1
|
Psidium guajava induces cytotoxicity in human malignant glioblastoma cell line: Role of reactive oxygen species. Toxicol In Vitro 2023; 89:105567. [PMID: 36758825 DOI: 10.1016/j.tiv.2023.105567] [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: 09/24/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
One of the deadliest types of CNS primary brain cancers is glioblastoma multiforme (GBM), and the survival rate of patients is about 7.2%. The standard treatment for GBM is surgical interventions followed by temozolomide. We investigated for the first time, the cytotoxic impacts of Psidium guajava (P. guajava) on the U87 GBM cell line. We measured cell toxicity through the MTT test following 24 h, 48 h, and 72 h treatment with different concentrations of fruit and seed hydroalcoholic extracts of P. guajava (25-400 μg/ml). Lipid peroxidation assay, reactive oxygen species (ROS) production, and apoptosis rate were evaluated 24 h after treatment by extracts of P. guajava. Moreover, to determine the Bax/Bcl-2 and NF-κB genes expression, we performed a real-time polymerase chain reaction (RT-PCR). Our finding demonstrated that 50-400 μg/ml of P. guajava extracts dose-dependently decreased the viability of U87 cells. Also, treatment by extracts increased lipid peroxidation, ROS production, and apoptosis in a dose-dependent manner. Moreover, the RT-PCR demonstrated an up-regulation in Bax\Bcl-2 and NF-κB. Thus, P. guajava inhibited the proliferation of U87 GBM cells and increased apoptosis probably through Bax/Bcl-2 and NF-κB regulation.
Collapse
|
2
|
Hybrid Techniques of Analyzing MRI Images for Early Diagnosis of Brain Tumours Based on Hybrid Features. Processes (Basel) 2023. [DOI: 10.3390/pr11010212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Brain tumours are considered one of the deadliest tumours in humans and have a low survival rate due to their heterogeneous nature. Several types of benign and malignant brain tumours need to be diagnosed early to administer appropriate treatment. Magnetic resonance (MR) images provide details of the brain’s internal structure, which allow radiologists and doctors to diagnose brain tumours. However, MR images contain complex details that require highly qualified experts and a long time to analyse. Artificial intelligence techniques solve these challenges. This paper presents four proposed systems, each with more than one technology. These techniques vary between machine, deep and hybrid learning. The first system comprises artificial neural network (ANN) and feedforward neural network (FFNN) algorithms based on the hybrid features between local binary pattern (LBP), grey-level co-occurrence matrix (GLCM) and discrete wavelet transform (DWT) algorithms. The second system comprises pre-trained GoogLeNet and ResNet-50 models for dataset classification. The two models achieved superior results in distinguishing between the types of brain tumours. The third system is a hybrid technique between convolutional neural network and support vector machine. This system also achieved superior results in distinguishing brain tumours. The fourth proposed system is a hybrid of the features of GoogLeNet and ResNet-50 with the LBP, GLCM and DWT algorithms (handcrafted features) to obtain representative features and classify them using the ANN and FFNN. This method achieved superior results in distinguishing between brain tumours and performed better than the other methods. With the hybrid features of GoogLeNet and hand-crafted features, FFNN achieved an accuracy of 99.9%, a precision of 99.84%, a sensitivity of 99.95%, a specificity of 99.85% and an AUC of 99.9%.
Collapse
|
3
|
Hamid SA, Zia N, Maqsood S, Rafiq N, Fatima M, Syed Y, Tabori U, Bartels U, Hawkins C, Huang A, Ramsawami V, Mushtaq N, Bouffet E. Impact of dedicated pediatric neuro-oncological services in a developing country: A single-institution, Pakistani experience. Pediatr Blood Cancer 2022; 69:e29887. [PMID: 35856658 DOI: 10.1002/pbc.29887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Brain tumors are the most common solid neoplasms and the second most common malignancy in the pediatric age group. Due to the complexity of their management, pediatric central nervous system (CNS) tumors are not a priority in low- and middle-income countries (LMICs). METHODS In an attempt to improve the survival rate and overall care, we introduced a dedicated pediatric neuro-oncology service in our institute and evaluated its impact by dividing the pre- and post-era into two cohorts and comparing them: 1998-2013 (16 years: cohort A) and 2014-2019 (6 years: cohort B, after the start of dedicated neuro-oncology services). RESULTS We observed that after the implementation of a proper neuro-oncology service, the proportion of patients treated with curative intent increased, and survival improved in cohort B. The patient volume also increased from 15.5 per year in cohort A to 44.8 per year in cohort B. The percentage of children given radiation therapy also increased significantly, while the proportion of children treated with chemotherapy remained stable. CONCLUSION A dedicated multidisciplinary team trained and knowledgeable in the specialty of pediatric neuro-oncology can enhance and improve outcomes, and supportive care and help can provide good quality of life to children and their families with brain neoplasms.
Collapse
Affiliation(s)
- Syed Ahmer Hamid
- Department of Pediatric Hematology and Oncology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Nida Zia
- Department of Pediatric Hematology and Oncology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Sidra Maqsood
- Indus Hospital Research Centre, Indus Hospital & Health Network, Karachi, Pakistan
| | - Naila Rafiq
- Department of Pediatric Hematology and Oncology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Mushkbar Fatima
- Indus Hospital Research Centre, Indus Hospital & Health Network, Karachi, Pakistan
| | - Yumna Syed
- Department of Pediatric Hematology and Oncology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Uri Tabori
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ute Bartels
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cynthia Hawkins
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Annie Huang
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Vijay Ramsawami
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Naureen Mushtaq
- Department of Oncology, The Aga Khan University Hospital, Karachi, Pakistan
| | - Eric Bouffet
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
4
|
Lazow MA, Salloum R, Pressey JG. Comorbidity Burden in a Cohort of Adolescent and Young Adult Patients Diagnosed with Central Nervous System Tumors and Sarcomas. J Adolesc Young Adult Oncol 2022; 12:215-223. [PMID: 35675692 DOI: 10.1089/jayao.2022.0006] [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
Purpose: Adolescent and young adult (AYA) oncology patients experience unique biological, behavioral, and socioeconomic challenges, for which provision of care must be tailored. AYAs with central nervous system (CNS) tumors and sarcomas represent a vulnerable population with worse outcomes and potential for serious sequelae from intense multimodal therapy. Comorbidity burden impacts treatment tolerance, adherence, and efficacy, yet has been understudied among these high-risk AYA patients. Methods: Utilizing a validated AYA oncology comorbidity index, we (1) measured comorbid conditions present at diagnosis in AYA-aged patients with CNS tumors and sarcomas and (2) compared baseline comorbidity burden across ascending AYA age groups (15-19, 20-29, and 30-39 years) and with pediatric patients (10-14 years). Results: The cohort included 131 AYAs and 50 pediatric patients. Mean comorbidity score significantly differed between pediatric (0.8) and AYA (1.7) patients, and across ascending age subgroups (0.8 [10-14] < 1.2 [15-19] < 1.7 [20-29] < 2.5 [30-39]). AYAs were significantly more likely than pediatric patients to have ≥2 or ≥3 comorbidities (47% vs. 18%, 24% vs. 6%), with increasing prevalence across ascending age subgroups. Frequency of overweight/obese status, smoking/substance use, obstetric/gynecologic conditions, and cardiovascular comorbidities increased with age. In multivariate analyses adjusting for sex, tumor type, and race, age remained a significant predictor of comorbidity score. Conclusions: AYAs with CNS tumors or sarcomas have a high burden of baseline comorbidities, which increase with age at diagnosis, conferring susceptibility to treatment-related toxicity and mortality. Improving the prognosis for AYAs requires appropriate identification of pre-existing comorbidities and tailoring therapeutic and supportive care accordingly.
Collapse
Affiliation(s)
- Margot A Lazow
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Pediatric Neuro-Oncology Program, Division of Hematology, Oncology, and BMT, Nationwide Children's Hospital, Columbus, Ohio, USA.,The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Ralph Salloum
- Pediatric Neuro-Oncology Program, Division of Hematology, Oncology, and BMT, Nationwide Children's Hospital, Columbus, Ohio, USA.,The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Joseph G Pressey
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| |
Collapse
|
5
|
Balogun JA, Bankole OB, Okere O, Uche EO, Balogun FM, Shilong DJ, Jimoh AO, Adeolu AA. Epidemiology of brain tumors among adolescents and young adults in Nigeria. J Clin Neurosci 2021; 96:50-55. [PMID: 34974248 DOI: 10.1016/j.jocn.2021.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/16/2021] [Indexed: 12/25/2022]
Abstract
Adolescents and Young Adults (AYA), have distinct endocrine and psychosocial peculiarities. Brain tumors occur less among AYAs, compared to other age groups and with better prognosis. There is however a paucity of literature about brain tumors in AYA in sub-Saharan Africa. We aim to describe the clinical characteristics of brain tumors in AYA across five neurosurgical centers in Nigeria and the associated factors. We report results for older children (10-14 years), adolescents (15-19 years) and young adults (20-24 years). This was a retrospective review of AYA with brain tumors over a 10-year period (2010-2019). Data analysis was by descriptive statistics, Chi square test and multinomial regression at α0.05. There were 104 AYAand the male to female ratio was 1.2:1. Headache (79.8%) and visual symptoms (65.4%) were the most common presenting symptoms. Focal limb weakness (44.1%) occurred less frequently. Median duration of symptoms prior to presentation was 9 months. Glioma was the most common tumor (31, 29.8%) while pituitary adenoma and craniopharyngioma constituted 30.8% of the tumors. Patients with symptom duration of ≤one year were more likely to have infratentorial tumors. There was no significant association between the KPS following intervention and the AYA characteristics. Age group was not significantly associated with any of the presenting symptoms except ataxia, which was significantly higher among the 10 to 14 years group.We have described the epidemiology of brain tumors within AYA in Nigeria and highlighted a need to maximize their care and meet their special needs.
Collapse
Affiliation(s)
- James A Balogun
- Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, Nigeria; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria.
| | - Olufemi B Bankole
- Neurosurgery Unit, Department of Surgery, College of Medicine University of Lagos, Nigeria; Neurosurgery Unit, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oghenekevwe Okere
- Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| | - Enoch O Uche
- Neurosurgery Unit, Department of Surgery, University of Nigeria Ituku/Ozalla Campus, Enugu, Nigeria
| | - Folusho M Balogun
- Adolescent Health Unit, Institute of Child Health, College of Medicine University of Ibadan, Nigeria
| | - Danaan J Shilong
- Neurosurgery Division, Department of Surgery, College of Health Sciences University of Jos, Jos, Nigeria
| | - Abdullahi O Jimoh
- Neurosurgery Unit, Department of Surgery Ahmadu Bello University, Zaria, Nigeria
| | - Augustine A Adeolu
- Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, Nigeria; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria
| |
Collapse
|
6
|
Roux A, Beccaria K, Blauwblomme T, Mahlaoui N, Chretien F, Varlet P, Puget S, Pallud J. Toward a transitional care from childhood and adolescence to adulthood in surgical neurooncology? A lesson from the Necker-Enfants Malades and the Sainte-Anne Hospitals collaboration. J Neurosurg Pediatr 2021; 28:380-386. [PMID: 34330092 DOI: 10.3171/2021.3.peds2141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/23/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Transitional care in surgical neurooncology is poorly studied. However, this period is pivotal, since it allows the patient to be empowered in his or her disease management. Here, the authors describe the experience of the Necker-Enfants Malades and the Sainte-Anne Hospital collaboration. METHODS The mixed transitional consultations started in September 2019 in a dedicated space for transitional care, named the "La Suite" department, located in the Necker-Enfants Malades Hospital, Paris, France. The authors organized planned consultations to schedule the clinical and radiological follow-up in the adult neurosurgical department but also emergency consultations to manage tumor recurrence in young adult patients. Transitional care was performed jointly by pediatric and adult neurosurgeons who have developed clinical and research skills in the field of surgical neurooncology. Neuropathological analysis was performed by a neuropathologist who is specialized in pediatric and adult neurooncology. RESULTS Fourteen patients benefited from a mixed transitional consultation. All of them accepted to start their management in an adult neurosurgical environment. Eleven patients (78.6%) for whom the disease was controlled benefited from a planned consultation. Three patients (21.4%) required rapid neurosurgical management for a tumor recurrence (n = 2) or for a new primary CNS tumor (n = 1) and benefited from an emergency consultation. CONCLUSIONS For adult patients harboring a brain tumor during childhood or adolescence, the authors suggest that neurosurgeons specialized in adult surgical neurooncology with a full knowledge in pediatric neurooncology will combine the required skills to optimize care management for these patients within a dedicated multidisciplinary organization framework.
