Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features.

<h4>Background</h4>Medulloblastoma is the most common malignant brain tumor in children. Despite recent improvements in cure rates, prediction of disease outcome remains a major challenge and survivors suffer from serious therapy-related side-effects. Recent data showed that patients wit...

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Autores principales: Marcel Kool, Jan Koster, Jens Bunt, Nancy E Hasselt, Arjan Lakeman, Peter van Sluis, Dirk Troost, Netteke Schouten-van Meeteren, Huib N Caron, Jacqueline Cloos, Alan Mrsić, Bauke Ylstra, Wieslawa Grajkowska, Wolfgang Hartmann, Torsten Pietsch, David Ellison, Steven C Clifford, Rogier Versteeg
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spelling oai:doaj.org-article:85a9aa46f4a043bb939c4550eb28e8062021-11-25T06:18:48ZIntegrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features.1932-620310.1371/journal.pone.0003088https://doaj.org/article/85a9aa46f4a043bb939c4550eb28e8062008-08-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/18769486/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Medulloblastoma is the most common malignant brain tumor in children. Despite recent improvements in cure rates, prediction of disease outcome remains a major challenge and survivors suffer from serious therapy-related side-effects. Recent data showed that patients with WNT-activated tumors have a favorable prognosis, suggesting that these patients could be treated less intensively, thereby reducing the side-effects. This illustrates the potential benefits of a robust classification of medulloblastoma patients and a detailed knowledge of associated biological mechanisms.<h4>Methods and findings</h4>To get a better insight into the molecular biology of medulloblastoma we established mRNA expression profiles of 62 medulloblastomas and analyzed 52 of them also by comparative genomic hybridization (CGH) arrays. Five molecular subtypes were identified, characterized by WNT signaling (A; 9 cases), SHH signaling (B; 15 cases), expression of neuronal differentiation genes (C and D; 16 and 11 cases, respectively) or photoreceptor genes (D and E; both 11 cases). Mutations in beta-catenin were identified in all 9 type A tumors, but not in any other tumor. PTCH1 mutations were exclusively identified in type B tumors. CGH analysis identified several fully or partly subtype-specific chromosomal aberrations. Monosomy of chromosome 6 occurred only in type A tumors, loss of 9q mostly occurred in type B tumors, whereas chromosome 17 aberrations, most common in medulloblastoma, were strongly associated with type C or D tumors. Loss of the inactivated X-chromosome was highly specific for female cases of type C, D and E tumors. Gene expression levels faithfully reflected the chromosomal copy number changes. Clinicopathological features significantly different between the 5 subtypes included metastatic disease and age at diagnosis and histology. Metastatic disease at diagnosis was significantly associated with subtypes C and D and most strongly with subtype E. Patients below 3 yrs of age had type B, D, or E tumors. Type B included most desmoplastic cases. We validated and confirmed the molecular subtypes and their associated clinicopathological features with expression data from a second independent series of 46 medulloblastomas.<h4>Conclusions</h4>The new medulloblastoma classification presented in this study will greatly enhance the understanding of this heterogeneous disease. It will enable a better selection and evaluation of patients in clinical trials, and it will support the development of new molecular targeted therapies. Ultimately, our results may lead to more individualized therapies with improved cure rates and a better quality of life.Marcel KoolJan KosterJens BuntNancy E HasseltArjan LakemanPeter van SluisDirk TroostNetteke Schouten-van MeeterenHuib N CaronJacqueline CloosAlan MrsićBauke YlstraWieslawa GrajkowskaWolfgang HartmannTorsten PietschDavid EllisonSteven C CliffordRogier VersteegPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 3, Iss 8, p e3088 (2008)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Marcel Kool
Jan Koster
Jens Bunt
Nancy E Hasselt
Arjan Lakeman
Peter van Sluis
Dirk Troost
Netteke Schouten-van Meeteren
Huib N Caron
Jacqueline Cloos
Alan Mrsić
Bauke Ylstra
Wieslawa Grajkowska
Wolfgang Hartmann
Torsten Pietsch
David Ellison
Steven C Clifford
Rogier Versteeg
Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features.
description <h4>Background</h4>Medulloblastoma is the most common malignant brain tumor in children. Despite recent improvements in cure rates, prediction of disease outcome remains a major challenge and survivors suffer from serious therapy-related side-effects. Recent data showed that patients with WNT-activated tumors have a favorable prognosis, suggesting that these patients could be treated less intensively, thereby reducing the side-effects. This illustrates the potential benefits of a robust classification of medulloblastoma patients and a detailed knowledge of associated biological mechanisms.<h4>Methods and findings</h4>To get a better insight into the molecular biology of medulloblastoma we established mRNA expression profiles of 62 medulloblastomas and analyzed 52 of them also by comparative genomic hybridization (CGH) arrays. Five molecular subtypes were identified, characterized by WNT signaling (A; 9 cases), SHH signaling (B; 15 cases), expression of neuronal differentiation genes (C and D; 16 and 11 cases, respectively) or photoreceptor genes (D and E; both 11 cases). Mutations in beta-catenin were identified in all 9 type A tumors, but not in any other tumor. PTCH1 mutations were exclusively identified in type B tumors. CGH analysis identified several fully or partly subtype-specific chromosomal aberrations. Monosomy of chromosome 6 occurred only in type A tumors, loss of 9q mostly occurred in type B tumors, whereas chromosome 17 aberrations, most common in medulloblastoma, were strongly associated with type C or D tumors. Loss of the inactivated X-chromosome was highly specific for female cases of type C, D and E tumors. Gene expression levels faithfully reflected the chromosomal copy number changes. Clinicopathological features significantly different between the 5 subtypes included metastatic disease and age at diagnosis and histology. Metastatic disease at diagnosis was significantly associated with subtypes C and D and most strongly with subtype E. Patients below 3 yrs of age had type B, D, or E tumors. Type B included most desmoplastic cases. We validated and confirmed the molecular subtypes and their associated clinicopathological features with expression data from a second independent series of 46 medulloblastomas.<h4>Conclusions</h4>The new medulloblastoma classification presented in this study will greatly enhance the understanding of this heterogeneous disease. It will enable a better selection and evaluation of patients in clinical trials, and it will support the development of new molecular targeted therapies. Ultimately, our results may lead to more individualized therapies with improved cure rates and a better quality of life.
format article
author Marcel Kool
Jan Koster
Jens Bunt
Nancy E Hasselt
Arjan Lakeman
Peter van Sluis
Dirk Troost
Netteke Schouten-van Meeteren
Huib N Caron
Jacqueline Cloos
Alan Mrsić
Bauke Ylstra
Wieslawa Grajkowska
Wolfgang Hartmann
Torsten Pietsch
David Ellison
Steven C Clifford
Rogier Versteeg
author_facet Marcel Kool
Jan Koster
Jens Bunt
Nancy E Hasselt
Arjan Lakeman
Peter van Sluis
Dirk Troost
Netteke Schouten-van Meeteren
Huib N Caron
Jacqueline Cloos
Alan Mrsić
Bauke Ylstra
Wieslawa Grajkowska
Wolfgang Hartmann
Torsten Pietsch
David Ellison
Steven C Clifford
Rogier Versteeg
author_sort Marcel Kool
title Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features.
title_short Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features.
title_full Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features.
title_fullStr Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features.
title_full_unstemmed Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features.
title_sort integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features.
publisher Public Library of Science (PLoS)
publishDate 2008
url https://doaj.org/article/85a9aa46f4a043bb939c4550eb28e806
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