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Dandapath I, Das S, Charan BD, Garg A, Suri A, Kedia S, Sharma MC, Sarkar C, Khonglah Y, Ahmed S, Suri V. Evaluation of KIAA1549::BRAF fusions and clinicopathological insights of pilocytic astrocytomas. Ann Diagn Pathol 2024; 72:152318. [PMID: 38733671 DOI: 10.1016/j.anndiagpath.2024.152318] [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: 02/14/2024] [Revised: 04/07/2024] [Accepted: 04/15/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Pilocytic astrocytoma (PAs) represents a significant portion of childhood primary brain tumors, with distinct histological and radiological features. The prevalence of KIAA1549::BRAF fusion in PAs has been well-established, this study aims to assess the prevalence of KIAA1549::BRAF fusions and explore their associations with tumor characteristics, radiological findings, and patient outcomes in PAs. METHODS Histologically confirmed cases of PAs from a 5-year period were included in the study. Demographic, histopathological, and radiological data were collected, and immunohistochemistry was performed to characterize tumor markers. FISH and qRT-PCR assays were employed to detect KIAA1549::BRAF fusions. Statistical analyses were conducted to examine associations between fusion status and various other parameters. RESULTS Histological analysis revealed no significant differences in tumor features based on fusion status. However, younger age groups showed higher fusion prevalence. Radiologically, fusion-positive cases were distributed across different tumor subtypes SE, CWE and NCWE. Survival analysis did not demonstrate a significant impact of fusion status on overall survival, however most cases with recurrence and death harboured KIAA1549::BRAF fusion. Of 200 PAs, KIAA1549::BRAF fusions were detected in 64 % and 74 % of cases via qRT-PCR and FISH, respectively. Concordance between the two platforms was substantial (86 %). CONCLUSION KIAA1549::BRAF fusions are prevalent in PAs and can be reliably detected using both FISH and qRT-PCR assays. Cost considerations suggest qRT-PCR as a more economical option for fusion detection in routine clinical practice.
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Affiliation(s)
- Iman Dandapath
- Neuropathology Laboratory, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Sumanta Das
- Neuropathology Laboratory, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Bheru Dan Charan
- Department of Neuroradiology, All, India Institute of Medical Science, New Delhi, India
| | - Ajay Garg
- Department of Neuroradiology, All, India Institute of Medical Science, New Delhi, India
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shweta Kedia
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Mehar Chand Sharma
- Neuropathology Laboratory, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Chitra Sarkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Yookarin Khonglah
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Shabnam Ahmed
- Department of Pathology, GNRC Hospitals, Dispur, Assam, India
| | - Vaishali Suri
- Neuropathology Laboratory, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
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2
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Papusha L, Zaytseva M, Panferova A, Salnikova E, Samarin A, Vilesova I, Voronin K, Protsvetkina A, Podlipaeva S, Zakharov I, Usman N, Hwang E, Karachunskiy A, Packer RJ, Novichkova G, Druy A. Midline Low-Grade Gliomas of Early Childhood: Focus on Targeted Therapies. JCO Precis Oncol 2024; 8:e2300590. [PMID: 38976815 DOI: 10.1200/po.23.00590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 04/02/2024] [Accepted: 04/15/2024] [Indexed: 07/10/2024] Open
Abstract
PURPOSE Midline low-grade gliomas (mLGGs) of early childhood have a poorer prognosis compared with tumors of other localizations and in older patients. LGGs are associated with aberrant activation of RAS-RAF-MEK pathway, and pharmacological inhibition of the pathway has therapeutic promise. The aim of this study was clinical and molecular characterization of infantile mLGGs, with emphasis on the efficacy of targeted kinase inhibition. PATIENTS AND METHODS This study enrolled 40 patients with mLGG age <3 years. The majority of the patients (30/40) received first-line chemotherapy (CT) as per International Society of Paediatric Oncology LGG 2004 guidelines. In all patients, molecular genetic investigation of tumor tissue by polymerase chain reaction and RNA sequencing was performed. The median follow-up was 3.5 years. RESULTS First-line CT failed in 24 of 30 recipients. The identified molecular profiles included KIAA1549::BRAF fusions in 26 patients, BRAF V600E in six patients, FGFR1::TACC1 fusions in two patients, and rare fusion transcripts in four patients. At disease progression, targeted therapy (TT) was initiated in 27 patients (22 patients received trametinib) on the basis of molecular findings. TT was administered for a median of 16 months, with partial response achieved in 12 of 26 (46%) patients in which response was evaluated. Severe adverse events were detected only on trametinib monotherapy: acute damage of GI or urinary mucosa complicated by hemorrhage and development of transfusion-dependent anemia in four patients and grade 3 skin toxicity in three patients. CONCLUSION mLGGs of early childhood are often aggressive tumors, resistant to CT, and frequently require alternative treatment. The majority of patients harbor druggable molecular targets and respond to molecular TT.
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Affiliation(s)
- Ludmila Papusha
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Margarita Zaytseva
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Agnesa Panferova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Ekaterina Salnikova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Alexey Samarin
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Irina Vilesova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Kirill Voronin
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Anastasia Protsvetkina
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | | | - Ilya Zakharov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Natalia Usman
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Eugene Hwang
- Division of Oncology, Children's National Hospital, Washington, DC
- Brain Tumor Institute, Children's National Hospital, Washington, DC
| | - Alexander Karachunskiy
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Roger J Packer
- Brain Tumor Institute, Children's National Hospital, Washington, DC
- Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Washington, DC
| | - Galina Novichkova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Alexander Druy
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
- Research Institute of Medical Cell Technologies, Yekaterinburg, Russia
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3
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Grinstein-Koren O, Lusthaus M, Tabibian-Keissar H, Kaplan I, Buchner A, Ilatov R, Vered M, Zlotogorski-Hurvitz A. Pathological changes in oral epithelium and the expression of SARS-CoV-2 entry receptors, ACE2 and furin. PLoS One 2024; 19:e0300269. [PMID: 38489333 PMCID: PMC10942036 DOI: 10.1371/journal.pone.0300269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/24/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Expression of angiotensin-converting enzyme (ACE)-2 and co-factors like furin, play key-roles in entry of SARS-CoV-2 into host cells. Furin is also involved in oral carcinogenesis. We investigated their expression in oral pre-malignant/malignant epithelial pathologies to evaluate whether ACE2 and furin expression might increase susceptibility of patients with these lesions for SARS-CoV-2 infection. METHODS Study included normal oral mucosa (N = 14), epithelial hyperplasia-mild dysplasia (N = 27), moderate-to-severe dysplasia (N = 24), squamous cell carcinoma (SCC, N = 34) and oral lichen planus (N = 51). Evaluation of ACE2/furin membranous/membranous-cytoplasmic immunohistochemical expression was divided by epithelial thirds (basal/middle/upper), on a 5-tier scale (0, 1-weak, 1.5 -weak-to-moderate, 2-moderate, 3-strong). Total score per case was the sum of all epithelial thirds, and the mean staining score per group was calculated. Real time-polymerase chain reaction was performed for ACE2-RNA. Statistical differences were analyzed by One-way ANOVA, significance at p<0.05. RESULTS All oral mucosa samples were negative for ACE2 immuno-expression and its transcripts. Overall, furin expression was weakly present with total mean expression being higher in moderate-to-severe dysplasia and hyperplasia-mild dysplasia than in normal epithelium (p = 0.01, each) and SCC (p = 0.008, p = 0.009, respectively). CONCLUSIONS Oral mucosa, normal or with epithelial pathologies lacked ACE2 expression. Furin was weak and mainly expressed in dysplastic lesions. Thus, patients with epithelial pathologies do not seem to be at higher risk for SARS-CoV-2 infection. Overall, results show that oral mucosae do not seem to be a major site of SARS-CoV-2 entry and these were discussed vis-à-vis a comprehensive analysis of the literature.
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Affiliation(s)
- Osnat Grinstein-Koren
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michal Lusthaus
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Ilana Kaplan
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Institute of Pathology, Rabin Medical Center, Petach-Tikva, Israel
| | - Amos Buchner
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ron Ilatov
- Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Marilena Vered
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Institute of Pathology, The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Ayelet Zlotogorski-Hurvitz
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Petach-Tikva, Israel
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4
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Adela M, Ales V, Petr B, Katerina V, David S, Lucie S, Lucie S, Miroslav K, Josef Z, Martin K, Zuzana H, Petr L, Jakub T, Vladimir B, Ivana P, David JTW, Martin S, Terezia S, Lenka K, Michal Z. Integrated genomic analysis reveals actionable targets in pediatric spinal cord low-grade gliomas. Acta Neuropathol Commun 2022; 10:143. [PMID: 36163281 PMCID: PMC9513869 DOI: 10.1186/s40478-022-01446-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022] Open
Abstract
Gliomas are the most common central nervous tumors in children and adolescents. However, spinal cord low-grade gliomas (sLGGs) are rare, with scarce information on tumor genomics and epigenomics. To define the molecular landscape of sLGGs, we integrated clinical data, histology, and multi-level genetic and epigenetic analyses on a consecutive cohort of 26 pediatric patients. Driver molecular alteration was found in 92% of patients (24/26). A novel variant of KIAA1549:BRAF fusion (ex10:ex9) was identified using RNA-seq in four cases. Importantly, only one-third of oncogenic drivers could be revealed using standard diagnostic methods, and two-thirds of pediatric patients with sLGGs required extensive molecular examination. The majority (23/24) of detected alterations were potentially druggable targets. Four patients in our cohort received targeted therapy with MEK or NTRK inhibitors. Three of those exhibited clinical improvement (two with trametinib, one with larotrectinib), and two patients achieved partial response. Methylation profiling was implemented to further refine the diagnosis and revealed intertumoral heterogeneity in sLGGs. Although 55% of tumors clustered with pilocytic astrocytoma, other rare entities were identified in this patient population. In particular, diffuse leptomeningeal glioneuronal tumors (n = 3) and high-grade astrocytoma with piloid features (n = 1) and pleomorphic xanthoastrocytoma (n = 1) were present. A proportion of tumors (14%) had no match with the current version of the classifier. Complex molecular genetic sLGGs characterization was invaluable to refine diagnosis, which has proven to be essential in such a rare tumor entity. Moreover, identifying a high proportion of drugable targets in sLGGs opened an opportunity for new treatment modalities.
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Affiliation(s)
- Misove Adela
- Prague Brain Tumor Research Group, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.,Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Vicha Ales
- Prague Brain Tumor Research Group, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.,Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Broz Petr
- Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.,Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University Prague and Faculty Hospital Motol, Prague, Czech Republic
| | - Vanova Katerina
- Prague Brain Tumor Research Group, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.,Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Sumerauer David
- Prague Brain Tumor Research Group, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.,Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Stolova Lucie
- Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Sramkova Lucie
- Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Koblizek Miroslav
- Prague Brain Tumor Research Group, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.,Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University Prague and Faculty Hospital Motol, Prague, Czech Republic
| | - Zamecnik Josef
- Prague Brain Tumor Research Group, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.,Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University Prague and Faculty Hospital Motol, Prague, Czech Republic
| | - Kyncl Martin
- Department of Radiology, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Holubova Zuzana
- Department of Radiology, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Liby Petr
- Department of Neurosurgery, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Taborsky Jakub
- Department of Neurosurgery, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Benes Vladimir
- Department of Neurosurgery, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Pernikova Ivana
- Department of Neurology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jones T W David
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.,Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sill Martin
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stancokova Terezia
- Department of Pediatric Oncology and Hematology, Children's University Hospital, Banska Bystrica, Slovakia
| | - Krskova Lenka
- Prague Brain Tumor Research Group, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.,Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University Prague and Faculty Hospital Motol, Prague, Czech Republic
| | - Zapotocky Michal
- Prague Brain Tumor Research Group, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic. .,Department of Pediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
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5
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Coutant M, Lhermitte B, Guérin E, Chammas A, Reita D, Sebastia C, Douzal V, Gabor F, Salmon A, Chenard MP, Todeschi J, Coca A, Heng MA, Vincent F, Entz-Werlé N. Retrospective and integrative analyses of molecular characteristics and their specific imaging parameters in pediatric grade 1 gliomas. Pediatr Blood Cancer 2022; 69:e29575. [PMID: 35373885 DOI: 10.1002/pbc.29575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pediatric low-grade gliomas (PLGG) are the most common brain tumors diagnosed during childhood and represent a heterogeneous group associating variable molecular abnormalities. To go further and develop specific statistical patterns between tumor molecular background, imaging features, and patient outcome, a retrospective study was performed in a group of non-neurofibromatosis type 1 (non-NF1) grade 1 PLGGs. PATIENTS AND METHODS Seventy-eight children, followed from 2004 to 2017, were retrospectively reported. In this population, we analyzed radiological and molecular parameters. Their therapeutic management comprised surgery or surgery plus chemotherapies. RESULTS Considering all 78 patients, 59 had only a surgical removal and 19 patients were treated with postoperative chemotherapy. Twelve progressions were reported in the partially resected and chemotherapeutic groups, whereas four deaths occurred only in the highly treated patients. As expected, in the global cohort, PLGG with BRAF p.V600E and/or CDKN2A loss exhibited poor outcomes and we evidenced significant associations between those molecular characteristics and their imaging presentation. In the chemo-treated patients, when associating initial and 6-month magnetic resonance imaging (MRI) parameters to the molecular features, the good risk situations were significantly linked to the presence of a large tumor cyst at diagnosis and the appearance during treatment of a higher cystic proportion that we called cystic conversion. CONCLUSION So, additionally to the presence of BRAF p.V600E or CDKN2A deletion in grade 1 PLGGs, the absence on diagnostic MRI of cystic parts and/or cystic conversion at 6-month chemotherapy were significantly linked to a worst prognosis and response to treatment. These imaging features should be considered as prognostic markers in future PLGG studies.
