Division of Pathology andHaematology, The Labatt Brain Tumor Research Centre, The Hospital for Sick Children,Toronto, Ontario, Canada.
J Clin Oncol. 2010 Mar 10;28(8):1337-44. doi: 10.1200/JCO.2009.25.5463. Epub 2010 Feb 8.
Diffuse intrinsic pontine glioma (DIPG) is one of the most devastating of pediatric malignancies and one for which no effective therapy exists. A major contributor to the failure of therapeutic trials is the assumption that biologic properties of brainstem tumors in children are identical to cerebral high-grade gliomas of adults. A better understanding of the biology of DIPG itself is needed in order to develop agents targeted more specifically to these children's disease. Herein, we address this lack of knowledge by performing the first high-resolution single nucleotide polymorphism (SNP) -based DNA microarray analysis of a series of DIPGs.
Eleven samples (nine postmortem and two pretreatment surgical samples), the largest series thus far examined, were hybridized to SNP arrays (250 k or 6.0). The study was approved by the research ethics board at our institution. All array findings were validated using quantitative polymerase chain reaction, fluorescence in situ hybridization, immunohistochemistry, and/or microsatellite analysis.
Analysis of DIPG copy number alterations showed recurrent changes distinct from those of pediatric supratentorial high-grade astrocytomas. Thirty-six percent of DIPGs had gains in platelet-derived growth factor receptor alpha (PDGFRA; 4 to 18 copies) and all showed PDGFR-alpha expression. Low-level gains in poly (ADP-ribose) polymerase (PARP) -1 were identified in three cases. Pathway analysis revealed genes with loss of heterozygosity were enriched for DNA repair pathways.
To our knowledge, our data provides the first, comprehensive high-resolution genomic analysis of pediatric DIPG. Our findings of recurrent involvement of the PDGFR pathway as well as defects in DNA repair pathways coupled with gain of PARP-1 highlight two potential, biologically based, therapeutic targets directed specifically at this devastating disease.
弥漫性内在脑桥神经胶质瘤(DIPG)是儿科最具破坏性的恶性肿瘤之一,目前尚无有效的治疗方法。治疗试验失败的一个主要原因是假设儿童脑干肿瘤的生物学特性与成人的高级别大脑胶质瘤相同。为了开发针对这些儿童疾病的更具针对性的药物,需要更好地了解 DIPG 本身的生物学特性。在这里,我们通过对一系列 DIPG 进行首次高分辨率单核苷酸多态性(SNP)-基于 DNA 微阵列分析来解决这一知识空白。
共分析了 11 个样本(9 个尸检样本和 2 个术前手术样本),这是迄今为止检查的最大系列,这些样本均与 SNP 芯片(250 k 或 6.0)杂交。该研究得到了我们机构研究伦理委员会的批准。所有阵列发现均使用定量聚合酶链反应、荧光原位杂交、免疫组织化学和/或微卫星分析进行验证。
DIPG 拷贝数改变的分析显示,与小儿幕上高级别星形细胞瘤的改变不同。36%的 DIPG 存在血小板衍生生长因子受体α(PDGFRA;4 至 18 个拷贝)的增益,并且所有 DIPG 均显示 PDGFR-α表达。在三个病例中发现了低水平的多聚(ADP-核糖)聚合酶 1(PARP-1)增益。通路分析显示杂合性缺失的基因富集了 DNA 修复途径。
据我们所知,我们的数据提供了首个全面的儿科 DIPG 高分辨率基因组分析。我们发现 PDGFR 途径的反复参与以及 DNA 修复途径的缺陷与 PARP-1 的增益相结合,突出了两个潜在的、基于生物学的、专门针对这种毁灭性疾病的治疗靶点。