bims-malgli 2022-06-26 papers

bims-malgli

Biomed News

on Biology of malignant gliomas

Issue of 2022–06–26
eightteen papers selected by
Oltea Sampetrean, Keio University

Novel cancer gene discovery using a forward genetic screen in RCAS-PDGFB-driven gliomas.
A map of the spatial distribution and tumour-associated macrophage states in glioblastoma and grade-4 IDH-mutant astrocytoma.
FRK inhibits glioblastoma progression via phosphorylating YAP and inducing its ubiquitylation and degradation by Siah1.
Editorial: Brain Tumors and Neuroinflammation.
Oct4A palmitoylation modulates tumorigenicity and stemness in human glioblastoma cells.
Spatiotemporal analysis of glioma heterogeneity reveals COL1A1 as an actionable target to disrupt tumor progression.
Pediatric high-grade gliomas and the WHO CNS Tumor Classification-Perspectives of pediatric neuro-oncologists and neuropathologists in light of recent updates.
Activation of STAT3 through combined SRC and EGFR signaling drives resistance to a mitotic kinesin inhibitor in glioblastoma.
Generation of immunocompetent syngeneic allograft mouse models for pediatric diffuse midline glioma.
Targeting Acid Ceramidase Inhibits Glioblastoma Cell Migration through Decreased AKT Signaling.
The first-in-human phase I study of a brain penetrant mutant IDH1 inhibitor DS-1001 in patients with recurrent or progressive IDH1-mutant gliomas.
Leptomeningeal disease and tumor dissemination in a murine diffuse intrinsic pontine glioma model: implications for the study of the tumor-cerebrospinal fluid-ependymal microenvironment.
Single-cell epigenetic analysis reveals principles of chromatin states in H3.3-K27M gliomas.
Wee1 kinase inhibitor adavosertib with radiation in newly diagnosed diffuse intrinsic pontine glioma: A Children's Oncology Group phase I consortium study.
Author Correction: Loss of MAT2A compromises methionine metabolism and represents a vulnerability in H3K27M mutant glioma by modulating the epigenome.
Update on the current knowledge of lymphatic drainage system and its emerging roles in glioma management.
Clinical implications of the 2021 edition of the WHO classification of central nervous system tumours.
BRAF inhibitors in BRAFV600E mutated pediatric high-grade gliomas: upfront or at recurrence?

Neuro Oncol. 2022 Jun 23. pii: noac158. [Epub ahead of print]

Novel cancer gene discovery using a forward genetic screen in RCAS-PDGFB-driven gliomas.

Holger Weishaupt, Matko Čančer, Gabriela Rosén, Karl O Holmberg, Susana Häggqvist, Ignas Bunikis, Yiwen Jiang, Smitha Sreedharan, Ulf Gyllensten, Oren J Becher, Lene Uhrbom, Adam Ameur, Fredrik J Swartling.

   BACKGROUND: Malignant gliomas, the most common malignant brain tumors in adults, represent a heterogeneous group of diseases with poor prognosis. Retroviruses can cause permanent genetic alterations that modify genes close to the viral integration site.
METHODS: Here we describe the use of a high-throughput pipeline coupled to the commonly used tissue-specific retroviral RCAS-TVA mouse tumor model system. Utilizing next generation sequencing, we show that retroviral integration sites can be reproducibly detected in malignant stem cell lines generated from RCAS-PDGFB-driven glioma biopsies.
RESULTS: A large fraction of common integration sites contained genes that have been dysregulated or misexpressed in glioma. Others overlapped with loci identified in previous glioma-related forward genetic screens, but several novel putative cancer-causing genes were also found. Integrating retroviral tagging and clinical data, Ppfibp1 was highlighted as a frequently tagged novel glioma-causing gene. Retroviral integrations into the locus resulted in Ppfibp1 upregulation, and Ppfibp1-tagged cells generated tumors with shorter latency upon orthotopic transplantation. In human gliomas, increased PPFIBP1 expression was significantly linked to poor prognosis and PDGF treatment resistance.
CONCLUSIONS: Altogether, the current study has demonstrated a novel approach to tagging glioma genes via forward genetics, validating previous results, and identifying PPFIBP1 as a putative oncogene in gliomagenesis.

Keywords:  Forward Genetics Screen; Glioblastoma; Liprin-beta-1; PDGFB; RCAS

DOI:  https://doi.org/10.1093/neuonc/noac158
J Pathol. 2022 Jun 20.

A map of the spatial distribution and tumour-associated macrophage states in glioblastoma and grade-4 IDH-mutant astrocytoma.