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Affiliation(s)
- Marie Coutant
- Pediatric Onco-Hematology Unit, University Hospital of Strasbourg, Strasbourg, France
| | - Benoit Lhermitte
- Pathology Department, University Hospital of Strasbourg, Strasbourg, France
| | - Eric Guérin
- Laboratory of Biochemistry, University Hospital of Strasbourg, Strasbourg, France.,Molecular Genetics of Cancer Platform, University Hospital of Strasbourg, Strasbourg, France
| | - Agathe Chammas
- Radiology Department, Pediatric Unit, University Hospital of Strasbourg, Strasbourg, France
| | - Damien Reita
- Laboratory of Biochemistry, University Hospital of Strasbourg, Strasbourg, France.,Molecular Genetics of Cancer Platform, University Hospital of Strasbourg, Strasbourg, France
| | - Consuelo Sebastia
- Radiology Department, Pediatric Unit, University Hospital of Strasbourg, Strasbourg, France
| | - Valérie Douzal
- Radiology Department, Pediatric Unit, University Hospital of Strasbourg, Strasbourg, France
| | - Flaviu Gabor
- Radiology Department, Pediatric Unit, University Hospital of Strasbourg, Strasbourg, France
| | - Alexandra Salmon
- Pediatric Onco-Hematology Unit, University Hospital of Strasbourg, Strasbourg, France
| | - Marie-Pierre Chenard
- Pathology Department, University Hospital of Strasbourg, Strasbourg, France.,Centre de Ressources Biologiques, University Hospital of Strasbourg, Strasbourg, France
| | - Julien Todeschi
- Neurosurgery Department, University Hospital of Strasbourg, Strasbourg, France
| | - Andres Coca
- Neurosurgery Department, University Hospital of Strasbourg, Strasbourg, France
| | - Marie-Amelie Heng
- Pediatric Onco-Hematology Unit, University Hospital of Strasbourg, Strasbourg, France
| | - Florence Vincent
- Pediatric Onco-Hematology Unit, University Hospital of Strasbourg, Strasbourg, France
| | - Natacha Entz-Werlé
- Pediatric Onco-Hematology Unit, University Hospital of Strasbourg, Strasbourg, France.,UMR CNRS 7021, Laboratory of Bioimaging and Pathologies, Tumoral signaling and Therapeutic Targets, Faculty of Pharmacy, Illkirch, France
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6
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Survival and functional outcomes in paediatric thalamic and thalamopeduncular low grade gliomas. Acta Neurochir (Wien) 2022; 164:1459-1472. [PMID: 35043265 DOI: 10.1007/s00701-021-05106-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/28/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Childhood thalamopeduncular gliomas arise at the interface of the thalamus and cerebral peduncle. The optimal treatment is total resection but not at the cost of neurological function. We present long-term clinical and oncological outcomes of maximal safe resection. METHODS Retrospective review of prospectively collected data: demography, symptomatology, imaging, extent of resection, surgical complications, histology, functional and oncological outcome. RESULTS During 16-year period (2005-2020), 21 patients were treated at our institution. These were 13 girls and 8 boys (mean age 7.6 years). Presentation included progressive hemiparesis in 9 patients, raised intracranial pressure in 9 patients and cerebellar symptomatology in 3 patients. The tumour was confined to the thalamus in 6 cases. Extent of resection was judged on postoperative imaging as total (6), near-total (6) and less extensive (9). Surgical complications included progression of baseline neurological status in 6 patients, and 5 of these gradually improved to preoperative status. All tumours were classified as low-grade gliomas. Disease progression was observed in 9 patients (median progression-free survival 7.3 years). At last follow-up (median 6.1 years), all patients were alive, median Lansky score of 90. Seven patients were without evidence of disease, 6 had stable disease, 7 stable following progression and 1 had progressive disease managed expectantly. CONCLUSION Paediatric patients with low-grade thalamopeduncular gliomas have excellent long-term functional and oncological outcomes when gross total resection is not achievable. Surgery should aim at total resection; however, neurological function should not be endangered due to excellent chance for long-term survival.
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7
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Wolter M, Felsberg J, Malzkorn B, Kaulich K, Reifenberger G. Droplet digital PCR-based analyses for robust, rapid, and sensitive molecular diagnostics of gliomas. Acta Neuropathol Commun 2022; 10:42. [PMID: 35361262 PMCID: PMC8973808 DOI: 10.1186/s40478-022-01335-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/20/2022] [Indexed: 11/10/2022] Open
Abstract
Classification of gliomas involves the combination of histological features with molecular biomarkers to establish an integrated histomolecular diagnosis. Here, we report on the application and validation of a set of molecular assays for glioma diagnostics based on digital PCR technology using the QX200™ Droplet Digital™ PCR (ddPCR) system. The investigated ddPCR-based assays enable the detection of diagnostically relevant glioma-associated mutations in the IDH1, IDH2, H3-3A, BRAF, and PRKCA genes, as well as in the TERT promoter. In addition, ddPCR-based assays assessing diagnostically relevant copy number alterations were studied, including 1p/19q codeletion, gain of chromosome 7 and loss of chromosome 10 (+ 7/-10), EGFR amplification, duplication of the BRAF locus, and CDKN2A homozygous deletion. Results obtained by ddPCR were validated by other methods, including immunohistochemistry, Sanger sequencing, pyrosequencing, microsatellite analyses for loss of heterozygosity, as well as real-time PCR- or microarray-based copy number assays. Particular strengths of the ddPCR approach are (1) its high analytical sensitivity allowing for reliable detection of mutations even with low mutant allele frequencies, (2) its quantitative determination of mutant allele frequencies and copy number changes, and (3) its rapid generation of results within a single day. Thus, in line with other recent studies our findings support ddPCR analysis as a valuable approach for molecular glioma diagnostics in a fast, quantitative and highly sensitive manner.
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8
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Lind KT, Chatwin HV, DeSisto J, Coleman P, Sanford B, Donson AM, Davies KD, Willard N, Ewing CA, Knox AJ, Mulcahy Levy JM, Gilani A, Green AL. Novel RAF Fusions in Pediatric Low-Grade Gliomas Demonstrate MAPK Pathway Activation. J Neuropathol Exp Neurol 2021; 80:1099-1107. [PMID: 34850053 DOI: 10.1093/jnen/nlab110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Brain tumors are the most common solid tumor in children, and low-grade gliomas (LGGs) are the most common childhood brain tumor. Here, we report on 3 patients with LGG harboring previously unreported or rarely reported RAF fusions: FYCO1-RAF1, CTTNBP2-BRAF, and SLC44A1-BRAF. We hypothesized that these tumors would show molecular similarity to the canonical KIAA1549-BRAF fusion that is the most widely seen alteration in pilocytic astrocytoma (PA), the most common pediatric LGG variant, and that this similarity would include mitogen-activated protein kinase (MAPK) pathway activation. To test our hypothesis, we utilized immunofluorescent imaging and RNA-sequencing in normal brain, KIAA1549-BRAF-harboring tumors, and our 3 tumors with novel fusions. We performed immunofluorescent staining of ERK and phosphorylated ERK (p-ERK), identifying increased p-ERK expression in KIAA1549-BRAF fused PA and the novel fusion samples, indicative of MAPK pathway activation. Geneset enrichment analysis further confirmed upregulated downstream MAPK activation. These results suggest that MAPK activation is the oncogenic mechanism in noncanonical RAF fusion-driven LGG. Similarity in the oncogenic mechanism suggests that LGGs with noncanonical RAF fusions are likely to respond to MEK inhibitors.
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Affiliation(s)
- Katherine T Lind
- From the Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Hannah V Chatwin
- Department of Pediatrics, University of Colorado School of Medicine, Morgan Adams Foundation Pediatric Brain Tumor Research Program, Aurora, Colorado, USA
| | - John DeSisto
- Department of Pediatrics, University of Colorado School of Medicine, Morgan Adams Foundation Pediatric Brain Tumor Research Program, Aurora, Colorado, USA
| | - Philip Coleman
- Department of Pediatrics, University of Colorado School of Medicine, Morgan Adams Foundation Pediatric Brain Tumor Research Program, Aurora, Colorado, USA
| | - Bridget Sanford
- Department of Pediatrics, University of Colorado School of Medicine, Morgan Adams Foundation Pediatric Brain Tumor Research Program, Aurora, Colorado, USA
| | - Andrew M Donson
- Department of Pediatrics, University of Colorado School of Medicine, Morgan Adams Foundation Pediatric Brain Tumor Research Program, Aurora, Colorado, USA
| | - Kurtis D Davies
- Department of Pathology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nicholas Willard
- Department of Pathology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Calvin A Ewing
- Department of Pediatrics, University of Colorado School of Medicine, Morgan Adams Foundation Pediatric Brain Tumor Research Program, Aurora, Colorado, USA
| | - Aaron J Knox
- Department of Pediatrics, University of Colorado School of Medicine, Morgan Adams Foundation Pediatric Brain Tumor Research Program, Aurora, Colorado, USA
| | | | - Ahmed Gilani
- Department of Pathology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Adam L Green
- Department of Pediatrics, University of Colorado School of Medicine, Morgan Adams Foundation Pediatric Brain Tumor Research Program, Aurora, Colorado, USA
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9
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Dandapath I, Chakraborty R, Kaur K, Mahajan S, Singh J, Sharma MC, Sarkar C, Suri V. Molecular alterations of low-grade gliomas in young patients: Strategies and platforms for routine evaluation. Neurooncol Pract 2021; 8:652-661. [PMID: 34777834 PMCID: PMC8579091 DOI: 10.1093/nop/npab053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In recent years, it has been established that molecular biology of pediatric low-grade gliomas (PLGGs) is entirely distinct from adults. The majority of the circumscribed pediatric gliomas are driven by mitogen-activated protein kinase (MAPK) pathway, which has yielded important diagnostic, prognostic, and therapeutic biomarkers. Further, the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT) Steering Committee in their fourth meeting, suggested including a panel of molecular markers for integrated diagnosis in "pediatric-type" diffuse gliomas. However, a designated set of platforms for the evaluation of these alterations has yet not been mentioned for easier implementation in routine molecular diagnostics. Herein, we have reviewed the relevance of analyzing these markers and discussed the strategies and platforms best apposite for clinical laboratories.
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Affiliation(s)
- Iman Dandapath
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Kavneet Kaur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Swati Mahajan
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Jyotsna Singh
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Mehar C Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Chitra Sarkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishali Suri
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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10
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Cytokines in Pediatric Pilocytic Astrocytomas: A Clinico-Pathological Study. NEUROSCI 2021. [DOI: 10.3390/neurosci2010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pilocytic astrocytomas (PCA) are WHO Grade I tumors with a favorable prognosis. Surgical resection is usually curative. Nonetheless, progressive and/or metastatic disease occurs in 20% of patients. For these patients, treatment options are limited. The role of the immune system in PCA has not previously been reported. We hypothesize that the circulating cytokines contribute to tumorigenicity in PCA. This is an exploratory study with a focus on the identification of circulating cerebrospinal (CSF) cytokines associated with PCA. The primary objective is to demonstrate that CSF cytokines will be differentially expressed in the subset of PCAs that are difficult to treat in comparison to their surgically amendable counterparts. This is a single-institution, retrospective study of prospectively collected data. Patients with a confirmed histological diagnosis of PCA who have simultaneous intraoperative CSF sampling are included. Cerebrospinal fluid samples are subjected to multiplex cytokine profiling. Patient-derived PCA lines from selected patients in the same study cohort are cultured. Their cell culture supernatants are collected and interrogated using the sample multiplex platform as the CSF. A total of 8 patients are recruited. There were two patients with surgically difficult tumors associated with leptomeningeal involvement. Multiplex profiling of the cohort’s CSF samples showed elevated expressions of IFN-γ, IL-2, IL-12p70, IL-1β, IL-4, and TNF-α in these two patients in comparison to the remaining cohort. Next, primary cell lines derived from the same PCA patients demonstrated a similar trend of differential cytokine expression in their cell culture supernatant in vitro. Although our findings are preliminary at this stage, this is the first study in pediatric PCAs that show cytokine expression differences between the two groups of PCA with different clinical behaviors.
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11
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Chiacchiarini M, Besharat ZM, Carai A, Miele E, Del Baldo G, Mastronuzzi A, Catanzaro G, Ferretti E. Pediatric low-grade gliomas: molecular characterization of patient-derived cellular models. Childs Nerv Syst 2021; 37:771-778. [PMID: 32162034 DOI: 10.1007/s00381-020-04559-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/27/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Pediatric low-grade gliomas (pLGGs), the most frequent pediatric brain tumors, include different entities harboring distinct histological and molecular features. A major limitation in the development of treatments for these tumors is the absence of reliable in vitro models that would allow a better understanding of the molecular mechanisms that support their growth. Surgical excision is the primary treatment method and the extent of resection represents one of the strongest prognostic factors. pLGGs that cannot be completely resected are prone to recur and associated with relapses and extensive morbidities, thus remaining a major clinical challenge. METHODS We established a protocol to successfully derive primary patient-derived pLGG cells and to fully characterize them from a molecular point of view. RESULTS Primary patients-derived pLGG cells were extensively analyzed in order to confirm their reliability as cellular models. Specifically, we evaluated the growth rate, senescence, and molecular features, such as BRAF mutational status, methylation, and protein expression profile. CONCLUSION This study extensively describes pLGG primary cellular models in terms of isolation, culture method, and molecular characterization that can be used to investigate pLGG biology.
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Affiliation(s)
- Martina Chiacchiarini
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Zein Mersini Besharat
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Andrea Carai
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Evelina Miele
- Department of Hematology/Oncology and Stem Cell Transplantation, IRCCS Bambino Gesu Children's Hospital, Rome, Italy
| | - Giada Del Baldo
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Angela Mastronuzzi
- Department of Hematology/Oncology and Stem Cell Transplantation, IRCCS Bambino Gesu Children's Hospital, Rome, Italy
| | - Giuseppina Catanzaro
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Elisabetta Ferretti
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
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12
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Bobach IS, Stougaard M. SNP-based detection of allelic imbalance: A novel approach for identifying KIAA1549-BRAF fusion in pilocytic astrocytoma using DNA sequencing. Exp Mol Pathol 2021; 120:104621. [PMID: 33626378 DOI: 10.1016/j.yexmp.2021.104621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 11/19/2022]
Abstract
Pilocytic astrocytoma (PA) is the most common glioma subtype found in children, and it is a non-malignant tumor type. The majority of PAs is caused by an approximately 2 Mb tandem duplication within 7q34 which creates an in-frame KIAA1549-BRAF fusion gene. The kinase domain of BRAF is fused to the N-terminal of KIAA1549, whereby BRAF is constitutively activated. We here present a novel approach for identifying KIAA1549-BRAF fusion based on single nucleotide polymorphism (SNP) analysis and next generation sequencing (NGS). Highly polymorphic SNPs in the duplicated area and in adjacent areas were selected and a custom targeted amplicon based NGS panel was designed. The panel was tested on DNA extracted from formalin fixed and paraffin embedded tissue from a retrospective cohort, consisting of biopsies from patients with PA, anaplastic astrocytoma, oligodendroglioma and glioblastoma as well as two non-tumor biopsies. The panel could distinguish chromosome 7 gain from BRAF fusion and correctly identified 8/9 PA samples with KIAA1549-BRAF fusion confirmed by RNA sequencing. The one biopsy where no fusion was detected was fresh frozen and from the RNA sequencing expected to have very low tumor content. No allelic imbalance was detected in either oligodendroglioma or in the non-tumor biopsies.
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Affiliation(s)
- Ida Schwartz Bobach
- Department of Clinical Medicine, Aarhus University, Denmark; Department of Pathology, Aarhus University Hospital, Denmark
| | - Magnus Stougaard
- Department of Clinical Medicine, Aarhus University, Denmark; Department of Pathology, Aarhus University Hospital, Denmark.
