paris, France
| | - Ines B Brecht
- Department of Pediatric Oncology and Hematology, University Hospitals Tubingen, Tubingen, Germany
| | - Giada Del Baldo
- Department of Hematology/Oncology, Cell Therapy, Gene Therapy and Hemopoietic Transplant, IRCCS, Bambino Gesu Pediatric Hospital, Roma, Italy
| | - Sandeep Kumar Dhanda
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Maria Luisa Garrè
- Neuro-Oncology Unit, Department of Neurochirurgia, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Corrie E M Gidding
- Neuro-Oncology Department, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Steffen Hirsch
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg Health Center, Heidelberg, Germany
| | - Pauline Hoarau
- Department of Children and Adolescents Oncology, Gustave Roussy, Villejuif, France
| | - Mette Jorgensen
- Oncology, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - Christian Kratz
- Paediatric Haematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Lucie Lafay-Cousin
- Section of Pediatric Hematology Oncology and Bone Marrow Transplantation, Alberta Children's Hospital and Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Angela Mastronuzzi
- Pediatric Hematology/Oncology and Stem Cells Transplatation, Bambino Gesu Pediatric Hospital, Roma, Italy
| | - Lorenza Pastorino
- Department of Oncology, Biology and Genetics, University of Genoa, Genoa, Italy
- Genetics of Rare Cancers, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Stefan M Pfister
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg Health Center, Heidelberg, Germany
- Division of Pediatric Neurooncology, DKFZ, Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christopher Schroeder
- Institute of Medical Genetics and Applied Genomics, University of Tubingen Institute of Human Genetics, Tubingen, Germany
| | - Miriam Jane Smith
- Division of Evolution, Infection and Genomics, The University of Manchester, Manchester, UK
| | - Pia Vahteristo
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
- Department of Medical and Clinical Genetics, Applied Tumor Genomics Research Program, University of Helsinki, Helsinki, Finland
| | - Roseline Vibert
- Department of Genetics, PSL Research University, Institute Curie, Paris, France
| | - Catheline Vilain
- Department of Genetics, Hôpital Universitaire des Enfants Reine Fabiola, ULB Center of Human Genetics, Universite Libre de Bruxelles, Bruxelles, Belgium
- Department of Genetics, Hôpital Erasme, ULB Center of Human Genetics, Universite Libre de Bruxelles, Bruxelles, Belgium
| | - Nicolas Waespe
- CANSEARCH Research Platform, Depatment of pediatric oncology and hematology, University of Geneva, Geneva, Switzerland
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ingrid M Winship
- Department of Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - D Gareth Evans
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester Academic Health Science Centre, School of Biological Sciences,Division of Evolution, Infection and Genomics, The University of Manchester, Manchester, UK
| | - Laurence Brugieres
- Team "Genomics and Oncogenesis of pediatric Brain Tumors"-Paris Saclay University, INSERM U981, VILLEJUIF, France
- Department of Children and Adolescents Oncology, Gustave Roussy Institute, Villejuif, France
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Molecular Bases of Human Malformation Syndromes Involving the SHH Pathway: GLIA/R Balance and Cardinal Phenotypes. Int J Mol Sci 2021; 22:ijms222313060. [PMID: 34884862 PMCID: PMC8657641 DOI: 10.3390/ijms222313060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 11/27/2021] [Accepted: 11/30/2021] [Indexed: 12/11/2022] Open
Abstract
Human hereditary malformation syndromes are caused by mutations in the genes of the signal transduction molecules involved in fetal development. Among them, the Sonic hedgehog (SHH) signaling pathway is the most important, and many syndromes result from its disruption. In this review, we summarize the molecular mechanisms and role in embryonic morphogenesis of the SHH pathway, then classify the phenotype of each malformation syndrome associated with mutations of major molecules in the pathway. The output of the SHH pathway is shown as GLI activity, which is generated by SHH in a concentration-dependent manner, i.e., the sum of activating form of GLI (GLIA) and repressive form of GLI (GLIR). Which gene is mutated and whether the mutation is loss-of-function or gain-of-function determine in which concentration range of SHH the imbalance occurs. In human malformation syndromes, too much or too little GLI activity produces symmetric phenotypes affecting brain size, craniofacial (midface) dysmorphism, and orientation of polydactyly with respect to the axis of the limb. The symptoms of each syndrome can be explained by the GLIA/R balance model.
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Molecular alterations in retinoblastoma beyond RB1. Exp Eye Res 2021; 211:108753. [PMID: 34478740 DOI: 10.1016/j.exer.2021.108753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/29/2021] [Indexed: 12/24/2022]
Abstract
Retinoblastoma is the most common malignant ocular tumor in children. Although RB1 alterations are most frequently involved in the etiology of retinoblastoma, candidate driver events and somatic alterations leading to cell transformation, tumor onset and progression remain poorly understood. In this study, we identified novel genomic alterations in tumors with a panel of 160 genes. Sanger sequencing and Multiplex Ligation-dependent Probe Amplification (MLPA) were initially performed for identifying patients without apparent RB1 alterations in blood DNA. Subsequently, NGS analyses of 24 paired (blood/tumor) samples of these patients were carried out for identifying somatic mutations and copy number variation in RB1 and other 159 genes. One novel pathogenic RB1 mutation and seven novel VUS were identified as well as 90 novel pathogenic mutations in 61 other genes. Twenty-three genes appeared exclusively mutated in tumors without altered RB1 alleles and three frequently affected biological pathways while five other tumors did not show pathogenic RB1 alterations or SNV/indels in 159 other genes. Curiously, deletion of GATA2, AKT1, ARID1A, DNMT3A, MAP2K2, MEN1, MTOR, PTCH1 and SUFU (in homo- or heterozygosity) were exclusively found in these tumors when compared to those with any pathogenic alterations, probably indicating genes that might be essential for the development of retinoblastoma regardless of a functional RB1. Identification of genes associated with retinoblastoma will contribute to understanding presently unknown aspects of this malignancy, which might be essential for its initiation and progression, as well as providing valuable molecular markers.
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Patterson JD, Henson JC, Breese RO, Bielamowicz KJ, Rodriguez A. CAR T Cell Therapy for Pediatric Brain Tumors. Front Oncol 2020; 10:1582. [PMID: 32903405 PMCID: PMC7435009 DOI: 10.3389/fonc.2020.01582] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/22/2020] [Indexed: 12/31/2022] Open
Abstract
Chimeric Antigen Receptor (CAR) T cell therapy has recently begun to be used for solid tumors such as glioblastoma multiforme. Many children with pediatric malignant brain tumors develop extensive long-term morbidity of intensive multimodal curative treatment. Others with certain diagnoses and relapsed disease continue to have limited therapies and a dismal prognosis. Novel treatments such as CAR T cells could potentially improve outcomes and ameliorate the toxicity of current treatment. In this review, we discuss the potential of using CAR therapy for pediatric brain tumors. The emerging insights on the molecular subtypes and tumor microenvironment of these tumors provide avenues to devise strategies for CAR T cell therapy. Unique characteristics of these brain tumors, such as location and associated morbid treatment induced neuro-inflammation, are novel challenges not commonly encountered in adult brain tumors. Despite these considerations, CAR T cell therapy has the potential to be integrated into treatment schema for aggressive pediatric malignant brain tumors in the future.
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Affiliation(s)
- John D Patterson
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jeffrey C Henson
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Rebecca O Breese
- Department of General Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, United States
| | - Kevin J Bielamowicz
- Division of Hematology/Oncology, Department of Pediatrics, Arkansas Children's Research Institute, Little Rock, AR, United States
| | - Analiz Rodriguez
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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AlRayahi J, Zapotocky M, Ramaswamy V, Hanagandi P, Branson H, Mubarak W, Raybaud C, Laughlin S. Pediatric Brain Tumor Genetics: What Radiologists Need to Know. Radiographics 2019; 38:2102-2122. [PMID: 30422762 DOI: 10.1148/rg.2018180109] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Brain tumors are the most common solid tumors in the pediatric population. Pediatric neuro-oncology has changed tremendously during the past decade owing to ongoing genomic advances. The diagnosis, prognosis, and treatment of pediatric brain tumors are now highly reliant on the genetic profile and histopathologic features of the tumor rather than the histopathologic features alone, which previously were the reference standard. The clinical information expected to be gleaned from radiologic interpretations also has evolved. Imaging is now expected to not only lead to a relevant short differential diagnosis but in certain instances also aid in predicting the specific tumor and subtype and possibly the prognosis. These processes fall under the umbrella of radiogenomics. Therefore, to continue to actively participate in patient care and/or radiogenomic research, it is important that radiologists have a basic understanding of the molecular mechanisms of common pediatric central nervous system tumors. The genetic features of pediatric low-grade gliomas, high-grade gliomas, medulloblastomas, and ependymomas are reviewed; differences between pediatric and adult gliomas are highlighted; and the critical oncogenic pathways of each tumor group are described. The role of the mitogen-activated protein kinase pathway in pediatric low-grade gliomas and of histone mutations as epigenetic regulators in pediatric high-grade gliomas is emphasized. In addition, the oncogenic drivers responsible for medulloblastoma, the classification of ependymomas, and the associated imaging correlations and clinical implications are discussed. ©RSNA, 2018.
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Affiliation(s)
- Jehan AlRayahi
- From the Departments of Diagnostic Imaging (J.A., W.M.), Neurooncology (M.Z., V.R.), and Pediatric Neuroradiology (H.B., C.R., S.L.), The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Diagnostic Imaging (J.A., P.H.) and Pediatric Interventional Radiology (W.M.), Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar
| | - Michal Zapotocky
- From the Departments of Diagnostic Imaging (J.A., W.M.), Neurooncology (M.Z., V.R.), and Pediatric Neuroradiology (H.B., C.R., S.L.), The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Diagnostic Imaging (J.A., P.H.) and Pediatric Interventional Radiology (W.M.), Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar
| | - Vijay Ramaswamy
- From the Departments of Diagnostic Imaging (J.A., W.M.), Neurooncology (M.Z., V.R.), and Pediatric Neuroradiology (H.B., C.R., S.L.), The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Diagnostic Imaging (J.A., P.H.) and Pediatric Interventional Radiology (W.M.), Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar
| | - Prasad Hanagandi
- From the Departments of Diagnostic Imaging (J.A., W.M.), Neurooncology (M.Z., V.R.), and Pediatric Neuroradiology (H.B., C.R., S.L.), The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Diagnostic Imaging (J.A., P.H.) and Pediatric Interventional Radiology (W.M.), Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar
| | - Helen Branson
- From the Departments of Diagnostic Imaging (J.A., W.M.), Neurooncology (M.Z., V.R.), and Pediatric Neuroradiology (H.B., C.R., S.L.), The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Diagnostic Imaging (J.A., P.H.) and Pediatric Interventional Radiology (W.M.), Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar
| | - Walid Mubarak
- From the Departments of Diagnostic Imaging (J.A., W.M.), Neurooncology (M.Z., V.R.), and Pediatric Neuroradiology (H.B., C.R., S.L.), The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Diagnostic Imaging (J.A., P.H.) and Pediatric Interventional Radiology (W.M.), Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar
| | - Charles Raybaud
- From the Departments of Diagnostic Imaging (J.A., W.M.), Neurooncology (M.Z., V.R.), and Pediatric Neuroradiology (H.B., C.R., S.L.), The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Diagnostic Imaging (J.A., P.H.) and Pediatric Interventional Radiology (W.M.), Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar
| | - Suzanne Laughlin
- From the Departments of Diagnostic Imaging (J.A., W.M.), Neurooncology (M.Z., V.R.), and Pediatric Neuroradiology (H.B., C.R., S.L.), The Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada M5G 1X8; and Departments of Diagnostic Imaging (J.A., P.H.) and Pediatric Interventional Radiology (W.M.), Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar
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8
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Abstract
Developments over the past five years have significantly advanced our ability to use genome-scale analyses—including high-density genotyping, transcriptome sequencing, exome sequencing, and genome sequencing—to identify the genetic basis of childhood cancer. This article reviews several key results from an expanding number of genomic studies of pediatric cancer: ( a) Histopathologic subtypes of cancers can be associated with a high incidence of germline predisposition, ( b) neurodevelopmental disorders or highly penetrant cancer predisposition syndromes can result from specific patterns of variation in genes encoding the SMARC family of chromatin remodelers, ( c) genome-wide association studies with relatively small pediatric cancer cohorts have successfully identified single-nucleotide polymorphisms with large effect sizes and provided insight into population differences in cancer risk, and ( d) multiple exome or genome analyses of unselected childhood cancer cohorts have yielded a 7–10% incidence of pathogenic variants in cancer predisposition genes. This work supports the increasing use of genomic sequencing in the care of pediatric cancer patients and at-risk family members.
