Functional precision medicine identifies new therapeutic candidates for medulloblastoma

Medulloblastoma is among the most common malignant brain tumors in children. Recent studies have identified at least four subgroups of the disease that differ in terms of molecular characteristics and patient outcomes. Despite this heterogeneity, most patients with medulloblastoma receive similar th...

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Hauptverfasser: Rusert, Jessica M. (VerfasserIn) , Juarez, Edwin F. (VerfasserIn) , Brabetz, Sebastian (VerfasserIn) , Jensen, James (VerfasserIn) , Garancher, Alexandra (VerfasserIn) , Chau, Lianne Q. (VerfasserIn) , Tacheva-Grigorova, Silvia K. (VerfasserIn) , Wahab, Sameerah (VerfasserIn) , Udaka, Yoko T. (VerfasserIn) , Finlay, Darren (VerfasserIn) , Şeker-Cin, Huriye (VerfasserIn) , Reardon, Brendan (VerfasserIn) , Gröbner, Susanne (VerfasserIn) , Serrano, Jonathan (VerfasserIn) , Ecker, Jonas (VerfasserIn) , Qi, Lin (VerfasserIn) , Kogiso, Mari (VerfasserIn) , Du, Yuchen (VerfasserIn) , Baxter, Patricia A. (VerfasserIn) , Henderson, Jacob J. (VerfasserIn) , Berens, Michael E. (VerfasserIn) , Vuori, Kristiina (VerfasserIn) , Milde, Till (VerfasserIn) , Cho, Yoon-Jae (VerfasserIn) , Li, Xiao-Nan (VerfasserIn) , Olson, James M. (VerfasserIn) , Reyes, Iris (VerfasserIn) , Snuderl, Matija (VerfasserIn) , Wong, Terence C. (VerfasserIn) , Dimmock, David P. (VerfasserIn) , Nahas, Shareef A. (VerfasserIn) , Malicki, Denise (VerfasserIn) , Crawford, John R. (VerfasserIn) , Levy, Michael L. (VerfasserIn) , Allen, Eliezer M. Van (VerfasserIn) , Pfister, Stefan (VerfasserIn) , Tamayo, Pablo (VerfasserIn) , Kool, Marcel (VerfasserIn) , Mesirov, Jill P. (VerfasserIn) , Wechsler-Reya, Robert J. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: October 12, 2020
In: Cancer research
Year: 2020, Jahrgang: 80, Heft: 23, Pages: 5393-5407
ISSN:1538-7445
DOI:10.1158/0008-5472.CAN-20-1655
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1158/0008-5472.CAN-20-1655
Verlag, lizenzpflichtig, Volltext: https://cancerres.aacrjournals.org/content/80/23/5393
Volltext
Verfasserangaben:Jessica M. Rusert, Edwin F. Juarez, Sebastian Brabetz, James Jensen, Alexandra Garancher, Lianne Q. Chau, Silvia K. Tacheva-Grigorova, Sameerah Wahab, Yoko T. Udaka, Darren Finlay, Huriye Seker-Cin, Brendan Reardon, Susanne Gröbner, Jonathan Serrano, Jonas Ecker, Lin Qi, Mari Kogiso, Yuchen Du, Patricia A. Baxter, Jacob J. Henderson, Michael E. Berens, Kristiina Vuori, Till Milde, Yoon-Jae Cho, Xiao-Nan Li, James M. Olson, Iris Reyes, Matija Snuderl, Terence C. Wong, David P. Dimmock, Shareef A. Nahas, Denise Malicki, John R. Crawford, Michael L. Levy, Eliezer M. Van Allen, Stefan M. Pfister, Pablo Tamayo, Marcel Kool, Jill P. Mesirov, and Robert J. Wechsler-Reya

MARC

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520 |a Medulloblastoma is among the most common malignant brain tumors in children. Recent studies have identified at least four subgroups of the disease that differ in terms of molecular characteristics and patient outcomes. Despite this heterogeneity, most patients with medulloblastoma receive similar therapies, including surgery, radiation, and intensive chemotherapy. Although these treatments prolong survival, many patients still die from the disease and survivors suffer severe long-term side effects from therapy. We hypothesize that each patient with medulloblastoma is sensitive to different therapies and that tailoring therapy based on the molecular and cellular characteristics of patients' tumors will improve outcomes. To test this, we assembled a panel of orthotopic patient-derived xenografts (PDX) and subjected them to DNA sequencing, gene expression profiling, and high-throughput drug screening. Analysis of DNA sequencing revealed that most medulloblastomas do not have actionable mutations that point to effective therapies. In contrast, gene expression and drug response data provided valuable information about potential therapies for every tumor. For example, drug screening demonstrated that actinomycin D, which is used for treatment of sarcoma but rarely for medulloblastoma, was active against PDXs representing Group 3 medulloblastoma, the most aggressive form of the disease. Functional analysis of tumor cells was successfully used in a clinical setting to identify more treatment options than sequencing alone. These studies suggest that it should be possible to move away from a one-size-fits-all approach and begin to treat each patient with therapies that are effective against their specific tumor. - Significance: These findings show that high-throughput drug screening identifies therapies for medulloblastoma that cannot be predicted by genomic or transcriptomic analysis. 
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