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Watanabe G, Conching A, Fry L, Putzler D, Khan MF, Haider MA, Haider AS, Ferini G, Rodriguez-Beato FY, Sharma M, Umana GE, Palmisciano P. Intraventricular Glioma in Pediatric Patients: A Systematic Review of Demographics, Clinical Characteristics, and Outcomes. World Neurosurg 2024; 186:252-262.e10. [PMID: 38608813 DOI: 10.1016/j.wneu.2024.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE We conducted a systematic review on pediatric intraventricular gliomas to survey the patient population, tumor characteristics, management, and outcomes. METHODS PubMed, Scopus, Web-of-Science, and Cochrane were searched using PRISMA guidelines to include studies reporting pediatric patients with intraventricular gliomas. RESULTS A total of 30 studies with 317 patients were included. Most patients were male (54%), diagnosed at a mean age of 8 years (0.2-19), and frequently exhibited headache (24%), nausea and vomiting (21%), and seizures (15%). Tumors were predominantly located in the fourth (48%) or lateral ventricle (44%). Most tumors were WHO grade 1 (68%). Glioblastomas were rarely reported (2%). Management included surgical resection (97%), radiotherapy (27%), chemotherapy (8%), and cerebrospinal fluid diversion for hydrocephalus (38%). Gross total resection was achieved in 59% of cases. Cranial nerve deficit was the most common postsurgical complication (28%) but most were reported in articles published prior to the year 2000 (89%). Newer cases published during or after the year 2000 exhibited significantly higher rates of gross total resection (78% vs. 39%, P < 0.01), lower rates of recurrence (26% vs. 47%, P < 0.01), longer average overall survival time (42 vs. 21 months, P = 0.02), and a higher proportion of patients alive (83% vs. 70%, P = 0.03) than in older cases. CONCLUSIONS Pediatric intraventricular gliomas correlate with parenchymal pediatric gliomas in terms of age at diagnosis and general outcomes. The mainstay of management is complete surgical excision and more recent studies report longer overall survival rates and less cranial nerve complications.
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Affiliation(s)
- Gina Watanabe
- University of Hawaii at Manoa John A. Burns School of Medicine, Honolulu, Hawaii, USA.
| | - Andie Conching
- University of Hawaii at Manoa John A. Burns School of Medicine, Honolulu, Hawaii, USA
| | - Lane Fry
- University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Dillon Putzler
- University of Hawaii at Manoa John A. Burns School of Medicine, Honolulu, Hawaii, USA
| | | | | | - Ali S Haider
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gianluca Ferini
- Department of Radiation Oncology, REM Radioterapia srl, Viagrande, Italy
| | | | - Mayur Sharma
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Paolo Palmisciano
- Department of Neurological Surgery, University of California, Davis, Sacramento, California, USA
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Da-Veiga MA, Coppieters N, Lombard A, Rogister B, Neirinckx V, Piette C. Comprehensive profiling of stem-like features in pediatric glioma cell cultures and their relation to the subventricular zone. Acta Neuropathol Commun 2023; 11:96. [PMID: 37328883 PMCID: PMC10276389 DOI: 10.1186/s40478-023-01586-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/20/2023] [Indexed: 06/18/2023] Open
Abstract
Pediatric high-grade gliomas (pHGG) are brain tumors occurring in children and adolescents associated with a dismal prognosis despite existing treatments. Therapeutic failure in both adult and pHGG has been partially imputed to glioma stem cells (GSC), a subset of cancer cells endowed with stem-like cell potential and malignant, invasive, adaptative, and treatment-resistant capabilities. Whereas GSC have largely been portrayed in adult tumors, less information has been provided in pHGG. The aim of our study was to comprehensively document the stem-like capacities of seven in-use pediatric glioma cell cultures (Res259, UW479, SF188, KNS42, SF8628, HJSD-DIPG-007 and HJSD-DIPG-012) using parallel in vitro assays assessing stem cell-related protein expression, multipotency, self-renewal and proliferation/quiescence, and in vivo investigation of their tumorigenicity and invasiveness. Data obtained from in vitro experiments revealed glioma subtype-dependent expression of stem cell-related markers and varying abilities for differentiation, self-renewal, and proliferation/quiescence. Among tested cultures, DMG H3-K27 altered cultures displayed a particular pattern of stem-like markers expression and a higher fraction of cells with self-renewal potential. Four cultures displaying distinctive stem-like profiles were further tested for their ability to initiate tumors and invade the brain tissue in mouse orthotopic xenografts. The selected cell cultures all showed a great tumor formation capacity, but only DMG H3-K27 altered cells demonstrated a highly infiltrative phenotype. Interestingly, we detected DMG H3-K27 altered cells relocated in the subventricular zone (SVZ), which has been previously described as a neurogenic area, but also a potential niche for brain tumor cells. Finally, we observed an SVZ-induced phenotypic modulation of the glioma cells, as evidenced by their increased proliferation rate. In conclusion, this study recapitulated a systematic stem-like profiling of various pediatric glioma cell cultures and call to a deeper characterization of DMG H3-K27 altered cells nested in the SVZ.