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13
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Tan JY, Wijesinghe IVS, Alfarizal Kamarudin MN, Parhar I. Paediatric Gliomas: BRAF and Histone H3 as Biomarkers, Therapy and Perspective of Liquid Biopsies. Cancers (Basel) 2021; 13:cancers13040607. [PMID: 33557011 PMCID: PMC7913734 DOI: 10.3390/cancers13040607] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 01/10/2023] Open
Abstract
Simple Summary Gliomas are major causes of worldwide cancer-associated deaths in children. Generally, paediatric gliomas can be classified into low-grade and high-grade gliomas. They differ significantly from adult gliomas in terms of prevalence, molecular alterations, molecular mechanisms and predominant histological types. The aims of this review article are: (i) to discuss the current updates of biomarkers in paediatric low-grade and high-grade gliomas including their diagnostic and prognostic values, and (ii) to discuss potential targeted therapies in treating paediatric low-grade and high-grade gliomas. Our findings revealed that liquid biopsy is less invasive than tissue biopsy in obtaining the samples for biomarker detections in children. In addition, future clinical trials should consider blood-brain barrier (BBB) penetration of therapeutic drugs in paediatric population. Abstract Paediatric gliomas categorised as low- or high-grade vary markedly from their adult counterparts, and denoted as the second most prevalent childhood cancers after leukaemia. As compared to adult gliomas, the studies of diagnostic and prognostic biomarkers, as well as the development of therapy in paediatric gliomas, are still in their infancy. A body of evidence demonstrates that B-Raf Proto-Oncogene or V-Raf Murine Sarcoma Viral Oncogene Homolog B (BRAF) and histone H3 mutations are valuable biomarkers for paediatric low-grade gliomas (pLGGs) and high-grade gliomas (pHGGs). Various diagnostic methods involving fluorescence in situ hybridisation, whole-genomic sequencing, PCR, next-generation sequencing and NanoString are currently used for detecting BRAF and histone H3 mutations. Additionally, liquid biopsies are gaining popularity as an alternative to tumour materials in detecting these biomarkers, but still, they cannot fully replace solid biopsies due to several limitations. Although histone H3 mutations are reliable prognosis biomarkers in pHGGs, children with these mutations have a dismal prognosis. Conversely, the role of BRAF alterations as prognostic biomarkers in pLGGs is still in doubt due to contradictory findings. The BRAF V600E mutation is seen in the majority of pLGGs (as seen in pleomorphic xanthoastrocytoma and gangliomas). By contrast, the H3K27M mutation is found in the majority of paediatric diffuse intrinsic pontine glioma and other midline gliomas in pHGGs. pLGG patients with a BRAF V600E mutation often have a lower progression-free survival rate in comparison to wild-type pLGGs when treated with conventional therapies. BRAF inhibitors (Dabrafenib and Vemurafenib), however, show higher overall survival and tumour response in BRAF V600E mutated pLGGs than conventional therapies in some studies. To date, targeted therapy and precision medicine are promising avenues for paediatric gliomas with BRAF V600E and diffuse intrinsic pontine glioma with the H3K27M mutations. Given these shortcomings in the current treatments of paediatric gliomas, there is a dire need for novel therapies that yield a better therapeutic response. The present review discusses the diagnostic tools and the perspective of liquid biopsies in the detection of BRAF V600E and H3K27M mutations. An in-depth understanding of these biomarkers and the therapeutics associated with the respective challenges will bridge the gap between paediatric glioma patients and the development of effective therapies.
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Affiliation(s)
| | | | | | - Ishwar Parhar
- Correspondence: ; Tel.: +603-5514-6304; Fax: +603-5515-6341
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14
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Stichel D, Schrimpf D, Sievers P, Reinhardt A, Suwala AK, Sill M, Reuss DE, Korshunov A, Casalini BM, Sommerkamp AC, Ecker J, Selt F, Sturm D, Gnekow A, Koch A, Simon M, Hernáiz Driever P, Schüller U, Capper D, van Tilburg CM, Witt O, Milde T, Pfister SM, Jones DTW, von Deimling A, Sahm F, Wefers AK. Accurate calling of KIAA1549-BRAF fusions from DNA of human brain tumours using methylation array-based copy number and gene panel sequencing data. Neuropathol Appl Neurobiol 2021; 47:406-414. [PMID: 33336421 DOI: 10.1111/nan.12683] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/14/2020] [Accepted: 12/13/2020] [Indexed: 12/20/2022]
Abstract
AIMS KIAA1549-BRAF fusions occur in certain brain tumours and provide druggable targets due to a constitutive activation of the MAP-kinase pathway. We introduce workflows for calling the KIAA1549-BRAF fusion from DNA methylation array-derived copy number as well as DNA panel sequencing data. METHODS Copy number profiles were analysed by automated screening and visual verification of a tandem duplication on chromosome 7q34, indicative of the KIAA1549-BRAF fusion. Pilocytic astrocytomas of the ICGC cohort with known fusion status were used for validation. KIAA1549-BRAF fusions were called from DNA panel sequencing data using the fusion callers Manta, Arriba with modified filtering criteria and deFuse. We screened DNA methylation and panel sequencing data of 7790 specimens from brain tumour and sarcoma entities. RESULTS We identified the fusion in 337 brain tumours with both DNA methylation and panel sequencing data. Among these, we detected the fusion from copy number data in 84% and from DNA panel sequencing data in more than 90% using Arriba with modified filters. While in 74% the KIAA1549-BRAF fusion was detected from both methylation array-derived copy number and panel sequencing data, in 9% it was detected from copy number data only and in 16% from panel data only. The fusion was almost exclusively found in pilocytic astrocytomas, diffuse leptomeningeal glioneuronal tumours and high-grade astrocytomas with piloid features. CONCLUSIONS The KIAA1549-BRAF fusion can be reliably detected from either DNA methylation array or DNA panel data. The use of both methods is recommended for the most sensitive detection of this diagnostically and therapeutically important marker.
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Affiliation(s)
- Damian Stichel
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniel Schrimpf
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Philipp Sievers
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annekathrin Reinhardt
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Abigail K Suwala
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Martin Sill
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David E Reuss
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andrey Korshunov
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
| | - Belén M Casalini
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alexander C Sommerkamp
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Jonas Ecker
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Florian Selt
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Dominik Sturm
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
| | - Astrid Gnekow
- Swabian Children's Cancer Center, University Hospital Augsburg, Augsburg, Germany
| | - Arend Koch
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,German Cancer Consortium (DKTK, Partner Site Berlin, German Cancer Research Center (DKFZ, Heidelberg, Germany
| | - Michèle Simon
- Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Pablo Hernáiz Driever
- Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Ulrich Schüller
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
| | - David Capper
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,German Cancer Consortium (DKTK, Partner Site Berlin, German Cancer Research Center (DKFZ, Heidelberg, Germany
| | - Cornelis M van Tilburg
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Olaf Witt
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Till Milde
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Stefan M Pfister
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
| | - David T W Jones
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Pediatric Glioma Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
| | - Annika K Wefers
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
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15
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Younes ST, Herrington B. In silico analysis identifies a putative cell-of-origin for BRAF fusion-positive cerebellar pilocytic astrocytoma. PLoS One 2020; 15:e0242521. [PMID: 33206716 PMCID: PMC7673500 DOI: 10.1371/journal.pone.0242521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/04/2020] [Indexed: 11/19/2022] Open
Abstract
Childhood cancers are increasingly recognized as disorders of cellular development. This study sought to identify the cellular and developmental origins of cerebellar pilocytic astrocytoma, the most common brain tumor of childhood. Using publicly available gene expression data from pilocytic astrocytoma tumors and controlling for driver mutation, a set of developmental-related genes which were overexpressed in cerebellar pilocytic astrocytoma was identified. These genes were then mapped onto several developmental atlases in order to identify normal cells with similar gene expression patterns and the developmental trajectory of those cells was interrogated. Eight known neuro-developmental genes were identified as being expressed in cerebellar pilocytic astrocytoma. Mapping those genes or their orthologs onto mouse neuro-developmental atlases identified overlap in their expression within the ventricular zone of the cerebellar anlage. Further analysis with a single cell RNA-sequencing atlas of the developing mouse cerebellum defined this overlap as occurring in ventricular zone progenitor cells at the division point between GABA-ergic neuronal and glial lineages, a developmental trajectory which closely mirrors that previously described to occur within pilocytic astrocytoma cells. Furthermore, ventricular zone progenitor cells and their progeny exhibited evidence of MAPK pathway activation, the paradigmatic oncogenic cascade known to be active in cerebellar pilocytic astrocytoma. Gene expression from developing human brain atlases recapitulated the same anatomic localizations and developmental trajectories as those found in mice. Taken together, these data suggest this population of ventricular zone progenitor cells as the cell-of-origin for BRAF fusion-positive cerebellar pilocytic astrocytoma.
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Affiliation(s)
- Subhi Talal Younes
- MD/PhD Program, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Betty Herrington
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
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16
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Smith SC, Farooqi MS, Gener MA, Ginn K, Joyce JM, Bendorf TM, Cooley LD. Clinical Validation of Somatic Mutation Detection by the OncoScan CNV Plus Assay. J Mol Diagn 2020; 23:29-37. [PMID: 33080408 DOI: 10.1016/j.jmoldx.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/02/2020] [Accepted: 10/05/2020] [Indexed: 11/30/2022] Open
Abstract
The OncoScan CNV Plus Assay (OS+) is a single-nucleotide polymorphism microarray platform that can detect 74 hotspot somatic mutations (SMs) in nine genes via molecular inversion probes. We report validation of the SM component of OS+ using a cohort of pediatric high-grade brain tumor specimens. SM calls were generated from 46 brain tumor cases, most tested orthogonally via bidirectional Sanger sequencing. The initial calling algorithm result showed that 31 tumors were positive and 15 were negative for SM, with a total of 71 OS+ SM calls [28 high-confidence (HC) and 43 low-confidence (LC)]. Sanger sequencing was performed for 54 of the 71 calls (27 HC and 27 LC), as well as for 21 randomly selected hotspots across the 15 OS+ negative cases. HC calls (except EGFR) Sanger sequencing confirmed positive, negative calls confirmed negative, but none of the LC calls were Sanger-confirmed positive. An update of the OS+ algorithm resolved the LC calls, but of the 11 HC SM EGFR calls, Sanger sequencing confirmed only one. Two PTEN SM calls by OS+ in two separate cases were also negative per Sanger sequencing. We conclude that a majority of HC OS+ SM calls were accurate, except calls identified in EGFR and PTEN. Clinically, we report SMs identified by OS+ only after Sanger sequencing verification.
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Affiliation(s)
- Scott C Smith
- Department of Pathology & Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri; Department of Pathology & Laboratory Medicine, SUNY Upstate Medical University, Syracuse, New York
| | - Midhat S Farooqi
- Department of Pathology & Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri; Department of Pathology & Laboratory Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Melissa A Gener
- Department of Pathology & Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri; Department of Pathology & Laboratory Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Kevin Ginn
- Department of Pathology & Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri; Department of Pathology & Laboratory Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Julie M Joyce
- Department of Pathology & Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri; Department of Pathology & Laboratory Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Tara M Bendorf
- Department of Pathology & Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri; Department of Pathology & Laboratory Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Linda D Cooley
- Department of Pathology & Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri; Department of Pathology & Laboratory Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
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17
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Salles D, Laviola G, Malinverni ACDM, Stávale JN. Pilocytic Astrocytoma: A Review of General, Clinical, and Molecular Characteristics. J Child Neurol 2020; 35:852-858. [PMID: 32691644 DOI: 10.1177/0883073820937225] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Pilocytic astrocytomas are the primary tumors most frequently found in children and adolescents, accounting for approximately 15.6% of all brain tumors and 5.4% of all gliomas. They are mostly found in infratentorial structures such as the cerebellum and in midline cerebral structures such as the optic nerve, hypothalamus, and brain stem. The present study aimed to list the main characteristics about this tumor, to better understand the diagnosis and treatment of these patients, and was conducted on search of the published studies available in NCBI, PubMed, MEDLINE, Scielo, and Google Scholar. It was possible to define the main histologic findings observed in these cases, such as mitoses, necrosis, and Rosenthal fibers. We described the locations usually most affected by tumor development, and this was associated with the most frequent clinical features. The comparison between the molecular diagnostic methods showed great use of fluorescent in situ hybridization, polymerase chain reaction (PCR), and reverse transcriptase-PCR, important techniques for the detection of BRAF V600E mutation and BRAF-KIAA1549 fusion, characteristic molecular alterations in pilocytic astrocytomas.
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Affiliation(s)
- Débora Salles
- Department of Pathology, 28105Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil.,Laboratory of Molecular and Experimental Pathology, 28105Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
| | - Gabriela Laviola
- Department of Pathology, 28105Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil.,Laboratory of Molecular and Experimental Pathology, 28105Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
| | - Andréa Cristina de Moraes Malinverni
- Department of Pathology, 28105Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil.,Laboratory of Molecular and Experimental Pathology, 28105Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
| | - João Norberto Stávale
- Department of Pathology, 28105Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
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18
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Grob ST, Nobre L, Campbell KR, Davies KD, Ryall S, Aisner DL, Hoffman L, Zahedi S, Morin A, Crespo M, Nellan A, Green AL, Foreman N, Vibhakar R, Hankinson TC, Handler MH, Hawkins C, Tabori U, Kleinschmidt-DeMasters BK, Mulcahy Levy JM. Clinical and molecular characterization of a multi-institutional cohort of pediatric spinal cord low-grade gliomas. Neurooncol Adv 2020; 2:vdaa103. [PMID: 33063010 PMCID: PMC7542983 DOI: 10.1093/noajnl/vdaa103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background The mitogen-activated protein kinases/extracelluar signal-regulated kinases pathway is involved in cell growth and proliferation, and mutations in BRAF have made it an oncogene of interest in pediatric cancer. Previous studies found that BRAF mutations as well as KIAA1549–BRAF fusions are common in intracranial low-grade gliomas (LGGs). Fewer studies have tested for the presence of these genetic changes in spinal LGGs. The aim of this study was to better understand the prevalence of BRAF and other genetic aberrations in spinal LGG. Methods We retrospectively analyzed 46 spinal gliomas from patients aged 1–25 years from Children’s Hospital Colorado (CHCO) and The Hospital for Sick Children (SickKids). CHCO utilized a 67-gene panel that assessed BRAF and additionally screened for other possible genetic abnormalities of interest. At SickKids, BRAFV600E was assessed by droplet digital polymerase chain reaction and immunohistochemistry. BRAF fusions were detected by fluorescence in situ hybridization, reverse transcription polymerase chain reaction, or NanoString platform. Data were correlated with clinical information. Results Of 31 samples with complete fusion analysis, 13 (42%) harbored KIAA1549–BRAF. All 13 (100%) patients with confirmed KIAA1549–BRAF survived the entirety of the study period (median [interquartile range] follow-up time: 47 months [27–85 months]) and 15 (83.3%) fusion-negative patients survived (follow-up time: 37.5 months [19.8–69.5 months]). Other mutations of interest were also identified in this patient cohort including BRAFV600E, PTPN11, H3F3A, TP53, FGFR1, and CDKN2A deletion. Conclusion KIAA1549–BRAF was seen in higher frequency than BRAFV600E or other genetic aberrations in pediatric spinal LGGs and experienced lower death rates compared to KIAA1549–BRAF negative patients, although this was not statistically significant.