Wen Yin, Yi-Fang Ping, Fei Li, Sheng-Qing Lv, Xiao-Ning Zhang, Xue-Gang Li, Ying Guo, Qing Liu, Tian-Ran Li, Liu-Qing Yang, Kai-Di Yang, Yu-Qi Liu, Chun-Hua Luo, Tao Luo, Wen-Ying Wang, Min Mao, Min Luo, Zhi-Cheng He, Mian-Fu Cao, Cong Chen, Jing-Ya Miao, Hui Zeng, Chao Wang, Lei Zhou, Ying Yang, Xi Yang, Qiang-Hu Wang, Hua Feng, Yu Shi, Xiu-Wu Bian.

  Tumour-associated macrophages (TAMs) abundantly infiltrate high-grade gliomas and orchestrate immune response, but their diversity in isocitrate dehydrogenase (IDH)-differential grade-4 gliomas remains largely unknown. This study aimed to dissect the transcriptional states, spatial distribution and clinicopathological significance of distinct monocyte-derived TAM (Mo-TAM) and microglia-derived TAM (Mg-TAM) clusters across glioblastoma-IDH-wildtype and astrocytoma-IDH-mutant-grade 4 (Astro-IDH-mut-G4). Single-cell RNA sequencing was performed on four cases of human glioblastoma and three cases of Astro-IDH-mut-G4. Cell clustering, single-cell regulatory network inference and gene set enrichment analysis were performed to characterize the functional states of myeloid clusters. Spatial distribution of TAM subsets was determined in human glioma tissues using multiplex immunostaining. The prognostic value of different TAM-cluster specific geneset was evaluated in the TCGA glioma cohort. Profiling and unbiased clustering of 24,227 myeloid cells from glioblastoma and Astro-IDH-mut-G4 identified 9 myeloid cell clusters including monocyte, six Mo/Mg-TAM subsets, dendritic cell, and proliferative myeloid cluster. Different Mo/Mg-TAM clusters manifest functional and transcriptional diversity controlled by specific regulons. Multiplex immunostaining of subset-specific markers identified spatial enrichment of distinct TAM clusters at peri-vascular/necrotic areas in tumour parenchyma or at tumour-brain interface. Glioblastoma harboured a substantially higher number of monocytes and Mo-TAM-inflammatory cluster, whereas Astro-IDH-mut-G4 was with higher proportion of TAM subset mediating antigen presentation. Glioblastomas with higher proportion of monocytes exhibited a mesenchymal signature, increased angiogenesis and worse patient outcome. Our findings provide insight into myeloid cell diversity and its clinical relevance in IDH-differential grade-4 gliomas, and may serve as a resource for immunotherapy development. This article is protected by copyright. All rights reserved.

Keywords:  diffuse glioma; single-cell transcriptomics; spatial distribution; tumour-associated macrophage

DOI:  https://doi.org/10.1002/path.5984
Neuro Oncol. 2022 Jun 20. pii: noac156. [Epub ahead of print]

FRK inhibits glioblastoma progression via phosphorylating YAP and inducing its ubiquitylation and degradation by Siah1.

Yan Wang, Kai Wang, Jiale Fu, Yu Zhang, Yufei Mao, Xu Wang, Xiang Wang, Rutong Yu, Xiuping Zhou.

   BACKGROUND: We previously report that yes-associated protein (YAP), the core downstream effector of Hippo pathway, promotes the malignant progression of glioblastoma (GBM). However, although classical regulatory mechanisms of YAP are well explored, how YAP is modulated by the Hippo-independent manner remains poorly understood. Meanwhile, the non-receptor tyrosine kinase Fyn-related kinase (FRK), which exhibits low expression and possesses tumor suppressor effects in GBM, is reported to be involved in regulation of protein phosphorylation. Here, we examined whether FRK could impede tumor progression by modulating YAP activities.
METHODS: Human GBM cells and intracranial GBM model were used to assess the effects of FRK and YAP on the malignant biological behaviors of GBM. Immunoblotting and immunohistochemistry were used to detect the expression of core proteins in GBM tissues. Co-immunoprecipitation, proximity ligation assay, luciferase assay and ubiquitination assay were utilized to determine the protein-protein interactions and related molecular mechanisms.
RESULTS: The expression levels of FRK and YAP were inversely correlated with each other in glioma tissues. In addition, FRK promoted the ubiquitination and degradation of YAP, leading to tumor suppression in vitro and in vivo. Mechanistically, FRK interacted with and phosphorylated YAP on Tyr391/407/444, which recruited the classical E3 ubiquitin ligase Siah1 to catalyze ubiquitination and eventually degradation of YAP. Siah1 is required for YAP destabilization initiated by FRK.
CONCLUSIONS: We identify a novel mechanism by which FRK orchestrates tumor-suppression effect through phosphorylating YAP and inducing its ubiquitination by Siah1. FRK-Siah1-YAP signaling axis may serve as a potential therapeutic target for GBM treatment.

