bims-malgli 2021-09-26 papers

bims-malgli

Biomed News

on Biology of malignant gliomas

Issue of 2021–09–26
fourteen papers selected by
Oltea Sampetrean, Keio University

Glioblastoma Genetic Drivers Dictate the Function of Tumor-Associated Macrophages/Microglia and Responses to CSF1R Inhibition.
TGF- promotes microtube formation in glioblastoma through Thrombospondin 1.
Tertiary Lymphoid Structures in the Central Nervous System: Implications for Glioblastoma.
CCNU and ACNU exert efficient antitumor effects against glioblastoma models with acquired temozolomide resistance.
Nuclear receptor NR5A2 negatively regulates cell proliferation and tumor growth in nervous system malignancies.
Phenotypic plasticity of myeloid cells in glioblastoma development, progression, and therapeutics.
SON drives oncogenic RNA splicing in glioblastoma by regulating PTBP1/PTBP2 switching and RBFOX2 activity.
Anatomical phenotyping and staging of brain tumours.
Repurposing vandetanib plus everolimus for the treatment of ACVR1-mutant diffuse intrinsic pontine glioma.
Glioblastoma Clinical Trials: Current Landscape and Opportunities for Improvement.
Soft threshold partial least squares predicts the survival fraction of malignant glioma cells against different concentrations of methotrexate's derivatives.
Designing Clinical Trials for Combination Immunotherapy: A Framework for Glioblastoma.
Comprehensive molecular characterization of pediatric radiation-induced high-grade glioma.
Radiation-induced gliomas represent H3-/IDH-wild type pediatric gliomas with recurrent PDGFRA amplification and loss of CDKN2A/B.

Neuro Oncol. 2021 Sep 25. pii: noab228. [Epub ahead of print]

Glioblastoma Genetic Drivers Dictate the Function of Tumor-Associated Macrophages/Microglia and Responses to CSF1R Inhibition.

Rohit Rao, Rong Han, Sean Ogurek, Chengbin Xue, Lai Man Wu, Liguo Zhang, Li Zhang, Jian Hu, Timothy N Phoenix, Stephen N Waggoner, Q Richard Lu.

   BACKGROUND: Tumor-associated macrophages/microglia (TAMs) are prominent microenvironment components in human glioblastoma (GBM) that are potential targets for anti-tumor therapy. However, TAM depletion by CSF1R inhibition showed mixed results in clinical trials. We hypothesized that GBM subtype-specific tumor microenvironment convey distinct sensitivities to TAM targeting.
METHODS: We generated syngeneic PDGFB-driven and RAS-driven GBM models that resemble proneural-like and mesenchymal-like gliomas, and determined the effect of TAM targeting by CSF1R inhibitor PLX3397 on glioma growth. We also investigated the co-targeting of TAMs and angiogenesis on PLX3397-resistant RAS-driven GBM. Using single-cell transcriptomic profiling, we further explored differences in tumor microenvironment cellular compositions and functions in PDGFB- and RAS-driven gliomas.
RESULTS: We found that growth of PDGFB-driven tumors was markedly inhibited by PLX3397. In contrast, depletion of TAMs at the early phase accelerated RAS-driven tumor growth and had no effects on other proneural and mesenchymal GBM models. In addition, PLX3397-resistant RAS-driven tumors did not respond to PI3K signaling inhibition. Single-cell transcriptomic profiling revealed that PDGFB-driven gliomas induced expansion and activation of pro-tumor microglia, whereas TAMs in mesenchymal RAS-driven GBM were enriched in pro-inflammatory and angiogenic signaling. Co-targeting of TAMs and angiogenesis decreased cell proliferation and changed the morphology of RAS-driven gliomas.
CONCLUSIONS: Our work identify functionally distinct TAM subpopulations in the growth of different glioma subtypes. Notably, we uncover a potential responsiveness of resistant mesenchymal-like gliomas to combined anti-angiogenic therapy and CSF1R inhibition. These data highlight the importance of characterization of the microenvironment landscape in order to optimally stratify patients for TAM-targeted therapy.

Keywords:  CSF1R inhibition; Glioblastoma subtypes; Single cell transcriptomics; Tumor-associated microglia and macrophages; angiogenesis

DOI:  https://doi.org/10.1093/neuonc/noab228
Neuro Oncol. 2021 Sep 20. pii: noab212. [Epub ahead of print]

TGF- promotes microtube formation in glioblastoma through Thrombospondin 1.

