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Williams EA, Ravindranathan A, Gupta R, Stevers NO, Suwala AK, Hong C, Kim S, Yuan JB, Wu J, Barreto J, Lucas CHG, Chan E, Pekmezci M, LeBoit PE, Mully T, Perry A, Bollen A, Van Ziffle J, Devine WP, Reddy AT, Gupta N, Basnet KM, Macaulay RJB, Malafronte P, Lee H, Yong WH, Williams KJ, Juratli TA, Mata DA, Huang RSP, Hiemenz MC, Pavlick DC, Frampton GM, Janovitz T, Ross JS, Chang SM, Berger MS, Jacques L, Song JS, Costello JF, Solomon DA. Novel SOX10 indel mutations drive schwannomas through impaired transactivation of myelination gene programs. Neuro Oncol 2023; 25:2221-2236. [PMID: 37436963 PMCID: PMC10708934 DOI: 10.1093/neuonc/noad121] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Schwannomas are common peripheral nerve sheath tumors that can cause severe morbidity given their stereotypic intracranial and paraspinal locations. Similar to many solid tumors, schwannomas and other nerve sheath tumors are primarily thought to arise due to aberrant hyperactivation of the RAS growth factor signaling pathway. Here, we sought to further define the molecular pathogenesis of schwannomas. METHODS We performed comprehensive genomic profiling on a cohort of 96 human schwannomas, as well as DNA methylation profiling on a subset. Functional studies including RNA sequencing, chromatin immunoprecipitation-DNA sequencing, electrophoretic mobility shift assay, and luciferase reporter assays were performed in a fetal glial cell model following transduction with wildtype and tumor-derived mutant isoforms of SOX10. RESULTS We identified that nearly one-third of sporadic schwannomas lack alterations in known nerve sheath tumor genes and instead harbor novel recurrent in-frame insertion/deletion mutations in SOX10, which encodes a transcription factor responsible for controlling Schwann cell differentiation and myelination. SOX10 indel mutations were highly enriched in schwannomas arising from nonvestibular cranial nerves (eg facial, trigeminal, vagus) and were absent from vestibular nerve schwannomas driven by NF2 mutation. Functional studies revealed these SOX10 indel mutations have retained DNA binding capacity but impaired transactivation of glial differentiation and myelination gene programs. CONCLUSIONS We thus speculate that SOX10 indel mutations drive a unique subtype of schwannomas by impeding proper differentiation of immature Schwann cells.
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Affiliation(s)
- Erik A Williams
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Ajay Ravindranathan
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Rohit Gupta
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Nicholas O Stevers
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Abigail K Suwala
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Chibo Hong
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Somang Kim
- Department of Physics and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Jimmy Bo Yuan
- Department of Physics and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Jasper Wu
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Jairo Barreto
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Calixto-Hope G Lucas
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Emily Chan
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Melike Pekmezci
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Philip E LeBoit
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Thaddeus Mully
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Arie Perry
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Andrew Bollen
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Jessica Van Ziffle
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - W Patrick Devine
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Alyssa T Reddy
- Departments of Neurology and Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Nalin Gupta
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | | | | | | | - Han Lee
- Department of Pathology, University of California, Davis, Sacramento, California, USA
| | - William H Yong
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, California, USA
| | - Kevin Jon Williams
- Departments of Physiology and Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Tareq A Juratli
- Department of Neurosurgery, Division of Neuro-Oncology, Faculty of Medicine and Carl Gustav Carus University Hospital, Dresden, Germany
| | - Douglas A Mata
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
| | | | | | - Dean C Pavlick
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
| | | | - Tyler Janovitz
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
| | - Jeffrey S Ross
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
- Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Susan M Chang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Line Jacques
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Jun S Song