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Affiliation(s)
- Sydney T Grob
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Liana Nobre
- Department of Hematology and Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kristen R Campbell
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA
| | - Kurtis D Davies
- Department of Pathology, University of Colorado Denver, Aurora, Colorado, USA
| | - Scott Ryall
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Dara L Aisner
- Department of Pathology, University of Colorado Denver, Aurora, Colorado, USA
| | - Lindsey Hoffman
- Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Shadi Zahedi
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Andrew Morin
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Michele Crespo
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Anandani Nellan
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Adam L Green
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Nicholas Foreman
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Rajeev Vibhakar
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Todd C Hankinson
- The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA.,Department of Neurosurgery, University of Colorado Denver, Aurora, Colorado, USA
| | - Michael H Handler
- The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA.,Department of Neurosurgery, University of Colorado Denver, Aurora, Colorado, USA
| | - Cynthia Hawkins
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Uri Tabori
- Department of Hematology and Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Jean M Mulcahy Levy
- Department of Pediatrics, University of Colorado Denver, Aurora, Colorado, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, Colorado, USA
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19
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Clinical Relevance of BRAF V600E Mutation Status in Brain Tumors with a Focus on a Novel Management Algorithm. Target Oncol 2020; 15:531-540. [PMID: 32648041 PMCID: PMC7434793 DOI: 10.1007/s11523-020-00735-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The possible application of BRAF-targeted therapy in brain tumors is growing continuously. We have analyzed clinical strategies that address BRAF activation in primary brain tumors and verified current recommendations regarding screening for BRAF mutations. There is preliminary evidence for a range of positive responses in certain brain tumor types harboring the BRAF V600E mutation. National Comprehensive Cancer Network Guidelines for central nervous system cancers recommend screening for the BRAF V600E mutation in pilocytic astrocytoma, pleomorphic xanthoastrocytoma, and ganglioglioma. We suggest additional testing in glioblastomas WHO grade IV below the age of 30 years, especially those with epithelioid features, papillary craniopharyngiomas, and pediatric low-grade astrocytomas. BRAF-targeted therapy should be limited to the setting of a clinical trial. If the patient harboring a V600E mutation does not qualify for a trial, multimodality treatment is recommended. Dual inhibition of both RAF and MEK is expected to provide more potent and durable effects than anti-BRAF monotherapy. First-generation RAF inhibitors should be avoided. Gain-of-function mutations of EGFR and KIAA fusions may compromise BRAF-targeted therapy. BRAF alterations that result in MAPK pathway activation are common events in several types of brain tumors. BRAF V600E mutation emerges as a promising molecular target. The proposed algorithm was designed to help oncologists to provide the best therapeutic options for brain tumor patients.
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20
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Ryall S, Tabori U, Hawkins C. Pediatric low-grade glioma in the era of molecular diagnostics. Acta Neuropathol Commun 2020; 8:30. [PMID: 32164789 PMCID: PMC7066826 DOI: 10.1186/s40478-020-00902-z] [Citation(s) in RCA: 187] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/21/2020] [Indexed: 12/17/2022] Open
Abstract
Low grade gliomas are the most frequent brain tumors in children and encompass a spectrum of histologic entities which are currently assigned World Health Organisation grades I and II. They differ substantially from their adult counterparts in both their underlying genetic alterations and in the infrequency with which they transform to higher grade tumors. Nonetheless, children with low grade glioma are a therapeutic challenge due to the heterogeneity in their clinical behavior – in particular, those with incomplete surgical resection often suffer repeat progressions with resultant morbidity and, in some cases, mortality. The identification of up-regulation of the RAS–mitogen-activated protein kinase (RAS/MAPK) pathway as a near universal feature of these tumors has led to the development of targeted therapeutics aimed at improving responses while mitigating patient morbidity. Here, we review how molecular information can help to further define the entities which fall under the umbrella of pediatric-type low-grade glioma. In doing so we discuss the specific molecular drivers of pediatric low grade glioma and how to effectively test for them, review the newest therapeutic agents and their utility in treating this disease, and propose a risk-based stratification system that considers both clinical and molecular parameters to aid clinicians in making treatment decisions.
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21
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Cells with ganglionic differentiation frequently stain for VE1 antibody: a potential pitfall. Brain Tumor Pathol 2019; 37:14-21. [PMID: 31820133 DOI: 10.1007/s10014-019-00356-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Abstract
Mitogen-activated protein kinase (MAPK) pathway plays a major role in pediatric low-grade gliomas (pLGGs). Immunohistochemistry with mutant-specific antibody, VE1, has appeared to be the most affordable and rapidly deployable method to identify tumors with aberrant MAPK signaling pathway, by highlighting tumor with BRAFV600E mutation. Nonetheless, positive staining cases but not associated with BRAFV600E mutation are also seen. We analyzed 62 pLGGs for the two commonest genetic aberrations in MAPK pathway: KIAA1549-BRAF fusion, using reverse-transcriptase polymerase chain reaction, and BRAFV600E mutation, using VE1 antibody and Sanger sequencing. We recorded a specificity and accuracy rate of 68.75% and 75%, respectively, for VE1, when strong cytoplasmic staining is observed. Interestingly, we observed that cells with ganglionic features frequently bind VE1 but not associated with BRAFV600E mutation. Such observation was also confirmed in four cases of differentiating neuroblastoma. This false positive staining may serve as an important confounder in the interpretation of VE1 immunoreactivity with major therapeutic implication. It is important to confirm the presence of BRAFV600E mutation by DNA-based method, especially in tumor entities not known to, or rarely harbor such mutations.
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22
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Alexandraki KI, Kaltsas GA, Karavitaki N, Grossman AB. The Medical Therapy of Craniopharyngiomas: The Way Ahead. J Clin Endocrinol Metab 2019; 104:5751-5764. [PMID: 31369091 DOI: 10.1210/jc.2019-01299] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/26/2019] [Indexed: 02/07/2023]
Abstract
CONTEXT Craniopharyngiomas, which are categorized as adamantinomatous (ACPs) or papillary (PCPs), have traditionally been treated with surgery and/or radiotherapy, although when the tumors progress or recur, therapeutic possibilities are very limited. Following recent advances in their molecular pathogenesis, new medical therapeutic options have emerged. EVIDENCE ACQUISITION The search strategy that we selected to identify the appropriate evidence involved the following medical subject headings (MeSH) terms: ("Craniopharyngioma" [MeSH] AND "Craniopharyngioma/drug therapy" [MeSH]) NOT ("review" [Publication Type] OR "review literature as topic" [MeSH Terms] OR "review" [All Fields]) AND ("2009/05/01" [PDat]: "2019/04/28" [PDat]). EVIDENCE SYNTHESIS Mutations of β-catenin causing Wnt activation with alterations of the MEK/ERK pathway are encountered in the great majority of patients with ACPs; specific alterations also stratify patients to a more aggressive behavior. In most PCPs there is primary activation of the Ras/Raf/MEK/ERK pathway secondary to BRAF-V600E mutations. BRAF inhibitors, such as dabrafenib or vemurafenib, either alone or in combination with the MEK inhibitors trametinib and cobimetinib, have been administered to patients with PCPs producing clinically useful and, in some cases, sustained responses. In contrast to PCPs, drugs targeting β-catenin and its downstream MAPK pathway in ACPs have so far only been used in in vitro studies, but there appear to be promising new targets clinically. CONCLUSIONS The identification of specific genetic alterations in patients with craniopharyngiomas has expanded the therapeutic options, providing evidence for a customized approach using newer molecular agents. More studies including a larger number of carefully selected patients are required to evaluate the response to currently available and evolving agents alone and in combination.
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Affiliation(s)
- Krystallenia I Alexandraki
- Endocrine Unit, 1st Department of Propaedeutic Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gregory A Kaltsas
- Endocrine Unit, 1st Department of Propaedeutic Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Niki Karavitaki
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
- Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Ashley B Grossman
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
- Centre for Endocrinology, Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom
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23
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Kurani H, Gurav M, Shetty O, Chinnaswamy G, Moiyadi A, Gupta T, Jalali R, Epari S. Pilocytic astrocytomas: BRAFV600E and BRAF fusion expression patterns in pediatric and adult age groups. Childs Nerv Syst 2019; 35:1525-1536. [PMID: 31321520 DOI: 10.1007/s00381-019-04282-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/26/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE Pilocytic astrocytomas (PCAs) are characterized by two dominant molecular alterations of the BRAF gene, i.e., BRAFV600E mutation and KIAA1549-BRAF fusions which show a differential pattern of frequency across different age-groups. METHODS Formalin-fixed paraffin-embedded tissues of 358 (pediatric 276 and adult 82) consecutive PCAs were evaluated for BRAFV600E mutation by Sanger sequencing and KIAA1549:BRAF fusion transcripts (KIAA1549:BRAF 16-9, KIAA1549:BRAF 15-9, and KIAA1549:BRAF 16-11) by reverse transcriptase polymerase chain reaction, which were correlated with different clinicopathological features. RESULTS BRAFV600E mutation was detected in 8.9% pediatric and 9.75% adult PCAs, whereas 41.1% and 25.7% of pediatric and adult cases showed KIAA1549-BRAF fusions respectively. BRAFV600E did not show any statistically significant correlation with any of the clinical parameters (age, location, and gender). KIAA1549:BRAF fusions showed a significant statistical association with the pediatric age group and cerebellar location. KIAA1549-BRAF 16-9 was the commonest variant and was predominantly associated with cerebellar location than non-cerebellar whereas fusion variant 15-9 negatively correlated with cerebellar locations. CONCLUSIONS The present study showed overall frequency of 53.5% and 37.3% BRAF alterations in pediatric and adult PCA cases respectively. BRAF fusion in PCA cases showed a different distribution pattern across age groups and locations; while no such differential pattern was observed for BRAFV600E.
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Affiliation(s)
- Hetakshi Kurani
- Division of Molecular Pathology, Department of Pathology, Tata Memorial Centre, Homi Baba National Institute, Mumbai, 400012, India
| | - Mamta Gurav
- Division of Molecular Pathology, Department of Pathology, Tata Memorial Centre, Homi Baba National Institute, Mumbai, 400012, India
| | - Omshree Shetty
- Division of Molecular Pathology, Department of Pathology, Tata Memorial Centre, Homi Baba National Institute, Mumbai, 400012, India
| | - Girish Chinnaswamy
- Department of Pediatric Oncology, Tata Memorial Centre, Homi Baba National Institute, Mumbai, 400012, India
| | - Aliasagar Moiyadi
- Division of Neurosurgery, Department of Surgical Oncology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Baba National Institute, Mumbai, 400012, India
| | - Tejpal Gupta
- Department of Radiation Oncology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Baba National Institute, Mumbai, 400012, India
| | - Rakesh Jalali
- Department of Radiation Oncology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Baba National Institute, Mumbai, 400012, India
| | - Sridhar Epari
- Division of Molecular Pathology, Department of Pathology, Tata Memorial Centre, Homi Baba National Institute, Mumbai, 400012, India.
- Department of Pathology (& Division of Molecular Pathology), Tata Memorial Hospital and ACTREC, Tata Memorial Centre, Homi Baba National Institute, Mumbai, 400012, India.
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24
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Mitogenic and progenitor gene programmes in single pilocytic astrocytoma cells. Nat Commun 2019; 10:3731. [PMID: 31427603 PMCID: PMC6700116 DOI: 10.1038/s41467-019-11493-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 07/10/2019] [Indexed: 01/28/2023] Open
Abstract
Pilocytic astrocytoma (PA), the most common childhood brain tumor, is a low-grade glioma with a single driver BRAF rearrangement. Here, we perform scRNAseq in six PAs using methods that enabled detection of the rearrangement. When compared to higher-grade gliomas, a strikingly higher proportion of the PA cancer cells exhibit a differentiated, astrocyte-like phenotype. A smaller proportion of cells exhibit a progenitor-like phenotype with evidence of proliferation. These express a mitogen-activated protein kinase (MAPK) programme that was absent from higher-grade gliomas. Immune cells, especially microglia, comprise 40% of all cells in the PAs and account for differences in bulk expression profiles between tumor locations and subtypes. These data indicate that MAPK signaling is restricted to relatively undifferentiated cancer cells in PA, with implications for investigational therapies directed at this pathway. Pilocytic astrocytoma is a low-grade pediatric glioma, characterized by a single BRAF rearrangement. Here, Reitman and colleagues use single-cell RNA sequencing to reveal molecular hallmarks of the disease that might be targeted therapeutically.
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25
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Miklja Z, Pasternak A, Stallard S, Nicolaides T, Kline-Nunnally C, Cole B, Beroukhim R, Bandopadhayay P, Chi S, Ramkissoon SH, Mullan B, Bruzek AK, Gauthier A, Garcia T, Atchison C, Marini B, Fouladi M, Parsons DW, Leary S, Mueller S, Ligon KL, Koschmann C. Molecular profiling and targeted therapy in pediatric gliomas: review and consensus recommendations. Neuro Oncol 2019; 21:968-980. [PMID: 30805642 PMCID: PMC6682212 DOI: 10.1093/neuonc/noz022] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
As the field of neuro-oncology makes headway in uncovering the key oncogenic drivers in pediatric glioma, the role of precision diagnostics and therapies continues to rapidly evolve with important implications for the standard of care for clinical management of these patients. Four studies at major academic centers were published in the last year outlining the clinically integrated molecular profiling and targeting of pediatric brain tumors; all 4 demonstrated the feasibility and utility of incorporating sequencing into the care of children with brain tumors, in particular for children and young adults with glioma. Based on synthesis of the data from these studies and others, we provide consensus recommendations for the integration of precision diagnostics and therapeutics into the practice of pediatric neuro-oncology. Our primary consensus recommendation is that next-generation sequencing should be routinely included in the workup of most pediatric gliomas.