Justin V Joseph, Capucine R Magaut, Simon Storevik, Luiz H Geraldo, Thomas Mathivet, Md Abdul Latif, Justine Rudewicz, Joris Guyon, Matteo Gambaretti, Frida Haukas, Amalie Trones, Lars A Rømo Ystaas, Jubayer A Hossain, Sandra Ninzima, Sylvain Cuvellier, Wenjing Zhou, Tushar Tomar, Barbara Klink, Lalit Rane, Bronwyn K Irving, Joanne Marrison, Peter O'Toole, Heiko Wurdak, Jian Wang, Zhang Di, Even Birkeland, Frode S Berven, Frank Winkler, Frank A E Kruyt, Andreas Bikfalvi, Rolf Bjerkvig, Thomas Daubon, Hrvoje Miletic.

   BACKGROUND: Microtubes (MTs), cytoplasmic extensions of glioma cells, are important cell communication structures promoting invasion and treatment resistance through network formation. MTs are abundant in chemoresistant gliomas, in particular glioblastomas (GBMs), while they are uncommon in chemosensitive IDH-mutant and 1p/19q co-deleted oligodendrogliomas. The aim of this study was to identify potential signaling pathways involved in MT formation.
METHODS: Bioinformatics analysis of TCGA was performed to analyze differences between GBM and oligodendroglioma. Patient-derived GBM stem cell lines were used to investigate microtube formation under TGF-βstimulation and inhibition in vitro and in vivo in an orthotopic xenograft model. RNA sequencing and proteomics were performed to detect commonalities and differences between GBM cell lines stimulated with TGF-β.
RESULTS: Analysis of TCGA data showed that the TGF-β pathway is highly activated in GBMs compared to oligodendroglial tumors. We demonstrated that TGF-β1 stimulation of GBM cell lines promotes enhanced MT formation and communication via Calcium signaling. Inhibition of the TGF-β pathway significantly reduced MT formation and its associated invasion in vitro and in vivo. Downstream of TGF-β, we identified thrombospondin 1 (TSP1) as a potential mediator of MT formation in GBM through SMAD activation. TSP1 was upregulated upon TGF- β stimulation and enhanced MT formation, which was inhibited by TSP1 shRNAs in vitro and in vivo.
CONCLUSION: TGF-β and its downstream mediator TSP1 are important mediators of the MT network in GBM and blocking this pathway could potentially help to break the complex MT driven invasion/ resistance network.

Keywords:  SMAD; TGF-β; Tsp1; glioblastoma; microtubes

DOI:  https://doi.org/10.1093/neuonc/noab212
Front Immunol. 2021 ;12 724739

Tertiary Lymphoid Structures in the Central Nervous System: Implications for Glioblastoma.

Tiarne van de Walle, Alessandra Vaccaro, Mohanraj Ramachandran, Ilkka Pietilä, Magnus Essand, Anna Dimberg.

  Glioblastoma is the most common and aggressive brain tumor, which is uniformly lethal due to its extreme invasiveness and the absence of curative therapies. Immune checkpoint inhibitors have not yet proven efficacious for glioblastoma patients, due in part to the low prevalence of tumor-reactive T cells within the tumor microenvironment. The priming of tumor antigen-directed T cells in the cervical lymph nodes is complicated by the shortage of dendritic cells and lack of appropriate lymphatic vessels within the brain parenchyma. However, recent data suggest that naive T cells may also be primed within brain tumor-associated tertiary lymphoid structures. Here, we review the current understanding of the formation of these structures within the central nervous system, and hypothesize that promotion of tertiary lymphoid structures could enhance priming of tumor antigen-targeted T cells and sensitize glioblastomas to cancer immunotherapy.

Keywords:  brain; central nervous system; glioblastoma; glioma; immunotherapy; tertiary lymphoid structure

DOI:  https://doi.org/10.3389/fimmu.2021.724739
Cancer Sci. 2021 Sep 18.

CCNU and ACNU exert efficient antitumor effects against glioblastoma models with acquired temozolomide resistance.

