Chromosome 9q and 16q loss identified by genome-wide pooled-analysis are associated with tumor aggressiveness in patients with classic medulloblastoma.

Medulloblastoma (MB) is one of the most aggressive pediatric brain tumor. We report genome-wide pooled-analysis of classic MB variant of patients over 3 years of age at diagnosis. We combined array comparative genomic hybridization (aCGH) results from experimental analysis (31 cases) with two public databases (55 cases) in a final evaluation of 86 MBs. The most common chromosome structural aberrations were gains of 17q (45.3%), 1q (22.1%), and losses of 8p (15.1%), 10q (19.8%), 17p (37.2%), and 16q (16.3%). Isochromome (17q) was observed in 29.1% MBs. A significant association between poor patients survival and losses of 9q (p < 0.0023), 10q (p < 0.012), and 16q (p < 0.036) was observed. Univariate analysis showed association of 9q loss (p < 0.008) and 16q loss (p = 0.05) with adverse overall survival (OS). Chromosome 6 monosomy was a protective event although statistically borderline (p = 0.066). After adjusting for confounding factors, a poor OS was found for patients whose tumor has 9q loss [hazard ratio (HR) = 3.97; p < 0.006) or 16q loss (HR = 2.41; p = 0.038). Our results highlight the importance of genomic studies in different MB histological variants and indicate a genotype-phenotype correlation.

[1]  L. Rorke,et al.  Effects of medulloblastoma resections on outcome in children: a report from the Children's Cancer Group. , 1996, Neurosurgery.

[2]  Jan Mollenhauer,et al.  DMBT1, a new member of the SRCR superfamily, on chromosome 10q25.3–26.1 is deleted in malignant brain tumours , 1997, Nature Genetics.

[3]  Dirk Troost,et al.  Integrated Genomics Identifies Five Medulloblastoma Subtypes with Distinct Genetic Profiles, Pathway Signatures and Clinicopathological Features , 2008, PloS one.

[4]  D. Ellison,et al.  Wnt/Wingless Pathway Activation and Chromosome 6 Loss Characterise a Distinct Molecular Sub-Group of Medulloblastomas Associated with a Favourable Prognosis , 2006, Cell cycle.

[5]  T Pietsch,et al.  Medulloblastomas of the desmoplastic variant carry mutations of the human homologue of Drosophila patched. , 1997, Cancer research.

[6]  P. Schürmann,et al.  C‐MYC expression in medulloblastoma and its prognostic value , 2000, International journal of cancer.

[7]  J. Crolla,et al.  Clinical and molecular stratification of disease risk in medulloblastoma , 2001, British Journal of Cancer.

[8]  Z. Piao,et al.  Deletion mapping of chromosome 16q in hepatocellular carcinoma , 1999, British Journal of Cancer.

[9]  S. Pomeroy,et al.  Expression of the neurotrophin receptor TrkC is linked to a favorable outcome in medulloblastoma. , 1994, Proceedings of the National Academy of Sciences of the United States of America.

[10]  R. Arceci Adult and Pediatric Medulloblastomas Are Genetically Distinct and Require Different Algorithms for Molecular Risk Stratification , 2010 .

[11]  P. Cogen,et al.  Tumor suppressor genes and medulloblastoma , 1996, Journal of Neuro-Oncology.

[12]  D. Frappaz,et al.  Standard-risk medulloblastoma treated by adjuvant chemotherapy followed by reduced-dose craniospinal radiation therapy: a French Society of Pediatric Oncology Study. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  J. Sklar,et al.  Correlation of loss of heterozygosity at chromosome 9q with histological subtype in medulloblastomas. , 1995, The American journal of pathology.

[14]  M. Meyerson,et al.  Recurrent allelic deletions of chromosome arms 15q and 16q in human small cell lung carcinomas , 2000, Genes, chromosomes & cancer.

[15]  C. Eberhart,et al.  Genome Wide Copy Number Abnormalities in Pediatric Medulloblastomas as Assessed by Array Comparative Genome Hybridization , 2007, Brain pathology.

[16]  G. Tonini,et al.  Application of microarray-based technology to neuroblastoma. , 2005, Cancer letters.

[17]  S. Wellek,et al.  Prospective randomised trial of chemotherapy given before radiotherapy in childhood medulloblastoma. International Society of Paediatric Oncology (SIOP) and the (German) Society of Paediatric Oncology (GPO): SIOP II. , 1995, Medical and pediatric oncology.

[18]  R. McLendon,et al.  Prognostic implications of chromosome 17p deletions in human medulloblastomas , 2005, Journal of Neuro-Oncology.