- Department of Physics and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Joseph F Costello
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - David A Solomon
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
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Isakoff SJ, Lehman CD, Shannon KM, Basnet KM. Case 7-2020: A 52-Year-Old Man with a Mass in the Left Breast. N Engl J Med 2020; 382:856-864. [PMID: 32101669 DOI: 10.1056/nejmcpc1913470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
MESH Headings
- Axilla
- Breast/diagnostic imaging
- Breast/pathology
- Breast Neoplasms, Male/diagnostic imaging
- Breast Neoplasms, Male/genetics
- Breast Neoplasms, Male/pathology
- Breast Neoplasms, Male/therapy
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Combined Modality Therapy
- Diagnosis, Differential
- Female
- Genes, BRCA2
- Genetic Predisposition to Disease
- Humans
- Lymph Nodes/pathology
- Lymphatic Metastasis/pathology
- Male
- Middle Aged
- Mutation
- Pedigree
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Affiliation(s)
- Steven J Isakoff
- From the Departments of Medicine (S.J.I., K.M.S.), Radiology (C.D.L.), and Pathology (K.M.B.), Massachusetts General Hospital, and the Departments of Medicine (S.J.I.), Radiology (C.D.L.), and Pathology (K.M.B.), Harvard Medical School - both in Boston
| | - Constance D Lehman
- From the Departments of Medicine (S.J.I., K.M.S.), Radiology (C.D.L.), and Pathology (K.M.B.), Massachusetts General Hospital, and the Departments of Medicine (S.J.I.), Radiology (C.D.L.), and Pathology (K.M.B.), Harvard Medical School - both in Boston
| | - Kristen M Shannon
- From the Departments of Medicine (S.J.I., K.M.S.), Radiology (C.D.L.), and Pathology (K.M.B.), Massachusetts General Hospital, and the Departments of Medicine (S.J.I.), Radiology (C.D.L.), and Pathology (K.M.B.), Harvard Medical School - both in Boston
| | - Kristen M Basnet
- From the Departments of Medicine (S.J.I., K.M.S.), Radiology (C.D.L.), and Pathology (K.M.B.), Massachusetts General Hospital, and the Departments of Medicine (S.J.I.), Radiology (C.D.L.), and Pathology (K.M.B.), Harvard Medical School - both in Boston
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Bartlett J, Sgroi D, Treuner K, Zhang Y, Piper T, Salunga RC, Ahmed I, Basnet KM, Brachtel E, Pirrie S, Schnabel CA, Rea DW. Trans-aTTom: Breast Cancer Index for prediction of endocrine benefit and late distant recurrence (DR) in patients with HR+ breast cancer treated in the adjuvant tamoxifen—To offer more? (aTTom) trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
505 Background: The aTTom study is a prospective phase III trial that randomized 6953 HR+ women to stop or continue tamoxifen (TAM) for 5 more years after completing at least 4 years of prior TAM. Results at 9 years of median follow-up demonstrated fewer breast cancer recurrences (21% vs 25%; RR= 0.86 [95% CI 0.77-0.96]; P = 0.006) and reduced breast cancer mortality (13% vs 15%; HR= 0.91 [95% CI 0.80-1.04]; P = 0.18) but increased incidence of endometrial cancer with longer TAM use (P < 0.0001). The Breast Cancer Index (BCI) is a gene expression–based signature that stratifies patients based on the risk of overall (0-10y) and late (post-5y) DR and predicted the likelihood of benefit from extended endocrine therapy in MA.17. This Translational aTTom (Trans-aTTom) study is a large-scale validation of the predictive ability of BCI for extended endocrine therapy (EET) benefit. Methods: Patients treated in the aTTom trial with available primary tumor tissue were eligible for this multi-institutional prospective-retrospective study. Primary and secondary endpoints were recurrence-free interval (RFI) and disease-free interval (DFI), respectively. Statistical significance level for RFI was set at 0.0336 as per statistical plan. Kaplan-Meier and Cox proportional hazards regression analysis with time-varying coefficients were used to test the predictive activity of BCI by HoxB13/IL17BR (H/I) status (High vs Low). Likelihood ratio test based on Cox regression was used to evaluate treatment by biomarker interaction. Results: 2637 tumors were centrally assessed for ER, PR and HER2 status leading to 1822 HR+ patients analyzed (1018 N0, 583 N+). Initial results from patients with N+ disease at 12 years of median follow-up showed 287 (49%) were classified as H/I-High and 296 (51%) were classified as H/I-Low. H/I High patients showed a statistically significant benefit of 9.8% in RFI with 10y vs 5y of TAM (HR=0.35 [95% CI 0.15-0.85]; P=0.027), whereas H/I Low patients showed no benefit (-0.2% RFI; HR=1.07 [95% CI 0.69-1.65]; P=0.77). A statistically significant interaction between continuous BCI and treatment was demonstrated (P = 0.02). Conclusions: These data provide further validation and establish level 1B evidence for BCI as a predictive biomarker for preferential benefit from EET in HR+ breast cancer.