Shun Yamamuro, Masamichi Takahashi, Kaishi Satomi, Nobuyoshi Sasaki, Tatsuya Kobayashi, Eita Uchida, Daisuke Kawauchi, Tomoyuki Nakano, Takashi Fujii, Yoshitaka Narita, Akihide Kondo, Kojiro Wada, Atsuo Yoshino, Koichi Ichimura, Arata Tomiyama.

  Glioblastomas (GBMs) often acquire resistance against temozolomide (TMZ) after continuous treatment and recur as TMZ-resistant GBM (TMZ-R-GBM). Lomustine (CCNU) and nimustine (ACNU), which were previously used as standard therapeutic agents against GBMs before TMZ, have occasionally been employed for the salvage therapy of TMZ-R-GBMs; however, their efficacy has not yet been thoroughly examined. We therefore investigated the antitumor effects of CCNU and ACNU against TMZ-R-GBMs. As a model of TMZ-R-GBMs, TMZ resistant clones of human GBM cell lines (U87, U251MG, and U343MG) were established (TMZ-R-cells) by the culture of each GBM cells under continuous TMZ treatment, and the antitumor effects of TMZ, CCNU or ACNU against these cells were analyzed in vitro and in vivo. As a result, although growth arrest and apoptosis were triggered in all TMZ-R-cells after the administration of each drug, the antitumor effects of TMZ against TMZ-R-cells were significantly reduced as compared to those of parental cells, whereas CCNU and ACNU demonstrated efficient antitumor effects on TMZ-R-cells as well as parental cells. In addition, it was also demonstrated that TMZ resistance of TMZ-R-cells was regulated at the level of DNA damage response initiation. Furthermore, survival in mice was significantly prolonged by systemic treatment with CCNU or ACNU but not TMZ after implantation of TMZ-R-cells. These findings suggest that CCNU or ACNU may serve as a therapeutic agent in salvage treatment against TMZ-R-GBMs.

Keywords:  glioblastoma; lomustine; nimustine; nitrosourea; temozolomide resistance

DOI:  https://doi.org/10.1111/cas.15141
Proc Natl Acad Sci U S A. 2021 Sep 28. pii: e2015243118. [Epub ahead of print]118(39):

Nuclear receptor NR5A2 negatively regulates cell proliferation and tumor growth in nervous system malignancies.

Dimitrios Gkikas, Dimitris Stellas, Alexia Polissidis, Theodora Manolakou, Maroula G Kokotou, George Kokotos, Panagiotis K Politis.

  Nervous system malignancies are characterized by rapid progression and poor survival rates. These clinical observations underscore the need for novel therapeutic insights and pharmacological targets. To this end, here, we identify the orphan nuclear receptor NR5A2/LRH1 as a negative regulator of cancer cell proliferation and promising pharmacological target for nervous system-related tumors. In particular, clinical data from publicly available databases suggest that high expression levels of NR5A2 are associated with favorable prognosis in patients with glioblastoma and neuroblastoma tumors. Consistently, we experimentally show that NR5A2 is sufficient to strongly suppress proliferation of both human and mouse glioblastoma and neuroblastoma cells without inducing apoptosis. Moreover, short hairpin RNA-mediated knockdown of the basal expression levels of NR5A2 in glioblastoma cells promotes their cell cycle progression. The antiproliferative effect of NR5A2 is mediated by the transcriptional induction of negative regulators of the cell cycle, CDKN1A (encoding for p21cip1), CDKN1B (encoding for p27kip1) and Prox1 Interestingly, two well-established agonists of NR5A2, dilauroyl phosphatidylcholine (DLPC) and diundecanoyl phosphatidylcholine, are able to mimic the antiproliferative action of NR5A2 in human glioblastoma cells via the induction of the same critical genes. Most importantly, treatment with DLPC inhibits glioblastoma tumor growth in vivo in heterotopic and orthotopic xenograft mouse models. These data indicate a tumor suppressor role of NR5A2 in the nervous system and render this nuclear receptor a potential pharmacological target for the treatment of nervous tissue-related tumors.

Keywords:  LRH1; agonists; glioblastoma; neuroblastoma; proliferation

DOI:  https://doi.org/10.1073/pnas.2015243118
Oncogene. 2021 Sep 23.

Phenotypic plasticity of myeloid cells in glioblastoma development, progression, and therapeutics.