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Affiliation(s)
- Marc-Antoine Da-Veiga
- Laboratory of Nervous System Diseases and Therapy, GIGA Neuroscience, GIGA Institute, University of Liège, Liège, Belgium
| | - Natacha Coppieters
- Laboratory of Nervous System Diseases and Therapy, GIGA Neuroscience, GIGA Institute, University of Liège, Liège, Belgium
| | - Arnaud Lombard
- Laboratory of Nervous System Diseases and Therapy, GIGA Neuroscience, GIGA Institute, University of Liège, Liège, Belgium
- Department of Neurosurgery, CHU Liège, Liège, Belgium
| | - Bernard Rogister
- Laboratory of Nervous System Diseases and Therapy, GIGA Neuroscience, GIGA Institute, University of Liège, Liège, Belgium
- Department of Neurology, CHU Liège, Liège, Belgium
| | - Virginie Neirinckx
- Laboratory of Nervous System Diseases and Therapy, GIGA Neuroscience, GIGA Institute, University of Liège, Liège, Belgium
| | - Caroline Piette
- Laboratory of Nervous System Diseases and Therapy, GIGA Neuroscience, GIGA Institute, University of Liège, Liège, Belgium
- Department of Pediatrics, Division of Hematology-Oncology, CHU Liège, Liège, Belgium
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Jiao Y, Wang M, Liu X, Wang J, Shou Y, Sun H. Clinical features and prognostic significance of tumor involved with subventricular zone in pediatric glioblastoma: a 10-year experience in a single hospital. Childs Nerv Syst 2022; 38:1469-1477. [PMID: 35474540 DOI: 10.1007/s00381-022-05522-7] [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: 10/03/2021] [Accepted: 04/10/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Tumors involved with subventricular zone (SVZ) predicted an adverse prognosis had been well proved in adult glioblastoma (GBM). However, we still know less about its impact on children due to the rarity of pediatric glioblastoma (pGBM). We performed this retrospective study to better understand the clinical and prognostic features of pGBM involved with SVZ. METHODS Fifty-two patients diagnosed with pGBM at our center between January 2011 and January 2021 were selected for review to demonstrate the characteristics of tumor contacting SVZ. Thirty patients who underwent concurrent chemoradiotherapy and adjuvant chemotherapy postoperatively were selected for survival analysis. RESULTS Of all the 52 patients, 21 were found to contact SVZ and 31 were not. The median PFS and OS in SVZ + patients were 5.2 and 8.9 months, respectively, whereas median PFS and OS were 11.9 and 17.9 months, respectively, in SVZ - patients. Multivariate analysis showed that involvement of SVZ was an independent prognostic factor for OS while focality at diagnosis was an independent prognostic factor for PFS. Tumors contacted with SVZ tend to have larger volumes, lower incidence of epilepsy, and lower total resect rate and they were more likely to originate from midline location. Age at diagnosis; gender; adjuvant therapy; focality at diagnosis; focality at relapse; mutational status of H3K27M, MGMT, IDH1, and IDH2; and expression of P53 and ATRX protein failed to characterize SVZ + patients. CONCLUSION Involvement of SVZ predicted worse OS in pGBM and it had some distinct clinical features in comparison with those that did not contact with SVZ. Multifocal tumor at diagnosis was related to a shorter PFS. We should make a further step to clarify its molecular features.