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Affiliation(s)
- John Bartlett
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Dennis Sgroi
- Center for Cancer Research, Massachusetts General Hospital, Boston, MA
| | | | | | - Tammy Piper
- University of Edinburgh, Edinburgh, United Kingdom
| | | | - Ikhlaaq Ahmed
- University of Birmingham, Birmingham, United Kingdom
| | | | | | - Sarah Pirrie
- School of Cancer Sciences, Birmingham, United Kingdom
| | | | - Daniel William Rea
- University of Birmingham, Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom
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Affiliation(s)
- Janet E Murphy
- From the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Massachusetts General Hospital, and the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Harvard Medical School - both in Boston
| | - Kimberly Shampain
- From the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Massachusetts General Hospital, and the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Harvard Medical School - both in Boston
| | - Laura E Riley
- From the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Massachusetts General Hospital, and the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Harvard Medical School - both in Boston
| | - Jeffrey W Clark
- From the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Massachusetts General Hospital, and the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Harvard Medical School - both in Boston
| | - Kristen M Basnet
- From the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Massachusetts General Hospital, and the Departments of Medicine (J.E.M., J.W.C.), Radiology (K.S.), Obstetrics and Gynecology (L.E.R.), and Pathology (K.M.B.), Harvard Medical School - both in Boston
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Basnet KM, Bentley-Lewis R, Wexler DJ, Kilic F, Roberts DJ. Prevalence of Intervillous Thrombi Is Increased in Placentas from Pregnancies Complicated by Diabetes. Pediatr Dev Pathol 2017; 19:502-505. [PMID: 26669929 DOI: 10.2350/15-11-1734-oa.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Intervillous thrombus (IVT) is a placental pathology of unclear cause. One possible cause is that IVT protects against fetomaternal transfusion due to trophoblastic disruption. A role for hyperglycemia in trophoblast apoptosis has been suggested. We sought to determine whether placentas from pregnancies complicated by diabetes had an increased incidence of IVT. Medical records of 206 patients with type 1 diabetes (n = 39), type 2 diabetes (n = 37), and gestational diabetes (GDM, n = 130) at the Massachusetts General Hospital were identified. Placental pathology reports were reviewed to determine prevalence of IVT. Gestational and maternal age-matched controls were selected from the pathology archives consisting of placentas examined only for the indication of group B streptococcus screen positivity; controls were confirmed euglycemic and reviewed for IVT. Fisher exact test was used for statistical analysis. An increased incidence of IVT was present in all diabetics (type 1, type 2, and GDM; 32 of 206; 15.5%; P = 0.04) and GDM exclusively (22 of 130; 16.9%; P = 0.03) versus controls (7 of 99; 7.1%). IVT were also increased in patients with type 1 diabetes (4 of 39; 10.3%) and type 2 diabetes (6 of 37; 16.2%) compared to controls (7 of 99; 7.1%), but the results did not attain statistical significance (P = 0.73 and 0.19, respectively). The incidence of IVT was increased in the placentas of patients with diabetes as a group (type 1, type 2, and GDM), and in patients with GDM in particular. This is the first report of an association between diabetes and an increased incidence of placental IVT.
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Affiliation(s)
- Kristen M Basnet
- 1 Department of Pathology, Massachusetts General Hospital, Boston, MA
| | - Rhonda Bentley-Lewis
- 2 Diabetes Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Deborah J Wexler
- 2 Diabetes Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Fusun Kilic
- 3 Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR
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Manian FA, Barshak MB, Lowry KP, Basnet KM, Stowell CP. CASE RECORDS of the MASSACHUSETTS GENERAL HOSPITAL. Case 27-2016. N Engl J Med 2016; 375:981-91. [PMID: 27602671 DOI: 10.1056/nejmcpc1607091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Farrin A Manian
- From the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Massachusetts General Hospital, and the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Harvard Medical School - both in Boston
| | - Miriam B Barshak
- From the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Massachusetts General Hospital, and the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Harvard Medical School - both in Boston
| | - Kathryn P Lowry
- From the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Massachusetts General Hospital, and the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Harvard Medical School - both in Boston
| | - Kristen M Basnet
- From the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Massachusetts General Hospital, and the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Harvard Medical School - both in Boston
| | - Christopher P Stowell
- From the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Massachusetts General Hospital, and the Departments of Medicine (F.A.M., M.B.B.), Radiology (K.P.L.), and Pathology (K.M.B., C.P.S.), Harvard Medical School - both in Boston
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