Keywords:  FRK; GBM; Siah1; YAP; ubiquitination

DOI:  https://doi.org/10.1093/neuonc/noac156
Front Cell Neurosci. 2022 ;16 941263

Editorial: Brain Tumors and Neuroinflammation.

Myriam Catalano.



Keywords:  GBM; gliomas; infiltration; neuroinflammation; phenotypic plasticity; tumor microenvironment; tumor-associated macrophages

DOI:  https://doi.org/10.3389/fncel.2022.941263
Neuro Oncol. 2022 Jun 21. pii: noac157. [Epub ahead of print]

Oct4A palmitoylation modulates tumorigenicity and stemness in human glioblastoma cells.

Xueran Chen, Wanxiang Niu, Xiaoqing Fan, Haoran Yang, Chenggang Zhao, Junqi Fan, Xuebiao Yao, Zhiyou Fang.

   BACKGROUND: Glioblastoma multiforme and other solid malignancies are heterogeneous, containing subpopulations of tumor cells that exhibit stem characteristics. Oct4, also known as POU5F1, is a key transcription factor in the self-renewal, proliferation, and differentiation of stem cells. Although it has been detected in advanced gliomas, the biological function of Oct4, and transcriptional machinery maintained by the stemness of Oct4 protein-mediated glioma stem cells (GSC), has not been fully determined.
METHODS: The expression of Oct4 variants was evaluated in brain-cancer cell lines, and in brain-tumor tissues, by quantitative real-time PCR, western blotting, and immunohistochemical analysis. The palmitoylation level of Oct4A was determined by the acyl-biotin exchange method, and the effects of palmitoylation Oct4A on GSCs were investigated by a series of in vitro (neuro-sphere formation assay, double immunofluorescence, pharmacological treatment, luciferase assay, and coimmunoprecipitation) and in vivo (xenograft model) experiments.
RESULTS: Here, we report that all three variants of Oct4 are expressed in different types of cerebral cancer, while Oct4A is important for maintaining tumorigenicity in GSCs. Palmitoylation mediated by ZDHHC17 was indispensable for preserving Oct4A from lysosome degradation to maintain its protein stability. Oct4A palmitoylation also helped to integrate Sox4 and Oct4A in the SOX2 enhancement subregion to maintain the stem performance of GSCs. We also designed Oct4A palmitoylation competitive inhibitors, inhibiting the self-renewal ability and tumorigenicity of GSCs.
CONCLUSIONS: These findings indicate that Oct4A acts on the tumorigenic activity of glioblastoma, and Oct4A palmitoylation is a candidate therapeutic target.

Keywords:  Glioblastoma multiforme; Glioma stem cells (GSCs); Oct4A; Palmitoylation; Sox2

DOI:  https://doi.org/10.1093/neuonc/noac157
Nat Commun. 2022 Jun 24. 13(1): 3606

Spatiotemporal analysis of glioma heterogeneity reveals COL1A1 as an actionable target to disrupt tumor progression.

Andrea Comba, Syed M Faisal, Patrick J Dunn, Anna E Argento, Todd C Hollon, Wajd N Al-Holou, Maria Luisa Varela, Daniel B Zamler, Gunnar L Quass, Pierre F Apostolides, Clifford Abel, Christine E Brown, Phillip E Kish, Alon Kahana, Celina G Kleer, Sebastien Motsch, Maria G Castro, Pedro R Lowenstein.

Intra-tumoral heterogeneity is a hallmark of glioblastoma that challenges treatment efficacy. However, the mechanisms that set up tumor heterogeneity and tumor cell migration remain poorly understood. Herein, we present a comprehensive spatiotemporal study that aligns distinctive intra-tumoral histopathological structures, oncostreams, with dynamic properties and a specific, actionable, spatial transcriptomic signature. Oncostreams are dynamic multicellular fascicles of spindle-like and aligned cells with mesenchymal properties, detected using ex vivo explants and in vivo intravital imaging. Their density correlates with tumor aggressiveness in genetically engineered mouse glioma models, and high grade human gliomas. Oncostreams facilitate the intra-tumoral distribution of tumoral and non-tumoral cells, and potentially the collective invasion of the normal brain. These fascicles are defined by a specific molecular signature that regulates their organization and function. Oncostreams structure and function depend on overexpression of COL1A1. Col1a1 is a central gene in the dynamic organization of glioma mesenchymal transformation, and a powerful regulator of glioma malignant behavior. Inhibition of Col1a1 eliminates oncostreams, reprograms the malignant histopathological phenotype, reduces expression of the mesenchymal associated genes, induces changes in the tumor microenvironment and prolongs animal survival. Oncostreams represent a pathological marker of potential value for diagnosis, prognosis, and treatment.