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Affiliation(s)
- Sharon E. Plon
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas 77030, USA
- Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Philip J. Lupo
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas 77030, USA
- Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, Texas 77030, USA
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9
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Mutations in SUFU and PTCH1 genes may cause different cutaneous cancer predisposition syndromes: similar, but not the same. Fam Cancer 2019; 17:601-606. [PMID: 29356994 DOI: 10.1007/s10689-018-0073-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Many cancer predisposition syndromes are preceded or accompanied by a range of typical skin signs. Gorlin syndrome is a rare multisystem inherited disorder which can predispose to basal cell carcinomas (BCCs), childhood medulloblastomas in addition to various developmental abnormalities; the majority of cases are due to mutations in the PTCH1 gene. Approximately 5% of cases have been attributed to a mutation in the SUFU gene. Certain phenotypic features have been identified as being more prevalent in individuals with a SUFU mutation such as childhood medulloblastoma, infundibulocystic BCCs and trichoepitheliomas. Recently hamartomatous skin lesions have also been noted in families with childhood medulloblastoma, a "Gorlin like" phenotype and a SUFU mutation. Here we describe a family previously diagnosed with Gorlin syndrome with a novel SUFU splice site deleterious genetic variant, who have several dermatological features including palmar sclerotic fibromas which has not been described in relation to a SUFU mutation before. We highlight the features more prominent in individuals with a SUFU mutation. It is important to note that emerging therapies for treatment of BCCs in patients with a PTCH1 mutation may not be effective in those with a SUFU mutation.
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10
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Yin WC, Satkunendran T, Mo R, Morrissy S, Zhang X, Huang ES, Uusküla-Reimand L, Hou H, Son JE, Liu W, Liu YC, Zhang J, Parker J, Wang X, Farooq H, Selvadurai H, Chen X, Ngan ESW, Cheng SY, Dirks PB, Angers S, Wilson MD, Taylor MD, Hui CC. Dual Regulatory Functions of SUFU and Targetome of GLI2 in SHH Subgroup Medulloblastoma. Dev Cell 2018; 48:167-183.e5. [PMID: 30554998 DOI: 10.1016/j.devcel.2018.11.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/07/2018] [Accepted: 11/09/2018] [Indexed: 01/09/2023]
Abstract
SUFU alterations are common in human Sonic Hedgehog (SHH) subgroup medulloblastoma (MB). However, its tumorigenic mechanisms have remained elusive. Here, we report that loss of Sufu alone is unable to induce MB formation in mice, due to insufficient Gli2 activation. Simultaneous loss of Spop, an E3 ubiquitin ligase targeting Gli2, restores robust Gli2 activation and induces rapid MB formation in Sufu knockout background. We also demonstrated a tumor-promoting role of Sufu in Smo-activated MB (∼60% of human SHH MB) by maintaining robust Gli activity. Having established Gli2 activation as a key driver of SHH MB, we report a comprehensive analysis of its targetome. Furthermore, we identified Atoh1 as a target and molecular accomplice of Gli2 that activates core SHH MB signature genes in a synergistic manner. Overall, our work establishes the dual role of SUFU in SHH MB and provides mechanistic insights into transcriptional regulation underlying Gli2-mediated SHH MB tumorigenesis.
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Affiliation(s)
- Wen-Chi Yin
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Thevagi Satkunendran
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Rong Mo
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sorana Morrissy
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Arthur and Sonic Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada; Department of Biochemistry & Molecular Biology, University of Calgary, Calgary, AB, Canada; Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Xiaoyun Zhang
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Eunice Shiao Huang
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Liis Uusküla-Reimand
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Huayun Hou
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada; Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Joe Eun Son
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Weifan Liu
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Yulu C Liu
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Jianing Zhang
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Joint Institute of Genetics and Genomic Medicine, Zhejiang University and University of Toronto, Toronto, ON, Canada
| | - Jessica Parker
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Xin Wang
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Arthur and Sonic Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Hamza Farooq
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Arthur and Sonic Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Hayden Selvadurai
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Arthur and Sonic Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Xin Chen
- Joint Institute of Genetics and Genomic Medicine, Zhejiang University and University of Toronto, Toronto, ON, Canada
| | - Elly Sau-Wai Ngan
- Department of Surgery, University of Hong Kong, Hong Kong SAR, China
| | - Steven Y Cheng
- Department of developmental Genetics, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Peter B Dirks
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada; Arthur and Sonic Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stephane Angers
- Department of Biochemistry, University of Toronto, Toronto, ON, Canada
| | - Michael D Wilson
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada; Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Michael D Taylor
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Arthur and Sonic Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Chi-Chung Hui
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada; Joint Institute of Genetics and Genomic Medicine, Zhejiang University and University of Toronto, Toronto, ON, Canada.
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11
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Targeting DDX3 in Medulloblastoma Using the Small Molecule Inhibitor RK-33. Transl Oncol 2018; 12:96-105. [PMID: 30292066 PMCID: PMC6171097 DOI: 10.1016/j.tranon.2018.09.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/31/2018] [Accepted: 09/07/2018] [Indexed: 02/08/2023] Open
Abstract
Medulloblastoma is the most common malignant tumor that arises from the cerebellum of the central nervous system. Clinically, medulloblastomas are treated by surgery, radiation, and chemotherapy, all of which result in toxicity and morbidity. Recent reports have identified that DDX3, a member of the RNA helicase family, is mutated in medulloblastoma. In this study, we demonstrate the role of DDX3 in driving medulloblastoma. With the use of a small molecule inhibitor of DDX3, RK-33, we could inhibit growth and promote cell death in two medulloblastoma cell lines, DAOY and UW228, with IC50 values of 2.5 μM and 3.5 μM, respectively. Treatment of DAOY and UW228 cells with RK-33 caused a G1 arrest, resulted in reduced TCF reporter activity, and reduced mRNA expression levels of downstream target genes of the WNT pathway, such as Axin2, CCND1, MYC, and Survivin. In addition, treatment of DAOY and UW228 cells with a combination of RK-33 and radiation exhibited a synergistic effect. Importantly, the combination of RK-33 and 5 Gy radiation caused tumor regression in a mouse xenograft model of medulloblastoma. Using immunohistochemistry, we observed DDX3 expression in both pediatric (55%) and adult (66%) medulloblastoma patients. Based on these results, we conclude that RK-33 is a promising radiosensitizing agent that inhibits DDX3 activity and down-regulates WNT/β-catenin signaling and could be used as a frontline therapeutic strategy for DDX3-expressing medulloblastomas in combination with radiation.
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12
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Draper GJ, Bithell JF, Bunch KJ, Kendall GM, Murphy MFG, Stiller CA. Childhood cancer research in Oxford II: The Childhood Cancer Research Group. Br J Cancer 2018; 119:763-770. [PMID: 30131553 PMCID: PMC6173767 DOI: 10.1038/s41416-018-0181-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/26/2018] [Accepted: 06/20/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND We summarise the work of the Childhood Cancer Research Group, particularly in relation to the UK National Registry of Childhood Tumours (NRCT). METHODS The Group was responsible for setting up and maintaining the NRCT. This registry was based on notifications from regional cancer registries, specialist children's tumour registries, paediatric oncologists and clinical trials organisers. For a large sample of cases, data on controls matched by date and place of birth were also collected. RESULTS Significant achievements of the Group include: studies of aetiology and of genetic epidemiology; proposals for, and participation in, international comparative studies of these diseases and on a classification system specifically for childhood cancer; the initial development of, and major contributions to, follow-up studies of the health of long-term survivors; the enhancement of cancer registration records by the addition of clinical data and of birth records. The Group made substantial contributions to the UK government's Committee on Medical Aspects of Radiation in the Environment. CONCLUSION An important part of the ethos of the Group was to work in collaboration with many other organisations and individuals, both nationally and internationally: many of the Group's achievements described here were the result of such collaborations.
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Affiliation(s)
- Gerald J Draper
- Department of Statistics, University of Oxford, 24-29 St Giles, Oxford, OX1 3LB, UK.
| | - John F Bithell
- Department of Statistics, University of Oxford, 24-29 St Giles, Oxford, OX1 3LB, UK
| | - Kathryn J Bunch
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Gerald M Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Michael F G Murphy
- Nuffield Department of Women's and Reproductive Health, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Charles A Stiller
- National Cancer Registration and Analysis Service, Public Health England, Chancellor Court, Oxford Business Park South, Oxford, OX4 2GX, UK
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13
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Guerrini-Rousseau L, Dufour C, Varlet P, Masliah-Planchon J, Bourdeaut F, Guillaud-Bataille M, Abbas R, Bertozzi AI, Fouyssac F, Huybrechts S, Puget S, Bressac-De Paillerets B, Caron O, Sevenet N, Dimaria M, Villebasse S, Delattre O, Valteau-Couanet D, Grill J, Brugières L. Germline SUFU mutation carriers and medulloblastoma: clinical characteristics, cancer risk, and prognosis. Neuro Oncol 2018; 20:1122-1132. [PMID: 29186568 PMCID: PMC6280147 DOI: 10.1093/neuonc/nox228] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Germline mutations of suppressor of fused homolog (SUFU) predispose to sonic hedgehog (SHH) medulloblastoma. Germline SUFU mutations have been reported in nevoid basal cell carcinoma syndrome (NBCCS), but little is known about the cancer risk and clinical spectrum. Methods We performed a retrospective review of all patients with medulloblastoma and a germline SUFU mutation in France. Results Twenty-two patients from 17 families were identified with medulloblastoma and a germline SUFU mutation (median age at diagnosis: 16.5 mo). Macrocrania was present in 20 patients, but only 5 met the diagnostic criteria for NBCCS. Despite treatment with surgery and chemotherapy, to avoid radiotherapy in all patients except one, the outcome was worse than expected for SHH medulloblastoma, due to the high incidence of local relapses (8/22 patients) and second malignancies (n = 6 in 4/22 patients). The 5-year progression-free survival and overall survival rates were 42% and 66%. Mutations were inherited in 79% of patients, and 34 additional SUFU mutation carriers were identified within 14 families. Medulloblastoma penetrance was incomplete, but higher than in Patched 1 (PTCH1) mutation carriers. Besides medulloblastoma, 19 other tumors were recorded among the 56 SUFU mutation carriers, including basal cell carcinoma (BCC) in 2 patients and meningioma in 3 patients. Conclusion Germline SUFU mutations strongly predispose to medulloblastoma in the first years of life, with worse prognosis than usually observed for SHH medulloblastoma. The clinical spectrum differs between SUFU and PTCH1 mutation carriers, and BCC incidence is much lower in SUFU mutation carriers. The optimal treatment of SUFU mutation-associated medulloblastoma has not been defined.