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Affiliation(s)
- Yang Jiao
- Department of Neurosurgery, the First Affiliated Hospital of Zhengzhou University, Jianshe East Road No 1Henan Province, Zhengzhou, 450000, People's Republic of China
| | - Meng Wang
- Department of Neurosurgery, the First Affiliated Hospital of Zhengzhou University, Jianshe East Road No 1Henan Province, Zhengzhou, 450000, People's Republic of China
| | - Xueyou Liu
- Department of Neurosurgery, the First Affiliated Hospital of Zhengzhou University, Jianshe East Road No 1Henan Province, Zhengzhou, 450000, People's Republic of China
| | - Junkuan Wang
- Department of Neurosurgery, the First Affiliated Hospital of Zhengzhou University, Jianshe East Road No 1Henan Province, Zhengzhou, 450000, People's Republic of China
| | - Yuwei Shou
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongwei Sun
- Department of Neurosurgery, the First Affiliated Hospital of Zhengzhou University, Jianshe East Road No 1Henan Province, Zhengzhou, 450000, People's Republic of China.
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Da-Veiga MA, Rogister B, Lombard A, Neirinckx V, Piette C. Glioma Stem Cells in Pediatric High-Grade Gliomas: From Current Knowledge to Future Perspectives. Cancers (Basel) 2022; 14:cancers14092296. [PMID: 35565425 PMCID: PMC9099564 DOI: 10.3390/cancers14092296] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Pediatric high-grade glioma (pHGG) has a dismal prognosis in which the younger the patient, the more restricted the treatments are, in regard to the incurred risks. Current therapies destroy many tumor cells but fail to target the highly malignant glioma stem cells (GSCs) that adapt quickly to give rise to recurring, treatment-resistant cancers. Despite a lack of consensus around an efficient detection, GSCs are well described in adult brain tumors but remain poorly investigated in pediatric cases, mostly due to their rarity. An improved knowledge about GSC roles in pediatric tumors would provide a key leverage towards the elimination of this sub-population, based on targeted treatments. The aim of this review is to sum up the state of art about GSCs in pHGG. Abstract In children, high-grade gliomas (HGG) and diffuse midline gliomas (DMG) account for a high proportion of death due to cancer. Glioma stem cells (GSCs) are tumor cells in a specific state defined by a tumor-initiating capacity following serial transplantation, self-renewal, and an ability to recapitulate tumor heterogeneity. Their presence was demonstrated several decades ago in adult glioblastoma (GBM), and more recently in pediatric HGG and DMG. In adults, we and others have previously suggested that GSCs nest into the subventricular zone (SVZ), a neurogenic niche, where, among others, they find shelter from therapy. Both bench and bedside evidence strongly indicate a role for the GSCs and the SVZ in GBM progression, fostering the development of innovative targeting treatments. Such new therapeutic approaches are of particular interest in infants, in whom standard therapies are often limited due to the risk of late effects. The aim of this review is to describe current knowledge about GSCs in pediatric HGG and DMG, i.e., their characterization, the models that apply to their development and maintenance, the specific signaling pathways that may underlie their activity, and their specific interactions with neurogenic niches. Finally, we will discuss the clinical relevance of these observations and the therapeutic advantages of targeting the SVZ and/or the GSCs in infants.
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Affiliation(s)
- Marc-Antoine Da-Veiga
- Laboratory of Nervous System Disorders and Therapy, GIGA Institute, University of Liège, 4000 Liège, Belgium; (M.-A.D.-V.); (B.R.); (A.L.); (V.N.)
| | - Bernard Rogister
- Laboratory of Nervous System Disorders and Therapy, GIGA Institute, University of Liège, 4000 Liège, Belgium; (M.-A.D.-V.); (B.R.); (A.L.); (V.N.)