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Affiliation(s)
- Zachary Miklja
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Amy Pasternak
- University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | | | | | - Cassie Kline-Nunnally
- University of California San Francisco (UCSF) Benioff Children’s Hospital, San Francisco, California
| | - Bonnie Cole
- Seattle Children’s Hospital/University of Washington (UW), Seattle, Washington
| | | | | | - Susan Chi
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Shakti H Ramkissoon
- Foundation Medicine, Morrisville, North Carolina
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Brendan Mullan
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Amy K Bruzek
- University of Michigan Medical School, Ann Arbor, Michigan
| | | | - Taylor Garcia
- University of Michigan Medical School, Ann Arbor, Michigan
| | | | - Bernard Marini
- University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | | | | | - Sarah Leary
- Seattle Children’s Hospital/University of Washington (UW), Seattle, Washington
| | - Sabine Mueller
- University of California San Francisco (UCSF) Benioff Children’s Hospital, San Francisco, California
| | - Keith L Ligon
- Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts
| | - Carl Koschmann
- University of Michigan Medical School, Ann Arbor, Michigan
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26
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Bret D, Chappuis V, Poncet D, Ducray F, Silva K, Mion F, Vasiljevic A, Ferraro-Peyret C, Mottolese C, Leblond P, Gabut M, Frappaz D, Streichenberger N, Meyronet D, Bringuier PP, Barritault M. A Multiplex Quantitative Reverse Transcription Polymerase Chain Reaction Assay for the Detection of KIAA1549-BRAF Fusion Transcripts in Formalin-Fixed Paraffin-Embedded Pilocytic Astrocytomas. Mol Diagn Ther 2019; 23:537-545. [PMID: 31087282 DOI: 10.1007/s40291-019-00403-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Genomic duplications and fusion involving BRAF and KIAA1549 that create fusion proteins with constitutive B-RAF kinase activity are a hallmark of pilocytic astrocytomas (PAs). The detection of KIAA1549-BRAF fusion transcripts is of paramount importance to classify these tumors and to identify patients who could benefit from BRAF inhibitors. In a clinical setting, the available material for molecular analysis from these pediatric tumors is often limited to formalin-fixed paraffin-embedded (FFPE) tissue. The aim of the present study was to develop a new method to detect the three most frequent KIAA1549-BRAF fusion transcripts, 15-9, 16-11, and 16-9, where numbers refer to the exons fused together, using a FFPE-compatible multiplex quantitative reverse transcription polymerase chain reaction (qRT-PCR). METHODS We compared performance of the assay to a reference singleplex method on a collection of 46 FFPE PAs. RESULTS The results showed that both methods are comparable. The multiplex method had an overall 97% sensitivity and 100% specificity compared to the singleplex method, and agreement between the two techniques was almost perfect (Cohen's kappa: 0.97). There was no evidence of a significant difference between the qRT-PCR efficiencies of the multiplex technique and of the singleplex assay for all fusion transcripts and for GAPDH, the latter used as a reference gene. The multiplex method consumed four times less complementary DNA (cDNA), cost less, and required half the hands-on technical time. CONCLUSION The results show that it could be beneficial to implement the multiplex method in a clinical setting, where samples presenting low quantity of degraded RNA are not unusual.
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Affiliation(s)
- David Bret
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France.,University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Valentin Chappuis
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France.,University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Delphine Poncet
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France.,University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - François Ducray
- University of Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Service de Neuro-oncologie, Hospices Civils de Lyon, Hôpital Neurologique, Lyon, France.,Transcriptome Diversity in Stem Cells Laboratory, Cancer Cell Plasticity Department, Cancer Research Centre of Lyon, INSERM U1052, CNRS, UMR 5286, Lyon, France
| | - Karen Silva
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - Fabrice Mion
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - Alexandre Vasiljevic
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France.,University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Carole Ferraro-Peyret
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France.,University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Carmine Mottolese
- Service de Neurochirurgie Lyon, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - Pierre Leblond
- Service d'Oncologie, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Mathieu Gabut
- Transcriptome Diversity in Stem Cells Laboratory, Cancer Cell Plasticity Department, Cancer Research Centre of Lyon, INSERM U1052, CNRS, UMR 5286, Lyon, France
| | - Didier Frappaz
- Service d'Oncologie, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Nathalie Streichenberger
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France.,University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - David Meyronet
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France.,University of Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Transcriptome Diversity in Stem Cells Laboratory, Cancer Cell Plasticity Department, Cancer Research Centre of Lyon, INSERM U1052, CNRS, UMR 5286, Lyon, France
| | - Pierre-Paul Bringuier
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France.,University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Marc Barritault
- Service de Cytologie et d'Anatomie Pathologique, Département de Biopathologie Moléculaire et de Département de Neuropathologie, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France. .,University of Lyon, Université Claude Bernard Lyon 1, Lyon, France. .,Transcriptome Diversity in Stem Cells Laboratory, Cancer Cell Plasticity Department, Cancer Research Centre of Lyon, INSERM U1052, CNRS, UMR 5286, Lyon, France.
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27
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Scheie D, Kufaishi HHA, Broholm H, Lund EL, de Stricker K, Melchior LC, Grauslund M. Biomarkers in tumors of the central nervous system - a review. APMIS 2019; 127:265-287. [PMID: 30740783 DOI: 10.1111/apm.12916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/07/2018] [Indexed: 12/21/2022]
Abstract
Until recently, diagnostics of brain tumors were almost solely based on morphology and immunohistochemical stainings for relatively unspecific lineage markers. Although certain molecular markers have been known for longer than a decade (combined loss of chromosome 1p and 19q in oligodendrogliomas), molecular biomarkers were not included in the WHO scheme until 2016. Now, the classification of diffuse gliomas rests on an integration of morphology and molecular results. Also, for many other central nervous system tumor entities, specific diagnostic, prognostic and predictive biomarkers have been detected and continue to emerge. Previously, we considered brain tumors with similar histology to represent a single disease entity. We now realize that histologically identical tumors might show alterations in different molecular pathways, and often represent separate diseases with different natural history and response to treatment. Hence, knowledge about specific biomarkers is of great importance for individualized treatment and follow-up. In this paper we review the biomarkers that we currently use in the diagnostic work-up of brain tumors.
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Affiliation(s)
- David Scheie
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | | | - Helle Broholm
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Eva Løbner Lund
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Morten Grauslund
- Department of Genetics and Pathology, Laboratory Medicine, Lund, Sweden
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28
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Appay R, Fina F, Macagno N, Padovani L, Colin C, Barets D, Ordioni J, Scavarda D, Giangaspero F, Badiali M, Korshunov A, M Pfister S, T W Jones D, Figarella-Branger D. Duplications of KIAA1549 and BRAF screening by Droplet Digital PCR from formalin-fixed paraffin-embedded DNA is an accurate alternative for KIAA1549-BRAF fusion detection in pilocytic astrocytomas. Mod Pathol 2018; 31:1490-1501. [PMID: 29802359 DOI: 10.1038/s41379-018-0050-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/14/2018] [Accepted: 02/15/2018] [Indexed: 11/09/2022]
Abstract
Pilocytic astrocytomas represent the most common glioma subtype in young patients and account for 5.4% of all gliomas. They are characterized by alterations in the RAS-MAP kinase pathway, the most frequent being a tandem duplication on chromosome 7q34 involving the BRAF gene, resulting in oncogenic BRAF fusion proteins. BRAF fusion involving the KIAA1549 gene is a hallmark of pilocytic astrocytoma, but it has also been recorded in rare cases of gangliogliomas, 1p/19q co-deleted oligodendroglial tumors, and it is also a common feature of disseminated oligodendroglial-like leptomeningeal neoplasm. In some difficult cases, evidence for KIAA1549-BRAF fusion is of utmost importance for the diagnosis. Moreover, because the KIAA1549-BRAF fusion constitutively activates the MAP kinase pathway, it represents a target for drugs such as MEK inhibitors, and therefore, the detection of this genetic abnormality is highly relevant in the context of clinical trials applying such new approaches. In the present study, we aimed to use the high sensitivity of Droplet Digital PCR (DDPCR™) to predict KIAA1549-BRAF fusion on very small amounts of formalin-fixed paraffin-embedded tissue in routine practice. Therefore, we analyzed a training cohort of 55 pilocytic astrocytomas in which the KIAA1549-BRAF fusion status was known by RNA sequencing used as our gold standard technique. Then, we analyzed a prospective cohort of 40 pilocytic astrocytomas, 27 neuroepithelial tumors remaining difficult to classify (pilocytic astrocytoma versus ganglioglioma or diffuse glioma), 15 dysembryoplastic neuroepithelial tumors, and 18 gangliogliomas. We could demonstrate the usefulness and high accuracy (100% sensitivity and specificity when compared to RNA sequencing) of DDPCR™ to assess the KIAA1549-BRAF fusion from very low amounts of DNA isolated from formalin-fixed paraffin-embedded specimens. BRAF duplication is both necessary and sufficient to predict this fusion in most cases and we propose that this single analysis could be used in routine practice to save time, money, and precious tissue.
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Affiliation(s)
- Romain Appay
- APHM, Hôpital de la Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France.,Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - Frédéric Fina
- APHM, Hôpital de la Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France.,APHM, Unité Développement Technique, Marseille, France
| | - Nicolas Macagno
- APHM, Hôpital de la Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France
| | - Laëtitia Padovani
- APHM, Hôpital de la Timone, Service de Radiothérapie, Marseille, France
| | - Carole Colin
- Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - Doriane Barets
- APHM, Hôpital de la Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France
| | - Joanna Ordioni
- APHM, Hôpital de la Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France
| | - Didier Scavarda
- APHM, Hôpital de la Timone, Service de Neurochirurgie Pédiatrique, Marseille, France
| | - Felice Giangaspero
- Department of Radiological, Oncological and Pathological Science, Sapienza University, Rome, Italy.,Neuromed Institute, IRCCS, Isernia, Pozzilli, Italy
| | - Manuela Badiali
- Laboratory of Genetics and Genomics, Microcitemico Pediatric Hospital, Cagliari, Italy
| | - Andrey Korshunov
- CCU Neuropathology, German Cancer Research Center and Department of Neuropathology, Heidelberg University, Heidelberg, Germany
| | - Stefan M Pfister
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David T W Jones
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dominique Figarella-Branger
- APHM, Hôpital de la Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France. .,Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France.
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29
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Lim YH, Burke AB, Roberts MS, Collins MT, Choate KA. Multilineage ACTB mutation in a patient with fibro-osseous maxillary lesion and pilocytic astrocytoma. Am J Med Genet A 2018; 176:2037-2040. [PMID: 30152002 DOI: 10.1002/ajmg.a.40475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/20/2018] [Accepted: 06/22/2018] [Indexed: 01/17/2023]
Affiliation(s)
- Young H Lim
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Andrea B Burke
- Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland.,Division of Oral and Maxillofacial Surgery, School of Dentistry, University of Washington, Seattle, Washington
| | - Mary S Roberts
- Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
| | - Michael T Collins
- Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
| | - Keith A Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
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30
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Kondo A, Shimizu Y, Adachi S, Ogino I, Suzuki M, Akiyama O, Arai H. A Comprehensive Method for Detecting Fusion Genes in Paediatric Brain Tumours. Cancer Genomics Proteomics 2018; 15:343-348. [PMID: 29976640 DOI: 10.21873/cgp.20093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Fusion genes driving tumourigenesis have drawn the attention of researchers and oncologists. Despite the importance of such molecular alterations, there are no comprehensive reproducible methods for detecting fusion genes. MATERIALS AND METHODS Nineteen paediatric brain tumours of five types, namely pilocytic astrocytoma, oligodendroglioma, anaplastic astrocytoma, glioblastoma and, ganglioglioma, were examined to detect fusion genes using a pyrosequencing-based method following RNA isolation, cDNA synthesis and real-time polymerase chain reaction. RESULTS Our method successfully detected KIAA1549-v-raf murine sarcoma viral oncogene homolog B1 (BRAF) fusion in 14 out of 19 patients suffering from five types of paediatric brain tumours providing information on fusion breakpoints within 2 h. CONCLUSION A comprehensive method for detecting fusion genes in paediatric brain tumours was evaluated. This method identified KIAA1549-BRAF fusion variants quickly. Our results may help researchers interested in the role of fusion genes in tumourigenesis.
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Affiliation(s)
- Akihide Kondo
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuzaburo Shimizu
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Adachi
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ikuko Ogino
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mario Suzuki
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Osamu Akiyama
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hajime Arai
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
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31
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Liu W, Tang J, Van Halm-Lutterodt N, Luo S, Li C. History and current state of pediatric neurosurgery at Beijing Tiantan Hospital Neurosurgery Center. Childs Nerv Syst 2018. [PMID: 29520436 DOI: 10.1007/s00381-018-3755-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Wei Liu
- Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing, 100050, China
| | - Jie Tang
- Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing, 100050, China
| | - Nicholas Van Halm-Lutterodt
- Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing, 100050, China.,Department of Orthopedics and Neurosurgery, University of Southern California, Los Angeles, CA, 90089, USA
| | - Shiqi Luo
- Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing, 100050, China.
| | - Chunde Li
- Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing, 100050, China.
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32
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Catanzaro G, Besharat ZM, Miele E, Chiacchiarini M, Po A, Carai A, Marras CE, Antonelli M, Badiali M, Raso A, Mascelli S, Schrimpf D, Stichel D, Tartaglia M, Capper D, von Deimling A, Giangaspero F, Mastronuzzi A, Locatelli F, Ferretti E. The miR-139-5p regulates proliferation of supratentorial paediatric low-grade gliomas by targeting the PI3K/AKT/mTORC1 signalling. Neuropathol Appl Neurobiol 2018; 44:687-706. [PMID: 29478280 DOI: 10.1111/nan.12479] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 02/06/2018] [Indexed: 12/25/2022]
Abstract
AIMS Paediatric low-grade gliomas (pLGGs) are a heterogeneous group of brain tumours associated with a high overall survival: however, they are prone to recur and supratentorial lesions are difficult to resect, being associated with high percentage of disease recurrence. Our aim was to shed light on the biology of pLGGs. METHODS We performed microRNA profiling on 45 fresh-frozen grade I tumour samples of various histological classes, resected from patients aged ≤16 years. We identified 93 microRNAs specifically dysregulated in tumours as compared to non-neoplastic brain tissue. Pathway analysis of the microRNAs signature revealed PI3K/AKT signalling as one of the centrally enriched oncogenic signalling. To date, activation of the PI3K/AKT pathway in pLGGs has been reported, although activation mechanisms have not been fully investigated yet. RESULTS One of the most markedly down-regulated microRNAs in our supratentorial pLGGs cohort was miR-139-5p, whose targets include the gene encoding the PI3K's (phosphatidylinositol 3-kinase) catalytic unit, PIK3CA. We investigated the role of miR-139-5p in regulating PI3K/AKT signalling by the use of human cell cultures derived from supratentorial pLGGs. MiR-139-5p overexpression inhibited pLGG cell proliferation and decreased the phosphorylation of PI3K target AKT and phosphorylated-p70 S6 kinase (p-p70 S6K), a hallmark of PI3K/AKT/mTORC1 signalling activation. The effect of miR-139-5p was mediated by PI3K inhibition, as suggested by the decrease in proliferation and phosphorylation of AKT and p70 S6K after treatment with the direct PI3K inhibitor LY294002. CONCLUSIONS These findings provide the first evidence that down-regulation of miR-139-5p in supratentorial pLGG drives cell proliferation by derepressing PI3K/AKT signalling.