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Affiliation(s)
- Léa Guerrini-Rousseau
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France,Corresponding author: Léa Guerrini-Rousseau, Gustave Roussy, Département de Cancérologie de l’Enfant et de l’Adolescent, 114 rue Edouard Vaillant, 94805 Villejuif, France ()
| | - Christelle Dufour
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Pascale Varlet
- Service de neuropathologie, Hôpital Sainte-Anne, Université Paris Descartes, Paris, France
| | - Julien Masliah-Planchon
- PSL Research University, INSERM U830 Génétique et Biologie des Cancers Institut Curie, Paris, France,Unité de génétique somatique, SIREDO pediatric oncology center, Institut Curie, Paris, France
| | - Franck Bourdeaut
- PSL Research University, INSERM U830 Génétique et Biologie des Cancers Institut Curie, Paris, France,Département d’oncologie Pédiatrique adolescents Jeunes Adultes, Institut Curie, Paris, France, SIREDO pediatric oncology center, Institut Curie, Paris, France,Institut Curie SIRIC - Laboratoire de Recherche Translationnelle en Oncologie Pédiatrique, Institut Curie, Paris, France
| | - Marine Guillaud-Bataille
- Département de Biologie et Pathologie Médicales, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Rachid Abbas
- INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France,Service de Biostatistique et d’Epidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - Fanny Fouyssac
- Onco-hématologie pédiatrique, Hôpital d’Enfants, CHU Nancy, Nancy, France
| | - Sophie Huybrechts
- Hematology-Oncology Unit, Hôpital Universitaire des Enfants Reine Fabiola, ULB Université libre de Bruxelles, Brussels, Belgium
| | - Stéphanie Puget
- Service de neurochirurgie pédiatrique, Hôpital Necker-Enfants malades, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | | | - Olivier Caron
- PSL Research University, INSERM U830 Génétique et Biologie des Cancers Institut Curie, Paris, France,Unité de génétique somatique, SIREDO pediatric oncology center, Institut Curie, Paris, France,Département de Médecine Oncologique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Nicolas Sevenet
- Laboratoire de génétique moléculaire, Département de bio-pathologie, Institut Bergonié, Bordeaux, France,INSERM U1218, Université de Bordeaux, Bordeaux, France,UFR des Sciences Pharmaceutiques, Université de Bordeaux, Bordeaux, France
| | - Marina Dimaria
- Département de Médecine Oncologique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Sophie Villebasse
- Département de Médecine Oncologique, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Olivier Delattre
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Dominique Valteau-Couanet
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Jacques Grill
- Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Saclay, Villejuif, France
| | - Laurence Brugières
- Département de Cancérologie de l’Enfant et de l’Adolescent, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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14
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Itch/β-arrestin2-dependent non-proteolytic ubiquitylation of SuFu controls Hedgehog signalling and medulloblastoma tumorigenesis. Nat Commun 2018. [PMID: 29515120 PMCID: PMC5841288 DOI: 10.1038/s41467-018-03339-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Suppressor of Fused (SuFu), a tumour suppressor mutated in medulloblastoma, is a central player of Hh signalling, a pathway crucial for development and deregulated in cancer. Although the control of Gli transcription factors by SuFu is critical in Hh signalling, our understanding of the mechanism regulating this key event remains limited. Here, we show that the Itch/β-arrestin2 complex binds SuFu and induces its Lys63-linked polyubiquitylation without affecting its stability. This process increases the association of SuFu with Gli3, promoting the conversion of Gli3 into a repressor, which keeps Hh signalling off. Activation of Hh signalling antagonises the Itch-dependent polyubiquitylation of SuFu. Notably, different SuFu mutations occurring in medulloblastoma patients are insensitive to Itch activity, thus leading to deregulated Hh signalling and enhancing medulloblastoma cell growth. Our findings uncover mechanisms controlling the tumour suppressive functions of SuFu and reveal that their alterations are implicated in medulloblastoma tumorigenesis. SuFu is a tumour suppressor in medulloblastoma and regulates Gli proteins in the Sonic Hedgehog pathway; however, the molecular mechanisms behind this regulation are unclear. Here, the authors show that the Itch/β-arrestin2 complex binds and ubiquitylates SuFu, facilitating the interaction with Gli3 and its conversion into the repressive form, thus counteracting medulloblastoma formation.
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15
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Huang D, Wang Y, Tang J, Luo S. Molecular mechanisms of suppressor of fused in regulating the hedgehog signalling pathway. Oncol Lett 2018; 15:6077-6086. [PMID: 29725392 DOI: 10.3892/ol.2018.8142] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 10/17/2017] [Indexed: 02/07/2023] Open
Abstract
Highly conserved throughout evolution, the hedgehog (Hh) signalling pathway has been demonstrated to be involved in embryonic development, stem cell maintenance and tissue homeostasis in animals ranging from invertebrates to vertebrates. In the human body, a variety of cancer types are associated with the aberrantly activated Hh signalling pathway. Multiple studies have revealed suppressor of fused (Sufu) as a key negative regulator of this signalling pathway. In vertebrates, Sufu primarily functions as a tumor suppressor factor by interacting with and inhibiting glioma-associated oncogene homologues (GLIs), which are the terminal transcription factors of the Hh signalling pathway and belong to the Kruppel family of zinc finger proteins; by contrast, the regulation of Sufu itself remains relatively unclear. In the present review article, we focus on the effects of Sufu on the Hh signalling pathway in tumourigenesis and the molecular mechanisms underlying the regulation of GLI by Sufu. In addition, the factors modulating the activity of Sufu at post-transcriptional levels are also discussed.
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Affiliation(s)
- Dengliang Huang
- Center for Experimental Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.,Jiangxi Key Laboratory of Molecular Diagnostics and Precision Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Yiting Wang
- Center for Experimental Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.,Jiangxi Key Laboratory of Molecular Diagnostics and Precision Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Jiabin Tang
- Center for Experimental Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Shiwen Luo
- Center for Experimental Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.,Jiangxi Key Laboratory of Molecular Diagnostics and Precision Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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16
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Kumar V, Kumar V, McGuire T, Coulter DW, Sharp JG, Mahato RI. Challenges and Recent Advances in Medulloblastoma Therapy. Trends Pharmacol Sci 2017; 38:1061-1084. [PMID: 29061299 DOI: 10.1016/j.tips.2017.09.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/19/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
Abstract
Medulloblastoma (MB) is the most common childhood brain tumor, which occurs in the posterior fossa. MB tumors are highly heterogeneous and have diverse genetic make-ups, with differential microRNA (miRNA) expression profiles and variable prognoses. MB can be classified into four subgroups, each with different origins, pathogenesis, and potential therapeutic targets. miRNA and small-molecule targeted therapies have emerged as a potential new therapeutic paradigm in MB treatment. However, the development of chemoresistance due to surviving cancer stem cells and dysregulation of miRNAs remains a challenge. Combination therapies using multiple drugs and miRNAs could be effective approaches. In this review we discuss various MB subtypes, barriers, and novel therapeutic options which may be less toxic than current standard treatments.
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Affiliation(s)
- Vinod Kumar
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Virender Kumar
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Timothy McGuire
- Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Donald W Coulter
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - John G Sharp
- Department of Genetics, Cell Biology, and Anatomy, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ram I Mahato
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA.
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17
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Kieran MW, Chisholm J, Casanova M, Brandes AA, Aerts I, Bouffet E, Bailey S, Leary S, MacDonald TJ, Mechinaud F, Cohen KJ, Riccardi R, Mason W, Hargrave D, Kalambakas S, Deshpande P, Tai F, Hurh E, Geoerger B. Phase I study of oral sonidegib (LDE225) in pediatric brain and solid tumors and a phase II study in children and adults with relapsed medulloblastoma. Neuro Oncol 2017; 19:1542-1552. [PMID: 28605510 PMCID: PMC5737275 DOI: 10.1093/neuonc/nox109] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Sonidegib (LDE225) is a potent, selective hedgehog (Hh) inhibitor of Smoothened. This study explored the safety and pharmacokinetics of sonidegib in children with relapsed/recurrent tumors followed by a phase II trial in pediatric and adult patients with relapsed medulloblastoma (MB) to assess tumor response. METHODS Pediatric patients aged ≥1 to <18 years were included according to a Bayesian design starting at 372 mg/m2 of continuous once daily oral sonidegib. Tumor samples were analyzed for Hh pathway activation using a validated 5-gene Hh signature assay. In phase II, pediatric patients were treated at the recommended phase II dose (RP2D) while adults received 800 mg daily. RESULTS Sixteen adult (16 MB) and 60 pediatric (39 MB, 21 other) patients with an age range of 2-17 years were enrolled. The RP2D of sonidegib in pediatric patients was established at 680 mg/m2 once daily. The phase II study was closed prematurely. The 5-gene Hh signature assay showed that the 4 complete responders (2 pediatric and 2 adult) and 1 partial responder (adult) all had Hh-activated tumors, while 5 patients with activated Hh had either stable disease (n = 3) or progressive disease (n = 2). No patient with an Hh-negative signature (n = 50) responded. The safety profile for pediatric patients was generally consistent with the one established for adult patients; however, growth plate changes were observed in prepubertal pediatric patients. CONCLUSIONS Sonidegib was well tolerated and the RP2D in pediatric patients was 680 mg/m2 once daily. Five of the 10 MB patients with activated Hh pathway demonstrated complete or partial responses.