[19]  C. Dang,et al.  Histopathological and Molecular Prognostic Markers in Medulloblastoma: c‐myc, N‐myc, TrkC, and Anaplasia , 2004, Journal of neuropathology and experimental neurology.

[20]  T. Curran,et al.  Genomics identifies medulloblastoma subgroups that are enriched for specific genetic alterations. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[21]  T. MacDonald,et al.  Medulloblastoma: Present Concepts of Stratification into Risk Groups , 2003, Pediatric Neurosurgery.

[22]  W. Kuo,et al.  Identification of a Novel Homozygous Deletion Region at 6q23.1 in Medulloblastomas Using High-Resolution Array Comparative Genomic Hybridization Analysis , 2005, Clinical Cancer Research.

[23]  S. Pomeroy,et al.  Overlay analysis of the oligonucleotide array gene expression profiles and copy number abnormalities as determined by array comparative genomic hybridization in medulloblastomas , 2007, Genes, chromosomes & cancer.

[24]  W. Poon,et al.  Analysis of loss of heterozygosity on chromosomes 10q, 11, and 16 in medulloblastomas. , 2001, Journal of neurosurgery.

[25]  E. Housepian,et al.  An operative staging system and a megavoltage radiotherapeutic technic for cerebellar medulloblastomas. , 1969, Radiology.

[26]  J. Crolla,et al.  Imbalances of chromosome 17 in medulloblastomas determined by comparative genomic hybridisation and fluorescence in situ hybridisation , 2000, Molecular pathology : MP.

[27]  D. Ellison,et al.  Combined Histopathological and Molecular Cytogenetic Stratification of Medulloblastoma Patients , 2004, Clinical Cancer Research.

[28]  N. Carter,et al.  A comprehensive study of chromosome 16q in invasive ductal and lobular breast carcinoma using array CGH , 2006, Oncogene.

[29]  Axel Benner,et al.  Outcome prediction in pediatric medulloblastoma based on DNA copy-number aberrations of chromosomes 6q and 17q and the MYC and MYCN loci. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[30]  P. Burger,et al.  “Large Cell/Anaplastic” Medulloblastomas: A Pediatric Oncology Group Study , 2000, Journal of neuropathology and experimental neurology.

[31]  R. F. Farr,et al.  Cerebellar Medulloblastoma: Treatment by Irradiation of the Whole Central Nervous System , 1953 .

[32]  R. F. Farr,et al.  Cerebellar medulloblastoma: treatment by irradiation of the whole central nervous system. , 1953, Acta radiologica.

[33]  L. Rorke,et al.  Treatment of children with medulloblastomas with reduced-dose craniospinal radiation therapy and adjuvant chemotherapy: A Children's Cancer Group Study. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[34]  F. Baas,et al.  Genetic Alterations in Childhood Medulloblastoma Analyzed by Comparative Genomic Hybridization , 2002, Journal of pediatric hematology/oncology.

[35]  A. Feinberg,et al.  A third Wilms' tumor locus on chromosome 16q. , 1992, Cancer research.

[36]  T. MacDonald,et al.  Medulloblastoma in childhood: new biological advances , 2007, The Lancet Neurology.

[37]  L. Rorke,et al.  Metastasis stage, adjuvant treatment, and residual tumor are prognostic factors for medulloblastoma in children: conclusions from the Children's Cancer Group 921 randomized phase III study. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[38]  D. Ellison,et al.  Combined genome‐wide allelotyping and copy number analysis identify frequent genetic losses without copy number reduction in medulloblastoma , 2006, Genes, chromosomes & cancer.

[39]  A. Ayala,et al.  Gains and losses of DNA sequences in childhood brain tumors analyzed by comparative genomic hybridization. , 2000, Cancer genetics and cytogenetics.

[40]  T. Merchant,et al.  Risk-adapted craniospinal radiotherapy followed by high-dose chemotherapy and stem-cell rescue in children with newly diagnosed medulloblastoma (St Jude Medulloblastoma-96): long-term results from a prospective, multicentre trial. , 2006, The Lancet. Oncology.

[41]  K. Wang,et al.  Loss of Heterozygosity Analysis of Chromosome 17p13.1–13.3 and its Correlation with Clinical Outcome in Medulloblastomas , 2004, Journal of Neuro-Oncology.

[42]  Claire L Weston,et al.  beta-Catenin status predicts a favorable outcome in childhood medulloblastoma: the United Kingdom Children's Cancer Study Group Brain Tumour Committee. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[43]  S. Pomeroy,et al.  Gain of 1q Is a Potential Univariate Negative Prognostic Marker for Survival in Medulloblastoma , 2007, Clinical Cancer Research.