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Affiliation(s)
- G Catanzaro
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Z M Besharat
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - E Miele
- Center for Life NanoScience@Sapienza, IIT, Rome, Italy
| | - M Chiacchiarini
- Department of Molecular Medicine, Sapienza University, Rome, Italy
- Center for Life NanoScience@Sapienza, IIT, Rome, Italy
| | - A Po
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - A Carai
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - C E Marras
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Antonelli
- Department of Radiological, Oncological and Pathological Science, Sapienza University, Rome, Italy
| | - M Badiali
- Bone Marrow Transplantation Unit, Microcitemico Children's Hospital, Cagliari, Italy
| | - A Raso
- Giannina Gaslini Institute, Genoa, Italy
| | - S Mascelli
- Giannina Gaslini Institute, Genoa, Italy
| | - D Schrimpf
- Department of Neuropathology, Heidelberg University, Heidelberg, Germany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Clinical Cooperation Unit (CCU) Neuropathology, Heidelberg, Germany
| | - D Stichel
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Clinical Cooperation Unit (CCU) Neuropathology, Heidelberg, Germany
| | - M Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, Rome, Italy
| | - D Capper
- Department of Neuropathology, Heidelberg University, Heidelberg, Germany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Clinical Cooperation Unit (CCU) Neuropathology, Heidelberg, Germany
- Department of Neuropathology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - A von Deimling
- Department of Neuropathology, Heidelberg University, Heidelberg, Germany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Clinical Cooperation Unit (CCU) Neuropathology, Heidelberg, Germany
| | - F Giangaspero
- Department of Radiological, Oncological and Pathological Science, Sapienza University, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - A Mastronuzzi
- Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - F Locatelli
- Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- University of Pavia, Pavia, Italy
| | - E Ferretti
- Department of Experimental Medicine, Sapienza University, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
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33
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Ryall S, Arnoldo A, Krishnatry R, Mistry M, Khor K, Sheth J, Ling C, Leung S, Zapotocky M, Guerreiro Stucklin A, Lassaletta A, Shago M, Tabori U, Hawkins CE. Multiplex Detection of Pediatric Low-Grade Glioma Signature Fusion Transcripts and Duplications Using the NanoString nCounter System. J Neuropathol Exp Neurol 2017; 76:562-570. [DOI: 10.1093/jnen/nlx042] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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34
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Park SH, Won J, Kim SI, Lee Y, Park CK, Kim SK, Choi SH. Molecular Testing of Brain Tumor. J Pathol Transl Med 2017; 51:205-223. [PMID: 28535583 PMCID: PMC5445205 DOI: 10.4132/jptm.2017.03.08] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 03/08/2017] [Indexed: 01/12/2023] Open
Abstract
The World Health Organization (WHO) classification of central nervous system (CNS) tumors was revised in 2016 with a basis on the integrated diagnosis of molecular genetics. We herein provide the guidelines for using molecular genetic tests in routine pathological practice for an accurate diagnosis and appropriate management. While astrocytomas and IDH-mutant (secondary) glioblastomas are characterized by the mutational status of IDH, TP53, and ATRX, oligodendrogliomas have a 1p/19q codeletion and mutations in IDH, CIC, FUBP1, and the promoter region of telomerase reverse transcriptase (TERTp). IDH-wildtype (primary) glioblastomas typically lack mutations in IDH, but are characterized by copy number variations of EGFR, PTEN, CDKN2A/B, PDGFRA, and NF1 as well as mutations of TERTp. High-grade pediatric gliomas differ from those of adult gliomas, consisting of mutations in H3F3A, ATRX, and DAXX, but not in IDH genes. In contrast, well-circumscribed low-grade neuroepithelial tumors in children, such as pilocytic astrocytoma, pleomorphic xanthoastrocytoma, and ganglioglioma, often have mutations or activating rearrangements in the BRAF, FGFR1, and MYB genes. Other CNS tumors, such as ependymomas, neuronal and glioneuronal tumors, embryonal tumors, meningothelial, and other mesenchymal tumors have important genetic alterations, many of which are diagnostic, prognostic, and predictive markers and therapeutic targets. Therefore, the neuropathological evaluation of brain tumors is increasingly dependent on molecular genetic tests for proper classification, prediction of biological behavior and patient management. Identifying these gene abnormalities requires cost-effective and high-throughput testing, such as next-generation sequencing. Overall, this paper reviews the global guidelines and diagnostic algorithms for molecular genetic testing of brain tumors.
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Affiliation(s)
- Sung-Hye Park
- Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea.,Neurosicence Institute, Seoul National University, College of Medicine, Seoul, Korea
| | - Jaekyung Won
- Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea
| | - Seong-Ik Kim
- Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea
| | - Yujin Lee
- Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea
| | - Seung-Hong Choi
- Department of Radiology, Seoul National University, College of Medicine, Seoul, Korea
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35
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Tomić TT, Olausson J, Wilzén A, Sabel M, Truvé K, Sjögren H, Dósa S, Tisell M, Lannering B, Enlund F, Martinsson T, Åman P, Abel F. A new GTF2I-BRAF fusion mediating MAPK pathway activation in pilocytic astrocytoma. PLoS One 2017; 12:e0175638. [PMID: 28448514 PMCID: PMC5407815 DOI: 10.1371/journal.pone.0175638] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 03/29/2017] [Indexed: 12/15/2022] Open
Abstract
Pilocytic astrocytoma (PA) is the most common pediatric brain tumor. A recurrent feature of PA is deregulation of the mitogen activated protein kinase (MAPK) pathway most often through KIAA1549-BRAF fusion, but also by other BRAF- or RAF1-gene fusions and point mutations (e.g. BRAFV600E). These features may serve as diagnostic and prognostic markers, and also facilitate development of targeted therapy. The aims of this study were to characterize the genetic alterations underlying the development of PA in six tumor cases, and evaluate methods for fusion oncogene detection. Using a combined analysis of RNA sequencing and copy number variation data we identified a new BRAF fusion involving the 5’ gene fusion partner GTF2I (7q11.23), not previously described in PA. The new GTF2I-BRAF 19–10 fusion was found in one case, while the other five cases harbored the frequent KIAA1549-BRAF 16–9 fusion gene. Similar to other BRAF fusions, the GTF2I-BRAF fusion retains an intact BRAF kinase domain while the inhibitory N-terminal domain is lost. Functional studies on GTF2I-BRAF showed elevated MAPK pathway activation compared to BRAFWT. Comparing fusion detection methods, we found Fluorescence in situ hybridization with BRAF break apart probe as the most sensitive method for detection of different BRAF rearrangements (GTF2I-BRAF and KIAA1549-BRAF). Our finding of a new BRAF fusion in PA further emphasis the important role of B-Raf in tumorigenesis of these tumor types. Moreover, the consistency and growing list of BRAF/RAF gene fusions suggests these rearrangements to be informative tumor markers in molecular diagnostics, which could guide future treatment strategies.
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Affiliation(s)
- Tajana Tešan Tomić
- Department of Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Josefin Olausson
- Department of Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Annica Wilzén
- Department of Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Magnus Sabel
- Children´s Cancer Centre, The Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Katarina Truvé
- Bioinformatics core facility, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
| | - Helene Sjögren
- Department of Clinical chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sándor Dósa
- Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Magnus Tisell
- Department of Neurosurgery, Sahlgrenska University hospital, Gothenburg, Sweden
| | - Birgitta Lannering
- Bioinformatics core facility, Sahlgrenska academy, University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Enlund
- Department of Clinical chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tommy Martinsson
- Department of Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Pierre Åman
- Sahlgrenska Cancer Center, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Frida Abel
- Department of Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- * E-mail:
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36
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A comprehensive review of paediatric low-grade diffuse glioma: pathology, molecular genetics and treatment. Brain Tumor Pathol 2017; 34:51-61. [DOI: 10.1007/s10014-017-0282-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 03/08/2017] [Indexed: 12/13/2022]
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37
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Next-Generation Sequencing Reveals Pathway Activations and New Routes to Targeted Therapies in Cutaneous Metastatic Melanoma. Am J Dermatopathol 2017; 39:1-13. [PMID: 28045747 DOI: 10.1097/dad.0000000000000729] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Comprehensive genomic profiling of clinical samples by next-generation sequencing (NGS) can identify one or more therapy targets for the treatment of metastatic melanoma (MM) with a single diagnostic test. METHODS NGS was performed on hybridization-captured, adaptor ligation-based libraries using DNA extracted from 4 formalin-fixed paraffin-embedded sections cut at 10 microns from 30 MM cases. The exons of 182 cancer-related genes were fully sequenced using the Illumina HiSeq 2000 at an average sequencing depth of 1098X and evaluated for genomic alterations (GAs) including point mutations, insertions, deletions, copy number alterations, and select gene fusions/rearrangements. Clinically relevant GAs (CRGAs) were defined as those identifying commercially available targeted therapeutics or therapies in registered clinical trials. RESULTS The 30 American Joint Committee on Cancer Stage IV MM included 17 (57%) male and 13 (43%) female patients with a mean age of 59.5 years (range 41-83 years). All MM samples had at least 1 GA, and an average of 2.7 GA/sample (range 1-7) was identified. The mean number of GA did not differ based on age or sex; however, on average, significantly more GAs were identified in amelanotic and poorly differentiated MM. GAs were most commonly identified in BRAF (12 cases, 40%), CDKN2A (6 cases, 20%), NF1 (8 cases, 26.7%), and NRAS (6 cases, 20%). CRGAs were identified in all patients, and represented 77% of the GA (64/83) detected. The median and mean CRGAs per tumor were 2 and 2.1, respectively (range 1-7). CONCLUSION Comprehensive genomic profiling of MM, using a single diagnostic test, uncovers an unexpectedly high number of CRGA that would not be identified by standard of care testing. Moreover, NGS has the potential to influence therapy selection and can direct patients to enter relevant clinical trials evaluating promising targeted therapies.
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38
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Pathak P, Kumar A, Jha P, Purkait S, Faruq M, Suri A, Suri V, Sharma MC, Sarkar C. Genetic alterations related to BRAF-FGFR genes and dysregulated MAPK/ERK/mTOR signaling in adult pilocytic astrocytoma. Brain Pathol 2017; 27:580-589. [PMID: 27608415 DOI: 10.1111/bpa.12444] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 09/05/2016] [Indexed: 01/05/2023] Open
Abstract
Pilocytic astrocytomas occur rarely in adults and show aggressive tumor behavior. However, their underlying molecular-genetic events are largely uncharacterized. Hence, 59 adult pilocytic astrocytoma (APA) cases of classical histology were studied (MIB-1 LI: 1%-5%). Analysis of BRAF alterations using qRT-PCR, confirmed KIAA1549-BRAF fusion in 11 (19%) and BRAF-gain in 2 (3.4%) cases. BRAF-V600E mutation was noted in 1 (1.7%) case by sequencing. FGFR1-mutation and FGFR-TKD duplication were seen in 7/59 (11.9%) and 3/59 (5%) cases, respectively. Overall 36% of APAs harbored BRAF and/or FGFR genetic alterations. Notably, FGFR related genetic alterations were enriched in tumors of supratentorial region (8/25, 32%) as compared with other locations (P = 0.01). The difference in age of cases with FGFR1-mutation (Mean age ± SD: 37.2 ± 15 years) vs. KIAA1549-BRAF fusion (Mean age ± SD: 25.1 ± 4.1 years) was statistically significant (P = 0.03). Combined BRAF and FGFR alterations were identified in 3 (5%) cases. Notably, the cases with more than one genetic alteration were in higher age group (Mean age ± SD: 50 ± 12 years) as compared with cases with single genetic alteration (Mean age ± SD: 29 ± 10; P = 0.003). Immunopositivity of p-MAPK/p-MEK1 was found in all the cases examined. The pS6-immunoreactivity, a marker of mTOR activation was observed in 34/39 (87%) cases. Interestingly, cases with BRAF and/or FGFR related alteration showed significantly lower pS6-immunostatining (3/12; 25%) as compared with those with wild-type BRAF and/or FGFR (16/27; 59%) (P = 0.04). Further, analysis of seven IDH wild-type adult diffuse astrocytomas (DA) showed FGFR related genetic alterations in 43% cases. These and previous results suggest that APAs are genetically similar to IDH wild-type adult DAs. APAs harbor infrequent BRAF alterations but more frequent FGFR alterations as compared with pediatric cases. KIAA1549-BRAF fusion inversely correlates with increasing age whereas FGFR1-mutation associates with older age. Activation of MAPK/ERK/mTOR signaling appears to be an important oncogenic event in APAs and may be underlying event of aggressive tumor behavior. The findings provided a rationale for potential therapeutic advantage of targeting MAPK/ERK/mTOR pathway in APAs.
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Affiliation(s)
- Pankaj Pathak
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Anupam Kumar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Prerana Jha
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Suvendu Purkait
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Mohammed Faruq
- Genomics and Molecular Medicine, Council of Scientific and Industrial Research - Institute of Genomics and Integrative Biology (CSIR- IGIB), New Delhi, India
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishali Suri
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Mehar C Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Chitra Sarkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Bridge JA. Reverse transcription-polymerase chain reaction molecular testing of cytology specimens: Pre-analytic and analytic factors. Cancer Cytopathol 2016; 125:11-19. [DOI: 10.1002/cncy.21762] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/22/2016] [Accepted: 06/23/2016] [Indexed: 01/02/2023]
Affiliation(s)
- Julia A. Bridge
- Department of Pathology and Microbiology; University of Nebraska Medical Center; Omaha Nebraska
- Department of Pediatrics; University of Nebraska Medical Center; Omaha Nebraska
- Department of Orthopedic Surgery; University of Nebraska Medical Center; Omaha Nebraska
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Masui K, Mischel PS, Reifenberger G. Molecular classification of gliomas. HANDBOOK OF CLINICAL NEUROLOGY 2016; 134:97-120. [PMID: 26948350 DOI: 10.1016/b978-0-12-802997-8.00006-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The identification of distinct genetic and epigenetic profiles in different types of gliomas has revealed novel diagnostic, prognostic, and predictive molecular biomarkers for refinement of glioma classification and improved prediction of therapy response and outcome. Therefore, the new (2016) World Health Organization (WHO) classification of tumors of the central nervous system breaks with the traditional principle of diagnosis based on histologic criteria only and incorporates molecular markers. This will involve a multilayered approach combining histologic features and molecular information in an "integrated diagnosis". We review the current state of diagnostic molecular markers for gliomas, focusing on isocitrate dehydrogenase 1 or 2 (IDH1/IDH2) gene mutation, α-thalassemia/mental retardation syndrome X-linked (ATRX) gene mutation, 1p/19q co-deletion and telomerase reverse transcriptase (TERT) promoter mutation in adult tumors, as well as v-raf murine sarcoma viral oncogene homolog B1 (BRAF) and H3 histone family 3A (H3F3A) aberrations in pediatric gliomas. We also outline prognostic and predictive molecular markers, including O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, and discuss the potential clinical relevance of biologic glioblastoma subtypes defined by integration of multiomics data. Commonly used methods for individual marker detection as well as novel large-scale DNA methylation profiling and next-generation sequencing approaches are discussed. Finally, we illustrate how advances in molecular diagnostics affect novel strategies of targeted therapy, thereby raising new challenges and identifying new leads for personalized treatment of glioma patients.
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Affiliation(s)
- Kenta Masui
- Department of Pathology, Tokyo Women's Medical University, Shinjku-ku, Tokyo, Japan; Ludwig Institute for Cancer Research, University of California San Diego, La Jolla, CA, USA
| | - Paul S Mischel
- Ludwig Institute for Cancer Research, University of California San Diego, La Jolla, CA, USA
| | - Guido Reifenberger
- Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany.