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Affiliation(s)
- Mark W Kieran
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Julia Chisholm
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Michela Casanova
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Alba A Brandes
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Isabelle Aerts
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Eric Bouffet
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Simon Bailey
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Sarah Leary
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Tobey J MacDonald
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Francoise Mechinaud
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Kenneth J Cohen
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Riccardo Riccardi
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Warren Mason
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Darren Hargrave
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | | | - Priya Deshpande
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | - Feng Tai
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
| | | | - Birgit Geoerger
- Pediatric Neuro-Oncology, Dana-Farber Boston Children’s Cancer Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA (M.W.K.); The Royal Marsden Hospital, Sutton, Surrey, UK (J.C.); Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (M.C.); Department of Medical Oncology, Azienda USL—IRCCS Institute of Neurological Science, Bologna, Italy (A.A.B.); Institut Curie and University Paris Descartes, Paris, France (I.A); Division of Haematology/Oncology at The Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Sir James Spence Institute of Child Health Royal Victoria Infirmary, Newcastle, UK (S.B.); Seattle Children’s Hospital, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (S.L.); Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA (T.J.M.); The Royal Children’s Hospital, Children’s Cancer Center, Melbourne, Australia (F.M.); The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA (K.J.C.); Catholic University of the Sacred Heart, Rome, Italy (R.R.); Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada (W.M.); Paediatric Oncology Unit, Great Ormond Street Hospital, London, UK (D.H.); Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA (S.K., P.D., F.T., E.H.); Gustave Roussy, Department of Pediatric and Adolescent Oncology, University Paris-Sud, Université Paris-Saclay, Villejuif, France (B.G.)
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Zhang X, Tian Y, Yang Y, Hao J. Development of anticancer agents targeting the Hedgehog signaling. Cell Mol Life Sci 2017; 74:2773-2782. [PMID: 28314894 PMCID: PMC11107598 DOI: 10.1007/s00018-017-2497-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/16/2017] [Accepted: 02/28/2017] [Indexed: 12/11/2022]
Abstract
Hedgehog signaling is an evolutionarily conserved pathway which is essential in embryonic and postnatal development as well as adult organ homeostasis. Abnormal regulation of Hedgehog signaling is implicated in many diseases including cancer. Consequently, substantial efforts have made in the past to develop potential therapeutic agents that specifically target the Hedgehog signaling for cancer treatment. Here, we review the therapeutic agents for inhibition of the Hedgehog signaling and their clinical advances in cancer treatment.
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Affiliation(s)
- Xiangqian Zhang
- College of Life Science, Yan'an University, Yan'an, 716000, Shaanxi, China
| | - Ye Tian
- College of Life Science, Yan'an University, Yan'an, 716000, Shaanxi, China
| | - Yanling Yang
- Medical College, Yan'an University, Yan'an, 716000, Shaanxi, China
| | - Jijun Hao
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, 91766, USA.
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA, 91766, USA.
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19
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Srinivasan VM, Ghali MGZ, North RY, Boghani Z, Hansen D, Lam S. Modern management of medulloblastoma: Molecular classification, outcomes, and the role of surgery. Surg Neurol Int 2016; 7:S1135-S1141. [PMID: 28194300 PMCID: PMC5299153 DOI: 10.4103/2152-7806.196922] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 10/14/2016] [Indexed: 12/20/2022] Open
Affiliation(s)
- Visish M Srinivasan
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
| | - Michael G Z Ghali
- Department of Neurobiology, Drexel University College of Medicine, Philadelphia, USA
| | - Robert Y North
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
| | - Zain Boghani
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
| | - Daniel Hansen
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
| | - Sandi Lam
- Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Texas, USA
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20
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Mangum R, Varga E, Boué DR, Capper D, Benesch M, Leonard J, Osorio DS, Pierson CR, Zumberge N, Sahm F, Schrimpf D, Pfister SM, Finlay JL. SHH desmoplastic/nodular medulloblastoma and Gorlin syndrome in the setting of Down syndrome: case report, molecular profiling, and review of the literature. Childs Nerv Syst 2016; 32:2439-2446. [PMID: 27444290 DOI: 10.1007/s00381-016-3185-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 07/07/2016] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Individuals with Down syndrome (DS) have an increased risk of acute leukemia compared to a markedly decreased incidence of solid tumors. Medulloblastoma, the most common malignant brain tumor of childhood, is particularly rare in the DS population, with only one published case. As demonstrated in a mouse model, DS is associated with cerebellar hypoplasia and a decreased number of cerebellar granule neuron progenitor cells (CGNPs) in the external granule cell layer (EGL). Treatment of these mice with sonic hedgehog signaling pathway (Shh) agonists promote normalization of CGNPs and improved cognitive functioning. CASE REPORT We describe a 21-month-old male with DS and concurrent desmoplastic/nodular medulloblastoma (DNMB)-a tumor derived from Shh dysregulation and over-activation of CGNPs. Molecular profiling further classified the tumor into the new consensus SHH molecular subgroup. Additional testing revealed a de novo heterozygous germ line mutation in the PTCH1 gene encoding a tumor suppressor protein in the Shh pathway. DISCUSSION The developmental failure of CGNPs in DS patients offers a plausible explanation for the rarity of medulloblastoma in this population. Conversely, patients with PTCH1 germline mutations experience Shh overstimulation resulting in Gorlin (Nevoid Basal Cell Carcinoma) syndrome and an increased incidence of malignant transformation of CGNPs leading to medulloblastoma formation. This represents the first documented report of an individual with DS simultaneously carrying PTCH1 germline mutation. CONCLUSION We have observed a highly unusual circumstance in which the PTCH1 mutation appears to "trump" the effects of DS in causation of Shh-activated medulloblastoma.
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Affiliation(s)
- Ross Mangum
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA.
| | - Elizabeth Varga
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Daniel R Boué
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - David Capper
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany.,Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Martin Benesch
- Division of Pediatric Hematology/Oncology, Medical University of Graz, Graz, Austria
| | - Jeffrey Leonard
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Diana S Osorio
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Christopher R Pierson
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Nicholas Zumberge
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Felix Sahm
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany.,Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Daniel Schrimpf
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany.,Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan M Pfister
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jonathan L Finlay
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
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21
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McCubrey JA, Rakus D, Gizak A, Steelman LS, Abrams SL, Lertpiriyapong K, Fitzgerald TL, Yang LV, Montalto G, Cervello M, Libra M, Nicoletti F, Scalisi A, Torino F, Fenga C, Neri LM, Marmiroli S, Cocco L, Martelli AM. Effects of mutations in Wnt/β-catenin, hedgehog, Notch and PI3K pathways on GSK-3 activity-Diverse effects on cell growth, metabolism and cancer. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2016; 1863:2942-2976. [PMID: 27612668 DOI: 10.1016/j.bbamcr.2016.09.004] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/14/2016] [Accepted: 09/02/2016] [Indexed: 02/07/2023]
Abstract
Glycogen synthase kinase-3 (GSK-3) is a serine/threonine kinase that participates in an array of critical cellular processes. GSK-3 was first characterized as an enzyme that phosphorylated and inactivated glycogen synthase. However, subsequent studies have revealed that this moon-lighting protein is involved in numerous signaling pathways that regulate not only metabolism but also have roles in: apoptosis, cell cycle progression, cell renewal, differentiation, embryogenesis, migration, regulation of gene transcription, stem cell biology and survival. In this review, we will discuss the roles that GSK-3 plays in various diseases as well as how this pivotal kinase interacts with multiple signaling pathways such as: PI3K/PTEN/Akt/mTOR, Ras/Raf/MEK/ERK, Wnt/beta-catenin, hedgehog, Notch and TP53. Mutations that occur in these and other pathways can alter the effects that natural GSK-3 activity has on regulating these signaling circuits that can lead to cancer as well as other diseases. The novel roles that microRNAs play in regulation of the effects of GSK-3 will also be evaluated. Targeting GSK-3 and these other pathways may improve therapy and overcome therapeutic resistance.
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Affiliation(s)
- James A McCubrey
- Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University Greenville, NC 27858, USA.
| | - Dariusz Rakus
- Department of Animal Molecular Physiology, Institute of Experimental Biology, Wroclaw University, Wroclaw, Poland
| | - Agnieszka Gizak
- Department of Animal Molecular Physiology, Institute of Experimental Biology, Wroclaw University, Wroclaw, Poland
| | - Linda S Steelman
- Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University Greenville, NC 27858, USA
| | - Steve L Abrams
- Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University Greenville, NC 27858, USA
| | - Kvin Lertpiriyapong
- Department of Comparative Medicine, Brody School of Medicine at East Carolina University, USA
| | - Timothy L Fitzgerald
- Department of Surgery, Brody School of Medicine at East Carolina University, USA
| | - Li V Yang
- Department of Internal Medicine, Hematology/Oncology Section, Brody School of Medicine at East Carolina University, USA
| | - Giuseppe Montalto
- Biomedical Department of Internal Medicine and Specialties, University of Palermo, Palermo, Italy; Consiglio Nazionale delle Ricerche, Istituto di Biomedicina e Immunologia Molecolare "Alberto Monroy", Palermo, Italy
| | - Melchiorre Cervello
- Consiglio Nazionale delle Ricerche, Istituto di Biomedicina e Immunologia Molecolare "Alberto Monroy", Palermo, Italy
| | - Massimo Libra
- Department of Bio-medical Sciences, University of Catania, Catania, Italy
| | | | - Aurora Scalisi
- Unit of Oncologic Diseases, ASP-Catania, Catania 95100, Italy
| | - Francesco Torino
- Department of Systems Medicine, Chair of Medical Oncology, Tor Vergata University of Rome, Rome, Italy
| | - Concettina Fenga
- Department of Biomedical, Odontoiatric, Morphological and Functional Images, Occupational Medicine Section - Policlinico "G. Martino" - University of Messina, Messina 98125, Italy
| | - Luca M Neri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Sandra Marmiroli
- Department of Surgery, Medicine, Dentistry and Morphology, University of Modena and Reggio Emilia, Modena, Italy
| | - Lucio Cocco
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Alberto M Martelli
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
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22
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Abstract
Medulloblastoma (MB) is one of the most frequent malignant brain tumors in children. The current standard treatment regimen consists of surgical resection, craniospinal irradiation, and adjuvant chemotherapy. Although these treatments have the potential to increase the survival of 70–80% of patients with MB, they are also associated with serious treatment-induced morbidity. The current risk stratification of MB is based on clinical factors, including age at presentation, metastatic status, and the presence of residual tumor following resection. In addition, recent genomic studies indicate that MB consists of at least four distinct molecular subgroups: WNT, sonic hedgehog (SHH), Group 3, and Group 4. WNT and SHH MBs are characterized by aberrations in the WNT and SHH signaling pathways, respectively. WNT MB has the best prognosis compared to the other MBs, while SHH MB has an intermediate prognosis. The underlying signaling pathways associated with Group 3 and 4 MBs have not been identified. Group 3 MB is frequently associated with metastasis, resulting in a poor prognosis, while Group 4 is sometimes associated with metastasis and has an intermediate prognosis. Group 4 is the most frequent MB and represents 35% of all MBs. These findings suggest that MB is a heterogeneous disease, and that MB subgroups have distinct molecular, demographic, and clinical characteristics. The molecular classification of MBs is redefining the risk stratification of patients with MB, and has the potential to identify new therapeutic strategies for the treatment of MB.