DOI: https://doi.org/10.1038/s41467-022-31340-1
Neurooncol Adv. 2022 Jan-Dec;4(1):4(1): vdac077

Pediatric high-grade gliomas and the WHO CNS Tumor Classification-Perspectives of pediatric neuro-oncologists and neuropathologists in light of recent updates.

Gerrit H Gielen, Joshua N Baugh, Dannis G van Vuurden, Sophie E M Veldhuijzen van Zanten, Darren Hargrave, Maura Massimino, Veronica Biassoni, Andres Morales la Madrid, Michael Karremann, Maria Wiese, Ulrich Thomale, Geert O Janssens, André O von Bueren, Thomas Perwein, Gunther Nussbaumer, Eelco W Hoving, Pitt Niehusmann, Marco Gessi, Robert Kwiecien, Simon Bailey, Torsten Pietsch, Felipe Andreiuolo, Christof M Kramm.

   Background: The WHO Classification of Tumors of the Central Nervous System has undergone major restructuring. Molecularly defined diagnostic criteria were introduced in 2016 (revised 4th edition) and expanded in 2021 (5th edition) to incorporate further essential diagnostic molecular parameters. We investigated potential differences between specialists in perception of these molecularly defined subtypes for pediatric high-grade gliomas (pedHGG).
Methods: We designed a 22-question survey studying the impact of the revised 4th edition of the WHO classification on pedHGG. Data were collected and statistically analyzed to examine the spectrum of viewpoints and possible differences between neuro-oncologists and neuropathologists.
Results: 465 participants from 53 countries were included; 187 pediatric neuro-oncologists (40%), 160 neuropathologists (34%), and 118 additional experts (26%). Neuro-oncologists reported issues with the introduction of molecularly defined tumor types, as well as the abolishment or renaming of established tumor entities, while neuropathologists did not to the same extent. Both groups indicated less relevant or insufficient diagnostic definitions were available in 2016. Reported issues were classified and assessed in the 2021 WHO classification and a substantial improvement was perceived. However, issues of high clinical relevance remain to be addressed, including the definition of clinical phenotypes for diffuse intrinsic pontine glioma and gliomatosis cerebri.
Conclusions: Within the WHO classification of pediatric brain tumors, such as pedHGG, rapid changes in molecular characterization have been introduced. This study highlights the ongoing need for cross talk between pathologist and oncologist to advance the classification of pedHGG subtypes and ensure biological relevance and clinical impact.

Keywords:  DIPG; World Health Organization; diffuse midline glioma; pediatric high-grade glioma

DOI:  https://doi.org/10.1093/noajnl/vdac077
Cell Rep. 2022 Jun 21. pii: S2211-1247(22)00777-X. [Epub ahead of print]39(12): 110991

Activation of STAT3 through combined SRC and EGFR signaling drives resistance to a mitotic kinesin inhibitor in glioblastoma.

Rajappa S Kenchappa, Athanassios Dovas, Michael G Argenziano, Christian T Meyer, Lauren E Stopfer, Matei A Banu, Brianna Pereira, Jessica Griffith, Afroz Mohammad, Surabhi Talele, Ashley Haddock, Natanael Zarco, William Elmquist, Forest White, Vito Quaranta, Peter Sims, Peter Canoll, Steven S Rosenfeld.

  Inhibitors of the mitotic kinesin Kif11 are anti-mitotics that, unlike vinca alkaloids or taxanes, do not disrupt microtubules and are not neurotoxic. However, development of resistance has limited their clinical utility. While resistance to Kif11 inhibitors in other cell types is due to mechanisms that prevent these drugs from disrupting mitosis, we find that in glioblastoma (GBM), resistance to the Kif11 inhibitor ispinesib works instead through suppression of apoptosis driven by activation of STAT3. This form of resistance requires dual phosphorylation of STAT3 residues Y705 and S727, mediated by SRC and epidermal growth factor receptor (EGFR), respectively. Simultaneously inhibiting SRC and EGFR reverses this resistance, and combined targeting of these two kinases in vivo with clinically available inhibitors is synergistic and significantly prolongs survival in ispinesib-treated GBM-bearing mice. We thus identify a translationally actionable approach to overcoming Kif11 inhibitor resistance that may work to block STAT3-driven resistance against other anti-cancer therapies as well.

Keywords:  CP: Cancer; EGFR; STAT3; Src; glioblastoma; inhibitor; kinesin

DOI:  https://doi.org/10.1016/j.celrep.2022.110991
Neurooncol Adv. 2022 Jan-Dec;4(1):4(1): vdac079

Generation of immunocompetent syngeneic allograft mouse models for pediatric diffuse midline glioma.