Zengpanpan Ye, Xiaolin Ai, Linjie Zhao, Fan Fei, Ping Wang, Shengtao Zhou.

Glioblastoma (GBM) is the most common and malignant type of intracranial tumors with poor prognosis. Accumulating evidence suggests that phenotypic alterations of infiltrating myeloid cells in the tumor microenvironment are important for GBM progression. Conventional tumor immunotherapy commonly targets T-cells, while innate immunity as a therapeutic target is an emerging field. Targeting infiltrating myeloid cells that induce immune suppression in the TME provides a novel direction to improve the prognosis of patients with GBM. The factors released by tumor cells recruit myeloid cells into tumor bed and reprogram infiltrating myeloid cells into immunostimulatory/immunosuppressive phenotypes. Reciprocally, infiltrating myeloid cells, especially microglia/macrophages, regulate GBM progression and affect therapeutic efficacy. Herein, we revisited biological characteristics and functions of infiltrating myeloid cells and discussed the recent advances in immunotherapies targeting infiltrating myeloid cells in GBM. With an evolving understanding of the complex interactions between infiltrating myeloid cells and tumor cells in the tumor microenvironment, we will expand novel immunotherapeutic regimens targeting infiltrating myeloid cells in GBM treatment and improve the outcomes of GBM patients.

DOI: https://doi.org/10.1038/s41388-021-02010-1
Nat Commun. 2021 Sep 21. 12(1): 5551

SON drives oncogenic RNA splicing in glioblastoma by regulating PTBP1/PTBP2 switching and RBFOX2 activity.

Jung-Hyun Kim, Kyuho Jeong, Jianfeng Li, James M Murphy, Lana Vukadin, Joshua K Stone, Alexander Richard, Johnny Tran, G Yancey Gillespie, Erik K Flemington, Robert W Sobol, Ssang-Teak Steve Lim, Eun-Young Erin Ahn.

While dysregulation of RNA splicing has been recognized as an emerging target for cancer therapy, the functional significance of RNA splicing and individual splicing factors in brain tumors is poorly understood. Here, we identify SON as a master regulator that activates PTBP1-mediated oncogenic splicing while suppressing RBFOX2-mediated non-oncogenic neuronal splicing in glioblastoma multiforme (GBM). SON is overexpressed in GBM patients and SON knockdown causes failure in intron removal from the PTBP1 transcript, resulting in PTBP1 downregulation and inhibition of its downstream oncogenic splicing. Furthermore, SON forms a complex with hnRNP A2B1 and antagonizes RBFOX2, which leads to skipping of RBFOX2-targeted cassette exons, including the PTBP2 neuronal exon. SON knockdown inhibits proliferation and clonogenicity of GBM cells in vitro and significantly suppresses tumor growth in orthotopic xenografts in vivo. Collectively, our study reveals that SON-mediated RNA splicing is a GBM vulnerability, implicating SON as a potential therapeutic target in brain tumors.

DOI: https://doi.org/10.1038/s41467-021-25892-x
Brain. 2021 Sep 23. pii: awab352. [Epub ahead of print]

Anatomical phenotyping and staging of brain tumours.

Kevin Akeret, Flavio Vasella, Victor E Staartjes, Julia Velz, Timothy Müller, Marian Christoph Neidert, Michael Weller, Luca Regli, Carlo Serra, Niklaus Krayenbühl.