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Affiliation(s)
- Noriyuki Kijima
- Department of Neurosurgery, Osaka National Hospital, National Hospital Organization
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23
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Barthelery NJ, Manfredi JJ. Cerebellum Development and Tumorigenesis: A p53-Centric Perspective. Trends Mol Med 2016; 22:404-413. [PMID: 27085812 DOI: 10.1016/j.molmed.2016.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/19/2016] [Accepted: 03/19/2016] [Indexed: 12/30/2022]
Abstract
The p53 protein has been extensively studied for its role in suppressing tumorigenesis, in part through surveillance and maintenance of genomic stability. p53 has been associated with the induction of a variety of cellular outcomes including cell cycle arrest, senescence, and apoptosis. This occurs primarily, but not exclusively, through transcriptional activation of specific target genes. By contrast, the participation of p53 in normal developmental processes has been largely understudied. This review focuses on possible functions of p53 in cerebellar development. It can be argued that a better understanding of such mechanisms will provide needed insight into the genesis of certain embryonic cancers including medulloblastomas, and thus lead to more effective therapies.
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Affiliation(s)
- Nicolas J Barthelery
- Department of Oncological Sciences and Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
| | - James J Manfredi
- Department of Oncological Sciences and Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA.
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24
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Goel V, Hurh E, Stein A, Nedelman J, Zhou J, Chiparus O, Huang PH, Gogov S, Sellami D. Population pharmacokinetics of sonidegib (LDE225), an oral inhibitor of hedgehog pathway signaling, in healthy subjects and in patients with advanced solid tumors. Cancer Chemother Pharmacol 2016; 77:745-55. [PMID: 26898300 DOI: 10.1007/s00280-016-2982-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 02/02/2016] [Indexed: 01/14/2023]
Abstract
PURPOSE Sonidegib (Odomzo) selectively inhibits smoothened and suppresses the growth of hedgehog pathway-dependent tumors. A population pharmacokinetic (PK) analysis of sonidegib in healthy subjects and patients with advanced solid tumors was conducted to characterize PK, determine variability, and estimate covariate effects. METHODS PK data from five phase 1 or 2 studies (N = 436) in the dose range from 100 to 3000 mg were analyzed using NONMEM. A two-compartment base model with first-order absorption, lag time, linear elimination, and bioavailability that decreased with dose was updated to describe the PK of sonidegib. Covariate analyses were performed and were incorporated into the population PK full model. RESULTS The base and full models were robust with a good fit to the study data. Population-predicted geometric means (inter-individual variability, CV%) of apparent oral clearance, apparent volume of distribution at steady state, accumulation ratio, and elimination half-life were 9.5 L/h (71.4 %), 9163 L (74.9 %), 21 (131 %) and 29.6 days (109 %). Clinically relevant covariate effects were: A high-fat meal increased sonidegib bioavailability fivefold, healthy volunteers had threefold higher clearance, sonidegib bioavailability decreased with increasing dose levels, and PPI coadministration reduced sonidegib bioavailability by 30 %. Sonidegib PK was not significantly impacted by baseline age, weight, total bilirubin, alanine aminotransferase, albumin, creatinine clearance, gender, and ethnicity (Western countries versus Japanese). CONCLUSION No dose adjustment is needed for mild hepatic impairment, mild and moderate renal impairment, age, weight, gender, or ethnicity. This population PK model adequately characterizes sonidegib PK characteristics and can be used for various simulations and applications.
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Affiliation(s)
- Varun Goel
- Novartis Institutes for BioMedical Research, Inc, Cambridge, MA, USA
| | - Eunju Hurh
- Novartis Institutes for BioMedical Research, Inc, Cambridge, MA, USA.,Ionis Pharmaceuticals, Inc, Carlsbad, CA, USA
| | - Andrew Stein
- Novartis Institutes for BioMedical Research, Inc, Cambridge, MA, USA
| | - Jerry Nedelman
- Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA
| | - Jocelyn Zhou
- Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA
| | - Ovidiu Chiparus
- Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA
| | - Pai-Hsi Huang
- Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA
| | | | - Dalila Sellami
- Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA.
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25
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Cao C, Wang W, Jiang P. Clustering of self-organizing map identifies five distinct medulloblastoma subgroups. Cancer Biomark 2016; 16:327-32. [PMID: 26889815 DOI: 10.3233/cbm-160570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Medulloblastoma is one the most malignant paediatric brain tumours. Molecular subgrouping these medulloblastomas will not only help identify specific cohorts for certain treatment but also improve confidence in prognostic prediction. OBJECTIVE Currently, there is a consensus of the existences of four distinct subtypes of medulloblastoma. We proposed a novel bioinformatics method, clustering of self-organizing map, to determine the subgroups and their molecular diversity. METHODS Microarray expression profiles of 46 medulloblastoma samples were analysed and five clusters with distinct demographics, clinical outcome and transcriptional profiles were identified. RESULTS The previously reported Wnt subgroup was identified as expected. Three other novel subgroups were proposed for later investigation. CONCLUSIONS Our findings underscore the value of SOM clustering for discovering the medulloblastoma subgroups. When the suggested subdivision has been confirmed in large cohorts, this method should serve as a part of routine classification of clinical samples.
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26
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Jongmans MCJ, Loeffen JLCM, Waanders E, Hoogerbrugge PM, Ligtenberg MJL, Kuiper RP, Hoogerbrugge N. Recognition of genetic predisposition in pediatric cancer patients: An easy-to-use selection tool. Eur J Med Genet 2016; 59:116-25. [PMID: 26825391 DOI: 10.1016/j.ejmg.2016.01.008] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 01/03/2016] [Accepted: 01/24/2016] [Indexed: 02/01/2023]
Abstract
Genetic predisposition for childhood cancer is under diagnosed. Identifying these patients may lead to therapy adjustments in case of syndrome-related increased toxicity or resistant disease and syndrome-specific screening programs may lead to early detection of a further independent malignancy. Cancer surveillance might also be warranted for affected relatives and detection of a genetic mutation can allow for reproductive counseling. Here we present an easy-to-use selection tool, based on a systematic review of pediatric cancer predisposing syndromes, to identify patients who may benefit from genetic counseling. The selection tool involves five questions concerning family history, the type of malignancy, multiple primary malignancies, specific features and excessive toxicity, which results in the selection of those patients that may benefit from referral to a clinical geneticist.
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Affiliation(s)
- Marjolijn C J Jongmans
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.
| | - Jan L C M Loeffen
- Department of Pediatric Oncology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Esmé Waanders
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | | | - Marjolijn J L Ligtenberg
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Roland P Kuiper
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Nicoline Hoogerbrugge
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
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27
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Multiple skin hamartomata: a possible novel clinical presentation of SUFU neoplasia syndrome. Fam Cancer 2015; 14:151-5. [PMID: 25287320 DOI: 10.1007/s10689-014-9752-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Medulloblastoma tumours may arise sporadically or as part of an inherited syndrome. A subset of children with medulloblastoma carry germline and somatic mutations in the SUFU tumour suppressor gene located at 10q24. We report a 55 year old woman referred for investigation on the basis of skin lesions and a family history of two children from different unions with medulloblastoma. Examination of our patient revealed facial papules (classified as benign folliculosebaceous hamartomatous lesions) and dysmorphology (macrocephaly, hypertelorism and prognathism). She reported her father and her son share the same dermatological features; photographs of the son display hypertelorism. Sequencing in our patient revealed a splice-site mutation in intron 6 of SUFU (c. 756+1G>A), predicted to lead to skipping of exon 6. We suggest that the emerging phenotype in SUFU associated with familial medulloblastoma may include hamartomatous skin lesions. Consideration of these features, along with macrocephaly will alert clinicians to the likely genetic basis of the syndrome, affording the opportunity for genetic counselling, prenatal or pre-implantation genetic diagnosis in at-risk families.
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28
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Saitoh Y, Setoguchi T, Nagata M, Tsuru A, Nakamura S, Nagano S, Ishidou Y, Nagao-Kitamoto H, Yokouchi M, Maeda S, Tanimoto A, Furukawa T, Komiya S. Combination of Hedgehog inhibitors and standard anticancer agents synergistically prevent osteosarcoma growth. Int J Oncol 2015; 48:235-42. [PMID: 26548578 DOI: 10.3892/ijo.2015.3236] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 10/15/2015] [Indexed: 11/06/2022] Open
Abstract
High-dose chemotherapy and surgical intervention have improved long-term prognosis for non-metastatic osteosarcoma to 50-80%. However, metastatic osteosarcoma exhibits resistance to standard chemotherapy. We and others have investigated the function of Hedgehog pathway in osteosarcoma. To apply our previous findings in clinical settings, we examined the effects of Hedgehog inhibitors including arsenic trioxide (ATO) and vismodegib combined with standard anticancer agents. We performed WST-1 assays using ATO, cisplatin (CDDP), ifosfamide (IFO), doxorubicin (DOX), and vismodegib. Combination-index (CI) was used to examine synergism using CalcuSyn software. Xenograft models were used to examine the synergism in vivo. WST-1 assays showed that 143B and Saos2 cell proliferation was inhibited by ATO combined with CDDP, IFO, DOX, and vismodegib. Combination of ATO and CDDP, IFO, DOX or vismodegib was synergistic when the two compounds were used on proliferating 143B and Saos2 human osteosarcoma cells. An osteosarcoma xenograft model showed that treatment with ATO and CDDP, IFO, or vismodegib significantly prevented osteosarcoma growth in vivo compared with vehicle treatment. Our findings indicate that combination of Hedgehog pathway inhibitors and standard FDA-approved anticancer agents with established safety for human use may be an attractive therapeutic method for treating osteosarcoma.
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Affiliation(s)
- Yoshinobu Saitoh
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Takao Setoguchi
- The Near-Future Locomotor Organ Medicine Creation Course (Kusunoki Kai), Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Masahito Nagata
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Arisa Tsuru
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Shunsuke Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Satoshi Nagano
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Yasuhiro Ishidou
- Department of Medical Joint Materials, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Hiroko Nagao-Kitamoto
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Masahiro Yokouchi
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Shingo Maeda
- Department of Medical Joint Materials, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Akihide Tanimoto
- Center for the Research of Advanced Diagnosis and Therapy of Cancer, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Tatsuhiko Furukawa
- Center for the Research of Advanced Diagnosis and Therapy of Cancer, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Setsuro Komiya
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
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29
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Huse JT, Rosenblum MK. The Emerging Molecular Foundations of Pediatric Brain Tumors. J Child Neurol 2015; 30:1838-50. [PMID: 25873586 DOI: 10.1177/0883073815579709] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/10/2015] [Indexed: 01/23/2023]
Abstract
Recent years have witnessed extensive molecular characterization of several pediatric brain tumor variants. These studies have dramatically shifted notions of disease classification and are likely to have similarly profound effects on patient management in the near future. In this review, we cover the molecular foundations of low-grade glial and glioneuronal neoplasms, high-grade glioma, ependymoma, and medulloblastoma, the details of which have only been recently elucidated in many cases. In doing so, we describe an array of biomarkers likely to play a major role in clinically relevant molecular stratification moving forward. We also discuss strategies for robust and efficient biomarker assessment in the clinical environment.