Aimée du Chatinier, Michaël H Meel, Arvid I Das, Dennis S Metselaar, Piotr Waranecki, Marianna Bugiani, Marjolein Breur, Erin F Simonds, Edbert D Lu, William A Weiss, Juan J Garcia Vallejo, Eelco W Hoving, Timothy N Phoenix, Esther Hulleman.

   Background: Diffuse midline gliomas (DMG) are highly malignant incurable pediatric brain tumors. A lack of effective treatment options highlights the need to investigate novel therapeutic strategies. This includes the use of immunotherapy, which has shown promise in other hard-to-treat tumors. To facilitate preclinical immunotherapeutic research, immunocompetent mouse models that accurately reflect the unique genetic, anatomical, and histological features of DMG patients are warranted.
Methods: We established cell cultures from primary DMG mouse models (C57BL/6) that were generated by brainstem targeted intra-uterine electroporation (IUE). We subsequently created allograft DMG mouse models by orthotopically implanting these tumor cells into syngeneic mice. Immunohistochemistry and -fluorescence, mass cytometry, and cell-viability assays were then used to verify that these murine tumors recapitulated human DMG.
Results: We generated three genetically distinct allograft models representing histone 3 wildtype (H3WT) and K27M-mutant DMG (H3.3K27M and H3.1K27M). These allograft models recapitulated the histopathologic phenotype of their human counterparts, including their diffuse infiltrative growth and expression of DMG-associated antigens. These murine pontine tumors also exhibited an immune microenvironment similar to human DMG, characterized by considerable myeloid cell infiltration and a paucity of T-lymphocytes and NK cells. Finally, we show that these murine DMG cells display similar sensitivity to histone deacetylase (HDAC) inhibition as patient-derived DMG cells.
Conclusions: We created and validated an accessible method to generate immunocompetent allograft models reflecting different subtypes of DMG. These models adequately recapitulated the histopathology, immune microenvironment, and therapeutic response of human DMG, providing useful tools for future preclinical studies.

Keywords:  DIPG; DMG; immunotherapy | syngeneic allograft; tumor microenvironment

DOI:  https://doi.org/10.1093/noajnl/vdac079
Cells. 2022 Jun 09. pii: 1873. [Epub ahead of print]11(12):

Targeting Acid Ceramidase Inhibits Glioblastoma Cell Migration through Decreased AKT Signaling.

Cyntanna C Hawkins, Amber B Jones, Emily R Gordon, Sarah E Williford, Yuvika Harsh, Julia K Ziebro, Catherine J Landis, Sajina Gc, David K Crossman, Sara J Cooper, Sasanka Ramanadham, Ninh Doan, Anita B Hjelmeland.

  Glioblastoma (GBM) remains one of the most aggressive cancers, partially due to its ability to migrate into the surrounding brain. The sphingolipid balance, or the balance between ceramides and sphingosine-1-phosphate, contributes to the ability of GBM cells to migrate or invade. Of the ceramidases which hydrolyze ceramides, acid ceramidase (ASAH1) is highly expressed in GBM samples compared to non-tumor brain. ASAH1 expression also correlates with genes associated with migration and focal adhesion. To understand the role of ASAH1 in GBM migration, we utilized shRNA knockdown and observed decreased migration that did not depend upon changes in growth. Next, we inhibited ASAH1 using carmofur, a clinically utilized small molecule inhibitor. Inhibition of ASAH1 by carmofur blocks in vitro migration of U251 (GBM cell line) and GBM cells derived from patient-derived xenografts (PDXs). RNA-sequencing suggested roles for carmofur in MAPK and AKT signaling. We found that carmofur treatment decreases phosphorylation of AKT, but not of MAPK. The decrease in AKT phosphorylation was confirmed by shRNA knockdown of ASAH1. Our findings substantiate ASAH1 inhibition using carmofur as a potential clinically relevant treatment to advance GBM therapeutics, particularly due to its impact on migration.

Keywords:  AKT; acid ceramidase; ceramides; glioblastoma; migration

DOI:  https://doi.org/10.3390/cells11121873
Neuro Oncol. 2022 Jun 20. pii: noac155. [Epub ahead of print]

The first-in-human phase I study of a brain penetrant mutant IDH1 inhibitor DS-1001 in patients with recurrent or progressive IDH1-mutant gliomas.