  Unlike other tumors, the anatomical extent of brain tumors is not objectified and quantified through staging. Staging systems are based on understanding the anatomical sequence of tumor progression and its relationship to histopathological dedifferentiation and survival. The aim of this study was to describe the spatiotemporal phenotype of the most frequent brain tumor entities, to assess the association of anatomical tumor features with survival probability and to develop a staging system for WHO grade 2 and 3 gliomas and glioblastoma. Anatomical phenotyping was performed on a consecutive cohort of 1000 patients with first diagnosis of a primary or secondary brain tumor. Tumor probability in different topographic, phylogenetic and ontogenetic parcellation units was assessed on preoperative MRI through normalization of the relative tumor prevalence to the relative volume of the respective structure. We analyzed the spatiotemporal tumor dynamics by cross-referencing preoperative against preceding and subsequent MRIs of the respective patient. The association between anatomical phenotype and outcome defined prognostically critical anatomical tumor features at diagnosis. Based on a hypothesized sequence of anatomical tumor progression, we developed a three-level staging system for WHO grade 2 and 3 gliomas and glioblastoma. This staging system was validated internally in the original cohort and externally in an independent cohort of 300 consecutive patients. While primary central nervous system lymphoma showed highest probability along white matter tracts, metastases enriched along terminal arterial flow areas. Neuroepithelial tumors mapped along all sectors of the ventriculocortical axis, while adjacent units were spared, consistent with a transpallial behavior within phylo-ontogenetic radial units. Their topographic pattern correlated with morphogenetic processes of convergence and divergence of radial units during phylo- and ontogenesis. While a ventriculofugal growth dominated in neuroepithelial tumors, a gradual deviation from this neuroepithelial spatiotemporal behavior was found with progressive histopathological dedifferentiation. The proposed three-level staging system for WHO grade 2 and 3 gliomas and glioblastoma correlated with the degree of histological dedifferentiation and proved accurate in terms of survival upon both internal and external validation. In conclusion, this study identified specific spatiotemporal phenotypes in brain tumors through topographic probability and growth pattern assessment. The association of anatomical tumor features with survival defined critical steps in the anatomical sequence of neuroepithelial tumor progression, based on which a staging system for WHO grade 2 and 3 gliomas and glioblastoma was developed and validated.

Keywords:  glioma; lymphoma; metastases; radial unit; topography

DOI:  https://doi.org/10.1093/brain/awab352
Cancer Discov. 2021 Sep 22. pii: candisc.1201.2020. [Epub ahead of print]

Repurposing vandetanib plus everolimus for the treatment of ACVR1-mutant diffuse intrinsic pontine glioma.

Diana M Carvalho, Peter J Richardson, Nagore Olaciregui, Reda Stankunaite, Cinzia Lavarino, Valeria Molinari, Elizabeth A Corley, Daniel P Smith, Ruth Ruddle, Adam Donovan, Akos Pal, Florence I Raynaud, Sara Temelso, Alan Mackay, John P Overington, Anne Phelan, David Sheppard, Andrew Mackinnon, Bassel Zebian, Safa Al-Sarraj, Ashirwad Merve, Jeremy Pryce, Jacques Grill, Michael Hubank, Ofelia Cruz, Andres Morales La Madrid, Sabine Mueller, Angel M Carcaboso, Fernando Carceller, Chris Jones.

Somatic mutations in ACVR1 are found in a quarter of children with diffuse intrinsic pontine glioma (DIPG), however there are no ACVR1 inhibitors licensed for the disease. Using an Artificial Intelligence-based platform to search for approved compounds for ACVR1-mutant DIPG, the combination of vandetanib and everolimus was identified as a possible therapeutic approach. Vandetanib, an inhibitor of VEGFR/RET/EGFR, was found to target ACVR1 (Kd=150nM) and reduce DIPG cell viability in vitro, but has limited ability to cross the blood-brain-barrier. In addition to mTOR, everolimus inhibits ABCG2 (BCRP) and ABCB1 (P-gp) transporters, and was synergistic in DIPG cells when combined with vandetanib in vitro. This combination is well-tolerated in vivo, and significantly extended survival and reduced tumor burden in an orthotopic ACVR1-mutant patient-derived DIPG xenograft model. Four patients with ACVR1-mutant DIPG were treated with vandetanib plus mTOR inhibitor, informing the dosing and toxicity profile of this combination for future clinical studies.

DOI: https://doi.org/10.1158/2159-8290.CD-20-1201
Clin Cancer Res. 2021 Sep 24. pii: clincanres.2750.2021. [Epub ahead of print]

Glioblastoma Clinical Trials: Current Landscape and Opportunities for Improvement.

Stephen J Bagley, Shawn Kothari, Rifaquat Rahman, Eudocia Q Lee, Gavin P Dunn, Evanthia Galanis, Susan M Chang, Louis Burt Nabors, Manmeet S Ahluwalia, Roger Stupp, Minesh P Mehta, David A Reardon, Stuart A Grossman, Erik P Sulman, John H Sampson, Simon Khagi, Michael Weller, Timothy F Cloughesy, Patrick Y Wen, Mustafa Khasraw.