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Affiliation(s)
- Jason T Huse
- Department of Pathology and Memorial Sloan-Kettering Cancer Center, New York, NY, USA Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Marc K Rosenblum
- Department of Pathology and Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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30
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Khatua S, Zaky W. The biologic era of childhood medulloblastoma and clues to novel therapies. Future Oncol 2015; 10:637-45. [PMID: 24754593 DOI: 10.2217/fon.13.185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Currently, the treatment of childhood medulloblastoma (MB) is tailored to risk groups defined by clinical parameters. Growing evidence of tumoral heterogeneity is apparent as response remains varied and unpredictable based on current treatment strategies, indicating the lack of understanding of the elusive biology that drives oncogenesis of these tumors. Advances in genomic technologies are revealing newer insights into the molecular pathogenesis of MB. Utilization of the genomic machinery has enabled the definition of new molecular markers and signaling pathways, resulting in a paradigm shift in the classification of childhood MB. Recent focus into the postgenomic era has revealed varied perturbations in the epigenetic machinery in these subtypes as likely predictive biomarkers and potential therapeutic targets. Ahead lies the task and challenge in the ability to comprehensively evaluate all these data, which could provide clues to profile the next-generation clinical trials combining conventional with molecularly targeted novel therapies.
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Affiliation(s)
- Soumen Khatua
- Pediatric Neuro-Oncology, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 87, Houston, TX 77030, USA
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31
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Abstract
The stem cell paradigm was first demonstrated in hematopoietic stem cells. Whilst classically it was cytokines and chemokines which were believed to control stem cell fate, more recently it has become apparent that the stem cell niche and highly conserved embryonic pathways play a key role in governing stem cell behavior. One of these pathways, the hedgehog signaling pathway, found in all organisms, is vitally important in embryogenesis, performing the function of patterning through early stages of development, and in adulthood, through the control of somatic stem cell numbers. In addition to these roles in health however, it has been found to be deregulated in a number of solid and hematological malignancies, components of the hedgehog pathway being associated with a poor prognosis. Further, these components represent viable therapeutic targets, with inhibition from a drug development perspective being readily achieved, making the hedgehog pathway an attractive potential therapeutic target. However, although the concept of cancer stem cells is well established, how these cells arise and the factors which influence their behavior are not yet fully understood. The role of the hedgehog signaling pathway and its potential as a therapeutic target in hematological malignancies is the focus of this review.
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Affiliation(s)
- Victoria Campbell
- Paul O’Gorman Leukaemia Research Centre, Institute of Cancer Sciences, College of Medical, Veterninary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Mhairi Copland
- Paul O’Gorman Leukaemia Research Centre, Institute of Cancer Sciences, College of Medical, Veterninary and Life Sciences, University of Glasgow, Glasgow, UK
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Shou Y, Robinson DM, Amakye DD, Rose KL, Cho YJ, Ligon KL, Sharp T, Haider AS, Bandaru R, Ando Y, Geoerger B, Doz F, Ashley DM, Hargrave DR, Casanova M, Tawbi HA, Rodon J, Thomas AL, Mita AC, MacDonald TJ, Kieran MW. A five-gene hedgehog signature developed as a patient preselection tool for hedgehog inhibitor therapy in medulloblastoma. Clin Cancer Res 2014; 21:585-93. [PMID: 25473003 DOI: 10.1158/1078-0432.ccr-13-1711] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Distinct molecular subgroups of medulloblastoma, including hedgehog (Hh) pathway-activated disease, have been reported. We identified and clinically validated a five-gene Hh signature assay that can be used to preselect patients with Hh pathway-activated medulloblastoma. EXPERIMENTAL DESIGN Gene characteristics of the Hh medulloblastoma subgroup were identified through published bioinformatic analyses. Thirty-two genes shown to be differentially expressed in fresh-frozen and formalin-fixed paraffin-embedded tumor samples and reproducibly analyzed by RT-PCR were measured in matched samples. These data formed the basis for building a multi-gene logistic regression model derived through elastic net methods from which the five-gene Hh signature emerged after multiple iterations. On the basis of signature gene expression levels, the model computed a propensity score to determine Hh activation using a threshold set a priori. The association between Hh activation status and tumor response to the Hh pathway inhibitor sonidegib (LDE225) was analyzed. RESULTS Five differentially expressed genes in medulloblastoma (GLI1, SPHK1, SHROOM2, PDLIM3, and OTX2) were found to associate with Hh pathway activation status. In an independent validation study, Hh activation status of 25 medulloblastoma samples showed 100% concordance between the five-gene signature and Affymetrix profiling. Further, in medulloblastoma samples from 50 patients treated with sonidegib, all 6 patients who responded were found to have Hh-activated tumors. Three patients with Hh-activated tumors had stable or progressive disease. No patients with Hh-nonactivated tumors responded. CONCLUSIONS This five-gene Hh signature can robustly identify Hh-activated medulloblastoma and may be used to preselect patients who might benefit from sonidegib treatment.
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Affiliation(s)
- Yaping Shou
- Novartis Institutes for BioMedical Research, Inc, Cambridge, Massachusetts
| | - Douglas M Robinson
- Novartis Institutes for BioMedical Research, Inc, Cambridge, Massachusetts
| | - Dereck D Amakye
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Kristine L Rose
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Yoon-Jae Cho
- Departments of Neurology and Neurosurgery, Stanford University School of Medicine, Stanford, California
| | - Keith L Ligon
- Pediatric Neuro-Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Pathology, Children's Hospital Boston, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts. Department of Medical Oncology and Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Thad Sharp
- Novartis Institutes for BioMedical Research, Inc, Cambridge, Massachusetts
| | - Asifa S Haider
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Raj Bandaru
- Novartis Institutes for BioMedical Research, Inc, Cambridge, Massachusetts
| | | | - Birgit Geoerger
- Institut Gustave Roussy, University Paris-Sud, Villejuif, France
| | - François Doz
- Institut Curie and University Paris Descartes, Sorbonne Paris Cité, France
| | | | | | | | - Hussein A Tawbi
- University of Pittsburgh Cancer Institute and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jordi Rodon
- Vall d'Hebron Institut d'Oncologia, and Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Alain C Mita
- Cancer Therapy and Research Center, University of Texas Health Science Center, San Antonio, Texas
| | - Tobey J MacDonald
- Children's Healthcare of Atlanta, Aflac Cancer and Blood Disorders Center, Emory University School of Medicine, Atlanta, Georgia
| | - Mark W Kieran
- Pediatric Neuro-Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
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Smith MJ, Beetz C, Williams SG, Bhaskar SS, O'Sullivan J, Anderson B, Daly SB, Urquhart JE, Bholah Z, Oudit D, Cheesman E, Kelsey A, McCabe MG, Newman WG, Evans DGR. Germline mutations in SUFU cause Gorlin syndrome-associated childhood medulloblastoma and redefine the risk associated with PTCH1 mutations. J Clin Oncol 2014; 32:4155-61. [PMID: 25403219 DOI: 10.1200/jco.2014.58.2569] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Heterozygous germline PTCH1 mutations are causative of Gorlin syndrome (naevoid basal cell carcinoma), but detection rates > 70% have rarely been reported. We aimed to define the causative mutations in individuals with Gorlin syndrome without PTCH1 mutations. METHODS We undertook exome sequencing on lymphocyte DNA from four unrelated individuals from families with Gorlin syndrome with no PTCH1 mutations found by Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA), or RNA analysis. RESULTS A germline heterozygous nonsense mutation in SUFU was identified in one of four exomes. Sanger sequencing of SUFU in 23 additional PTCH1-negative Gorlin syndrome families identified a SUFU mutation in a second family. Copy-number analysis of SUFU by MLPA revealed a large heterozygous deletion in a third family. All three SUFU-positive families fulfilled diagnostic criteria for Gorlin syndrome, although none had odontogenic jaw keratocysts. Each SUFU-positive family included a single case of medulloblastoma, whereas only two (1.7%) of 115 individuals with Gorlin syndrome and a PTCH1 mutation developed medulloblastoma. CONCLUSION We demonstrate convincing evidence that SUFU mutations can cause classical Gorlin syndrome. Our study redefines the risk of medulloblastoma in Gorlin syndrome, dependent on the underlying causative gene. Previous reports have found a 5% risk of medulloblastoma in Gorlin syndrome. We found a < 2% risk in PTCH1 mutation-positive individuals, with a risk up to 20× higher in SUFU mutation-positive individuals. Our data suggest childhood brain magnetic resonance imaging surveillance is justified in SUFU-related, but not PTCH1-related, Gorlin syndrome.
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Affiliation(s)
- Miriam J Smith
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Christian Beetz
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Simon G Williams
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Sanjeev S Bhaskar
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - James O'Sullivan
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Beverley Anderson
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Sarah B Daly
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Jill E Urquhart
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Zaynab Bholah
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Deemesh Oudit
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Edmund Cheesman
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Anna Kelsey
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - Martin G McCabe
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - William G Newman
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany
| | - D Gareth R Evans
- Miriam J. Smith, Simon G. Williams, Sanjeev S. Bhaskar, James O'Sullivan, Beverley Anderson, Sarah B. Daly, Jill E. Urquhart, Zaynab Bholah, William G. Newman, and D. Gareth R. Evans, Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre, and Central Manchester University Hospitals National Health Service (NHS) Foundation Trust; Deemesh Oudit, Christie NHS Foundation Trust; Edmund Cheesman and Anna Kelsey, Central Manchester University Hospital NHS Foundation Trust, Royal Manchester Children's Hospital; Martin G. McCabe, Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; and Christian Beetz, Institut für Klinische Chemie und Laboratoriumsdiagnostik Universitätsklinikum Jena, Jena, Germany.
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Kieran MW. Targeted treatment for sonic hedgehog-dependent medulloblastoma. Neuro Oncol 2014; 16:1037-47. [PMID: 24951114 PMCID: PMC4096181 DOI: 10.1093/neuonc/nou109] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 05/15/2014] [Indexed: 12/28/2022] Open
Abstract
Novel treatment options, including targeted therapies, are needed for patients with medulloblastoma (MB), especially for those with high-risk or recurrent/relapsed disease. Four major molecular subgroups of MB have been identified, one of which is characterized by activation of the sonic hedgehog (SHH) pathway. Preclinical data suggest that inhibitors of the hedgehog (Hh) pathway could become valuable treatment options for patients with this subgroup of MB. Indeed, agents targeting the positive regulator of the pathway, smoothened (SMO), have demonstrated efficacy in a subset of patients with SHH MB. However, because of resistance and the presence of mutations downstream of SMO, not all patients with SHH MB respond to SMO inhibitors. The development of agents that target these resistance mechanisms and the potential for their combination with traditional chemotherapy and SHH inhibitors will be discussed. Due to its extensive molecular heterogeneity, the future of MB treatment is in personalized therapy, which may lead to improved efficacy and reduced toxicity. This will include the development of clinically available tests that can efficiently discern the SHH subgroup. The preliminary use of these tests in clinical trials is also discussed herein.