Atsushi Natsume, Yoshiki Arakawa, Yoshitaka Narita, Kazuhiko Sugiyama, Nobuhiro Hata, Yoshihiro Muragaki, Naoki Shinojima, Toshihiro Kumabe, Ryuta Saito, Kazuya Motomura, Yohei Mineharu, Yasuji Miyakita, Fumiyuki Yamasaki, Yuko Matsushita, Koichi Ichimura, Kazumi Ito, Masaya Tachibana, Yasuyuki Kakurai, Naoko Okamoto, Takashi Asahi, Soichiro Nishijima, Tomoyuki Yamaguchi, Hiroshi Tsubouchi, Hideo Nakamura, Ryo Nishikawa.

   BACKGROUND: Approximately 70% of lower-grade gliomas harbor isocitrate dehydrogenase 1 (IDH1) mutations, resulting in accumulation of oncometabolite D-2-hydroxyglutarate (D-2-HG); this leads to epigenetic dysregulation, oncogenesis, and subsequent clonal expansion. DS-1001 is an oral brain-penetrant mutant IDH1 selective inhibitor. This first-in-human study investigated the safety, pharmacokinetics, pharmacodynamics, and efficacy of DS-1001.
METHODS: This was a multicenter, open-label, dose-escalation, phase I study of DS-1001 for recurrent/progressive IDH1-mutant (R132) glioma (N = 47) (NCT03030066). DS-1001 was administered orally at 125-1400 mg twice daily. Dose escalation used a modified continual reassessment method.
RESULTS: The maximum tolerated dose was not reached. Eight patients were continuing treatment at the data cut-off. Most adverse events (AEs) were grade 1-2. Twenty patients (42.6%) experienced at least one grade 3 AE. No grade 4 or 5 AEs or serious drug-related AEs were reported. Common AEs (>20%) were skin hyperpigmentation, diarrhea, pruritus, alopecia, arthralgia, nausea, headache, rash, and dry skin. The objective response rates were 17.1% for enhancing tumors and 33.3% for non-enhancing tumors. Median progression-free survival was 10.4 months (95% confidence interval [CI], 6.1 to 17.7 months) and not reached (95% CI, 24.1 to not reached) for the enhancing and non-enhancing glioma cohorts, respectively. Seven on-treatment brain tumor samples showed a significantly lower amount of D-2-HG compared with pre-study archived samples.
CONCLUSIONS: DS-1001 was well-tolerated with a favorable brain distribution. Recurrent/progressive IDH1-mutant glioma patients responded to treatment. A study of DS-1001 in patients with chemotherapy- and radiotherapy-naïve IDH1-mutated WHO grade 2 glioma is ongoing (NCT04458272).

Keywords:  D-2-HG; DS-1001; IDH1-mutant gliomas; brain-penetrant selective IDH1 inhibitor; lower-grade glioma

DOI:  https://doi.org/10.1093/neuonc/noac155
Neurooncol Adv. 2022 Jan-Dec;4(1):4(1): vdac059

Leptomeningeal disease and tumor dissemination in a murine diffuse intrinsic pontine glioma model: implications for the study of the tumor-cerebrospinal fluid-ependymal microenvironment.

Shelei Pan, Dezhuang Ye, Yimei Yue, Lihua Yang, Christopher P Pacia, Dakota DeFreitas, Prabagaran Esakky, Sonika Dahiya, David D Limbrick, Joshua B Rubin, Hong Chen, Jennifer M Strahle.

   Background: Leptomeningeal disease and hydrocephalus are present in up to 30% of patients with diffuse intrinsic pontine glioma (DIPG), however there are no animal models of cerebrospinal fluid (CSF) dissemination. As the tumor-CSF-ependymal microenvironment may play an important role in tumor pathogenesis, we identified characteristics of the Nestin-tumor virus A (Nestin-Tva) genetically engineered mouse model that make it ideal to study the interaction of tumor cells with the CSF and its associated pathways with implications for the development of treatment approaches to address CSF dissemination in DIPG.
Methods: A Nestin-Tva model of DIPG utilizing the 3 most common DIPG genetic alterations (H3.3K27M, PDGF-B, and p53) was used for this study. All mice underwent MR imaging and a subset underwent histopathologic analysis with H&E and immunostaining.
Results: Tumor dissemination within the CSF pathways (ventricles, leptomeninges) from the subependyma was present in 76% (25/33) of mice, with invasion of the choroid plexus, disruption of the ciliated ependyma and regional subependymal fluid accumulation. Ventricular enlargement consistent with hydrocephalus was present in 94% (31/33). Ventricle volume correlated with region-specific transependymal CSF flow (periventricular T2 signal), localized anterior to the lateral ventricles.
Conclusions: This is the first study to report CSF pathway tumor dissemination associated with subependymal tumor in an animal model of DIPG and is representative of CSF dissemination seen clinically. Understanding the CSF-tumor-ependymal microenvironment has significant implications for treatment of DIPG through targeting mechanisms of tumor spread within the CSF pathways.