Therapeutic advances for glioblastoma have been minimal over the past two decades. In light of the multitude of recent phase III trials that have failed to meet their primary endpoints following promising preclinical and early phase programs, a Society for Neuro-Oncology Think Tank was held in November, 2020 to prioritize areas for improvement in the conduct of glioblastoma clinical trials. Here, we review the literature, identify challenges related to clinical trial eligibility criteria and trial design in glioblastoma, and provide recommendations from the Think Tank. In addition, we provide a data-driven context with which to frame this discussion by analyzing key study design features of adult glioblastoma clinical trials listed on ClinicalTrials.gov as "recruiting" or "not-yet-recruiting" as of February, 2021.

DOI: https://doi.org/10.1158/1078-0432.CCR-21-2750
Sci Rep. 2021 Sep 21. 11(1): 18741

Soft threshold partial least squares predicts the survival fraction of malignant glioma cells against different concentrations of methotrexate's derivatives.

Tahir Mehmood, Mudassir Iqbal.

Chemotherapy appeared to be a significant advancement in cancer research, with fewer side effects. Methotrexate (MTX) is a widely used anticancer drug with strong activity but serious side effects. Several MTX derivatives have been reported, with modifications at various sites to reduce side effects and increase efficacy. The current study uses FTIR spectroscopy to predict the survival fraction of human malignant glioma U87 (MG-U87) cell lines against MTX derivatives. Together with Parent MTX several aldehydes viz. Benzaldehyde, Chlorobenzaldehyde, 2-Chlorobenzaldehyde, 3-Nitrobenzaldehyde, 5-Chloro-2-hydroxybenz-aldehyde, 2-Hydroxy-5-Nitrobenzaldehyde, 2-Thiocarboxyaldehyde, Trans-2-pentenal, and Glutaraldehyde are treated with MTX to obtain MTX derivatives. The prediction of survival fraction of malignant glioma cells is carried out by Lasso, Elastic net and Soft PLS at different concentration levels of synthesized derivatives, including 400 μM, 200 μM, 100 μM, 50 μM, 25 μM and 12.5 μM. The cross-validated prediction error is minimised to optimise spectral wavelength selection and model parameters. It appears that the RMSE computed from test data is significantly varying with the change of models (p = 0.012), with the change of concentrations levels (p [Formula: see text]) and with the change of combination of models and concentration level (p [Formula: see text]). StPLS outperforms in predicting survival fraction of glioma cells at the concentration level 50 μM, 100 μM and 400 μM respectively with relative RMSE = 0.1,0.14 and 0.55. Lasso outperforms at the concentration level 12.5 μM, and 200 μM respectively with relative RMSE = 0.4 and 0.14. Elastic net outperforms at the concentration level 25 μM with relative RMSE = 0.8. Consistently appeared influential wavelength identifies the influential functional compounds which best predicts the survival fraction. Hence FTIR appears potential candidate for estimating survival fraction of MTX derivatives.

DOI: https://doi.org/10.1038/s41598-021-97891-3
Clin Cancer Res. 2021 Sep 24. pii: clincanres.2681.2021. [Epub ahead of print]

Designing Clinical Trials for Combination Immunotherapy: A Framework for Glioblastoma.

Kirit Singh, Kristen A Batich, Patrick Y Wen, Aaron C Tan, Stephen J Bagley, Michael Lim, Michael Platten, Howard Colman, David M Ashley, Susan M Chang, Rifaquat Rahman, Evanthia Galanis, Alireza Mansouri, Vinay K Puduvalli, David A Reardon, Solmaz Sahebjam, John H Sampson, John Simes, Donald A Berry, Gelareh Zadeh, Timothy F Cloughesy, Minesh P Mehta, Steven Piantadosi, Michael Weller, Amy B Heimberger, Mustafa Khasraw.

Immunotherapy has revolutionized treatment for many hard-to-treat cancers but has yet to produce significant improvement in outcomes for patients with glioblastoma. This reflects the multiple and unique mechanisms of immune evasion and escape in this highly heterogeneous tumor. Glioblastoma engenders profound local and systemic immunosuppression and is remarkably effective at inducing T cell dysfunction, posing a challenge to any immunotherapy-based approach. To overcome these mechanisms, multiple disparate modes of immune-oriented therapy will be required. However, designing trials that can evaluate these combinatorial approaches requires careful consideration. In this review, we explore the immunotherapy resistance mechanisms that have been encountered to date and how combinatorial approaches may address these. We also describe the unique aspects of trial design in both pre-clinical and clinical settings and consider endpoints and markers of response best suited for an intervention involving multiple agents.