Collapse
Affiliation(s)
- Alexandre Roux
- 1Service de Neurochirurgie, GHU Paris-Hôpital Sainte-Anne, Paris.,2Université de Paris, Sorbonne Paris Cité, Paris.,3INSERM UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris
| | - Kévin Beccaria
- 2Université de Paris, Sorbonne Paris Cité, Paris.,4Service de Neurochirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris
| | - Thomas Blauwblomme
- 2Université de Paris, Sorbonne Paris Cité, Paris.,4Service de Neurochirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris
| | - Nizar Mahlaoui
- 5Centre de référence déficits immunitaires héréditaires (Ceredih), Hôpital universitaire Necker-Enfants malades, AP-HP, Paris; Unité d'immuno-hématologie et rhumatologie pédiatrique, Hôpital universitaire Necker-Enfants malades, AP-HP, Paris.,6La Suite, Hôpital universitaire Necker-Enfants malades, AP-HP, Paris; and
| | - Fabrice Chretien
- 2Université de Paris, Sorbonne Paris Cité, Paris.,7Service de Neuropathologie, GHU Paris-Hôpital Sainte-Anne, Paris, France
| | - Pascale Varlet
- 2Université de Paris, Sorbonne Paris Cité, Paris.,3INSERM UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris.,7Service de Neuropathologie, GHU Paris-Hôpital Sainte-Anne, Paris, France
| | - Stéphanie Puget
- 2Université de Paris, Sorbonne Paris Cité, Paris.,4Service de Neurochirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris
| | - Johan Pallud
- 1Service de Neurochirurgie, GHU Paris-Hôpital Sainte-Anne, Paris.,2Université de Paris, Sorbonne Paris Cité, Paris.,3INSERM UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris
| |
Collapse
|
7
|
Daggubati V, Hochstelter J, Bommireddy A, Choudhury A, Krup AL, Kaur P, Tong P, Li A, Xu L, Reiter JF, Raleigh DR. Smoothened-activating lipids drive resistance to CDK4/6 inhibition in Hedgehog-associated medulloblastoma cells and preclinical models. J Clin Invest 2021; 131:141171. [PMID: 33476305 DOI: 10.1172/jci141171] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/14/2021] [Indexed: 12/14/2022] Open
Abstract
Medulloblastoma is an aggressive pediatric brain tumor that can be driven by misactivation of the Hedgehog (HH) pathway. CDK6 is a critical effector of oncogenic HH signaling, but attempts to target the HH pathway in medulloblastoma have been encumbered by resistance to single-agent molecular therapy. We identified mechanisms of resistance to CDK6 inhibition in HH-associated medulloblastoma by performing orthogonal CRISPR and CRISPR interference screens in medulloblastoma cells treated with a CDK4/6 inhibitor and RNA-Seq of a mouse model of HH-associated medulloblastoma with genetic deletion of Cdk6. Our concordant in vitro and in vivo data revealed that decreased ribosomal protein expression underlies resistance to CDK6 inhibition in HH-associated medulloblastoma, leading to ER stress and activation of the unfolded protein response (UPR). These pathways increased the activity of enzymes producing Smoothened-activating (SMO-activating) sterol lipids that sustained oncogenic HH signaling in medulloblastoma despite cell-cycle attenuation. We consistently demonstrated that concurrent genetic deletion or pharmacological inhibition of CDK6 and HSD11ß2, an enzyme producing SMO-activating lipids, additively blocked cancer growth in multiple mouse genetic models of HH-associated medulloblastoma. Our data reveal what we believe to be a novel pathway of resistance to CDK4/6 inhibition as well as a novel combination therapy to treat the most common malignant brain tumor in children.
Collapse
Affiliation(s)
- Vikas Daggubati
- Department of Radiation Oncology.,Department of Neurological Surgery.,Biomedical Sciences Graduate Program, and.,Medical Scientist Training Program, UCSF, San Francisco, California, USA
| | | | | | - Abrar Choudhury
- Department of Radiation Oncology.,Department of Neurological Surgery.,Biomedical Sciences Graduate Program, and.,Medical Scientist Training Program, UCSF, San Francisco, California, USA
| | | | | | - Pakteema Tong
- Department of Medicinal Chemistry, University of Washington, Seattle, Washington, USA
| | - Amy Li
- Department of Medicinal Chemistry, University of Washington, Seattle, Washington, USA
| | - Libin Xu
- Department of Medicinal Chemistry, University of Washington, Seattle, Washington, USA
| | - Jeremy F Reiter
- Department of Biochemistry and Biophysics, Cardiovascular Research Institute, Chan Zuckerberg Biohub, UCSF, San Francisco, California, USA
| | - David R Raleigh
- Department of Radiation Oncology.,Department of Neurological Surgery.,Biomedical Sciences Graduate Program, and
| |
Collapse
|
8
|
Harrup R, White VM, Coory M, Walker R, Anazodo A, Skaczkowski G, Bibby H, Osborn M, Phillips MB, Conyers R, Thompson K, Orme LM, Pinkerton R, Nicholls W. Treatment and Outcomes for Central Nervous System Tumors in Australian Adolescents and Young Adults: A Population-Based National Study. J Adolesc Young Adult Oncol 2020; 10:202-208. [PMID: 32856982 DOI: 10.1089/jayao.2020.0074] [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
Purpose: While central nervous system (CNS) tumors account for only 10% of adolescent and young adult (AYA) cancers, they are the leading cause of cancer death in this age group. Using national data for Australia, we describe the presentation, treatment, and survival for AYAs diagnosed with CNS tumors. Methods: A population-based study of 15-24 year-olds diagnosed with CNS tumors (low- and high-grade glioma [LGG, HGG], medulloblastoma [MB], primitive neuroectodermal tumors [PNET], ependymoma [EP]) or other (e.g., low-grade neuronal tumor) between 2007 and 2012. Clinical details were extracted from hospital medical records for each patient. Treatment centers were classified as pediatric or adult services. Results: Two hundred seventy-five patients (129 LGG, 77 HGG, 23 MB, 10 PNET, 19 EP, 17 other) were identified, with 17% treated at pediatric hospitals. Symptoms (headache [53%], nausea [31%]) were present for a median of 3 weeks before consulting a health professional. Of LGG patients, 15% had radiotherapy (RT) and 12% chemotherapy (CT). Of HGG patients, 81% had RT and 75% CT. All MB and PNET were managed with surgery, and 74% of MB and 80% of PNET had both RT and CT. Treatment did not differ by treatment center type. Five-year survival for LGG and EP was over 80%, but was 42% for HGG and 20% for PNET. Conclusions: This national, population-based study indicates similar treatment for AYA patients with CNS tumors between pediatric and adult services. Poor outcomes for HGG and PNET patients highlight the need for clinical trials of novel approaches for these tumors.
Collapse
Affiliation(s)
- Rosemary Harrup
- Medical Oncology/Haematology, Royal Hobart Hospital, Tasmania, Australia
| | - Victoria M White
- School of Psychology, Deakin University, Victoria, Australia.,Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | - Michael Coory
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
| | - Rick Walker
- Oncology Services Group, Queensland Children's Hospital, Queensland, Australia.,Oncology Unit, Princess Alexandra Hospital, Queensland, Australia.,School of Medicine, University of Queensland, Queensland, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, New South Wales, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Australia
| | - Gemma Skaczkowski
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia.,Department of Rural Health, Allied Health and Human Performance, University of South Australia, Australia
| | - Helen Bibby
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | - Michael Osborn
- Youth Cancer Service, Royal Adelaide Hospital, South Australia, Australia.,Department of Haematology and Oncology, Women's and Children's Hospital, South Australia, Australia
| | - Marianne B Phillips
- Oncology, Haematology & Bone Marrow Transplantation, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Rachel Conyers
- Children's Cancer Centre, The Royal Children's Hospital, Victoria, Australia
| | - Kate Thompson
- Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Victoria, Australia
| | - Lisa M Orme
- Children's Cancer Centre, The Royal Children's Hospital, Victoria, Australia
| | - Ross Pinkerton
- Hummingbird House Children's Hospice, Brisbane, Australia
| | - Wayne Nicholls
- Oncology Services Group, Queensland Children's Hospital, Queensland, Australia.,School of Medicine, University of Queensland, Queensland, Australia
| |
Collapse
|
9
|
Ng S, Zouaoui S, Bessaoud F, Rigau V, Roux A, Darlix A, Bauchet F, Mathieu-Daudé H, Trétarre B, Figarella-Branger D, Pallud J, Frappaz D, Roujeau T, Bauchet L. An epidemiology report for primary central nervous system tumors in adolescents and young adults: a nationwide population-based study in France, 2008-2013. Neuro Oncol 2020; 22:851-863. [PMID: 31796950 PMCID: PMC7283028 DOI: 10.1093/neuonc/noz227] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Primary central nervous system tumors (PCNST) among adolescents and young adults (AYA, 15-39 y) have rarely been reported. We present a nationwide report of PCNST histologically confirmed in the French AYA population between 2008 and 2013. METHODS Patients were identified through the French Brain Tumor Database (FBTDB), a national dataset that includes prospectively all histologically confirmed cases of PCNST in France. Patients aged 15 to 39 years with histologically confirmed PCNST diagnosed between 2008 and 2013 were included. For each of the 143 histological subtypes of PCNST, crude rates, sex, surgery, and age distribution were provided. To enable international comparisons, age-standardized incidence rates were adjusted to the world-standard, European, and USA populations. RESULTS For 6 years, 9661 PCNST (males/females: 4701/4960) were histologically confirmed in the French AYA population. The overall crude rate was 8.15 per 100 000 person-years. Overall, age-standardized incidence rates were (per 100 000 person-years, population of reference: world/Europe/USA): 7.64/8.07/8.21, respectively. Among patients aged 15-24 years, the crude rate was 5.13 per 100 000. Among patients aged 25-39 years, the crude rate was 10.10 per 100 000. Age-standardized incidence rates were reported for each of the 143 histological subtypes. Moreover, for each histological subtype, data were detailed by sex, age, type of surgery (surgical resection or biopsy), and cryopreserved samples. CONCLUSION These data represent an exhaustive report of all histologically confirmed cases of PCNST with their frequency and distribution in the French AYA population in 2008-2013. For the first time in this age group, complete histological subtypes and rare tumor identification are detailed.
Collapse
Affiliation(s)
- Sam Ng
- Department of Neurosurgery, Gui de Chauliac Hospital, University Hospital Center (CHU) Montpellier, Montpellier University Medical Center, Montpellier, France
| | - Sonia Zouaoui
- Department of Neurosurgery, Gui de Chauliac Hospital, University Hospital Center (CHU) Montpellier, Montpellier University Medical Center, Montpellier, France
| | - Faiza Bessaoud
- Tumor Registry of the Hérault, Institut du Cancer de Montpellier, Montpellier, France
| | - Valérie Rigau
- Department of Neuropathology, Gui de Chauliac Hospital, CHU Montpellier, Montpellier University Medical Center, Montpellier, France
| | - Alexandre Roux
- Department of Neurosurgery, University Hospital Group Paris, Sainte-Anne Hospital, Paris, France
- Paris Descartes University, Imaging Biomarkers of Brain Disorders, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - Amélie Darlix
- Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
- Neuro-Oncology Group of Languedoc Roussillon, Institut du Cancer de Montpellier, Montpellier, France
| | - Fabienne Bauchet
- Neuro-Oncology Group of Languedoc Roussillon, Institut du Cancer de Montpellier, Montpellier, France
| | - Hélène Mathieu-Daudé
- Neuro-Oncology Group of Languedoc Roussillon, Institut du Cancer de Montpellier, Montpellier, France
- Department of Medical Informatics, Institut du Cancer de Montpellier, Montpellier, France
| | - Brigitte Trétarre
- Tumor Registry of the Hérault, Institut du Cancer de Montpellier, Montpellier, France
| | - Dominique Figarella-Branger
- Aix-Marseille University, National Center for Scientific Research, Institute of Neuro-Physiopathology, Marseille, France
- Department of Pathology and Neuropathology, Timone Hospital, Marseille, France
| | - Johan Pallud
- Department of Neurosurgery, University Hospital Group Paris, Sainte-Anne Hospital, Paris, France
- Paris Descartes University, Imaging Biomarkers of Brain Disorders, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | | | - Thomas Roujeau
- Department of Neurosurgery, Gui de Chauliac Hospital, University Hospital Center (CHU) Montpellier, Montpellier University Medical Center, Montpellier, France
| | - Luc Bauchet
- Department of Neurosurgery, Gui de Chauliac Hospital, University Hospital Center (CHU) Montpellier, Montpellier University Medical Center, Montpellier, France
- Neuro-Oncology Group of Languedoc Roussillon, Institut du Cancer de Montpellier, Montpellier, France
- National Institute of Health and Medical Research unit 1051, Montpellier, France
| |
Collapse
|
10
|
Jones DT, Bandopadhayay P, Jabado N. The Power of Human Cancer Genetics as Revealed by Low-Grade Gliomas. Annu Rev Genet 2019; 53:483-503. [DOI: 10.1146/annurev-genet-120417-031642] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The human brain contains a vast number of cells and shows extraordinary cellular diversity to facilitate the many cognitive and automatic commands governing our bodily functions. This complexity arises partly from large-scale structural variations in the genome, evolutionary processes to increase brain size, function, and cognition. Not surprisingly given recent technical advances, low-grade gliomas (LGGs), which arise from the glia (the most abundant cell type in the brain), have undergone a recent revolution in their classification and therapy, especially in the pediatric setting. Next-generation sequencing has uncovered previously unappreciated diverse LGG entities, unraveling genetic subgroups and multiple molecular alterations and altered pathways, including many amenable to therapeutic targeting. In this article we review these novel entities, in which oncogenic processes show striking age-related neuroanatomical specificity (highlighting their close interplay with development); the opportunities they provide for targeted therapies, some of which are already practiced at the bedside; and the challenges of implementing molecular pathology in the clinic.
Collapse
Affiliation(s)
- David T.W. Jones
- Pediatric Glioma Research Group, Hopp Children's Cancer Center Heidelberg (KiTZ), 69120 Heidelberg, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Pratiti Bandopadhayay
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts 02215, USA
- The Broad Institute of MIT and Harvard, Boston, Massachusetts 02142, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Nada Jabado
- Departments of Pediatric and Human Genetics, McGill University and the Research Institute of the McGill University Health Center, Montreal, Quebec H4A 3J1, Canada
| |
Collapse
|
11
|
Jessa S, Blanchet-Cohen A, Krug B, Vladoiu M, Coutelier M, Faury D, Poreau B, De Jay N, Hébert S, Monlong J, Farmer WT, Donovan LK, Hu Y, McConechy MK, Cavalli FMG, Mikael LG, Ellezam B, Richer M, Allaire A, Weil AG, Atkinson J, Farmer JP, Dudley RWR, Larouche V, Crevier L, Albrecht S, Filbin MG, Sartelet H, Lutz PE, Nagy C, Turecki G, Costantino S, Dirks PB, Murai KK, Bourque G, Ragoussis J, Garzia L, Taylor MD, Jabado N, Kleinman CL. Stalled developmental programs at the root of pediatric brain tumors. Nat Genet 2019; 51:1702-1713. [PMID: 31768071 PMCID: PMC6885128 DOI: 10.1038/s41588-019-0531-7] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 10/18/2019] [Indexed: 02/08/2023]
Abstract
Childhood brain tumors have suspected prenatal origins. To identify vulnerable developmental states, we generated a single-cell transcriptome atlas of >65,000 cells from embryonal pons and forebrain, two major tumor locations. We derived signatures for 191 distinct cell populations and defined regional cellular diversity and differentiation dynamics. Projection of bulk tumor transcriptomes onto this dataset shows that WNT medulloblastomas match the rhombic lip-derived mossy fiber neuronal lineage, embryonal tumors with multilayered rosettes fully recapitulate a neuronal lineage, while Group 2a/b atypical teratoid/rhabdoid tumors may originate outside of the neuroectoderm. Importantly, single-cell tumor profiles reveal highly defined cell hierarchies mirroring transcriptional programs of the corresponding normal lineages. Our findings identify impaired differentiation of specific neural progenitors as a common mechanism underlying these pediatric cancers and provide a rational framework for future modeling and therapeutic interventions.