Keywords:  cerebrospinal fluid; diffuse intrinsic pontine glioma; hydrocephalus; leptomeninges; subventricular zone

DOI:  https://doi.org/10.1093/noajnl/vdac059
Mol Cell. 2022 Jun 10. pii: S1097-2765(22)00490-7. [Epub ahead of print]

Single-cell epigenetic analysis reveals principles of chromatin states in H3.3-K27M gliomas.

Nofar Harpaz, Tamir Mittelman, Olga Beresh, Ofir Griess, Noa Furth, Tomer-Meir Salame, Roni Oren, Liat Fellus-Alyagor, Alon Harmelin, Sanda Alexandrescu, Joana Graca Marques, Mariella G Filbin, Guy Ron, Efrat Shema.

  Cancer cells are highly heterogeneous at the transcriptional level and epigenetic state. Methods to study epigenetic heterogeneity are limited in throughput and information obtained per cell. Here, we adapted cytometry by time-of-flight (CyTOF) to analyze a wide panel of histone modifications in primary tumor-derived lines of diffused intrinsic pontine glioma (DIPG). DIPG is a lethal glioma, driven by a histone H3 lysine 27 mutation (H3-K27M). We identified two epigenetically distinct subpopulations in DIPG, reflecting inherent heterogeneity in expression of the mutant histone. These two subpopulations are robust across tumor lines derived from different patients and show differential proliferation capacity and expression of stem cell and differentiation markers. Moreover, we demonstrate the use of these high-dimensional data to elucidate potential interactions between histone modifications and epigenetic alterations during the cell cycle. Our work establishes new concepts for the analysis of epigenetic heterogeneity in cancer that could be applied to diverse biological systems.

Keywords:  CyTOF; DIPG; H3-K27M; cancer heterogeneity; chromatin; epigenetic heterogeneity; glioma; histone modifications; oncohistone; single-cell

DOI:  https://doi.org/10.1016/j.molcel.2022.05.023
Neurooncol Adv. 2022 Jan-Dec;4(1):4(1): vdac073

Wee1 kinase inhibitor adavosertib with radiation in newly diagnosed diffuse intrinsic pontine glioma: A Children's Oncology Group phase I consortium study.

Sabine Mueller, Tabitha Cooney, Xiaodong Yang, Sharmistha Pal, Ralph Ermoian, Amar Gajjar, Xiaowei Liu, Komal Prem, Charles G Minard, Joel M Reid, Marvin Nelson, Daphne Haas-Kogan, Elizabeth Fox, Brenda J Weigel.

   Background: Children with diffuse intrinsic pontine gliomas (DIPG) have a dismal prognosis. Adavosertib (AZD1775) is an orally available, blood-brain barrier penetrant, Wee1 kinase inhibitor. Preclinical efficacy against DIPG is heightened by radiation induced replication stress.
Methods: Using a rolling six design, 7 adavosertib dose levels (DLs) (50 mg/m2 alternating weeks, 50 mg/m2 alternating with weeks of every other day, 50 mg/m2, then 95, 130, 160, 200 mg/m2) were assessed. Adavosertib was only given on days of cranial radiation therapy (CRT).The duration of CRT (54 Gy over 30 fractions; 6 weeks) constituted the dose limiting toxicity (DLT) period. Endpoints included tolerability, pharmacokinetics, overall survival (OS) and peripheral blood γH2AX levels as a marker of DNA damage.
Results: A total of 46 eligible patients with newly diagnosed DIPG [median (range) age 6 (3-21) years; 52% female] were enrolled. The recommend phase 2 dose (RP2D) of adavosertib was 200 mg/m2/d during days of CRT. Dose limiting toxicity included ALT elevation (n = 1, DL4) and neutropenia (n = 1, DL7). The mean Tmax, T1/2 and Clp on Day 1 were 2 h, 4.4 h, and 45.2 L/hr/m2, respectively. Modest accumulation of adavosertib was observed comparing day 5 versus day 1 AUC0-8h (accumulation ratio = 1.6). OS was 11.1 months (95% CI: 9.4, 12.5) and did not differ from historical control.
Conclusion: Adavosertib in combination with CRT is well tolerated in children with newly diagnosed DIPG, however, compared to historical controls, did not improve OS. These results can inform future trial design in children with high-risk cancer.

Keywords:  DIPG; Wee1; adavosertib; radiation-sensitization; toxicity

DOI:  https://doi.org/10.1093/noajnl/vdac073
Nat Cancer. 2022 Jun 23.

Author Correction: Loss of MAT2A compromises methionine metabolism and represents a vulnerability in H3K27M mutant glioma by modulating the epigenome.