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Affiliation(s)
- Mark W Kieran
- Pediatric Medical Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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Anchang B, Do MT, Zhao X, Plevritis SK. CCAST: a model-based gating strategy to isolate homogeneous subpopulations in a heterogeneous population of single cells. PLoS Comput Biol 2014; 10:e1003664. [PMID: 25078380 PMCID: PMC4117418 DOI: 10.1371/journal.pcbi.1003664] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 04/25/2014] [Indexed: 12/12/2022] Open
Abstract
A model-based gating strategy is developed for sorting cells and analyzing populations of single cells. The strategy, named CCAST, for Clustering, Classification and Sorting Tree, identifies a gating strategy for isolating homogeneous subpopulations from a heterogeneous population of single cells using a data-derived decision tree representation that can be applied to cell sorting. Because CCAST does not rely on expert knowledge, it removes human bias and variability when determining the gating strategy. It combines any clustering algorithm with silhouette measures to identify underlying homogeneous subpopulations, then applies recursive partitioning techniques to generate a decision tree that defines the gating strategy. CCAST produces an optimal strategy for cell sorting by automating the selection of gating markers, the corresponding gating thresholds and gating sequence; all of these parameters are typically manually defined. Even though CCAST is optimized for cell sorting, it can be applied for the identification and analysis of homogeneous subpopulations among heterogeneous single cell data. We apply CCAST on single cell data from both breast cancer cell lines and normal human bone marrow. On the SUM159 breast cancer cell line data, CCAST indicates at least five distinct cell states based on two surface markers (CD24 and EPCAM) and provides a gating sorting strategy that produces more homogeneous subpopulations than previously reported. When applied to normal bone marrow data, CCAST reveals an efficient strategy for gating T-cells without prior knowledge of the major T-cell subtypes and the markers that best define them. On the normal bone marrow data, CCAST also reveals two major mature B-cell subtypes, namely CD123+ and CD123- cells, which were not revealed by manual gating but show distinct intracellular signaling responses. More generally, the CCAST framework could be used on other biological and non-biological high dimensional data types that are mixtures of unknown homogeneous subpopulations.
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Affiliation(s)
- Benedict Anchang
- Department of Radiology, Center for Cancer Systems Biology, Stanford University, Stanford, California, United States of America
| | - Mary T. Do
- Department of Radiology, Center for Cancer Systems Biology, Stanford University, Stanford, California, United States of America
| | - Xi Zhao
- Department of Radiology, Center for Cancer Systems Biology, Stanford University, Stanford, California, United States of America
| | - Sylvia K. Plevritis
- Department of Radiology, Center for Cancer Systems Biology, Stanford University, Stanford, California, United States of America
- * E-mail:
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Tibes R, Mesa RA. Targeting hedgehog signaling in myelofibrosis and other hematologic malignancies. J Hematol Oncol 2014; 7:18. [PMID: 24598114 PMCID: PMC3975838 DOI: 10.1186/1756-8722-7-18] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 02/20/2014] [Indexed: 01/05/2023] Open
Abstract
Treatment of myelofibrosis (MF), a BCR-ABL-negative myeloproliferative neoplasm, is challenging. The only current potentially curative option, allogeneic hematopoietic stem cell transplant, is recommended for few patients. The remaining patients are treated with palliative therapies to manage MF-related anemia and splenomegaly. Identification of a mutation in the Janus kinase 2 (JAK2) gene (JAK2 V617F) in more than half of all patients with MF has prompted the discovery and clinical development of inhibitors that target JAK2. Although treatment with JAK2 inhibitors has been shown to improve symptom response and quality of life in patients with MF, these drugs do not alter the underlying disease; therefore, novel therapies are needed. The hedgehog (Hh) signaling pathway has been shown to play a role in normal hematopoiesis and in the tumorigenesis of hematologic malignancies. Moreover, inhibitors of the Hh pathway have been shown to inhibit growth and self-renewal capacity in preclinical models of MF. In a mouse model of MF, combined inhibition of the Hh and JAK pathways reduced JAK2 mutant allele burden, reduced bone marrow fibrosis, and reduced white blood cell and platelet counts. Preliminary clinical data also suggest that inhibition of the Hh pathway, alone or in combination with JAK2 inhibition, may enable disease modification in patients with MF. Future studies, including one combining the Hh pathway inhibitor sonidegib and the JAK2 inhibitor ruxolitinib, are underway in patients with MF and will inform whether this combination approach can lead to true disease modification.
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Affiliation(s)
- Raoul Tibes
- Mayo Clinic Cancer Center, NCI Designated Comprehensive Cancer Center, 13400 E. Shea Blvd, Scottsdale, AZ 85259, USA
| | - Ruben A Mesa
- Mayo Clinic Cancer Center, NCI Designated Comprehensive Cancer Center, 13400 E. Shea Blvd, Scottsdale, AZ 85259, USA
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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.
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Affiliation(s)
- Mary Rose Pambid
- Department of Pediatrics, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Trinh TN, McLaughlin EA, Gordon CP, McCluskey A. Hedgehog signalling pathway inhibitors as cancer suppressing agents. MEDCHEMCOMM 2014. [DOI: 10.1039/c3md00334e] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Cherry AL, Finta C, Karlström M, Jin Q, Schwend T, Astorga-Wells J, Zubarev RA, Del Campo M, Criswell AR, de Sanctis D, Jovine L, Toftgård R. Structural basis of SUFU-GLI interaction in human Hedgehog signalling regulation. ACTA CRYSTALLOGRAPHICA. SECTION D, BIOLOGICAL CRYSTALLOGRAPHY 2013; 69:2563-79. [PMID: 24311597 PMCID: PMC3852661 DOI: 10.1107/s0907444913028473] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/16/2013] [Indexed: 12/13/2022]
Abstract
Hedgehog signalling plays a fundamental role in the control of metazoan development, cell proliferation and differentiation, as highlighted by the fact that its deregulation is associated with the development of many human tumours. SUFU is an essential intracellular negative regulator of mammalian Hedgehog signalling and acts by binding and modulating the activity of GLI transcription factors. Despite its central importance, little is known about SUFU regulation and the nature of SUFU-GLI interaction. Here, the crystal and small-angle X-ray scattering structures of full-length human SUFU and its complex with the key SYGHL motif conserved in all GLIs are reported. It is demonstrated that GLI binding is associated with major conformational changes in SUFU, including an intrinsically disordered loop that is also crucial for pathway activation. These findings reveal the structure of the SUFU-GLI interface and suggest a mechanism for an essential regulatory step in Hedgehog signalling, offering possibilities for the development of novel pathway modulators and therapeutics.
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Affiliation(s)
- Amy L Cherry
- Department of Biosciences and Nutrition and Center for Biosciences, Karolinska Institutet, Novum, Hälsovägen 7, SE-141 83 Huddinge, Sweden
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Unraveling the therapeutic potential of the Hedgehog pathway in cancer. Nat Med 2013; 19:1410-22. [PMID: 24202394 DOI: 10.1038/nm.3389] [Citation(s) in RCA: 420] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 10/01/2013] [Indexed: 02/07/2023]
Abstract
Major progress has been made in recent years in the development of Hedgehog (Hh) pathway inhibitors for the treatment of patients with cancer. Promising clinical trial results have been obtained in cancers that harbor activating mutations of the Hh pathway, such as basal cell carcinoma and medulloblastoma. However, for many cancers, in which Hh ligand overexpression is thought to drive tumor growth, results have been disappointing. Here we review the preclinical data that continue to shape our understanding of the Hh pathway in tumorigenesis and the emerging clinical experience with smoothened inhibitors.
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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
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Lim CB, Prêle CM, Cheah HM, Cheng YY, Klebe S, Reid G, Watkins DN, Baltic S, Thompson PJ, Mutsaers SE. Mutational analysis of hedgehog signaling pathway genes in human malignant mesothelioma. PLoS One 2013; 8:e66685. [PMID: 23826113 PMCID: PMC3691204 DOI: 10.1371/journal.pone.0066685] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 05/08/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Hedgehog (HH) signaling pathway is critical for embryonic development and adult homeostasis. Recent studies have identified regulatory roles for this pathway in certain cancers with mutations in the HH pathway genes. The extent to which mutations of the HH pathway genes are involved in the pathogenesis of malignant mesothelioma (MMe) is unknown. METHODOLOGY/PRINCIPAL FINDINGS Real-time PCR analysis of HH pathway genes PTCH1, GLI1 and GLI2 were performed on 7 human MMe cell lines. Exon sequencing of 13 HH pathway genes was also performed in cell lines and human MMe tumors. In silico programs were used to predict the likelihood that an amino-acid substitution would have a functional effect. GLI1, GLI2 and PTCH1 were highly expressed in MMe cells, indicative of active HH signaling. PTCH1, SMO and SUFU mutations were found in 2 of 11 MMe cell lines examined. A non-synonymous missense SUFU mutation (p.T411M) was identified in LO68 cells. In silico characterization of the SUFU mutant suggested that the p.T411M mutation might alter protein function. However, we were unable to demonstrate any functional effect of this mutation on Gli activity. Deletion of exons of the PTCH1 gene was found in JU77 cells, resulting in loss of one of two extracellular loops implicated in HH ligand binding and the intracellular C-terminal domain. A 3-bp insertion (69_70insCTG) in SMO, predicting an additional leucine residue in the signal peptide segment of SMO protein was also identified in LO68 cells and a MMe tumour. CONCLUSIONS/SIGNIFICANCE We identified the first novel mutations in PTCH1, SUFU and SMO associated with MMe. Although HH pathway mutations are relatively rare in MMe, these data suggest a possible role for dysfunctional HH pathway in the pathogenesis of a subgroup of MMe and help rationalize the exploration of HH pathway inhibitors for MMe therapy.
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Affiliation(s)
- Chuan Bian Lim
- Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, Department of Medicine, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
| | - Cecilia M. Prêle
- Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, Department of Medicine, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology and Western Australian Institute for Medical Research, University of Western Australia, Crawley, WA, Australia
| | - Hui Min Cheah
- Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, Department of Medicine, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
| | - Yuen Yee Cheng
- Asbestos Diseases Research Institute (ADRI), University of Sydney, Sydney, NSW, Australia
| | - Sonja Klebe
- Department of Anatomical Pathology, SA Pathology and Flinders University, Flinders Medical Centre, Adelaide, Australia
| | - Glen Reid
- Asbestos Diseases Research Institute (ADRI), University of Sydney, Sydney, NSW, Australia
| | - D. Neil Watkins
- Centre for Cancer Research, Monash Institute for Medical Research, Monash University, Melbourne, Victoria, Australia
| | - Svetlana Baltic
- Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, Department of Medicine, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
| | - Philip J. Thompson
- Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, Department of Medicine, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
| | - Steven E. Mutsaers
- Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, Department of Medicine, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology and Western Australian Institute for Medical Research, University of Western Australia, Crawley, WA, Australia
- * E-mail:
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Bourdeaut F, Miquel C, Di Rocco F, Grison C, Richer W, Brugieres L, Pierron G, James S, Baujat G, Delattre O, Collet C. Germline mutations in FGF receptors and medulloblastomas. Am J Med Genet A 2013; 161A:382-5. [PMID: 23325524 DOI: 10.1002/ajmg.a.35719] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 09/24/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Franck Bourdeaut
- INSERMU830, Laboratoire de génétique et biologie des cancers, Institut Curie, Paris, France.