Collapse
Affiliation(s)
- Selin Jessa
- Quantitative Life Sciences, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Alexis Blanchet-Cohen
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Brian Krug
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Maria Vladoiu
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Marie Coutelier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Damien Faury
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada.,The Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
| | - Brice Poreau
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada.,The Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.,Service de Génétique et Procréation, Centre Hospitalier Universitaire, Grenoble-Alpes, Grenoble, France
| | - Nicolas De Jay
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Steven Hébert
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Jean Monlong
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,UC Santa Cruz Genomics Institute, University of California, Santa Cruz, CA, USA
| | - W Todd Farmer
- Centre for Research in Neuroscience, Brain Repair and Integrative Neuroscience Program, The Research Institute of the McGill University Health Centre, Montreal General Hospital, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Laura K Donovan
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Yixing Hu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | | | - Florence M G Cavalli
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leonie G Mikael
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada.,The Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
| | - Benjamin Ellezam
- Department of Pathology, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada
| | - Maxime Richer
- Department of Pathology, Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Andréa Allaire
- Department of Pathology, Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Alexander G Weil
- Department of Pediatric Neurosurgery, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada
| | - Jeffrey Atkinson
- Department of Pediatric Surgery, Division of Neurosurgery, Montreal Children's Hospital, McGill University, Montreal, Querbec, Canada
| | - Jean-Pierre Farmer
- Department of Pediatric Surgery, Division of Neurosurgery, Montreal Children's Hospital, McGill University, Montreal, Querbec, Canada
| | - Roy W R Dudley
- Department of Pediatric Surgery, Division of Neurosurgery, Montreal Children's Hospital, McGill University, Montreal, Querbec, Canada
| | - Valerie Larouche
- Department of Pediatrics, Centre mère-enfant Soleil du CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Louis Crevier
- Department of Surgery, Université de Laval, Quebec City, Quebec, Canada
| | - Steffen Albrecht
- Department of Pathology, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Mariella G Filbin
- Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Hervé Sartelet
- Department of Pathology, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Pierre-Eric Lutz
- Centre National de la Recherche Scientifique, Institut des Neurosciences Cellulaires et Intégratives, Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Corina Nagy
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Santiago Costantino
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada.,Department of Ophthalmology, Université de Montréal, Montreal, Quebec, Canada
| | - Peter B Dirks
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Keith K Murai
- Centre for Research in Neuroscience, Brain Repair and Integrative Neuroscience Program, The Research Institute of the McGill University Health Centre, Montreal General Hospital, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Guillaume Bourque
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada.,Canadian Center for Computational Genomics, Montreal, Quebec, Canada
| | - Jiannis Ragoussis
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Livia Garzia
- Cancer Research Program, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Division of Orthopedic Surgery, Faculty of Surgery, McGill University, Montreal, Quebec, Canada
| | - Michael D Taylor
- Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada. .,The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada. .,Department of Surgery, University of Toronto, Toronto, Ontario, Canada. .,Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada. .,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. .,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
| | - Nada Jabado
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada. .,Department of Pediatrics, McGill University, Montreal, Quebec, Canada. .,The Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
| | - Claudia L Kleinman
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada. .,Department of Human Genetics, McGill University, Montreal, Quebec, Canada.
| |
Collapse
|
12
|
Rosenberg DM, Geever BW, Patel AS, Chaker AN, Bhimani AD, Kheirkhah P, Hobbs JG, Esfahani DR, Mehta AI. Supratentorial and Infratentorial Approaches to Pineal Surgery: A Database Analysis. J Neurol Surg B Skull Base 2019; 80:364-370. [PMID: 31316882 PMCID: PMC6635120 DOI: 10.1055/s-0038-1675231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/10/2018] [Indexed: 01/01/2023] Open
Abstract
Objectives Neoplasms involving the pineal gland are rare. When they do occur, tumor resection is anatomically challenging and is traditionally addressed by either a supratentorial or an infratentorial approach. To date, no large, multicenter studies have been performed that systematically analyze outcomes comparing these two approaches. This study aimed to evaluate outcomes for patients undergoing pineal neoplasm resection, comparing supratentorial and infratentorial approaches. Design Retrospective database review. Setting Multi-institutional database. Participants From 2005 to 2016, 60 patients were identified, with 13 undergoing a supratentorial approach and 47 undergoing an infratentorial approach. Main Outcome Measures Patient demographics, comorbidities, and 30-day postoperative outcomes were investigated using the American College of Surgeons National Surgical Quality Improvement Program database. Demographics, readmission, reoperation, and complication rates were analyzed and compared with previous studies. Results Patient demographics were similar between these two groups. The overall complication rates for the supratentorial and infratentorial approaches were 30.8 and 17%, respectively, and the difference was not statistically significant. The most common medical complications encountered were respiratory and hematological. Conclusion As the first multi-institutional database analysis of approaches to the pineal gland, this study provides an analysis of patient demographics, comorbidities, and postoperative complications. After controlling for preoperative risk factors and demographic characteristics, no statistically significant differences in postoperative outcomes were found between infratentorial and supratentorial approaches. The mean readmission, reoperation, and complication rates were found to be 2.1, 8.3, and 20%, respectively. The lack of significant difference between approaches suggests that clinical decision-making should depend upon anatomical considerations and physician preference, although the complications illustrated here may provide some preoperative guidance.
Collapse
Affiliation(s)
- David M. Rosenberg
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Brett W. Geever
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Akash S. Patel
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Anisse N. Chaker
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Abhiraj D. Bhimani
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Pouyan Kheirkhah
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Jonathan G. Hobbs
- Section of Neurosurgery, Department of Surgery, University of Chicago, Chicago, Illinois, United States
| | - Darian R. Esfahani
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Ankit I. Mehta
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| |
Collapse
|
13
|
Fernández-Méndez R, Richards HK, Seeley HM, Pickard JD, Joannides AJ. Current epidemiology of cerebrospinal fluid shunt surgery in the UK and Ireland (2004-2013). J Neurol Neurosurg Psychiatry 2019; 90:747-754. [PMID: 30910858 PMCID: PMC6585267 DOI: 10.1136/jnnp-2018-319927] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/07/2019] [Accepted: 02/10/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To determine current epidemiology and clinical characteristics of cerebrospinal fluid (CSF) shunt surgery, including revisions. METHODS A retrospective, multicentre, registry-based study was conducted based on 10 years' data from the UK Shunt Registry, including primary and revision shunting procedures reported between 2004 and 2013. Incidence rates of primary shunts, descriptive statistics and shunt revision rates were calculated stratified by age group, geographical region and year of operation. RESULTS 41 036 procedures in 26 545 patients were submitted during the study period, including 3002 infants, 4389 children and 18 668 adults. Procedures included 20 947 (51.0%) primary shunt insertions in 20 947 patients, and 20 089 (49.0%) revision procedures. Incidence rates of primary shunt insertions for infants, children and adults were 39.5, 2.4 and 3.5 shunts per 100 000 person-years, respectively. These varied by geographical subregion and year of operation. The most common underlying diagnoses were perinatal intraventricular haemorrhage (35.3%) and malformations (33.9%) in infants, tumours (40.5%) and malformations (16.3%) in children, and tumours (24.6%), post-haemorrhagic hydrocephalus (16.2%) and idiopathic normal pressure hydrocephalus (14.2%) in adults. Ninety-day revision rates were 21.9%, 18.6% and 12.8% among infants, children and adults, respectively, while first-year revision rates were 31.0%, 25.2% and 17.4%. The main reasons for revision were underdrainage and infection, but overdrainage and mechanical failure continue to pose problems. CONCLUSIONS Our report informs patients, carers, clinicians, providers and commissioners of healthcare, researchers and industry of the current epidemiology of shunting for CSF disorders, including the potential risks of complications and frequency of revision.
Collapse
Affiliation(s)
- Rocío Fernández-Méndez
- Clinical Neurosciences, University of Cambridge, Cambridge, UK .,United Kingdom Shunt Registry, Cambridge, UK
| | - Hugh K Richards
- Clinical Neurosciences, University of Cambridge, Cambridge, UK.,United Kingdom Shunt Registry, Cambridge, UK
| | - Helen M Seeley
- Clinical Neurosciences, University of Cambridge, Cambridge, UK.,United Kingdom Shunt Registry, Cambridge, UK
| | - John D Pickard
- Clinical Neurosciences, University of Cambridge, Cambridge, UK.,United Kingdom Shunt Registry, Cambridge, UK.,NIHR Brain Injury MedTech Co-operative, Cambridge, UK
| | - Alexis J Joannides
- Clinical Neurosciences, University of Cambridge, Cambridge, UK.,United Kingdom Shunt Registry, Cambridge, UK.,NIHR Brain Injury MedTech Co-operative, Cambridge, UK
| | | |
Collapse
|
14
|
Dastpeyman M, Giacomin P, Wilson D, Nolan MJ, Bansal PS, Daly NL. A C-Terminal Fragment of Chlorotoxin Retains Bioactivity and Inhibits Cell Migration. Front Pharmacol 2019; 10:250. [PMID: 30949052 PMCID: PMC6435586 DOI: 10.3389/fphar.2019.00250] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/26/2019] [Indexed: 11/13/2022] Open
Abstract
Chlorotoxin was originally isolated from the venom of the Israeli scorpion Leiurus quinquestriatus, and has potential as a tumor imaging agent based on its selective binding to tumor cells. Several targets have been suggested for chlorotoxin including voltage-gated chloride channels, and it has been shown to have anti-angiogenic activity and inhibit cell migration. The structure of chlorotoxin is stabilized by four disulfide bonds and contains β-sheet and helical structure. Interestingly, the reduced form has previously been shown to inhibit cell migration to the same extent as the wild type, but structural analysis indicates that the reduced form of the peptide does not maintain the native secondary structure and appears unstructured in solution. This lack of structure suggests that a short stretch of amino acids might be responsible for the bioactivity. To explore this hypothesis, we have synthesized fragments of chlorotoxin without disulfide bonds. As expected for such small peptides, NMR analysis indicated that the peptides were unstructured in solution. However, the peptide corresponding to the eight C-terminal residues inhibited cell migration, in contrast to the other fragments. Our results suggest that the C-terminal region plays a critical role in the bioactivity of chlorotoxin.
Collapse
Affiliation(s)
- Mohadeseh Dastpeyman
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - Paul Giacomin
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - David Wilson
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - Matthew J Nolan
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - Paramjit S Bansal
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - Norelle L Daly
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| |
Collapse
|
15
|
Raleigh DR, Reiter JF. Misactivation of Hedgehog signaling causes inherited and sporadic cancers. J Clin Invest 2019; 129:465-475. [PMID: 30707108 DOI: 10.1172/jci120850] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The Hedgehog pathway is critical for the development of diverse organs. Misactivation of the Hedgehog pathway can cause developmental abnormalities and cancers, including medulloblastoma, the most common pediatric brain tumor, and basal cell carcinoma, the most common cancer in the United States. Here, we review how basic, translational, and clinical studies of the Hedgehog pathway have helped reveal how cells communicate, how intercellular communication controls development, how signaling goes awry to cause cancer, and how to use targeted molecular agents to treat both inherited and sporadic cancers.
Collapse
Affiliation(s)
- David R Raleigh
- Department of Radiation Oncology.,Department of Neurological Surgery, and
| | - Jeremy F Reiter
- Department of Biochemistry and Biophysics, UCSF, San Francisco, California, USA
| |
Collapse
|
16
|
Spinelli C, Adnani L, Choi D, Rak J. Extracellular Vesicles as Conduits of Non-Coding RNA Emission and Intercellular Transfer in Brain Tumors. Noncoding RNA 2018; 5:ncrna5010001. [PMID: 30585246 PMCID: PMC6468529 DOI: 10.3390/ncrna5010001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 12/14/2022] Open
Abstract
Non-coding RNA (ncRNA) species have emerged in as molecular fingerprints and regulators of brain tumor pathogenesis and progression. While changes in ncRNA levels have been traditionally regarded as cell intrinsic there is mounting evidence for their extracellular and paracrine function. One of the key mechanisms that enables ncRNA to exit from cells is their selective packaging into extracellular vesicles (EVs), and trafficking in the extracellular space and biofluids. Vesicular export processes reduce intracellular levels of specific ncRNA in EV donor cells while creating a pool of EV-associated ncRNA in the extracellular space and biofluids that enables their uptake by other recipient cells; both aspects have functional consequences. Cancer cells produce several EV subtypes (exosomes, ectosomes), which differ in their ncRNA composition, properties and function. Several RNA biotypes have been identified in the cargo of brain tumor EVs, of which microRNAs are the most studied, but other species (snRNA, YRNA, tRNA, and lncRNA) are often more abundant. Of particular interest is the link between transforming oncogenes and the biogenesis, cargo, uptake and function of tumor-derived EV, including EV content of oncogenic RNA. The ncRNA repertoire of EVs isolated from cerebrospinal fluid and serum is being developed as a liquid biopsy platform in brain tumors.