Brian J Golbourn, Matthew E Halbert, Katharine Halligan, Srinidhi Varadharajan, Brian Krug, Nneka E Mbah, Nisha Kabir, Ann-Catherine J Stanton, Abigail L Locke, Stephanie M Casillo, Yanhua Zhao, Lauren M Sanders, Allison Cheney, Steven J Mullett, Apeng Chen, Michelle Wassell, Anthony Andren, Jennifer Perez, Esther P Jane, Daniel R David Premkumar, Robert F Koncar, Shideh Mirhadi, Lauren H McCarl, Yue-Fang Chang, Yijen L Wu, Taylor A Gatesman, Andrea F Cruz, Michal Zapotocky, Baoli Hu, Gary Kohanbash, Xiuxing Wang, Alenoush Vartanian, Michael F Moran, Frank Lieberman, Nduka M Amankulor, Stacy G Wendell, Olena M Vaske, Ashok Panigrahy, James Felker, Kelsey C Bertrand, Claudia L Kleinman, Jeremy N Rich, Robert M Friedlander, Alberto Broniscer, Costas Lyssiotis, Nada Jabado, Ian F Pollack, Stephen C Mack, Sameer Agnihotri.

DOI: https://doi.org/10.1038/s43018-022-00407-9
Immunology. 2022 Jun 19.

Update on the current knowledge of lymphatic drainage system and its emerging roles in glioma management.

Yu-Long Lan, Hongjin Wang, Aiqin Chen, Jianmin Zhang.

  The draining of brain interstitial fluid (ISF) to cerebrospinal fluid (CSF) and the subsequent draining of CSF to meningeal lymphatics is well-known. Nonetheless, its role in the development of glioma is a remarkable finding that has to be extensively understood. The glymphatic system (GS) collects CSF from the subarachnoid space and brain ISF through aquaporin-4 (AQP4) water channels. The glial limiting membrane and the perivascular astrocyte-end-feet membrane both have elevated levels of AQP4. CSF is thought to drain through the nerve sheaths of the olfactory and other cranial nerves as well as spinal meningeal lymphatics via dorsal or basal lymphatic vessels. Meningeal lymphatic vessels (MLVs) exist below the skull in the dorsal and basal regions. In this view, MLVs offer a pathway to drain macromolecules and traffic immunological cells from the CNS into cervical lymph nodes (CLNs), and thus can be used as a candidate curing strategy against glioma and other associated complications, such as neuroinflammation. Taken together, the lymphatic drainage system could provide a route or approach for drug targeting of glioma and other neurological conditions. Nevertheless, its pathophysiological role in glioma remains elusive, which needs extensive research. The current review aims to explore the lymphatic drainage system, its role in glioma progression, and possible therapeutic techniques that target MLVs in the CNS. This article is protected by copyright. All rights reserved.

Keywords:  Glioma; Glymphatic system; Immune; Lymphatics; Treatment

DOI:  https://doi.org/10.1111/imm.13517
Nat Rev Neurol. 2022 Jun 21.

Clinical implications of the 2021 edition of the WHO classification of central nervous system tumours.

Craig Horbinski, Tamar Berger, Roger J Packer, Patrick Y Wen.

A new edition of the WHO classification of tumours of the CNS was published in 2021. Although the previous edition of this classification was published just 5 years earlier, in 2016, rapid advances in our understanding of the molecular underpinnings of CNS tumours, including the diversity of clinically relevant molecular types and subtypes, necessitated a new classification system. Compared with the 2016 scheme, the new classification incorporates even more molecular alterations into the diagnosis of many tumours and reorganizes gliomas into adult-type diffuse gliomas, paediatric-type diffuse low-grade and high-grade gliomas, circumscribed astrocytic gliomas, and ependymal tumours. A number of new entities are incorporated into the 2021 classification, especially tumours that preferentially or exclusively arise in the paediatric population. Such a substantial revision of the WHO scheme will have major implications for the diagnosis and treatment of patients with CNS tumours. In this Perspective, we summarize the main changes in the classification of diffuse and circumscribed gliomas, ependymomas, embryonal tumours and meningiomas, and discuss how each change will influence post-surgical treatment, clinical trial enrolment and cooperative studies. Although the 2021 WHO classification of CNS tumours is a major conceptual advance, its implementation on a routine clinical basis presents some challenges that will require innovative solutions.

DOI: https://doi.org/10.1038/s41582-022-00679-w
Neuro Oncol. 2022 Jun 24. pii: noac160. [Epub ahead of print]

BRAF inhibitors in BRAFV600E mutated pediatric high-grade gliomas: upfront or at recurrence?

Liana Nobre, Eric Bouffet.

DOI: https://doi.org/10.1093/neuonc/noac160