- Department of Neurology, CHU of Liège, 4000 Liège, Belgium
| | - Arnaud Lombard
- Laboratory of Nervous System Disorders and Therapy, GIGA Institute, University of Liège, 4000 Liège, Belgium; (M.-A.D.-V.); (B.R.); (A.L.); (V.N.)
- Department of Neurosurgery, CHU of Liège, 4000 Liège, Belgium
| | - Virginie Neirinckx
- Laboratory of Nervous System Disorders and Therapy, GIGA Institute, University of Liège, 4000 Liège, Belgium; (M.-A.D.-V.); (B.R.); (A.L.); (V.N.)
| | - Caroline Piette
- Laboratory of Nervous System Disorders and Therapy, GIGA Institute, University of Liège, 4000 Liège, Belgium; (M.-A.D.-V.); (B.R.); (A.L.); (V.N.)
- Department of Pediatrics, Division of Hematology-Oncology, CHU Liège, 4000 Liège, Belgium
- Correspondence:
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Lombard A, Digregorio M, Delcamp C, Rogister B, Piette C, Coppieters N. The Subventricular Zone, a Hideout for Adult and Pediatric High-Grade Glioma Stem Cells. Front Oncol 2021; 10:614930. [PMID: 33575218 PMCID: PMC7870981 DOI: 10.3389/fonc.2020.614930] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/09/2020] [Indexed: 12/23/2022] Open
Abstract
Both in adult and children, high-grade gliomas (WHO grades III and IV) account for a high proportion of death due to cancer. This poor prognosis is a direct consequence of tumor recurrences occurring within few months despite a multimodal therapy consisting of a surgical resection followed by chemotherapy and radiotherapy. There is increasing evidence that glioma stem cells (GSCs) contribute to tumor recurrences. In fact, GSCs can migrate out of the tumor mass and reach the subventricular zone (SVZ), a neurogenic niche persisting after birth. Once nested in the SVZ, GSCs can escape a surgical intervention and resist to treatments. The present review will define GSCs and describe their similarities with neural stem cells, residents of the SVZ. The architectural organization of the SVZ will be described both for humans and rodents. The migratory routes taken by GSCs to reach the SVZ and the signaling pathways involved in their migration will also be described hereafter. In addition, we will debate the advantages of the microenvironment provided by the SVZ for GSCs and how this could contribute to tumor recurrences. Finally, we will discuss the clinical relevance of the SVZ in adult GBM and pediatric HGG and the therapeutic advantages of targeting that neurogenic region in both clinical situations.
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Affiliation(s)
- Arnaud Lombard
- Laboratory of Nervous System Disorders and Therapy, Groupement Interdisciplinaire de Génoprotéomique Appliquée (GIGA)-Neurosciences Research Centre, University of Liège, Liège, Belgium.,Department of Neurosurgery, CHU of Liège, Liège, Belgium
| | - Marina Digregorio
- Laboratory of Nervous System Disorders and Therapy, Groupement Interdisciplinaire de Génoprotéomique Appliquée (GIGA)-Neurosciences Research Centre, University of Liège, Liège, Belgium
| | - Clément Delcamp
- Laboratory of Nervous System Disorders and Therapy, Groupement Interdisciplinaire de Génoprotéomique Appliquée (GIGA)-Neurosciences Research Centre, University of Liège, Liège, Belgium
| | - Bernard Rogister
- Laboratory of Nervous System Disorders and Therapy, Groupement Interdisciplinaire de Génoprotéomique Appliquée (GIGA)-Neurosciences Research Centre, University of Liège, Liège, Belgium.,Department of Neurology, CHU of Liège, Liège, Belgium
| | - Caroline Piette
- Laboratory of Nervous System Disorders and Therapy, Groupement Interdisciplinaire de Génoprotéomique Appliquée (GIGA)-Neurosciences Research Centre, University of Liège, Liège, Belgium.,Department of Pediatrics, Division of Hematology-Oncology, CHU of Liège, Liège, Belgium
| | - Natacha Coppieters
- Laboratory of Nervous System Disorders and Therapy, Groupement Interdisciplinaire de Génoprotéomique Appliquée (GIGA)-Neurosciences Research Centre, University of Liège, Liège, Belgium
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