DOI: https://doi.org/10.1158/1078-0432.CCR-21-2681
Nat Commun. 2021 Sep 20. 12(1): 5531

Comprehensive molecular characterization of pediatric radiation-induced high-grade glioma.

John DeSisto, John T Lucas, Ke Xu, Andrew Donson, Tong Lin, Bridget Sanford, Gang Wu, Quynh T Tran, Dale Hedges, Chih-Yang Hsu, Gregory T Armstrong, Michael Arnold, Smita Bhatia, Patrick Flannery, Rakeb Lemma, Lakotah Hardie, Ulrich Schüller, Sujatha Venkataraman, Lindsey M Hoffman, Kathleen Dorris, Jean M Mulcahy Levy, Todd C Hankinson, Michael Handler, Arthur K Liu, Nicholas Foreman, Rajeev Vibhakar, Kenneth Jones, Sariah Allen, Jinghui Zhang, Suzanne J Baker, Thomas E Merchant, Brent A Orr, Adam L Green.

Radiation-induced high-grade gliomas (RIGs) are an incurable late complication of cranial radiation therapy. We performed DNA methylation profiling, RNA-seq, and DNA sequencing on 32 RIG tumors and an in vitro drug screen in two RIG cell lines. We report that based on DNA methylation, RIGs cluster primarily with the pediatric receptor tyrosine kinase I high-grade glioma subtype. Common copy-number alterations include Chromosome (Ch.) 1p loss/1q gain, and Ch. 13q and Ch. 14q loss; focal alterations include PDGFRA and CDK4 gain and CDKN2A and BCOR loss. Transcriptomically, RIGs comprise a stem-like subgroup with lesser mutation burden and Ch. 1p loss and a pro-inflammatory subgroup with greater mutation burden and depleted DNA repair gene expression. Chromothripsis in several RIG samples is associated with extrachromosomal circular DNA-mediated amplification of PDGFRA and CDK4. Drug screening suggests microtubule inhibitors/stabilizers, DNA-damaging agents, MEK inhibition, and, in the inflammatory subgroup, proteasome inhibitors, as potentially effective therapies.

DOI: https://doi.org/10.1038/s41467-021-25709-x
Nat Commun. 2021 Sep 20. 12(1): 5530

Radiation-induced gliomas represent H3-/IDH-wild type pediatric gliomas with recurrent PDGFRA amplification and loss of CDKN2A/B.

Maximilian Y Deng, Dominik Sturm, Elke Pfaff, Martin Sill, Damian Stichel, Gnana Prakash Balasubramanian, Stephan Tippelt, Christof Kramm, Andrew M Donson, Adam L Green, Chris Jones, Jens Schittenhelm, Martin Ebinger, Martin U Schuhmann, Barbara C Jones, Cornelis M van Tilburg, Andrea Wittmann, Andrey Golanov, Marina Ryzhova, Jonas Ecker, Till Milde, Olaf Witt, Felix Sahm, David Reuss, David Sumerauer, Josef Zamecnik, Andrey Korshunov, Andreas von Deimling, Stefan M Pfister, David T W Jones.

Long-term complications such as radiation-induced second malignancies occur in a subset of patients following radiation-therapy, particularly relevant in pediatric patients due to the long follow-up period in case of survival. Radiation-induced gliomas (RIGs) have been reported in patients after treatment with cranial irradiation for various primary malignancies such as acute lymphoblastic leukemia (ALL) and medulloblastoma (MB). We perform comprehensive (epi-) genetic and expression profiling of RIGs arising after cranial irradiation for MB (n = 23) and ALL (n = 9). Our study reveals a unifying molecular signature for the majority of RIGs, with recurrent PDGFRA amplification and loss of CDKN2A/B and an absence of somatic hotspot mutations in genes encoding histone 3 variants or IDH1/2, uncovering diagnostic markers and potentially actionable targets.

DOI: https://doi.org/10.1038/s41467-021-25708-y