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Sadighi Z, Vats T, Khatua S. Childhood medulloblastoma: the paradigm shift in molecular stratification and treatment profile. J Child Neurol 2012; 27:1302-7. [PMID: 22826514 DOI: 10.1177/0883073812449690] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Medulloblastoma is the most common malignant brain tumor of childhood, accounting for nearly 25% to 30% of primary central nervous system tumors in children younger than 18 years of age. Risk stratification into low and high risk categories has been based on age of clinical presentation, extent of postsurgical residual tumor, and disease dissemination. The World Health Organization (WHO) in 2007 recognized 5 histological subtypes as classic, anaplastic, large cell, desmoplastic/nodular, and medulloblastoma with extensive nodularity. Recent work with gene expression profiling along with histological classification has generated a novel combined histopathological and molecular stratification scheme into 4 subgroups (Wnt, Shh, group 3, and group 4). This could now help to identify patients who might benefit from dose escalation and de-escalation of therapy. Restratification brings optimism in treating these patients as scholars now have the ability to profile a more targeted therapy approach. This review discusses the literature regarding this new research endeavor.
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Affiliation(s)
- Zsila Sadighi
- Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Abstract
The Hedgehog (Hh) signaling pathway has been implicated in tumor initiation and metastasis across different malignancies. Major mechanisms by which the Hh pathway is aberrantly activated can be attributed to mutations of members of Hh pathway or excessive/inappropriate expression of Hh pathway ligands. The Hh signaling pathway also affects the regulation of cancer stem cells, leading to their capabilities in tumor formation, disease progression, and metastasis. Preliminary results of early phase clinical trials of Hh inhibitors administered as monotherapy demonstrated promising results in patients with basal cell carcinoma and medulloblastoma, but clinically meaningful anticancer efficacy across other tumor types seems to be lacking. Additionally, cases of resistance have been already observed. Mutations of SMO, activation of Hh pathway components downstream to SMO, and upregulation of alternative signaling pathways are possible mechanisms of resistance development. Determination of effective Hh inhibitor-based combination regimens and development of correlative biomarkers relevant to this pathway should remain as clear priorities for future research.
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Affiliation(s)
- Solmaz Sahebjam
- Drug Development Program, Division of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
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Abstract
Medulloblastoma, the most common malignant paediatric brain tumour, is currently diagnosed and stratified using a combination of clinical and demographic variables. Recent transcriptomic approaches have demonstrated that the histological entity known as medulloblastoma is comprised of multiple clinically and molecularly distinct subgroups. The current consensus is that four defined subgroups of medulloblastoma exist: WNT, SHH, Group 3, and Group 4. Each subgroup probably contains at least one additional level of hierarchy, with some evidence for multiple subtypes within each subgroup. The demographic and clinical differences between the subgroups present immediate and pressing questions to be addressed in the next round of clinical trials for patients with medulloblastoma. Many of the genetically defined targets for rational medulloblastoma therapies are unique to a given subgroup, suggesting the need for subgroup-specific trials of novel therapies. The development of practical, robust and widely accepted subgroup biomarkers that are amenable to the conditions of a prospective clinical trial is, therefore, an urgent need for the paediatric neuro-oncology community. In this Review, we discuss the clinical implications of molecular subgrouping in medulloblastoma, highlighting how these subgroups are transitioning from a research topic in the laboratory to a clinically relevant topic with important implications for patient care.
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Brugières L, Remenieras A, Pierron G, Varlet P, Forget S, Byrde V, Bombled J, Puget S, Caron O, Dufour C, Delattre O, Bressac-de Paillerets B, Grill J. High frequency of germline SUFU mutations in children with desmoplastic/nodular medulloblastoma younger than 3 years of age. J Clin Oncol 2012; 30:2087-93. [PMID: 22508808 DOI: 10.1200/jco.2011.38.7258] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Germline mutations of the SUFU gene have been shown to be associated with genetic predisposition to medulloblastoma, mainly in families with multiple cases of medulloblastoma and/or in patients with symptoms similar to those of Gorlin syndrome. To evaluate the contribution of these mutations to the genesis of sporadic medulloblastomas, we screened a series of unselected patients with medulloblastoma for germline SUFU mutations. PATIENTS AND METHODS A complete mutational analysis of the SUFU gene was performed on genomic DNA in all 131 consecutive patients treated for medulloblastoma in the pediatrics department of the Institut Gustave Roussy between 1972 and 2009 and for whom a blood sample was available. RESULTS We identified eight germline mutations of the SUFU gene: one large genomic duplication and seven point mutations. Mutations were identified in three of three individuals with medulloblastoma with extensive nodularity, four of 20 with desmoplastic/nodular medulloblastomas, and one of 108 with other subtypes. All eight patients were younger than 3 years of age at diagnosis. The mutations were inherited from the healthy father in four of six patient cases in which the parents accepted genetic testing; de novo mutations accounted for the other two patient cases. Associated events were macrocrania in six patients, hypertelorism in three patients, and multiple basal cell carcinomas in the radiation field after age 18 years in one patient. CONCLUSION These data indicate that germline SUFU mutations were responsible for a high proportion of desmoplastic medulloblastoma in children younger than 3 years of age. Genetic testing should be offered to all children diagnosed with sonic hedgehog-driven medulloblastoma at a young age.
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Taylor MD, Northcott PA, Korshunov A, Remke M, Cho YJ, Clifford SC, Eberhart CG, Parsons DW, Rutkowski S, Gajjar A, Ellison DW, Lichter P, Gilbertson RJ, Pomeroy SL, Kool M, Pfister SM. Molecular subgroups of medulloblastoma: the current consensus. Acta Neuropathol 2012; 123:465-72. [PMID: 22134537 PMCID: PMC3306779 DOI: 10.1007/s00401-011-0922-z] [Citation(s) in RCA: 1289] [Impact Index Per Article: 107.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 11/19/2011] [Accepted: 11/22/2011] [Indexed: 12/14/2022]
Abstract
Medulloblastoma, a small blue cell malignancy of the cerebellum, is a major cause of morbidity and mortality in pediatric oncology. Current mechanisms for clinical prognostication and stratification include clinical factors (age, presence of metastases, and extent of resection) as well as histological subgrouping (classic, desmoplastic, and large cell/anaplastic histology). Transcriptional profiling studies of medulloblastoma cohorts from several research groups around the globe have suggested the existence of multiple distinct molecular subgroups that differ in their demographics, transcriptomes, somatic genetic events, and clinical outcomes. Variations in the number, composition, and nature of the subgroups between studies brought about a consensus conference in Boston in the fall of 2010. Discussants at the conference came to a consensus that the evidence supported the existence of four main subgroups of medulloblastoma (Wnt, Shh, Group 3, and Group 4). Participants outlined the demographic, transcriptional, genetic, and clinical differences between the four subgroups. While it is anticipated that the molecular classification of medulloblastoma will continue to evolve and diversify in the future as larger cohorts are studied at greater depth, herein we outline the current consensus nomenclature, and the differences between the medulloblastoma subgroups.
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Affiliation(s)
- Michael D. Taylor
- Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Toronto, Canada
- Program in Developmental and Stem Cell Biology, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Paul A. Northcott
- Program in Developmental and Stem Cell Biology, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Andrey Korshunov
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center, Heidelberg, Germany
| | - Marc Remke
- Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Yoon-Jae Cho
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, USA
| | - Steven C. Clifford
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Charles G. Eberhart
- Departments of Pathology, Ophthalmology and Oncology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - D. Williams Parsons
- Department of Pediatrics, Texas Children’s Cancer Center, Baylor College of Medicine, Houston, USA
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amar Gajjar
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, USA
| | - David W. Ellison
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, USA
| | - Peter Lichter
- Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany
| | - Richard J. Gilbertson
- Department of Developmental Neurobiology, St. Jude Children’s Research Hospital, Memphis, USA
| | - Scott L. Pomeroy
- Department of Neurology, Children’s Hospital Boston, Harvard Medical School, Boston, USA
| | - Marcel Kool
- Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany
| | - Stefan M. Pfister
- Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
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FISH and chips: the recipe for improved prognostication and outcomes for children with medulloblastoma. Cancer Genet 2012; 204:577-88. [PMID: 22200083 DOI: 10.1016/j.cancergen.2011.11.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 11/03/2011] [Accepted: 11/07/2011] [Indexed: 11/20/2022]
Abstract
Rapidly evolving genomic technologies have permitted progressively detailed studies of medulloblastoma biology in recent years. These data have increased our understanding of the molecular pathogenesis of medulloblastoma, identified prognostic markers, and suggested future avenues for targeted therapy. Although current randomized trials are still stratified based largely on clinical variables, the use of molecular markers is approaching routine use in the clinic. In particular, integrated genomics has uncovered that medulloblastoma comprises four distinct molecular and clinical variants: WNT, sonic hedgehog (SHH), group 3, and group 4. Children with WNT medulloblastoma have improved survival, whereas those with group 3 medulloblastoma have a dismal prognosis. Additionally, integrated genomics has shown that adult medulloblastoma is molecularly and clinically distinct from the childhood variants. Prognostic and predictive markers identified by genomics should drive changes in stratification of treatment protocols for medulloblastoma patients on clinical trials once they can be demonstrated to be reliable, reproducible, and practical. Cases with excellent prognoses (WNT cases) should be considered for therapy de-escalation, whereas those with bleak prognoses (group 3 cases) should be prioritized for experimental therapy. In this review, we will summarize the genomic data published over the past decade and attempt to interpret its prognostic significance, relevance to the clinic, and use in upcoming clinical trials.
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Mimeault M, Batra SK. Complex oncogenic signaling networks regulate brain tumor-initiating cells and their progenies: pivotal roles of wild-type EGFR, EGFRvIII mutant and hedgehog cascades and novel multitargeted therapies. Brain Pathol 2011; 21:479-500. [PMID: 21615592 DOI: 10.1111/j.1750-3639.2011.00505.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Complex signaling cross-talks between different growth factor cascades orchestrate the primary brain cancer development. Among the frequent deregulated oncogenic pathways, the ligand-activated wild-type epidermal growth factor receptor (EGFR), constitutively activated EGFRvIII mutant and sonic hedgehog pathways have attracted much attention because of their pivotal roles in pediatric medulloblastomas and adult glioblastoma multiformes (GBM) brain tumors. The enhanced expression levels and activation of EGFR, EGFRvIII mutant and hedgehog signaling elements can provide key roles for the sustained growth, migration and local invasion of brain tumor-initiating cells (BTICs) and their progenies, resistance to current therapies and disease relapse. These tumorigenic cascades also can cooperate with Wnt/β-catenin, Notch, platelet-derived growth factor (PDGF)/PDGF receptors (PDGFRs), hepatocyte growth factor (HGF)/c-Met receptor and vascular endothelial growth factor (VEGF)/VEGF receptors (VEGFRs) for the acquisition of a more malignant behavior and survival advantages by brain tumor cells during disease progression. Therefore, the simultaneous targeting of these oncogenic signaling components including wild-type EGFR, EGFRvIII mutant and hedgehog pathways may constitute a potential therapeutic approach of great clinical interest to eradicate BTICs and improve the efficacy of current clinical treatments by radiation and/or chemotherapy against aggressive and recurrent medulloblastomas and GBMs.
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Affiliation(s)
- Murielle Mimeault
- Department of Biochemistry and Molecular Biology, College of Medicine, Eppley Cancer Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, Neb. 68198-5870, USA.
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