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Kumar-Sinha C, Kalyana-Sundaram S, Chinnaiyan AM. Landscape of gene fusions in epithelial cancers: seq and ye shall find. Genome Med 2015; 7:129. [PMID: 26684754 PMCID: PMC4683719 DOI: 10.1186/s13073-015-0252-1] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Enabled by high-throughput sequencing approaches, epithelial cancers across a range of tissue types are seen to harbor gene fusions as integral to their landscape of somatic aberrations. Although many gene fusions are found at high frequency in several rare solid cancers, apart from fusions involving the ETS family of transcription factors which have been seen in approximately 50% of prostate cancers, several other common solid cancers have been shown to harbor recurrent gene fusions at low frequencies. On the other hand, many gene fusions involving oncogenes, such as those encoding ALK, RAF or FGFR kinase families, have been detected across multiple different epithelial carcinomas. Tumor-specific gene fusions can serve as diagnostic biomarkers or help define molecular subtypes of tumors; for example, gene fusions involving oncogenes such as ERG, ETV1, TFE3, NUT, POU5F1, NFIB, PLAG1, and PAX8 are diagnostically useful. Tumors with fusions involving therapeutically targetable genes such as ALK, RET, BRAF, RAF1, FGFR1-4, and NOTCH1-3 have immediate implications for precision medicine across tissue types. Thus, ongoing cancer genomic and transcriptomic analyses for clinical sequencing need to delineate the landscape of gene fusions. Prioritization of potential oncogenic "drivers" from "passenger" fusions, and functional characterization of potentially actionable gene fusions across diverse tissue types, will help translate these findings into clinical applications. Here, we review recent advances in gene fusion discovery and the prospects for medicine.
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Affiliation(s)
- Chandan Kumar-Sinha
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
| | - Shanker Kalyana-Sundaram
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
| | - Arul M Chinnaiyan
- Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
- Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
- Howard Hughes Medical Institute, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
- Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
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Pages M, Lacroix L, Tauziede-Espariat A, Castel D, Daudigeos-Dubus E, Ridola V, Gilles S, Fina F, Andreiuolo F, Polivka M, Lechapt-Zalcman E, Puget S, Boddaert N, Liu XQ, Bridge JA, Grill J, Chretien F, Varlet P. Papillary glioneuronal tumors: histological and molecular characteristics and diagnostic value of SLC44A1-PRKCA fusion. Acta Neuropathol Commun 2015; 3:85. [PMID: 26671581 PMCID: PMC4681033 DOI: 10.1186/s40478-015-0264-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 12/05/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Papillary Glioneuronal Tumor (PGNT) is a grade I tumor which was classified as a separate entity in the World Health Organization Classification of the Central Nervous System 2007 in the group of mixed glioneuronal tumors. This tumor is rare and subclassifying PGNT represents a challenge. Recently, a fusion between SLC44A1 and PRKCA which encodes a protein kinase C involved in MAPK signaling pathway has been described in two studies (five cases). The current study aimed at raising the cytogenetic, histological and molecular profiles of PGNT and to determine if SLC44A1-PRKCA fusion represented a specific diagnostic marker to distinguish it from other glioneuronal tumors. RESULTS We report on four pediatric cases of PGNT, along with clinico-radiologic and immunohistological features for which SLC44A1-PRKCA fusion assessment by fluorescence in situ hybridization, BRAF V600E and FGFR1 mutation by immunohistochemistry and direct DNA sequencing and KIAA1549-BRAF fusion by RT-PCR were performed. MAPK signaling pathway activation was investigated using phospho-ERK immunohistochemistry and western blot. We analyzed fifteen cases of tumors with challenging histological or clinical differential diagnoses showing respectively a papillary architecture or periventricular location (PGNT mimics). fluorescence in situ hybridization analysis revealed a constant SLC44A1-PRKCA fusion signal in all PGNTs. None of PGNT mimics showed the SLC44A1-PRKCA fusion signal pattern. All PGNTs were negative for BRAF V600E and FGFR1 mutation, and KIAA1549-BRAF fusion. Phospho-ERK analysis provides arguments for the activation of the MAPK signaling pathway in these tumors. CONCLUSIONS Here we confirmed and extended the molecular data on PGNT. These results suggest that PGNT belong to low grade glioma with MAPK signaling pathway deregulation. SLC44A1-PRKCA fusion seems to be a specific characteristic of PGNT with a high diagnostic value and detectable by FISH.
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BRAF Fusion Analysis in Pilocytic Astrocytomas: KIAA1549-BRAF 15-9 Fusions Are More Frequent in the Midline Than Within the Cerebellum. J Neuropathol Exp Neurol 2015. [PMID: 26222501 PMCID: PMC4554227 DOI: 10.1097/nen.0000000000000226] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Pilocytic astrocytomas (PAs) are increasingly tested for KIAA1549-BRAF fusions. We used reverse transcription polymerase chain reaction for the 3 most common KIAA1549-BRAF fusions, together with BRAF V600E and histone H3.3 K27M analyses to identify relationships of these molecular characteristics with clinical features in a cohort of 32 PA patients. In this group, the overall BRAF fusion detection rate was 24 (75%). Ten (42%) of the 24 had the 16-9 fusion, 8 (33%) had only the 15-9 fusion, and 1 (4%) of the patients had only the 16-11 fusion. In the PAs with only the 15-9 fusion, 1 PA was in the cerebellum and 7 were centered in the midline outside of the cerebellum, that is, in the hypothalamus (n = 4), optic pathways (n = 2), and brainstem (n = 1). Tumors within the cerebellum were negatively associated with fusion 15-9. Seven (22%) of the 32 patients had tumor-related deaths and 25 of the patients (78%) were alive between 2 and 14 years after initial biopsy. Age, sex, tumor location, 16-9 fusion, and 15-9 fusion were not associated with overall survival. Thus, in this small cohort, 15-9 KIAA1549-BRAF fusion was associated with midline PAs located outside of the cerebellum; these tumors, which are generally difficult to resect, are prone to recurrence.
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Jonsson P, Coarfa C, Mesmar F, Raz T, Rajapakshe K, Thompson JF, Gunaratne PH, Williams C. Single-Molecule Sequencing Reveals Estrogen-Regulated Clinically Relevant lncRNAs in Breast Cancer. Mol Endocrinol 2015; 29:1634-45. [PMID: 26426411 DOI: 10.1210/me.2015-1153] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Estrogen receptor (ER)α-positive tumors are commonly treated with ERα antagonists or inhibitors of estrogen synthesis, but most tumors develop resistance, and we need to better understand the pathways that underlie the proliferative and tumorigenic role of this estrogen-activated transcription factor. We here present the first single-molecule sequencing of the estradiol-induced ERα transcriptome in the luminal A-type human breast cancer cell lines MCF7 and T47D. Sequencing libraries were prepared from the polyadenylated RNA fraction after 8 hours of estrogen or vehicle treatment. Single-molecule sequencing was carried out in biological and technical replicates and differentially expressed genes were defined and analyzed for enriched processes. Correlation analysis with clinical expression and survival were performed, and follow-up experiments carried out using time series, chromatin immunoprecipitation and quantitative real-time PCR. We uncovered that ERα in addition to regulating approximately 2000 protein-coding genes, also regulated up to 1000 long noncoding RNAs (lncRNAs). Most of these were up-regulated, and 178 lncRNAs were regulated in both cell lines. We demonstrate that Long Intergenic Non-protein Coding RNA 1016 (LINC01016) and LINC00160 are direct transcriptional targets of ERα, correlate with ERα expression in clinical samples, and show prognostic significance in relation to breast cancer survival. We show that silencing of LINC00160 results in reduced proliferation, demonstrating that lncRNA expression have functional consequences. Our findings suggest that ERα regulation of lncRNAs is clinically relevant and that their functions and potential use as biomarkers for endocrine response are important to explore.
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Affiliation(s)
- Philip Jonsson
- Center for Nuclear Receptors and Cell Signaling (P.J., F.M., C.W.), Department of Biology and Biochemistry, and Department of Biology and Biochemistry (P.H.G.), University of Houston, Houston, Texas 77204; Molecular and Human Genetics (C.C., K.R.) and Human Genome Sequencing Center (P.H.G.), Baylor College of Medicine, Houston, Texas 77030; Helicos Biosciences (T.R., J.F.T.), Cambridge, Massachusetts 02139; SciLifeLab, School of Biotechnology (C.W.), The Royal Institute of Technology-KTH, 17121 Solna, Sweden; and Department of Biosciences and Nutrition (C.W.), Novum, Karolinska Institutet, 14183 Stockholm, Sweden
| | - Cristian Coarfa
- Center for Nuclear Receptors and Cell Signaling (P.J., F.M., C.W.), Department of Biology and Biochemistry, and Department of Biology and Biochemistry (P.H.G.), University of Houston, Houston, Texas 77204; Molecular and Human Genetics (C.C., K.R.) and Human Genome Sequencing Center (P.H.G.), Baylor College of Medicine, Houston, Texas 77030; Helicos Biosciences (T.R., J.F.T.), Cambridge, Massachusetts 02139; SciLifeLab, School of Biotechnology (C.W.), The Royal Institute of Technology-KTH, 17121 Solna, Sweden; and Department of Biosciences and Nutrition (C.W.), Novum, Karolinska Institutet, 14183 Stockholm, Sweden
| | - Fahmi Mesmar
- Center for Nuclear Receptors and Cell Signaling (P.J., F.M., C.W.), Department of Biology and Biochemistry, and Department of Biology and Biochemistry (P.H.G.), University of Houston, Houston, Texas 77204; Molecular and Human Genetics (C.C., K.R.) and Human Genome Sequencing Center (P.H.G.), Baylor College of Medicine, Houston, Texas 77030; Helicos Biosciences (T.R., J.F.T.), Cambridge, Massachusetts 02139; SciLifeLab, School of Biotechnology (C.W.), The Royal Institute of Technology-KTH, 17121 Solna, Sweden; and Department of Biosciences and Nutrition (C.W.), Novum, Karolinska Institutet, 14183 Stockholm, Sweden
| | - Tal Raz
- Center for Nuclear Receptors and Cell Signaling (P.J., F.M., C.W.), Department of Biology and Biochemistry, and Department of Biology and Biochemistry (P.H.G.), University of Houston, Houston, Texas 77204; Molecular and Human Genetics (C.C., K.R.) and Human Genome Sequencing Center (P.H.G.), Baylor College of Medicine, Houston, Texas 77030; Helicos Biosciences (T.R., J.F.T.), Cambridge, Massachusetts 02139; SciLifeLab, School of Biotechnology (C.W.), The Royal Institute of Technology-KTH, 17121 Solna, Sweden; and Department of Biosciences and Nutrition (C.W.), Novum, Karolinska Institutet, 14183 Stockholm, Sweden
| | - Kimal Rajapakshe
- Center for Nuclear Receptors and Cell Signaling (P.J., F.M., C.W.), Department of Biology and Biochemistry, and Department of Biology and Biochemistry (P.H.G.), University of Houston, Houston, Texas 77204; Molecular and Human Genetics (C.C., K.R.) and Human Genome Sequencing Center (P.H.G.), Baylor College of Medicine, Houston, Texas 77030; Helicos Biosciences (T.R., J.F.T.), Cambridge, Massachusetts 02139; SciLifeLab, School of Biotechnology (C.W.), The Royal Institute of Technology-KTH, 17121 Solna, Sweden; and Department of Biosciences and Nutrition (C.W.), Novum, Karolinska Institutet, 14183 Stockholm, Sweden
| | - John F Thompson
- Center for Nuclear Receptors and Cell Signaling (P.J., F.M., C.W.), Department of Biology and Biochemistry, and Department of Biology and Biochemistry (P.H.G.), University of Houston, Houston, Texas 77204; Molecular and Human Genetics (C.C., K.R.) and Human Genome Sequencing Center (P.H.G.), Baylor College of Medicine, Houston, Texas 77030; Helicos Biosciences (T.R., J.F.T.), Cambridge, Massachusetts 02139; SciLifeLab, School of Biotechnology (C.W.), The Royal Institute of Technology-KTH, 17121 Solna, Sweden; and Department of Biosciences and Nutrition (C.W.), Novum, Karolinska Institutet, 14183 Stockholm, Sweden
| | - Preethi H Gunaratne
- Center for Nuclear Receptors and Cell Signaling (P.J., F.M., C.W.), Department of Biology and Biochemistry, and Department of Biology and Biochemistry (P.H.G.), University of Houston, Houston, Texas 77204; Molecular and Human Genetics (C.C., K.R.) and Human Genome Sequencing Center (P.H.G.), Baylor College of Medicine, Houston, Texas 77030; Helicos Biosciences (T.R., J.F.T.), Cambridge, Massachusetts 02139; SciLifeLab, School of Biotechnology (C.W.), The Royal Institute of Technology-KTH, 17121 Solna, Sweden; and Department of Biosciences and Nutrition (C.W.), Novum, Karolinska Institutet, 14183 Stockholm, Sweden
| | - Cecilia Williams
- Center for Nuclear Receptors and Cell Signaling (P.J., F.M., C.W.), Department of Biology and Biochemistry, and Department of Biology and Biochemistry (P.H.G.), University of Houston, Houston, Texas 77204; Molecular and Human Genetics (C.C., K.R.) and Human Genome Sequencing Center (P.H.G.), Baylor College of Medicine, Houston, Texas 77030; Helicos Biosciences (T.R., J.F.T.), Cambridge, Massachusetts 02139; SciLifeLab, School of Biotechnology (C.W.), The Royal Institute of Technology-KTH, 17121 Solna, Sweden; and Department of Biosciences and Nutrition (C.W.), Novum, Karolinska Institutet, 14183 Stockholm, Sweden
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KIAA1549: BRAF Gene Fusion and FGFR1 Hotspot Mutations Are Prognostic Factors in Pilocytic Astrocytomas. J Neuropathol Exp Neurol 2015; 74:743-54. [PMID: 26083571 PMCID: PMC4470527 DOI: 10.1097/nen.0000000000000213] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Up to 20% of patients with pilocytic astrocytoma (PA) experience a poor outcome. BRAF alterations and Fibroblast growth factor receptor 1 (FGFR1) point mutations are key molecular alterations in Pas, but their clinical implications are not established. We aimed to determine the frequency and prognostic role of these alterations in a cohort of 69 patients with PAs. We assessed KIAA1549:BRAF fusion by fluorescence in situ hybridization and BRAF (exon 15) mutations by capillary sequencing. In addition, FGFR1 expression was analyzed using immunohistochemistry, and this was compared with gene amplification and hotspot mutations (exons 12 and 14) assessed by fluorescence in situ hybridization and capillary sequencing. KIAA1549:BRAF fusion was identified in almost 60% of cases. Two tumors harbored mutated BRAF. Despite high FGFR1 expression overall, no cases had FGFR1 amplifications. Three cases harbored a FGFR1 p.K656E point mutation. No correlation was observed between BRAF and FGFR1 alterations. The cases were predominantly pediatric (87%), and no statistical differences were observed in molecular alterations–related patient ages. In summary, we confirmed the high frequency of KIAA1549:BRAF fusion in PAs and its association with a better outcome. Oncogenic mutations of FGFR1, although rare, occurred in a subset of patients with worse outcome. These molecular alterations may constitute alternative targets for novel clinical approaches, when radical surgical resection is unachievable.
