Ontology highlight
ABSTRACT: Background
Tumor heterogeneity underlies resistance and disease progression in glioblastoma (GBM), and tumors most commonly recur adjacent to the surgical resection margins in contrast non-enhancing (NE) regions. To date, no targeted therapies have meaningfully altered overall patient survival in the up-front setting. The aim of this study was to characterize intratumoral heterogeneity in recurrent GBM using bulk samples from primary resection and recurrent samples taken from contrast-enhancing (EN) and contrast NE regions.Methods
Whole exome and RNA sequencing were performed on matched bulk primary and multiple recurrent EN and NE tumor samples from 16 GBM patients who received standard of care treatment alone or in combination with investigational clinical trial regimens.Results
Private mutations emerge across multi-region sampling in recurrent tumors. Genomic clonal analysis revealed increased enrichment in gene alterations regulating the G2M checkpoint, Kras signaling, Wnt signaling, and DNA repair in recurrent disease. Subsequent functional studies identified augmented PI3K/AKT transcriptional and protein activity throughout progression, validated by phospho-protein levels. Moreover, a mesenchymal transcriptional signature was observed in recurrent EN regions, which differed from the proneural signature in recurrent NE regions.Conclusions
Subclonal populations observed within bulk resected primary GBMs transcriptionally evolve across tumor recurrence (EN and NE regions) and exhibit aberrant gene expression of common signaling pathways that persist despite standard or targeted therapy. Our findings provide evidence that there are both adaptive and clonally mediated dependencies of GBM on key pathways, such as the PI3K/AKT axis, for survival across recurrences.
SUBMITTER: Blomquist MR
PROVIDER: S-EPMC7388612 | biostudies-literature | 2020 Jan-Dec
REPOSITORIES: biostudies-literature
Blomquist Mylan R MR Ensign Shannon Fortin SF D'Angelo Fulvio F Phillips Joanna J JJ Ceccarelli Michele M Peng Sen S Halperin Rebecca F RF Caruso Francesca P FP Garofano Luciano L Byron Sara A SA Liang Winnie S WS Craig David W DW Carpten John D JD Prados Michael D MD Trent Jeffrey M JM Berens Michael E ME Iavarone Antonio A Dhruv Harshil H Tran Nhan L NL
Neuro-oncology advances 20200101 1
<h4>Background</h4>Tumor heterogeneity underlies resistance and disease progression in glioblastoma (GBM), and tumors most commonly recur adjacent to the surgical resection margins in contrast non-enhancing (NE) regions. To date, no targeted therapies have meaningfully altered overall patient survival in the up-front setting. The aim of this study was to characterize intratumoral heterogeneity in recurrent GBM using bulk samples from primary resection and recurrent samples taken from contrast-en ...[more]