Collapse
Affiliation(s)
- Cristiana Spinelli
- The Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada.
| | - Lata Adnani
- The Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada.
| | - Dongsic Choi
- The Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada.
| | - Janusz Rak
- The Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada.
| |
Collapse
|
17
|
Ahomäki R, Kero A, Koivisto M, Madanat-Harjuoja L, Malila N, Lähteenmäki PM. Purchases of antidepressants after cancer at a young age in Finland. Int J Cancer 2018; 144:1227-1233. [PMID: 30357818 DOI: 10.1002/ijc.31942] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 09/05/2018] [Accepted: 10/04/2018] [Indexed: 12/16/2022]
Abstract
According to previous studies, childhood cancer survivors have an elevated risk for late mental health effects. However, only few studies exist on young adulthood (YA) cancer survivors' mental health outcomes. In our study, we examined first time antidepressant (AD) medication purchases of childhood and YA cancer patients compared to siblings. The first time AD medication purchases of 7,093 cancer patients aged 0-34 years at diagnosis and a sibling cohort (N = 26,882) were retrieved from the Social Insurance Institution of Finland (Kela) since 1.1.1993. Cancer patients diagnosed between 1.1.1994 and 31.12.2004 were identified from the Finnish Cancer Registry and sibling controls via the Population Registry Centre. Statistical analyses were performed via the Cox regression model, and the hazard ratios (HR) were adjusted for age and gender. Increased hazard ratios for AD purchases were found in the younger (0-19 years at cancer diagnosis) [HR 5.2, 95%CI (3.7-7.2)] and older (age 20-34 years at cancer diagnosis) [HR 4.5, 95%CI (3.9-5.2)] cancer patient groups compared to siblings. The gender effect was similar in patients and controls, showing that females have higher risk for AD purchases than males. Males in the younger patient group had highest HR (5.6) for AD purchases compared to siblings. Patients with sarcoma or CNS tumor in the younger age group and leukemia or CNS malignancy in the older age group had the highest risk for AD medication purchases. The frequency and risk for AD purchases has been increasing during recent decades in both cancer patient age groups compared to siblings. Thus, cancer patients' psychological support should be properly assessed already after primary treatment. Certain diagnostic groups as well as female patients may require more psychological support than others.
Collapse
Affiliation(s)
- Ritva Ahomäki
- Turku University Hospital, Department of Pediatrics and Adolescent Medicine, and Turku University, Turku, Finland
| | - Andreina Kero
- Turku University Hospital, Department of Pediatrics and Adolescent Medicine, and Turku University, Turku, Finland
| | - Mari Koivisto
- University of Turku, Department of Biostatistics, Turku, Finland
| | | | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland
| | - Päivi M Lähteenmäki
- Turku University Hospital, Department of Pediatrics and Adolescent Medicine, and Turku University, Turku, Finland
| |
Collapse
|
18
|
Tawil N, Chennakrishnaiah S, Bassawon R, Johnson R, D'Asti E, Rak J. Single cell coagulomes as constituents of the oncogene-driven coagulant phenotype in brain tumours. Thromb Res 2018; 164 Suppl 1:S136-S142. [PMID: 29703472 DOI: 10.1016/j.thromres.2018.01.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 02/07/2023]
Abstract
Molecular profiling of human cancers revealed a startling diversity in disease-causing mechanisms superseding histological and anatomical commonalities. The emerging molecular subtypes and disease entities are often driven by distinct oncogenic pathways and their effectors, including those acting extracellularly on the vascular and coagulation systems. Indeed, several oncogenic mutations such as those affecting protein-coding genes (RAS, EGFR, PTEN, TP53) and non-coding RNA (microRNA) regulate multiple effectors of the coagulation system (coagulome), including tissue factor, protease activated receptors, clotting factors, mediators of platelet function and fibrinolysis. This is exemplified by differential coagulome profiles in the molecular subtypes of glioblastoma, medulloblastoma and other human tumours. There is mounting clinical evidence that the mutational status of cancer driver genes such as KRAS or IDH1 may influence the risk of venous thromboembolism in patients with colorectal, lung or brain cancers. Notably, single cell sequencing in glioblastoma revealed a remarkable intra-tumoural heterogeneity of cancer cell populations with regard to their individual coagulomes, suggesting a combinatorial and dynamic nature of the global pro-thrombotic phenotype. We suggest that the cellular complexity of specific cancers may define their mechanisms of interactions with the coagulation system, and the risks of thrombosis. Thus, more biologically- based, disease-specific and personalized approaches may be needed to diagnose and manage cancer-related thrombosis.
Collapse
Affiliation(s)
- Nadim Tawil
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada
| | | | - Rayhaan Bassawon
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada
| | - Radia Johnson
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada
| | - Esterina D'Asti
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada
| | - Janusz Rak
- McGill University, Montreal Children's Hospital, RI MUHC, Montreal, Quebec, Canada.
| |
Collapse
|
19
|
Guerra-Mora JR, Bravo-Ángel U, Hernández-Reséndiz RE, Vicuña-González RM, Frías-Guillén J, Bercholc-Urinowsky IJ, Bravo-Reyna CC, García-González U. Anaplasic astrocytoma with exophytic growth in Sylvian fissure in a pediatric patient: a case report. J Surg Case Rep 2018; 2018:rjy079. [PMID: 29732137 PMCID: PMC5917768 DOI: 10.1093/jscr/rjy079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/01/2018] [Accepted: 04/09/2018] [Indexed: 11/13/2022] Open
Abstract
Gliomas are the most frequent supratentorial intracranial tumors in the pediatric population. Usually, they are intra-axial lesions with a characteristic image pattern, however, there are few reported cases of gliomas with exophytic growth. There are no previous reports in the literature of gliomas with exophytic growth in the Sylvian fissure. Fourteen year-old female patient who started with seizures. In imaging studies, a neoplasic mass with an exophytic portion in the left Sylvian fissure was found. Macroscopically, total resection was performed, definitive diagnosis was anaplastic astrocytoma. She presented recurrence and is currently receiving adjuvant treatment. Supratentorial gliomas with exophytic growth are extremely rare. We report the first case in the pediatric population, and we consider it is important to know its imaging and macroscopic characteristics for its initial management and to take it into account as a differential diagnosis of exophytic lesions.
Collapse
Affiliation(s)
- José Raúl Guerra-Mora
- Department of Neurology and Neurosurgery, South Central High Specialty Hospital, Pemex, Mexico
| | - Ulises Bravo-Ángel
- Neurosurgery and Neurology Department, Mexican Oil Company (Pemex) Villahemosa Regional Hospital, Instituto de Seguridad Social del Estado de Tabasco 'Julian Manzur Ocaña Medical Center', Tabasco, Mexico
| | | | | | | | | | | | - Ulises García-González
- Department of Neurology and Neurosurgery, South Central High Specialty Hospital, Pemex, Mexico
| |
Collapse
|
20
|
Genthe JR, Min J, Farmer DM, Shelat AA, Grenet JA, Lin W, Finkelstein D, Vrijens K, Chen T, Guy RK, Clements WK, Roussel MF. Ventromorphins: A New Class of Small Molecule Activators of the Canonical BMP Signaling Pathway. ACS Chem Biol 2017; 12:2436-2447. [PMID: 28787124 DOI: 10.1021/acschembio.7b00527] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Here, we describe three new small-molecule activators of BMP signaling found by high throughput screening of a library of ∼600 000 small molecules. Using a cell-based luciferase assay in the BMP4-responsive human cervical carcinoma clonal cell line, C33A-2D2, we identified three compounds with similar chemotypes that each ventralize zebrafish embryos and stimulate increased expression of the BMP target genes, bmp2b and szl. Because these compounds ventralize zebrafish embryos, we have termed them "ventromorphins." As expected for a BMP pathway activator, they induce the differentiation of C2C12 myoblasts to osteoblasts. Affymetrix RNA analysis confirmed the differentiation results and showed that ventromorphins treatment elicits a genetic response similar to BMP4 treatment. Unlike isoliquiritigenin (SJ000286237), a flavone that maximally activates the pathway after 24 h of treatment, all three ventromorphins induced SMAD1/5/8 phosphorylation within 30 min of treatment and achieved peak activity within 1 h, indicating that their responses are consistent with directly activating BMP signaling.
Collapse
Affiliation(s)
- Jamie R. Genthe
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - Jaeki Min
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - Dana M. Farmer
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - Anang A. Shelat
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - Jose A. Grenet
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - Wenwei Lin
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - David Finkelstein
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - Karen Vrijens
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - Taosheng Chen
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - R. Kiplin Guy
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - Wilson K. Clements
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| | - Martine F. Roussel
- Departments
of Hematology, ‡Chemical Biology and Therapeutics, §Tumor Cell Biology,
and ∥Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, United States
| |
Collapse
|
21
|
Molecular Basis of Pediatric Brain Tumors. Neuromolecular Med 2017; 19:256-270. [DOI: 10.1007/s12017-017-8455-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 07/21/2017] [Indexed: 01/03/2023]
|
22
|
Zanato S, Traverso A, Tremolada M, Sinatora F, Porreca A, Pozziani G, Di Florio N, Capello F, Marzollo A, Tumino M, Cattelan C, Basso G, Messina C. Psychopathological Aspects in Childhood Hematopoietic Stem Cell Transplantation (HSCT): The Perception of Parents and Adolescents. Front Psychol 2017; 8:272. [PMID: 28424633 PMCID: PMC5380719 DOI: 10.3389/fpsyg.2017.00272] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/13/2017] [Indexed: 01/06/2023] Open
Abstract
Background: Data about psychosocial sequelae of childhood Hematopoietic Stem Cell Transplantation (HSCT) are limited and the association with a specific donor type or other medical factors is largely unknown (Chang et al., 2012). The aim of the present study was to compare the psychological aspects of pediatric HSCT survivors with healthy peers. A secondary aim was to detect whether parents and children differed in the perception of mental health status. The influence of medical factors on psychological status was also examined. Method: Thirty seven HSCT survivors (23 males) with a mean age of 14.4 years (SD = 3.03; range 8.16-18.33) were recruited. Twenty-six patients underwent an allogenic HSCT (matched unrelated donor, n = 20; matched sibling donor, n = 6) and 11 patients received an autologous HSCT. The children psychological aspects were assessed using the Youth Self Report (YSR) (Achenbach and Rescorla, 2001) and compared to a group of matched healthy peers. At the same time, parents were requested to complete the Child Behavior Checklist 6-18 (Achenbach and Rescorla, 2001). Medical and socio-demographic data were also collected. Results: HSCT survivors reported significantly higher levels of somatic complains (t27 = 3.14; p = 0.004; mean = 3.1) when compared to healthy peers (mean = 1.5). The parent CBCL scores on "child total competence" exceeded the normative clinical cutoff in 48.6% cases. Inter-rater agreement between parent and patient reports was present only in three scales: total competence score (K = 0.06, p = 0.002), somatic complaints (K = 0.21, p = 0.003) and attention problems (k = 0.13; p = 0.02). According to Ancova models, internalizing problems were more frequent in HSCT from family donors (F2 = 3.13; p = 0.06) or in the presence of acute complications (F1 = 11.95; p = 0.003). Conclusion: In contrast to the perception of parents, pediatric HSCT survivors reported good psychological health. However, they complained about more somatic problems as compared with healthy peers. Medical aspects such as donor source and the presence of acute complications should be taken into consideration for the psychological approach in order to improve pediatric HSCT survivor care.
Collapse
Affiliation(s)
- Silvia Zanato
- Psychiatric Unit, Department of Women's and Children's Health, University Hospital of PaduaPadua, Italy
| | - Annalisa Traverso
- Psychiatric Unit, Department of Women's and Children's Health, University Hospital of PaduaPadua, Italy
| | - Marta Tremolada
- Department of Developmental and Social Psychology, University of PaduaPadua, Italy
| | - Francesco Sinatora
- Psychiatric Unit, Department of Women's and Children's Health, University Hospital of PaduaPadua, Italy
| | - Alessio Porreca
- Psychiatric Unit, Department of Women's and Children's Health, University Hospital of PaduaPadua, Italy
| | - Giorgio Pozziani
- Psychiatric Unit, Department of Women's and Children's Health, University Hospital of PaduaPadua, Italy
| | - Nicoletta Di Florio
- Psychiatric Unit, Department of Women's and Children's Health, University Hospital of PaduaPadua, Italy
| | - Fabia Capello
- Department of Developmental and Social Psychology, University of PaduaPadua, Italy
| | - Antonio Marzollo
- Department of Developmental and Social Psychology, University of PaduaPadua, Italy
| | - Manuela Tumino
- Department of Developmental and Social Psychology, University of PaduaPadua, Italy
| | - Chiara Cattelan
- Psychiatric Unit, Department of Women's and Children's Health, University Hospital of PaduaPadua, Italy
| | - Giuseppe Basso
- Department of Developmental and Social Psychology, University of PaduaPadua, Italy
| | - Chiara Messina
- Department of Developmental and Social Psychology, University of PaduaPadua, Italy
| |
Collapse
|
23
|
Pletschko T, Felnhofer A, Schwarzinger A, Weiler L, Slavc I, Leiss U. Applying the International Classification of Functioning-Children and Youth Version to Pediatric Neuro-oncology. J Child Neurol 2017; 32:23-28. [PMID: 28257280 DOI: 10.1177/0883073816669647] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Given the increased survival rates in patients with pediatric central nervous system tumors, late effects such as treatment- and/or illness-related neurologic sequelae as well as neuropsychological deficits and social difficulties have moved into focus in follow-up care. In order to provide personalized treatment recommendations for pediatric brain tumor survivors, it is crucial not only to assess cognitive impairments but also to measure a patient's functional deficiencies, for example, restricted participation in everyday social activities. Thus, this article introduces the International Classification of Functioning-Children and Youth version (ICF-CY) as a conceptual framework for quantifying functional limitations and informing long-term care in pediatric neuro-oncology. A standardized self-report and proxy-report questionnaire for measuring participation is briefly discussed and specific recommendations based on so-called core sets for clinical practice in pediatric neuro-oncology are provided.