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Cieslik M, Chugh R, Wu YM, Wu M, Brennan C, Lonigro R, Su F, Wang R, Siddiqui J, Mehra R, Cao X, Lucas D, Chinnaiyan AM, Robinson D. The use of exome capture RNA-seq for highly degraded RNA with application to clinical cancer sequencing. Genome Res 2015; 25:1372-81. [PMID: 26253700 PMCID: PMC4561495 DOI: 10.1101/gr.189621.115] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/15/2015] [Indexed: 12/30/2022]
Abstract
RNA-seq by poly(A) selection is currently the most common protocol for whole transcriptome sequencing as it provides a broad, detailed, and accurate view of the RNA landscape. Unfortunately, the utility of poly(A) libraries is greatly limited when the input RNA is degraded, which is the norm for research tissues and clinical samples, especially when specimens are formalin-fixed. To facilitate the use of RNA sequencing beyond cell lines and in the clinical setting, we developed an exome-capture transcriptome protocol with greatly improved performance on degraded RNA. Capture transcriptome libraries enable measuring absolute and differential gene expression, calling genetic variants, and detecting gene fusions. Through validation against gold-standard poly(A) and Ribo-Zero libraries from intact RNA, we show that capture RNA-seq provides accurate and unbiased estimates of RNA abundance, uniform transcript coverage, and broad dynamic range. Unlike poly(A) selection and Ribo-Zero depletion, capture libraries retain these qualities regardless of RNA quality and provide excellent data from clinical specimens including formalin-fixed paraffin-embedded (FFPE) blocks. Systematic improvements across key applications of RNA-seq are shown on a cohort of prostate cancer patients and a set of clinical FFPE samples. Further, we demonstrate the utility of capture RNA-seq libraries in a patient with a highly malignant solitary fibrous tumor (SFT) enrolled in our clinical sequencing program called MI-ONCOSEQ. Capture transcriptome profiling from FFPE revealed two oncogenic fusions: the pathognomonic NAB2-STAT6 inversion and a therapeutically actionable BRAF fusion, which may drive this specific cancer's aggressive phenotype.
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Affiliation(s)
- Marcin Cieslik
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Rashmi Chugh
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA
| | - Yi-Mi Wu
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Ming Wu
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA; Howard Hughes Medical Institute, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA
| | - Christine Brennan
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Robert Lonigro
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Fengyun Su
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Rui Wang
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Javed Siddiqui
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Rohit Mehra
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Xuhong Cao
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA; Howard Hughes Medical Institute, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA
| | - David Lucas
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA
| | - Arul M Chinnaiyan
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA; Howard Hughes Medical Institute, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA; Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA; Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA
| | - Dan Robinson
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
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Weller M, Wick W, Aldape K, Brada M, Berger M, Pfister SM, Nishikawa R, Rosenthal M, Wen PY, Stupp R, Reifenberger G. Glioma. Nat Rev Dis Primers 2015; 1:15017. [PMID: 27188790 DOI: 10.1038/nrdp.2015.17] [Citation(s) in RCA: 665] [Impact Index Per Article: 73.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gliomas are primary brain tumours that are thought to derive from neuroglial stem or progenitor cells. On the basis of their histological appearance, they have been traditionally classified as astrocytic, oligodendroglial or ependymal tumours and assigned WHO grades I-IV, which indicate different degrees of malignancy. Tremendous progress in genomic, transcriptomic and epigenetic profiling has resulted in new concepts of classifying and treating gliomas. Diffusely infiltrating gliomas in adults are now separated into three overarching tumour groups with distinct natural histories, responses to treatment and outcomes: isocitrate dehydrogenase (IDH)-mutant, 1p/19q co-deleted tumours with mostly oligodendroglial morphology that are associated with the best prognosis; IDH-mutant, 1p/19q non-co-deleted tumours with mostly astrocytic histology that are associated with intermediate outcome; and IDH wild-type, mostly higher WHO grade (III or IV) tumours that are associated with poor prognosis. Gliomas in children are molecularly distinct from those in adults, the majority being WHO grade I pilocytic astrocytomas characterized by circumscribed growth, favourable prognosis and frequent BRAF gene fusions or mutations. Ependymal tumours can be molecularly subdivided into distinct epigenetic subgroups according to location and prognosis. Although surgery, radiotherapy and alkylating agent chemotherapy are still the mainstay of treatment, individually tailored strategies based on tumour-intrinsic dominant signalling pathways and antigenic tumour profiles may ultimately improve outcome. For an illustrated summary of this Primer, visit: http://go.nature.com/TXY7Ri.
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Affiliation(s)
- Michael Weller
- Department of Neurology and Brain Tumor Center, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 26, CH-8091 Zurich, Switzerland
| | - Wolfgang Wick
- Neurology Clinic, University of Heidelberg and German Cancer Research Center, Heidelberg, Germany
| | - Ken Aldape
- Department of Pathology, University Health Network, Toronto, Ontario, Canada
| | - Michael Brada
- Department of Molecular and Clinical Cancer Medicine and Department of Radiation Oncology, University of Liverpool and Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Mitchell Berger
- Department of Neurological Surgery and Brain Tumor Research Center, University of California, San Francisco, California, USA
| | - Stefan M Pfister
- Division of Pediatric Neuro-Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Pediatric Haematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Ryo Nishikawa
- Department of Neuro-Oncology and Neurosurgery, Saitama Medical University, Saitama, Japan
| | - Mark Rosenthal
- Department of Medical Oncology, The Royal Melbourne Hospital, Victoria 3050, Australia
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts, USA
| | - Roger Stupp
- Department of Oncology and Brain Tumor Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Guido Reifenberger
- Department of Neuropathology, Heinrich Heine University Düsseldorf, and German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) Heidelberg, partner site Essen/Düsseldorf, Germany
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Bergthold G, Bandopadhayay P, Hoshida Y, Ramkissoon S, Ramkissoon L, Rich B, Maire CL, Paolella BR, Schumacher SE, Tabak B, Ferrer-Luna R, Ozek M, Sav A, Santagata S, Wen PY, Goumnerova LC, Ligon AH, Stiles C, Segal R, Golub T, Grill J, Ligon KL, Chan JA, Kieran MW, Beroukhim R. Expression profiles of 151 pediatric low-grade gliomas reveal molecular differences associated with location and histological subtype. Neuro Oncol 2015; 17:1486-96. [PMID: 25825052 DOI: 10.1093/neuonc/nov045] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 02/26/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Pediatric low-grade gliomas (PLGGs), the most frequent pediatric brain tumor, comprise a heterogeneous group of diseases. Recent genomic analyses suggest that these tumors are mostly driven by mitogene-activated protein kinase (MAPK) pathway alterations. However, little is known about the molecular characteristics inherent to their clinical and histological heterogeneity. METHODS We performed gene expression profiling on 151 paraffin-embedded PLGGs from different locations, ages, and histologies. Using unsupervised and supervised analyses, we compared molecular features with age, location, histology, and BRAF genomic status. We compared molecular differences with normal pediatric brain expression profiles to observe whether those patterns were mirrored in normal brain. RESULTS Unsupervised clustering distinguished 3 molecular groups that correlated with location in the brain and histological subtype. "Not otherwise specified" (NOS) tumors did not constitute a unified class. Supratentorial pilocytic astrocytomas (PAs) were significantly enriched with genes involved in pathways related to inflammatory activity compared with infratentorial tumors. Differences based on tumor location were not mirrored in location-dependent differences in expression within normal brain tissue. We identified significant differences between supratentorial PAs and diffuse astrocytomas as well as between supratentorial PAs and dysembryoplastic neuroepithelial tumors but not between supratentorial PAs and gangliogliomas. Similar expression patterns were observed between childhood and adolescent PAs. We identified differences between BRAF-duplicated and V600E-mutated tumors but not between primary and recurrent PLGGs. CONCLUSION Expression profiling of PLGGs reveals significant differences associated with tumor location, histology, and BRAF genomic status. Supratentorial PAs, in particular, are enriched in inflammatory pathways that appear to be tumor-related.
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Affiliation(s)
- Guillaume Bergthold
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Pratiti Bandopadhayay
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Yujin Hoshida
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Shakti Ramkissoon
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Lori Ramkissoon
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Benjamin Rich
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Cecile L Maire
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Brenton R Paolella
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Steven E Schumacher
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Barbara Tabak
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Ruben Ferrer-Luna
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Memet Ozek
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Aydin Sav
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Sandro Santagata
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Patrick Yung Wen
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Liliana C Goumnerova
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Azra H Ligon
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Charles Stiles
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Rosalind Segal
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Todd Golub
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Jacques Grill
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Keith L Ligon
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Jennifer A Chan
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Mark W Kieran
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
| | - Rameen Beroukhim
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., C.S., R.S., R.B.); Broad Institute, Cambridge, Massachusetts (G.B., P.B., B.R.P., S.E.S., B.T., R.F.-L., T.G., R.B.); Pediatric Neuro-Oncology Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Dana-Farber Cancer Institute and Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts (P.B., L.C.G., M.W.K.); Liver Cancer Program, Tisch Cancer Institute, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., S.S., P.Y.W., A.H.L., K.L.L., J.A.C.); Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts (S.R., L.R., B.R., C.L.M., K.L.L.); Department of Neurosurgery, Acibadem University Medical Center, Istanbul, Turkey (M.O.); Department of Pathology, Acibadem University Medical Center, Istanbul, Turkey (A.S.); Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts (L.C.G.); Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France (J.G.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (K.L.L.)
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Taha H, Yehia M, Mahmoud M, El-Beltagy M, Ghabriel M, El-Naggar S. Incidence of kiaa1549-braf fusion gene in Egyptian pediatric low grade glioma. Clin Transl Med 2015; 4:10. [PMID: 25883769 PMCID: PMC4392037 DOI: 10.1186/s40169-015-0052-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 02/03/2015] [Indexed: 01/04/2023] Open
Abstract
Background Low grade gliomas are the most common brain tumor in children. Tandem duplication involving the KIAA1549 and the BRAF kinase genes results in a gene fusion that has been recently characterized in a subset of low grade glioma While there is no clear evidence that the KIAA1549-BRAF gene fusion has an effect on prognosis, it is an attractive target for therapy development and as a diagnostic tool. Methods In the current study we examine the prevalence of KIAA1549-BRAF gene fusion in pediatric patients diagnosed with low grade glioma in the Egyptian population and its relationship to clinical and histological subtypes. Sixty patients between the ages of 1 to 18 years were analyzed for the presence of KIAA1549-BRAF fusion gene products using reverse transcription-PCR and sequencing. The clinicopathologic tumor characteristics were then analyzed in relation to the different fusion genes. Results KIAA1549-BRAF fusion genes were detected in 56.6% of patients. They were primarily associated with pilocytic astrocytoma (74.2%) and pilomyxoid astrocytoma (60%). Translocation 15–9 was the most common, representing (55.8%) of all positive samples followed by 16–9 (26.4%) and 16–11 (8.8%). Pilocytic astrocytomas presented primarily with 15–9 (32.2%), 16–9 (25.8%) and 16–11 (6.4%) while pilomyxoid astrocytomas presented with 15–9 (46.6%), 16–9 (6.6%) and 16–11 (6.6%) translocations. Conclusion Gene fusion is found to be significantly increased in cerebellar pilocytic astrocytoma tumors. Furthermore, 15–9 was found to have a higher incidence among our cohort compared to previous studies. While most of the gene fusion positive pilomyxoid astrocytomas were 15–9, we find the association none significant.
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Affiliation(s)
- Hala Taha
- Department of Pathology, Children's Cancer Hospital Egypt 57357, P.O Box 11441, 1 Sekeat El-Imam, Cairo, Egypt
| | - Maha Yehia
- Department of Pathology, Children's Cancer Hospital Egypt 57357, P.O Box 11441, 1 Sekeat El-Imam, Cairo, Egypt
| | - Madeha Mahmoud
- Department of Pediatric Oncology, Children's Cancer Hospital Egypt 57357, P.O Box 11441, 1 Sekeat El-Imam, Cairo, Egypt
| | - Mohamed El-Beltagy
- Department of Neurosurgery, Children's Cancer Hospital Egypt 57357, P.O Box 11441, 1 Sekeat El-Imam, Cairo, Egypt
| | - Myret Ghabriel
- Basic Research Department, Children's Cancer Hospital Egypt 57357, P.O Box 11441, 1 Sekeat El-Imam, Cairo, Egypt
| | - Shahenda El-Naggar
- Basic Research Department, Children's Cancer Hospital Egypt 57357, P.O Box 11441, 1 Sekeat El-Imam, Cairo, Egypt
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50
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Oncogenic KIAA1549-BRAF fusion with activation of the MAPK/ERK pathway in pediatric oligodendrogliomas. Cancer Genet 2015; 208:91-5. [PMID: 25794445 DOI: 10.1016/j.cancergen.2015.01.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 01/18/2015] [Accepted: 01/20/2015] [Indexed: 01/01/2023]
Abstract
Pediatric oligodendrogliomas (pODGs) are rare central nervous system tumors, and comparatively little is known about their molecular pathogenesis. Co-deletion of 1p/19q; and IDH1, CIC, and FUBP1 mutations, which are molecular signatures of adult oligodendrogliomas, are extremely rare in pODGs. In this report, two pODGs, one each of grade II and grade III, were evaluated using clinical, radiological, histopathologic, and follow-up methods. IDH1, TP53, CIC, H3F3A, and BRAF-V600 E mutations were analyzed by Sanger sequencing and immunohistochemical methods, and 1p/19q co-deletion was analyzed by fluorescence in situ hybridization. PDGFRA amplification, BRAF gain, intragenic duplication of FGFR-TKD, and KIAA1549-BRAF fusion (validated by Sanger sequencing) were analyzed by real-time reverse transcription PCR. Notably, both cases showed the oncogenic KIAA1549_Ex15-BRAF_Ex9 fusion transcript. Further, immunohistochemical analysis showed activation of the MAPK/ERK pathway in both of these cases. However, neither 1p/19q co-deletion; IDH1, TP53, CIC, H3F3A, nor BRAF-V600 E mutation; PDGFRA amplification; BRAF gain; nor duplication of FGFR-TKD was identified. Overall, this study highlights that pODGs can harbor the KIAA1549-BRAF fusion with aberrant MAPK/ERK signaling, and there exists an option of targeting these pathways in such patients. These results indicate that pODGs with the KIAA1549-BRAF fusion may represent a subset of this rare tumor that shares molecular and genetic features of pilocytic astrocytomas. These findings will increase our understanding of pODGs and may have clinical implications.
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