Collapse
Affiliation(s)
- Thomas Pletschko
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Anna Felnhofer
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Agathe Schwarzinger
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Liesa Weiler
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Irene Slavc
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Ulrike Leiss
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
24
|
Raleigh DR, Tomlin B, Buono BD, Roddy E, Sear K, Byer L, Felton E, Banerjee A, Torkildson J, Samuel D, Horn B, Braunstein SE, Haas-Kogan DA, Mueller S. Survival after chemotherapy and stem cell transplant followed by delayed craniospinal irradiation is comparable to upfront craniospinal irradiation in pediatric embryonal brain tumor patients. J Neurooncol 2016; 131:359-368. [PMID: 27778212 DOI: 10.1007/s11060-016-2307-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 10/17/2016] [Indexed: 01/28/2023]
Abstract
Pediatric embryonal brain tumor patients treated with craniospinal irradiation (CSI) are at risk for adverse effects, with greater severity in younger patients. Here we compare outcomes of CSI vs. high-dose chemotherapy (HD), stem cell transplant (SCT) and delayed CSI in newly diagnosed patients. Two hundred one consecutive patients treated for medulloblastoma (72 %), supratentorial primitive neuroectodermal tumor (sPNET; 18 %) or pineoblastoma (10 %) at two institutions between 1988 and 2014 were retrospectively identified. Progression free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared by log-rank tests. Adjuvant CSI regimens were used for 56 % of patients (upfront-CSI), and HD/SCT regimens were used in 32 % of patients. HD/SCT patients were significantly younger than those receiving upfront-CSI (2.9 vs. 7.8 years; P < 0.0001). There were no differences in metastases, extent of resection, or CSI dose between upfront-CSI and HD/SCT patients, but median follow-up was shorter in the HD/SCT group (6.2 vs. 3.9 years; P = 0.007). There were no significant outcome differences between upfront-CSI and HD/SCT patients who received CSI as a prophylaxis or following relapse (OS 66 % vs. 61 %, P = 0.13; PFS 67 % vs. 62 %, P = 0.12). Outcomes were equivalent when restricting analyses to HD/SCT patients who received prophylactic CSI prior to relapse (OS 66 % vs. 65 %, P = 0.5; PFS 67 % vs. 74 %, P = 0.8). At last follow-up, 48 % of HD/SCT patients had received neither definitive nor salvage radiotherapy. In this retrospective cohort, outcomes with adjuvant HD/SCT followed by delayed CSI are comparable to upfront-CSI for carefully surveyed pediatric embryonal brain tumor patients. Future prospective studies are required to validate this finding, and also to assess the impact of delayed CSI on neurocognitive outcomes.
Collapse
Affiliation(s)
- David R Raleigh
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Bryan Tomlin
- Department of Economics, California State University Chanel Islands, Camarillo, CA, USA
| | - Benedict Del Buono
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Erika Roddy
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Katherine Sear
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Lennox Byer
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Erin Felton
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Anu Banerjee
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Joseph Torkildson
- Pediatric Hematology-Oncology, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - David Samuel
- Pediatric Hematology-Oncology, Valley Children's Healthcare, Madera, CA, USA
| | - Biljana Horn
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Steve E Braunstein
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Daphne A Haas-Kogan
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Sabine Mueller
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA. .,Department of Neurology, Neurosurgery and Pediatrics, University of California San Francisco, 550 Sandler Neuroscience, 625 Nelson Rising Lane, 402B, Box 0434, San Francisco, CA, 94143, USA.
| |
Collapse
|
25
|
Fontebasso AM, Shirinian M, Khuong-Quang DA, Bechet D, Gayden T, Kool M, De Jay N, Jacob K, Gerges N, Hutter B, Şeker-Cin H, Witt H, Montpetit A, Brunet S, Lepage P, Bourret G, Klekner A, Bognár L, Hauser P, Garami M, Farmer JP, Montes JL, Atkinson J, Lambert S, Kwan T, Korshunov A, Tabori U, Collins VP, Albrecht S, Faury D, Pfister SM, Paulus W, Hasselblatt M, Jones DTW, Jabado N. Non-random aneuploidy specifies subgroups of pilocytic astrocytoma and correlates with older age. Oncotarget 2016; 6:31844-56. [PMID: 26378811 PMCID: PMC4741644 DOI: 10.18632/oncotarget.5571] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 08/15/2015] [Indexed: 11/25/2022] Open
Abstract
Pilocytic astrocytoma (PA) is the most common brain tumor in children but is rare in adults, and hence poorly studied in this age group. We investigated 222 PA and report increased aneuploidy in older patients. Aneuploid genomes were identified in 45% of adult compared with 17% of pediatric PA. Gains were non-random, favoring chromosomes 5, 7, 6 and 11 in order of frequency, and preferentially affecting non-cerebellar PA and tumors with BRAF V600E mutations and not with KIAA1549-BRAF fusions or FGFR1 mutations. Aneuploid PA differentially expressed genes involved in CNS development, the unfolded protein response, and regulators of genomic stability and the cell cycle (MDM2, PLK2),whose correlated programs were overexpressed specifically in aneuploid PA compared to other glial tumors. Thus, convergence of pathways affecting the cell cycle and genomic stability may favor aneuploidy in PA, possibly representing an additional molecular driver in older patients with this brain tumor.
Collapse
Affiliation(s)
- Adam M Fontebasso
- Division of Experimental Medicine, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| | - Margret Shirinian
- Department of Experimental Pathology, Immunology and Microbiology, American University Of Beirut, Beirut, Lebanon
| | - Dong-Anh Khuong-Quang
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| | - Denise Bechet
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| | - Tenzin Gayden
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| | - Marcel Kool
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| | - Nicolas De Jay
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| | - Karine Jacob
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| | - Noha Gerges
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| | - Barbara Hutter
- Division of Theoretical Bioinformatics, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Huriye Şeker-Cin
- Division of Pediatric Neurooncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Hendrik Witt
- Division of Pediatric Neurooncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology and Immunology, University of Heidelberg, Heidelberg, Germany
| | - Alexandre Montpetit
- McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Sébastien Brunet
- McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Pierre Lepage
- McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Geneviève Bourret
- McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Almos Klekner
- Department of Neurosurgery, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - László Bognár
- Department of Neurosurgery, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Peter Hauser
- 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Miklós Garami
- 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Jean-Pierre Farmer
- Department of Neurosurgery, Montreal Children's Hospital and McGill University Health Centre, Montreal, Canada
| | - Jose-Luis Montes
- Department of Neurosurgery, Montreal Children's Hospital and McGill University Health Centre, Montreal, Canada
| | - Jeffrey Atkinson
- Department of Neurosurgery, Montreal Children's Hospital and McGill University Health Centre, Montreal, Canada
| | - Sally Lambert
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Tony Kwan
- McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Andrey Korshunov
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Uri Tabori
- Division of Pediatric Hematology-Oncology and The Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Canada
| | - V Peter Collins
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Steffen Albrecht
- Department of Pathology, Montreal Children's Hospital and McGill University Health Centre, Montreal, Canada
| | - Damien Faury
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| | - Stefan M Pfister
- Division of Pediatric Neurooncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology and Immunology, University of Heidelberg, Heidelberg, Germany
| | - Werner Paulus
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - David T W Jones
- Division of Pediatric Neurooncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Nada Jabado
- Division of Experimental Medicine, McGill University and McGill University Health Centre, Montreal, Quebec, Canada.,Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada
| |
Collapse
|
26
|
Carradori D, Gaudin A, Brambilla D, Andrieux K. Application of Nanomedicine to the CNS Diseases. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2016; 130:73-113. [PMID: 27678175 DOI: 10.1016/bs.irn.2016.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Drug delivery to the brain is a challenge because of the many mechanisms that protect the brain from the entry of foreign substances. Numerous molecules which could be active against brain disorders are not clinically useful due to the presence of the blood-brain barrier. Nanoparticles can be used to deliver these drugs to the brain. Encapsulation within colloidal systems can allow the passage of nontransportable drugs across this barrier by masking their physicochemical properties. It should be noted that the status of the blood-brain barrier is different depending on the brain disease. In fact, in some pathological situations such as tumors or inflammatory disorders, its permeability is increased allowing very easy translocation of carriers. This chapter gathers the promising results obtained by using nanoparticles as drug delivery systems with the aim to improve the therapy of some CNS diseases such as brain tumor, Alzheimer's disease, and stroke. The data show that several approaches can be investigated: (1) carrying drug through a permeabilized barrier, (2) crossing the barrier thanks to receptor-mediated transcytosis pathway in order to deliver drug into the brain parenchyma, and also (3) targeting and treating the endothelial cells themselves to preserve locally the brain tissue. The examples given in this chapter contribute to demonstrate that delivering drugs into the brain is one of the most promising applications of nanotechnology in clinical neuroscience.
Collapse
Affiliation(s)
- D Carradori
- Advanced Drug Delivery and Biomaterials, Louvain Drug Research Institute, Université catholique de Louvain, Bruxelles, Belgium
| | - A Gaudin
- Yale University, New Haven, CT, United States
| | - D Brambilla
- Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland
| | - K Andrieux
- Université Paris Descartes, Université Paris-Sorbonne, UTCBS, UMR CNRS 8258, UE1022 INSERM, Paris, France.
| |
Collapse
|
27
|
Hong JF, Song YF, Liu Z, Zheng ZC, Chen HJ, Wang SS. Anticancer activity of taraxerol acetate in human glioblastoma cells and a mouse xenograft model via induction of autophagy and apoptotic cell death, cell cycle arrest and inhibition of cell migration. Mol Med Rep 2016; 13:4541-8. [PMID: 27081915 PMCID: PMC4878554 DOI: 10.3892/mmr.2016.5105] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 01/22/2016] [Indexed: 01/23/2023] Open
Abstract
The aim of the present study was to investigate the in vitro and in vivo anticancer and apoptotic effects of taraxerol acetate in U87 human glioblastoma cells. The effects on cell cycle phase distribution, cell cycle-associated proteins, autophagy, DNA fragmentation and cell migration were assessed. Cell viability was determined using the MTT assay, and phase contrast and fluorescence microscopy was utilized to determine the viability and apoptotic morphological features of the U87 cells. Flow cytometry using propidium iodide and Annexin V-fluorescein isothiocyanate demonstrated the effect of taraxerol acetate on the cell cycle phase distribution and apoptosis induction. Western blot analysis was performed to investigate the effect of the taraxerol acetate on cell cycle-associated proteins and autophagy-linked LC3B-II proteins. The results demonstrated that taraxerol acetate induced dose- and time-dependent cytotoxic effects in the U87 cells. Apoptotic induction following taraxerol acetate treatment was observed and the percentage of apoptotic cells increased from 7.3% in the control cells, to 16.1, 44.1 and 76.7% in the 10, 50 and 150 µM taraxerol acetate-treated cells, respectively. Furthermore, taraxerol acetate treatment led to sub-G1 cell cycle arrest with a corresponding decrease in the number of S-phase cells. DNA fragments were observed as a result of the gel electrophoresis experiment following taraxerol acetate treatment. To investigate the inhibitory effects of taraxerol acetate on the migration of U87 cell, a wound healing assay was conducted. The number of cells that migrated to the scratched area decreased significantly following treatment with taraxerol acetate. In addition, taraxerol acetate inhibited tumor growth in a mouse xenograft model. Administration of 0.25 and 0.75 µg/g taraxerol acetate reduced the tumor weight from 1.2 g in the phosphate-buffered saline (PBS)-treated group (control) to 0.81 and 0.42 g, respectively. Similarly, 0.25 and 0.75 µg/g taraxerol acetate injection reduced the tumor volume from 1.3 cm3 in the PBS-treated group (control) to 0.67 and 0.25 cm3, respectively.
Collapse
Affiliation(s)
- Jing-Fang Hong
- Department of Neurosurgery, Fuzhou General Hospital of Nanjing Military Command, Dongfang Hospital, Xiamen University, Fuzhou, Fujian 350025, P.R. China
| | - Ying-Fang Song
- Department of Pulmonary and Critical Care Medicine, Fuzhou General Hospital of Nanjing Military Command, Dongfang Hospital, Xiamen University, Fuzhou, Fujian 350025, P.R. China
| | - Zheng Liu
- Department of Neurosurgery, Fuzhou General Hospital of Nanjing Military Command, Dongfang Hospital, Xiamen University, Fuzhou, Fujian 350025, P.R. China
| | - Zhao-Cong Zheng
- Department of Neurosurgery, Fuzhou General Hospital of Nanjing Military Command, Dongfang Hospital, Xiamen University, Fuzhou, Fujian 350025, P.R. China
| | - Hong-Jie Chen
- Department of Neurosurgery, Fuzhou General Hospital of Nanjing Military Command, Dongfang Hospital, Xiamen University, Fuzhou, Fujian 350025, P.R. China
| | - Shou-Sen Wang
- Department of Neurosurgery, Fuzhou General Hospital of Nanjing Military Command, Dongfang Hospital, Xiamen University, Fuzhou, Fujian 350025, P.R. China
| |
Collapse
|
28
|
D'Asti E, Chennakrishnaiah S, Lee TH, Rak J. Extracellular Vesicles in Brain Tumor Progression. Cell Mol Neurobiol 2016; 36:383-407. [PMID: 26993504 DOI: 10.1007/s10571-015-0296-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/24/2015] [Indexed: 12/18/2022]
Abstract
Brain tumors can be viewed as multicellular 'ecosystems' with increasingly recognized cellular complexity and systemic impact. While the emerging diversity of malignant disease entities affecting brain tissues is often described in reference to their signature alterations within the cellular genome and epigenome, arguably these cell-intrinsic changes can be regarded as hardwired adaptations to a variety of cell-extrinsic microenvironmental circumstances. Conversely, oncogenic events influence the microenvironment through their impact on the cellular secretome, including emission of membranous structures known as extracellular vesicles (EVs). EVs serve as unique carriers of bioactive lipids, secretable and non-secretable proteins, mRNA, non-coding RNA, and DNA and constitute pathway(s) of extracellular exit of molecules into the intercellular space, biofluids, and blood. EVs are also highly heterogeneous as reflected in their nomenclature (exosomes, microvesicles, microparticles) attempting to capture their diverse origin, as well as structural, molecular, and functional properties. While EVs may act as a mechanism of molecular expulsion, their non-random uptake by heterologous cellular recipients defines their unique roles in the intercellular communication, horizontal molecular transfer, and biological activity. In the central nervous system, EVs have been implicated as mediators of homeostasis and repair, while in cancer they may act as regulators of cell growth, clonogenicity, angiogenesis, thrombosis, and reciprocal tumor-stromal interactions. EVs produced by specific brain tumor cell types may contain the corresponding oncogenic drivers, such as epidermal growth factor receptor variant III (EGFRvIII) in glioblastoma (and hence are often referred to as 'oncosomes'). Through this mechanism, mutant oncoproteins and nucleic acids may be transferred horizontally between cellular populations altering their individual and collective phenotypes. Oncogenic pathways also impact the emission rates, types, cargo, and biogenesis of EVs, as reflected by preliminary analyses pointing to differences in profiles of EV-regulating genes (vesiculome) between molecular subtypes of glioblastoma, and in other brain tumors. Molecular regulators of vesiculation can also act as oncogenes. These intimate connections suggest the context-specific roles of different EV subsets in the progression of specific brain tumors. Advanced efforts are underway to capture these events through the use of EVs circulating in biofluids as biomarker reservoirs and to guide diagnostic and therapeutic decisions.
Collapse
Affiliation(s)
- Esterina D'Asti
- RI MUHC, Montreal Children's Hospital, McGill University, 1001 Decarie Blvd, E M1 2244, Montreal, QC, H4A 3J1, Canada
| | - Shilpa Chennakrishnaiah
- RI MUHC, Montreal Children's Hospital, McGill University, 1001 Decarie Blvd, E M1 2244, Montreal, QC, H4A 3J1, Canada
| | - Tae Hoon Lee
- RI MUHC, Montreal Children's Hospital, McGill University, 1001 Decarie Blvd, E M1 2244, Montreal, QC, H4A 3J1, Canada
| | - Janusz Rak
- RI MUHC, Montreal Children's Hospital, McGill University, 1001 Decarie Blvd, E M1 2244, Montreal, QC, H4A 3J1, Canada.
| |
Collapse
|
29
|
von Bueren AO, Friedrich C, von Hoff K, Kwiecien R, Müller K, Pietsch T, Warmuth-Metz M, Hau P, Benesch M, Kuehl J, Kortmann RD, Rutkowski S. Metastatic medulloblastoma in adults: outcome of patients treated according to the HIT2000 protocol. Eur J Cancer 2015; 51:2434-43. [PMID: 26254812 DOI: 10.1016/j.ejca.2015.06.124] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 06/16/2015] [Accepted: 06/19/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Due to the rarity of metastatic medulloblastoma in adults, knowledge about the efficacy and toxicity of intensified chemotherapy and radiotherapy is limited. PATIENTS AND METHODS Adults with disseminated medulloblastoma registered in the HIT2000 trial as observational patients and treated according to one of two different treatment regimens were analysed. The sandwich strategy MET-HIT2000AB4 consists of postoperative chemotherapy, hyperfractionated craniospinal radiotherapy, and maintenance chemotherapy; while the HIT'91 maintenance strategy consists of postoperative craniospinal radiotherapy, and maintenance chemotherapy. RESULTS Twenty-three patients (median age: 30.7years), diagnosed from November 2001 to July 2009, and treated in 18 institutions in Germany and Austria, were eligible. The median follow-up of surviving patients was 3.99years. The 4-year event-free survival (EFS) and overall survival (OS)±standard error (SE) were 52%±12% and 91%±6%, respectively. The survival was similar in both treatment groups (HIT'91 maintenance strategy, n=9; MET-HIT2000AB4 sandwich strategy, n=14). Patients with large cell/anaplastic medulloblastoma relapsed and died (n=2; 4-year EFS/OS: 0%) and OS differed compared to patients with classic (n=11; 4-year EFS/OS: 71%/91%) and desmoplastic medulloblastoma (n=10; 4-year EFS/OS: 48%/100%), respectively (p=0.161 for EFS and p=0.033 for OS). Treatment-induced toxicities consisted mainly of neurotoxicity (50% of patients, ⩾ °II), followed by haematotoxicity and nephrotoxicity/ototoxicity. The professional outcome appeared to be negatively affected in the majority of evaluable patients (9/10). CONCLUSIONS Treatment of adults with metastatic medulloblastoma according to the intensified paediatric HIT2000 protocol was feasible with acceptable toxicities. EFS rates achieved by both chemotherapeutic protocols were favourable and appear to be inferior to those obtained in older children/adolescents with metastatic disease.
Collapse
Affiliation(s)
- André O von Bueren
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Germany; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University Medical Center Goettingen, Germany.
| | - Carsten Friedrich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Germany; Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Woman's and Children's Health, University Hospital Leipzig, Leipzig, Germany
| | - Katja von Hoff
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Germany
| | - Robert Kwiecien
- Institute of Biostatistics and Clinical Research, University of Muenster, Germany
| | - Klaus Müller
- Department of Radiation Oncology, University Medical Center of Leipzig, Germany
| | | | | | - Peter Hau
- Department of Neurology, University Medical Center Regensburg, Regensburg, Germany
| | - Martin Benesch
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Austria
| | - Joachim Kuehl
- Department of Pediatrics, University of Wuerzburg, Germany
| | - Rolf D Kortmann
- Department of Radiation Oncology, University Medical Center of Leipzig, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Germany
| |
Collapse
|
30
|
Gunn ME, Malila N, Lähdesmäki T, Arola M, Grönroos M, Matomäki J, Lähteenmäki PM. Late new morbidity in survivors of adolescent and young-adulthood brain tumors in Finland: a registry-based study. Neuro Oncol 2015; 17:1412-8. [PMID: 26136494 DOI: 10.1093/neuonc/nov115] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 05/28/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Brain tumors (BTs) in adolescence and young adulthood (AYA) differ from those in childhood or late adulthood. However, research concerning late effects in this particular survivor group is limited. This study evaluates late morbidity of survivors diagnosed in AYAs. METHODS We identified from the Finnish Cancer Registry all survivors diagnosed with BT at the ages 16-24 years between 1970 and 2004 (N = 315) and used data from the Hospital Discharge Registry to evaluate their late (≥5 y after diagnosis) morbidity requiring treatment in a specialized health care setting. A sibling cohort of BT patients diagnosed before the age of 25 years was used as a comparison cohort (N = 3615). RESULTS The AYA BT survivors had an increased risk for late-appearing endocrine diseases (HR, 2.9; 95% CI, 1.1-8.0), psychiatric disorders (HR, 2.0; 95% CI, 1.2-3.2), diseases of the nervous system (HR, 9; 95% CI, 6.6-14.0), disorders of vision/hearing loss (HR, 3.6; 95% CI, 1.5-8.5), diseases of the circulatory system (HR, 4.9; 95% CI, 2.9-8.1), and diseases of the kidney (HR, 5.9; 95% CI, 2.5-14.1). Survivors with irradiation had an increased risk for diseases of the nervous system compared with non-irradiated survivors (HR, 3.3; 95% CI, 1.8-6.2). The cumulative prevalence for most of the diagnoses remained significantly increased for survivors even 20 years after cancer diagnosis. CONCLUSIONS The AYA BT survivors have an increased risk of morbidity for multiple new outcomes for ≥5 years after their primary diagnosis. This emphasizes the need for structured late-effect follow-up for this patient group.
Collapse
Affiliation(s)
- Mirja Erika Gunn
- Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.)
| | - Nea Malila
- Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.)
| | - Tuire Lähdesmäki
- Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.)
| | - Mikko Arola
- Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.)
| | - Marika Grönroos
- Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.)
| | - Jaakko Matomäki
- Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.)
| | - Päivi Maria Lähteenmäki
- Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.)
| |
Collapse
|
31
|
Arnautovic A, Billups C, Broniscer A, Gajjar A, Boop F, Qaddoumi I. Delayed diagnosis of childhood low-grade glioma: causes, consequences, and potential solutions. Childs Nerv Syst 2015; 31:1067-77. [PMID: 25742877 PMCID: PMC4496265 DOI: 10.1007/s00381-015-2670-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 02/23/2015] [Indexed: 12/31/2022]
Abstract
PURPOSE Diagnosis of childhood brain tumors is delayed more than diagnosis of other pediatric cancers. However, the contribution of the most common pediatric brain tumors, lowgrade gliomas (LGG), to this delay has never been investigated. METHODS We retrospectively reviewed cases of childhood LGG diagnosed from January 1995 through December 2005 at our institution. The pre-diagnosis symptom interval (PSI) was conservatively calculated, and its association with race, sex, age, tumor site, tumor grade, and outcome measures (survival, disease progression, shunt use, seizures, extent of resection) was analyzed. Cases of neurofibromatosis type 1 were reported separately. RESULTS The 258 children had a median follow-up of 11.1 years, and 226 (88 %) remained alive. Greater pre-diagnosis symptom interval (PSI) was significantly associated with grade I (vs. grade II) tumors (p = 0.03) and age >10 years at diagnosis (p = 0.03). Half of the 16 spinal tumors had a PSI > 6 months. PSI was significantly associated with progression (p = 0.02) in grade I tumors (n = 195) and in grade I tumors outside the posterior fossa (n = 134, p = 0.03). Among children with grade I tumors, median PSI was longer in those who had seizures (10.3 months) than in those who did not (2.5 months) (p = 0.09). CONCLUSIONS Delayed diagnosis of childhood LGG allows tumor progression. To reduce time to diagnosis, medical curricula should emphasize inclusion of LGG in the differential diagnosis of CNS neoplasm.
Collapse
Affiliation(s)
- Aska Arnautovic
- Pediatric Oncology Education Program, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Catherine Billups
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Alberto Broniscer
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN 38105
| | - Amar Gajjar
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN 38105
| | - Frederick Boop
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN 38105
| |
Collapse
|
32
|
Ahomäki R, Gunn ME, Madanat-Harjuoja LM, Matomäki J, Malila N, Lähteenmäki PM. Late psychiatric morbidity in survivors of cancer at a young age: A nationwide registry-based study. Int J Cancer 2014; 137:183-92. [DOI: 10.1002/ijc.29371] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 11/18/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Ritva Ahomäki
- Department of Pediatrics; Turku University Hospital; Turku Finland
| | - Mirja E. Gunn
- Department of Pediatrics; Turku University Hospital; Turku Finland
| | | | | | - Nea Malila
- Finnish Cancer Registry; Helsinki Finland
- School of Health Sciences; University of Tampere; Tampere Finland
| | | |
Collapse
|
33
|
Epigenetic dysregulation: a novel pathway of oncogenesis in pediatric brain tumors. Acta Neuropathol 2014; 128:615-27. [PMID: 25077668 PMCID: PMC4201756 DOI: 10.1007/s00401-014-1325-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/07/2014] [Accepted: 07/19/2014] [Indexed: 12/21/2022]
Abstract
A remarkably large number of "epigenetic regulators" have been recently identified to be altered in cancers and a rapidly expanding body of literature points to "epigenetic addiction" (an aberrant epigenetic state to which a tumor is addicted) as a new previously unsuspected mechanism of oncogenesis. Although mutations are also found in canonical signaling pathway genes, we and others identified chromatin-associated proteins to be more commonly altered by somatic alterations than any other class of oncoprotein in several subgroups of childhood high-grade brain tumors. Furthermore, as these childhood malignancies carry fewer non-synonymous somatic mutations per case in contrast to most adult cancers, these mutations are likely drivers in these tumors. Herein, we will use as examples of this novel hallmark of oncogenesis high-grade astrocytomas, including glioblastoma, and a subgroup of embryonal tumors, embryonal tumor with multilayered rosettes (ETMR) to describe the novel molecular defects uncovered in these deadly tumors. We will further discuss evidence for their profound effects on the epigenome. The relative genetic simplicity of these tumors promises general insights into how mutations in the chromatin machinery modify downstream epigenetic signatures to drive transformation, and how to target this plastic genetic/epigenetic interface.
Collapse
|
34
|
Roth JJ, Santi M, Pollock AN, Harding BN, Rorke-Adams LB, Tooke LS, Biegel JA. Chromosome band 7q34 deletions resulting in KIAA1549-BRAF and FAM131B-BRAF fusions in pediatric low-grade Gliomas. Brain Pathol 2014; 25:182-92. [PMID: 25040262 DOI: 10.1111/bpa.12167] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 06/18/2014] [Indexed: 12/21/2022] Open
Abstract
The majority of pediatric low-grade gliomas (LGGs) are characterized by constitutive activation of the mitogen-activated protein kinase (MAPK) pathway through various mechanisms including BRAF mutations, inactivation of NF1, and KIAA1549-BRAF and FAM131B-BRAF fusions. The KIAA1549-BRAF fusion typically results from a 2.0 Mb tandem duplication in chromosome band 7q34. In the present study, single nucleotide polymorphism (SNP)-based array analysis of three LGGs demonstrated deletions in 7q34 that resulted in a BRAF fusion. Case 1 was likely a pilocytic astrocytoma (PA) with three deletions in 7q33q34 and an exon 15-9 KIAA1549-BRAF fusion. SNP array analysis of case 2, a possible dysembryoplastic neuroepithelial tumor (DNT), revealed a 2.6 Mb deletion, which included the 5' end of BRAF and extended to the 3' end of FAM131B. In case 3, deletions involving BRAF and FAM131B were observed in both a primary and a recurrent PA. RNA-based sequence analysis of cases 2 and 3 confirmed a fusion between FAM131B exon 2 and BRAF exon 9. The presence of fusion transcripts in these three LGGs highlights the utility of SNP array analysis to identify deletions that are suggestive of fusion proteins. BRAF fusions can result from multiple non-overlapping deletions, suggesting various complex mechanisms of formation.
Collapse
Affiliation(s)
- Jacquelyn J Roth
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | | | | | | | | | | | | |
Collapse
|
35
|
Bhujbal SV, de Vos P, Niclou SP. Drug and cell encapsulation: alternative delivery options for the treatment of malignant brain tumors. Adv Drug Deliv Rev 2014; 67-68:142-53. [PMID: 24491927 DOI: 10.1016/j.addr.2014.01.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 01/18/2014] [Accepted: 01/23/2014] [Indexed: 01/13/2023]
Abstract
Malignant brain tumors including glioblastoma are incurable cancers. Over the last years a number of promising novel treatment approaches have been investigated including the application of inhibitors of receptor tyrosine kinases and downstream targets, immune-based therapies and anti-angiogenic agents. Unfortunately so far the major clinical trials in glioblastoma patients did not deliver clear clinical benefits. Systemic brain tumor therapy is seriously hampered by poor drug delivery to the brain. Although in glioblastoma, the blood brain barrier is disrupted in the tumor core, the major part of the tumor is largely protected by an intact blood brain barrier. Active cytotoxic compounds encapsulated into liposomes, micelles, and nanoparticles constitute novel treatment options because they can be designed to facilitate entry into the brain parenchyma. In the case of biological therapeutics, encapsulation of therapeutic cells and their implantation into the surgical cavity represents another promising approach. This technology provides long term release of the active compound at the tumor site and reduces side effects associated with systemic delivery. The proof of principle of encapsulated cell factories has been successfully demonstrated in experimental animal models and should pave the way for clinical application. Here we review the challenges associated with the treatment of brain tumors and the different encapsulation options available for drugs and living cells, with an emphasis on alginate based cell encapsulation technology.
Collapse
|
36
|
Roth JJ, Santi M, Rorke-Adams LB, Harding BN, Busse TM, Tooke LS, Biegel JA. Diagnostic application of high resolution single nucleotide polymorphism array analysis for children with brain tumors. Cancer Genet 2014; 207:111-23. [PMID: 24767714 DOI: 10.1016/j.cancergen.2014.03.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 03/09/2014] [Accepted: 03/10/2014] [Indexed: 12/21/2022]
Abstract
Single nucleotide polymorphism (SNP) array analysis is currently used as a first tier test for pediatric brain tumors at The Children's Hospital of Philadelphia. The results from 100 consecutive patients are summarized in the present report. Eighty-seven percent of the tumors had at least one pathogenic copy number alteration. Nineteen of 56 low grade gliomas (LGGs) demonstrated a duplication in 7q34, which resulted in a KIAA1549-BRAF fusion. Chromosome band 7q34 deletions, which resulted in a FAM131B-BRAF fusion, were identified in one pilocytic astrocytoma (PA) and one dysembryoplastic neuroepithelial tumor (DNT). One ganglioglioma (GG) demonstrated a 6q23.3q26 deletion that was predicted to result in a MYB-QKI fusion. Gains of chromosomes 5, 6, 7, 11, and 20 were seen in a subset of LGGs. Monosomy 6, deletion of 9q and 10q, and an i(17)(q10) were each detected in the medulloblastomas (MBs). Deletions and regions of loss of heterozygosity that encompassed TP53, RB1, CDKN2A/B, CHEK2, NF1, and NF2 were identified in a variety of tumors, which led to a recommendation for germline testing. A BRAF p.Thr599dup or p.V600E mutation was identified by Sanger sequencing in one and five gliomas, respectively, and a somatic TP53 mutation was identified in a fibrillary astrocytoma. No TP53 hot-spot mutations were detected in the MBs. SNP array analysis of pediatric brain tumors can be combined with pathologic examination and molecular analyses to further refine diagnoses, offer more accurate prognostic assessments, and identify patients who should be referred for cancer risk assessment.
Collapse
Affiliation(s)
- Jacquelyn J Roth
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA.
| | - Mariarita Santi
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Lucy B Rorke-Adams
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Brian N Harding
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Tracy M Busse
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Laura S Tooke
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jaclyn A Biegel
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
| |
Collapse
|
37
|
Bandopadhayay P, Bergthold G, Nguyen B, Schubert S, Gholamin S, Tang Y, Bolin S, Schumacher SE, Zeid R, Masoud S, Yu F, Vue N, Gibson WJ, Paolella BR, Mitra S, Cheshier S, Qi J, Liu KW, Wechsler-Reya R, Weiss WA, Swartling FJ, Kieran MW, Bradner JE, Beroukhim R, Cho YJ. BET bromodomain inhibition of MYC-amplified medulloblastoma. Clin Cancer Res 2014; 20:912-25. [PMID: 24297863 PMCID: PMC4198154 DOI: 10.1158/1078-0432.ccr-13-2281] [Citation(s) in RCA: 270] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE MYC-amplified medulloblastomas are highly lethal tumors. Bromodomain and extraterminal (BET) bromodomain inhibition has recently been shown to suppress MYC-associated transcriptional activity in other cancers. The compound JQ1 inhibits BET bromodomain-containing proteins, including BRD4. Here, we investigate BET bromodomain targeting for the treatment of MYC-amplified medulloblastoma. EXPERIMENTAL DESIGN We evaluated the effects of genetic and pharmacologic inhibition of BET bromodomains on proliferation, cell cycle, and apoptosis in established and newly generated patient- and genetically engineered mouse model (GEMM)-derived medulloblastoma cell lines and xenografts that harbored amplifications of MYC or MYCN. We also assessed the effect of JQ1 on MYC expression and global MYC-associated transcriptional activity. We assessed the in vivo efficacy of JQ1 in orthotopic xenografts established in immunocompromised mice. RESULTS Treatment of MYC-amplified medulloblastoma cells with JQ1 decreased cell viability associated with arrest at G1 and apoptosis. We observed downregulation of MYC expression and confirmed the inhibition of MYC-associated transcriptional targets. The exogenous expression of MYC from a retroviral promoter reduced the effect of JQ1 on cell viability, suggesting that attenuated levels of MYC contribute to the functional effects of JQ1. JQ1 significantly prolonged the survival of orthotopic xenograft models of MYC-amplified medulloblastoma (P < 0.001). Xenografts harvested from mice after five doses of JQ1 had reduced the expression of MYC mRNA and a reduced proliferative index. CONCLUSION JQ1 suppresses MYC expression and MYC-associated transcriptional activity in medulloblastomas, resulting in an overall decrease in medulloblastoma cell viability. These preclinical findings highlight the promise of BET bromodomain inhibitors as novel agents for MYC-amplified medulloblastoma.
Collapse
Affiliation(s)
- Pratiti Bandopadhayay
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
- Pediatric Neuro-Oncology, Department of Pediatric Oncology, Dana-Farber Cancer Institute and Division of Pediatric Hematology/Oncology, Boston Children’s Hospital, Boston, MA USA
- The Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Guillaume Bergthold
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
- The Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Brian Nguyen
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA USA
| | - Simone Schubert
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA USA
| | - Sharareh Gholamin
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA USA
| | - Yujie Tang
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA USA
| | - Sara Bolin
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - Steven E Schumacher
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
- The Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Rhamy Zeid
- Department of Medical Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
| | - Sabran Masoud
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA USA
| | - Furong Yu
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA USA
| | - Nujsaubnusi Vue
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA USA
| | - William J Gibson
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
- The Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Brenton R Paolella
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
- The Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Siddharta Mitra
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA USA
| | - Samuel Cheshier
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA USA
| | - Jun Qi
- Department of Medical Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
| | - Kun-Wei Liu
- Tumor Initiation and Maintenance Program, NCI-Designated Cancer Center, Sanford-Burnham Medical Research Institute, La Jolla, CA USA
| | - Robert Wechsler-Reya
- Tumor Initiation and Maintenance Program, NCI-Designated Cancer Center, Sanford-Burnham Medical Research Institute, La Jolla, CA USA
| | - William A Weiss
- Departments of Neurology, Pediatrics and Neurosurgery, University of California, San Francisco, CA USA
| | - Fredrik J Swartling
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden
| | - Mark W Kieran
- Pediatric Neuro-Oncology, Department of Pediatric Oncology, Dana-Farber Cancer Institute and Division of Pediatric Hematology/Oncology, Boston Children’s Hospital, Boston, MA USA
| | - James E Bradner
- Department of Medical Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
- The Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Rameen Beroukhim
- Department of Cancer Biology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA USA
- Center for Cancer Genome Characterization, Dana-Farber Cancer Institute, Boston, MA USA
- The Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Yoon-Jae Cho
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA USA
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA USA
- Stanford Cancer Institute, Stanford University Medical Center, Stanford, CA USA
| |
Collapse
|
38
|
Alentorn A, Sanson M, Mokhtari K, Marie Y, Hoang-Xuan K, Delattre JY, Idbaih A. Insights revealed by high-throughput genomic arrays in nonglial primary brain tumors. Expert Rev Mol Diagn 2014; 12:265-77. [DOI: 10.1586/erm.12.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
39
|
Are pediatric brain tumors on the rise in the USA? Significant incidence and survival findings from the SEER database analysis. Childs Nerv Syst 2014; 30:147-54. [PMID: 24162619 DOI: 10.1007/s00381-013-2307-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 10/09/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Central nervous system tumors are the second most common form of cancer in children between the ages of 1 and 19 years. We aimed to provide the most recent data on the incidence and survival of these tumors in the USA and to assess the literature. METHODS Frequency, rates, and survival sessions were calculated using the November 2008 submission for the US Surveillance Epidemiology and End Results Program. Data were collected and analyzed for children and adolescents aged 1 to 19 years with primary brain tumors. RESULTS We found that the incidence rate of all pediatric brain tumors has been on a gradual but steady increase from 1973 to 2008 (p < 0.001). The average annual increase was 1.37 %. Our survival analysis of the individual tumors revealed that the 5-year overall survival for children diagnosed between 1974 and 1978 with medulloblastoma was 43.7 %. However, this increased to 62.8 % for children diagnosed between 1999 and 2003. A similar survival trend was also observed when all the other pediatric brain cancer histologies were collectively analyzed (p < 0.001). CONCLUSIONS From our study, we can conclude that contrary to previous reports indicating a plateau in the incidence rates of pediatric brain tumors since the mid-1980s, there has been an increase from 1973 to 2008. Potential causes include environmental carcinogens, but more research is needed to investigate the factors behind this sustained rise in incidence over the years.
Collapse
|
40
|
|
41
|
Epelman S. The adolescent and young adult with cancer: state of the art--brain tumor. Curr Oncol Rep 2013; 15:308-16. [PMID: 23737251 DOI: 10.1007/s11912-013-0329-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The management of adolescents and young adults with brain tumors, which consist of many different histologic subtypes, continues to be a challenge. Better outcome with a decrease of the side effects of the disease and therapy and improvement of quality of life has been demonstrated in recent decades for some tumors. Significant differences in survival and cure are also observed between adult and pediatric tumors of the same histologic grade. Genetic, developmental, and environmental factors likely influence the type of tumor and response observed, even though no clear pathologic features differentiate these lesions among children, adolescents, and adults. Similarly, treatment strategies are not identical among these populations; most patients receive surgery, followed by radiation therapy and multiagent chemotherapy. Advances in understanding the biology underlying the distribution of tumors in adolescents and young adults may influence the development of prospective trials. A more individualized view of these tumors will likely influence stratification of patients in future studies as well as selection for targeted agents. Accordingly, outcomes may improve and long-term morbidities may decrease.
Collapse
Affiliation(s)
- Sidnei Epelman
- Pediatric Oncology Department, Santa Marcelina Hospital, São Paulo, Brazil.
| |
Collapse
|
42
|
Fontebasso AM, Liu XY, Sturm D, Jabado N. Chromatin remodeling defects in pediatric and young adult glioblastoma: a tale of a variant histone 3 tail. Brain Pathol 2013; 23:210-6. [PMID: 23432647 DOI: 10.1111/bpa.12023] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 12/29/2012] [Indexed: 12/26/2022] Open
Abstract
Primary brain tumors occur in 8 out of 100 000 people and are the leading cause of cancer-related death in children. Among brain tumors, high-grade astrocytomas (HGAs) including glioblastoma multiforme (GBM) are aggressive and are lethal human cancers. Despite decades of concerted therapeutic efforts, HGAs remain essentially incurable in adults and children. Recent discoveries have revolutionized our understanding of these tumors in children and young adults. Recurrent somatic driver mutations in the tail of histone 3 variant 3 (H3.3), leading to amino acid substitutions at key residues, namely lysine (K) 27 (K27M) and glycine 34 (G34R/G34V), were identified as a new molecular mechanism in pediatric GBM. These mutations represent the pediatric counterpart of the recurrent mutations in isocitrate dehydrogenases (IDH) identified in young adult gliomas and provide a much-needed new pathway that can be targeted for therapeutic development. This review will provide an overview of the potential role of these mutations in altering chromatin structure and affecting specific molecular pathways ultimately leading to gliomagenesis. The distinct changes in chromatin structure and the specific downstream events induced by each mutation need characterizing independently if progress is to be made in tackling this devastating cancer.
Collapse
Affiliation(s)
- Adam M Fontebasso
- Division of Experimental Medicine, McGill University and McGill University Health Centre, Montreal, QC, Canada
| | | | | | | |
Collapse
|
43
|
Ach E, Gerhardt CA, Barrera M, Kupst MJ, Meyer EA, Patenaude AF, Vannatta K. Family factors associated with academic achievement deficits in pediatric brain tumor survivors. Psychooncology 2013; 22:1731-7. [PMID: 23059621 PMCID: PMC3574177 DOI: 10.1002/pon.3202] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 08/31/2012] [Accepted: 09/08/2012] [Indexed: 11/08/2022]
Abstract
PURPOSE The purpose of this study is to examine whether parental education, socioeconomic status, or family environment moderate the extent of academic achievement deficits in pediatric brain tumor survivors (PBTS) relative to classmate case-controls. PBTS are known to be at risk for cognitive and academic impairment; however, the degree of impairment varies. Prior research has focused on treatment risk, and efforts to examine the protective role of family resources and relationships have been lacking. METHODS Pediatric brain tumor survivors (N = 164), ages 8-15 and 1-5 years posttreatment, were recruited at five treatment centers in the United States and Canada. A case-control classmate, matched for age, gender, and race, was recruited for each survivor. The Wide Range Achievement Test, a demographic form, and the Family Environment Scale were administered in families' homes. Treatment data were abstracted from medical charts. RESULTS Pediatric brain tumor survivors demonstrated lower achievement than classmate-controls in reading, spelling, and arithmetic. Parental education and socioeconomic status were associated with levels of achievement demonstrated by PBTS but did not account for discrepancies between PBTS and classmate-controls. Deficits in achievement relative to classmate-controls, across all academic domains, were greater for survivors in families lower in support and higher in conflict. These associations remained after controlling for age at diagnosis, time since treatment, and whether treatment had involved chemotherapy, focal, or whole brain radiation. CONCLUSIONS These results support the development of interventions to enhance family functioning as well as educational resources as part of intervention and rehabilitation services to optimize academic progress in children who have been treated for brain tumors.
Collapse
Affiliation(s)
- Emily Ach
- The Research Institute at Nationwide Children’s Hospital and The Ohio State University
| | - Cynthia A. Gerhardt
- The Research Institute at Nationwide Children’s Hospital and The Ohio State University
| | | | - Mary Jo Kupst
- Children’s Hospital Milwaukee and the Medical College of Wisconsin
| | | | | | - Kathryn Vannatta
- The Research Institute at Nationwide Children’s Hospital and The Ohio State University
| |
Collapse
|
44
|
Gerges N, Fontebasso AM, Albrecht S, Faury D, Jabado N. Pediatric high-grade astrocytomas: a distinct neuro-oncological paradigm. Genome Med 2013; 5:66. [PMID: 23906214 PMCID: PMC3979088 DOI: 10.1186/gm470] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Brain tumors are the leading cause of cancer-related death in children. High-grade astrocytomas (HGAs), in particular, are lethal in children across all ages. Integrative genome-wide analyses of the tumor's genome, transcriptome and epigenome, using next-generation sequencing technologies and genome-wide DNA methylation arrays, have provided valuable breakthroughs in our understanding of the pathogenesis of HGAs across all ages. Recent profiling studies have provided insight into the epigenetic nature of gliomas in young adults and HGAs in children, particularly with the identification of recurrent gain-of-function driver mutations in the isocitrate dehydrogenase 1 and 2 genes (IDH1/2) and the epigenetic influence of their oncometabolite 2-hydroxyglutarate, as well as mutations in the histone 3 variant 3 gene (H3F3A) and loss-of-function mutations in the histone 3 lysine 36 trimethyltransferase gene (SETD2). Mutations in H3F3A result in amino acid substitutions at residues thought to directly (K27M) or indirectly (G34R/V) affect histone post-translational modifications, suggesting they have the capacity to affect the epigenome in a profound manner. Here, we review recent genomic studies, and discuss evidence supporting the molecular characterization of pediatric HGAs to complement traditional approaches, such as histology of resected tumors. We also describe newly identified molecular mechanisms and discuss putative therapeutic approaches for HGAs specific to pediatrics, highlighting the necessity for the evolution of HGA disease management approaches.
Collapse
Affiliation(s)
- Noha Gerges
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3
| | - Adam M Fontebasso
- Division of Experimental Medicine, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3
| | - Steffen Albrecht
- Department of Pathology, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada, H3H1P3
| | - Damien Faury
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3
| | - Nada Jabado
- Departments of Pediatrics and Human Genetics, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3 ; Division of Experimental Medicine, McGill University and McGill University Health Centre, Montreal, Quebec, Canada, H3Z2Z3
| |
Collapse
|
45
|
Janeway KA, Place AE, Kieran MW, Harris MH. Future of Clinical Genomics in Pediatric Oncology. J Clin Oncol 2013; 31:1893-903. [DOI: 10.1200/jco.2012.46.8470] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The somatic genomic alterations in pediatric cancers to some extent overlap with those seen in adult cancers, but the exact distribution throughout the genome and the types and frequency of alterations differ. The ultimate goal of genomic research in children, as with adults, is translation to the clinic to achieve more accurate diagnosis, more precise risk stratification, and more effective, less toxic therapy. The genomic features of pediatric malignancies and pediatric-specific issues in clinical investigation may make translating genomic discoveries to the clinic more difficult. However, through large-scale molecular profiling of pediatric tumors, continued coordinated efforts to evaluate novel therapies in the pediatric population, thoughtful phase II and III trial design, and continued drug development, genomically based therapies will become more common in the pediatric oncology clinic in the future.
Collapse
Affiliation(s)
- Katherine A. Janeway
- Katherine A. Janeway, Andrew E. Place, and Mark W. Kieran, Dana-Farber Children's Hospital Cancer Center; and Marian H. Harris, Boston Children's Hospital, Boston, MA
| | - Andrew E. Place
- Katherine A. Janeway, Andrew E. Place, and Mark W. Kieran, Dana-Farber Children's Hospital Cancer Center; and Marian H. Harris, Boston Children's Hospital, Boston, MA
| | - Mark W. Kieran
- Katherine A. Janeway, Andrew E. Place, and Mark W. Kieran, Dana-Farber Children's Hospital Cancer Center; and Marian H. Harris, Boston Children's Hospital, Boston, MA
| | - Marian H. Harris
- Katherine A. Janeway, Andrew E. Place, and Mark W. Kieran, Dana-Farber Children's Hospital Cancer Center; and Marian H. Harris, Boston Children's Hospital, Boston, MA
| |
Collapse
|
46
|
Vrijens K, Lin W, Cui J, Farmer D, Low J, Pronier E, Zeng FY, Shelat AA, Guy K, Taylor MR, Chen T, Roussel MF. Identification of small molecule activators of BMP signaling. PLoS One 2013; 8:e59045. [PMID: 23527084 PMCID: PMC3602516 DOI: 10.1371/journal.pone.0059045] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 02/11/2013] [Indexed: 12/13/2022] Open
Abstract
Bone Morphogenetic Proteins (BMPs) are morphogens that play a major role in regulating development and homeostasis. Although BMPs are used for the treatment of bone and kidney disorders, their clinical use is limited due to the supra-physiological doses required for therapeutic efficacy causing severe side effects. Because recombinant BMPs are expensive to produce, small molecule activators of BMP signaling would be a cost-effective alternative with the added benefit of being potentially more easily deliverable. Here, we report our efforts to identify small molecule activators of BMP signaling. We have developed a cell-based assay to monitor BMP signaling by stably transfecting a BMP-responsive human cervical carcinoma cell line (C33A) with a reporter construct in which the expression of luciferase is driven by a multimerized BMP-responsive element from the Id1 promoter. A BMP-responsive clone C33A-2D2 was used to screen a bioactive library containing ∼5,600 small molecules. We identified four small molecules of the family of flavonoids all of which induced luciferase activity in a dose-dependent manner and ventralized zebrafish embryos. Two of the identified compounds induced Smad1, 5 phosphorylation (P-Smad), Id1 and Id2 expression in a dose-dependent manner demonstrating that our assays identified small molecule activators of BMP signaling.
Collapse
Affiliation(s)
- Karen Vrijens
- Departments of Tumor Cell Biology, Memphis, Tennessee, United States of America
| | - Wenwei Lin
- Chemical Biology and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
| | - Jimmy Cui
- Chemical Biology and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
| | - Dana Farmer
- Departments of Tumor Cell Biology, Memphis, Tennessee, United States of America
| | - Jonathan Low
- Chemical Biology and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
| | - Elodie Pronier
- Departments of Tumor Cell Biology, Memphis, Tennessee, United States of America
- Institut National de la Santé et de la Recherche Medicale, U1009, Institut Gustave Roussy, Villejuif, France
| | - Fu-Yue Zeng
- Chemical Biology and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
| | - Anang A. Shelat
- Chemical Biology and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
| | - Kiplin Guy
- Chemical Biology and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
| | - Michael R. Taylor
- Chemical Biology and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
| | - Taosheng Chen
- Chemical Biology and Therapeutics, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
| | - Martine F. Roussel
- Departments of Tumor Cell Biology, Memphis, Tennessee, United States of America
- * E-mail:
| |
Collapse
|
47
|
Katchy KC, Alexander S, Al-Nashmi NM, Al-Ramadan A. Epidemiology of primary brain tumors in childhood and adolescence in Kuwait. SPRINGERPLUS 2013; 2:58. [PMID: 23519270 PMCID: PMC3601263 DOI: 10.1186/2193-1801-2-58] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 01/26/2013] [Indexed: 11/10/2022]
Abstract
The relatively high frequency of primary brain tumors (PBT) observed in childhood and adolescence in Kuwait has necessitated this epidemiological study. It is based on the records of the Department of Pathology, Al-Sabah Hospital, which examined all brain tumor biopsies done in this age group in Kuwait between 1995 and 2011. During this period, 75 boys (49%) boys and 77 (51%) girls had histologically confirmed PBT. They comprised 122 children (0-14 years) and 30 adolescents (15-19 years). The boys/girls ratio was 1.03 in childhood and 0.76 in adolescence. The age-adjusted incidence rate was 11.2/ million person-years. Early childhood (0-4 years) had the peak frequency of tumors (33%), highest adjusted age-specific incidence rate (3.8/million person-years) of all tumors and the least boys/girls rates ratio (0.38) for astrocytic tumors. Low grade and high grade tumors peaked in 5-9 and 0-4 years respectively. Risk factors (hereditary syndromes or previous radio-therapy) were identified in three patients. Three (2%) tumors were congenital. High grade tumors comprised 47% of childhood and 23% of adolescence PBT. The most common tumors in childhood were astrocytoma (37%), embryonal tumors (31%), ependymoma (8%), and in adolescence astrocytoma (27%), pituitary adenoma (23%) and glioblastoma (13%). Embryonal tumors formed 44% of PBT in early childhood. Gliomas constituted 54% and 43% of all PBT, but 25% and 57% of high grade tumors in childhood and adolescence respectively. Most common tumor locations were cerebellum (47%), ventricles (19%) and cerebral lobes (17%) in childhood and pituitary (30%), cerebellum (27%) and 13% each for cerebral lobes and ventricles in adolescence. Approximately 57% of childhood and 23% of adolescence PBT were infratentorial. In conclusion, despite the high relative frequency of PBT before the age of 20 years in Kuwait, its incidence rate is apparently low. Compared with Western countries, Kuwait has a lower incidence of malignant gliomas, but a higher frequency of cerebellar and intraventricular tumors. Embryonal tumors are remarkably common in early childhood.
Collapse
Affiliation(s)
- Kenneth Chukwuka Katchy
- Department of Pathology, Al-Sabah Hospital, Safat, Kuwait ; FRCPath, FRCPC, Department of Pathology, Al-Sabah Hospital, P.O.Box 4078, 13041 Safat, Kuwait
| | | | | | | |
Collapse
|
48
|
Liu XY, Gerges N, Korshunov A, Sabha N, Khuong-Quang DA, Fontebasso AM, Fleming A, Hadjadj D, Schwartzentruber J, Majewski J, Dong Z, Siegel P, Albrecht S, Croul S, Jones DTW, Kool M, Tonjes M, Reifenberger G, Faury D, Zadeh G, Pfister S, Jabado N. Frequent ATRX mutations and loss of expression in adult diffuse astrocytic tumors carrying IDH1/IDH2 and TP53 mutations. Acta Neuropathol 2012; 124:615-25. [PMID: 22886134 DOI: 10.1007/s00401-012-1031-3] [Citation(s) in RCA: 305] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 07/31/2012] [Accepted: 08/02/2012] [Indexed: 12/12/2022]
Abstract
Gliomas are the most common primary brain tumors in children and adults. We recently identified frequent alterations in chromatin remodelling pathways including recurrent mutations in H3F3A and mutations in ATRX (α-thalassemia/mental-retardation-syndrome-X-linked) in pediatric and young adult glioblastoma (GBM, WHO grade IV astrocytoma). H3F3A mutations were specific to pediatric high-grade gliomas and identified in only 3.4 % of adult GBM. Using sequencing and/or immunohistochemical analyses, we investigated ATRX alterations (mutation/loss of expression) and their association with TP53 and IDH1 or IDH2 mutations in 140 adult WHO grade II, III and IV gliomas, 17 pediatric WHO grade II and III astrocytomas and 34 pilocytic astrocytomas. In adults, ATRX aberrations were detected in 33 % of grade II and 46 % of grade III gliomas, as well as in 80 % of secondary and 7 % of primary GBMs. They were absent in the 17 grade II and III astrocytomas in children, and the 34 pilocytic astrocytomas. ATRX alterations closely overlapped with mutations in IDH1/2 (p < 0.0001) and TP53 (p < 0.0001) in samples across all WHO grades. They were prevalent in astrocytomas and oligoastrocytomas, but were absent in oligodendrogliomas (p < 0.0001). No significant association of ATRX mutation/loss of expression and alternative lengthening of telomeres was identified in our cohort. In summary, our data show that ATRX alterations are frequent in adult diffuse gliomas and are specific to astrocytic tumors carrying IDH1/2 and TP53 mutations. Combined alteration of these genes may contribute to drive the neoplastic growth in a major subset of diffuse astrocytomas in adults.
Collapse
|
49
|
Gilheeney SW, Kieran MW. Differences in molecular genetics between pediatric and adult malignant astrocytomas: age matters. Future Oncol 2012; 8:549-58. [PMID: 22646770 DOI: 10.2217/fon.12.51] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The microscope - the classical tool for the investigation of cells and tissues - remains the basis for the classification of tumors throughout the body. Nowhere has this been more true than in the grading of astrocytomas. In spite of the fact that our parents warned us not to judge a book by its cover, we have continued to assume that adult and pediatric malignant gliomas that look the same, will have the same mutations, and thus respond to the same therapy. Rapid advances in molecular biology have permitted us the opportunity to go inside the cell and characterize the genetic events that underlie the true molecular heterogeneity of adult and pediatric brain tumors. In this paper, we will discuss some of the important clinical differences between pediatric and adult gliomas, with a focus on the molecular analysis of these different age groups.
Collapse
Affiliation(s)
- Stephen W Gilheeney
- Pediatric Neuro-Oncology, Dana-Farber Children's Hospital Cancer Center, Boston, MA, USA.
| | | |
Collapse
|
50
|
Heath JA, Zacharoulis S, Kieran MW. Pediatric neuro-oncology: current status and future directions. Asia Pac J Clin Oncol 2012; 8:223-31. [PMID: 22897924 DOI: 10.1111/j.1743-7563.2012.01558.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Tumors of the central nervous system (CNS) are the most common solid malignancies in childhood and are the leading cause of cancer-related death in this age group. While an ongoing improvement in overall prognosis has been achieved in the last few decades, current therapeutic approaches still confer significant morbidities, especially for the very young. The traditional strategies of surgery, radiotherapy and conventional cytotoxic chemotherapy need to be further refined while newer approaches, including molecularly targeted agents, hold the promise of better responses, improved outcomes and reduced toxicities. This article discusses treatment standards, the focus of current clinical investigations and the future promise of novel, biologically based approaches for the most common pediatric CNS tumors: primitive neuroectodermal tumors including medulloblastomas, ependymomas and astrocytomas (both low-grade and high-grade glioma).
Collapse
Affiliation(s)
- John A Heath
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria, Australia.
| | | | | |
Collapse
|