Glioneuronal tumor with ATRX alteration, kinase fusion and anaplastic features (GTAKA): a molecularly distinct brain tumor type with recurrent NTRK gene fusions

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Henri Bogumil - , University Hospital Heidelberg (Author)
  • Martin Sill - , Hopp Children's Cancer Center Heidelberg (KiTZ) (Author)
  • Daniel Schrimpf - , University Hospital Heidelberg (Author)
  • Britta Ismer - , Hopp Children's Cancer Center Heidelberg (KiTZ) (Author)
  • Christina Blume - , University Hospital Heidelberg (Author)
  • Ramin Rahmanzade - , University Hospital Heidelberg (Author)
  • Felix Hinz - , University Hospital Heidelberg (Author)
  • Asan Cherkezov - , University Hospital Heidelberg (Author)
  • Rouzbeh Banan - , University Hospital Heidelberg (Author)
  • Dennis Friedel - , University Hospital Heidelberg (Author)
  • David E Reuss - , University Hospital Heidelberg (Author)
  • Florian Selt - , Hopp Children's Cancer Center Heidelberg (KiTZ) (Author)
  • Jonas Ecker - , Hopp Children's Cancer Center Heidelberg (KiTZ) (Author)
  • Till Milde - , Hopp Children's Cancer Center Heidelberg (KiTZ) (Author)
  • Kristian W Pajtler - , Hopp Children's Cancer Center Heidelberg (KiTZ) (Author)
  • Jens Schittenhelm - , University Hospital Tübingen (Author)
  • Jürgen Hench - , University Hospital Basel (Author)
  • Stephan Frank - , University Hospital Basel (Author)
  • Henning B Boldt - , Odense University Hospital (Author)
  • Bjarne Winther Kristensen - , Odense University Hospital (Author)
  • David Scheie - , Copenhagen University Hospital Rigshospitalet (Author)
  • Linea C Melchior - , Copenhagen University Hospital Rigshospitalet (Author)
  • Viola Olesen - , Copenhagen University Hospital Rigshospitalet (Author)
  • Astrid Sehested - , Copenhagen University Hospital Rigshospitalet (Author)
  • Daniel R Boué - , Nationwide Children’s Hospital, Ohio State University (Author)
  • Zied Abdullaev - , National Cancer Institute (Author)
  • Laveniya Satgunaseelan - , Royal Prince Alfred Hospital (Author)
  • Ina Kurth - , German Cancer Research Center (DKFZ) (Author)
  • Annekatrin Seidlitz - , National Center for Tumor Diseases (Partners: UKD, MFD, HZDR, DKFZ), Department of Radiation Oncology, OncoRay ZIC - National Center for Radiation Research in Oncology (Partners: UKD, HZDR), University Hospital Carl Gustav Carus Dresden, German Cancer Research Center (DKFZ), Helmholtz-Zentrum Dresden-Rossendorf (Author)
  • Christine L White - , Hudson Institute of Medical Research (Author)
  • Ho-Keung Ng - , The Chinese University of Hong Kong, Shenzhen (Author)
  • Zhi-Feng Shi - , Hong Kong and Shanghai Brain Consortium (HSBC) (Author)
  • Christine Haberler - , Medical University of Vienna (Author)
  • Martina Deckert - , University of Cologne (Author)
  • Marco Timmer - , University of Cologne (Author)
  • Roland Goldbrunner - , University of Cologne (Author)
  • Arnault Tauziède-Espariat - , GHU Paris Psychiatrie & Neuro sciences (Author)
  • Pascale Varlet - , GHU Paris Psychiatrie & Neuro sciences (Author)
  • Sebastian Brandner - , University College London Hospitals NHS Foundation Trust (Author)
  • Sanda Alexandrescu - , Boston Children's Hospital (Author)
  • Matija Snuderl - , The Child Study Center at NYU Langone Medical Center (Author)
  • Kenneth Aldape - , National Cancer Institute (Author)
  • Andrey Korshunov - , University Hospital Heidelberg (Author)
  • Olaf Witt - , Hopp Children's Cancer Center Heidelberg (KiTZ) (Author)
  • Christel Herold-Mende - , University Hospital Heidelberg (Author)
  • Andreas Unterberg - , University Hospital Heidelberg (Author)
  • Wolfgang Wick - , German Cancer Research Center (DKFZ) (Author)
  • Stefan M Pfister - , Hopp Children's Cancer Center Heidelberg (KiTZ) (Author)
  • Andreas von Deimling - , University Hospital Heidelberg (Author)
  • David T W Jones - , Hopp Children's Cancer Center Heidelberg (KiTZ) (Author)
  • Felix Sahm - , University Hospital Heidelberg (Author)
  • Philipp Sievers - , University Hospital Heidelberg (Author)

Abstract

Glioneuronal tumors are a heterogenous group of CNS neoplasms that can be challenging to accurately diagnose. Molecular methods are highly useful in classifying these tumors-distinguishing precise classes from their histological mimics and identifying previously unrecognized types of tumors. Using an unsupervised visualization approach of DNA methylation data, we identified a novel group of tumors (n = 20) that formed a cluster separate from all established CNS tumor types. Molecular analyses revealed ATRX alterations (in 16/16 cases by DNA sequencing and/or immunohistochemistry) as well as potentially targetable gene fusions involving receptor tyrosine-kinases (RTK; mostly NTRK1-3) in all of these tumors (16/16; 100%). In addition, copy number profiling showed homozygous deletions of CDKN2A/B in 55% of cases. Histological and immunohistochemical investigations revealed glioneuronal tumors with isomorphic, round and often condensed nuclei, perinuclear clearing, high mitotic activity and microvascular proliferation. Tumors were mainly located supratentorially (84%) and occurred in patients with a median age of 19 years. Survival data were limited (n = 18) but point towards a more aggressive biology as compared to other glioneuronal tumors (median progression-free survival 12.5 months). Given their molecular characteristics in addition to anaplastic features, we suggest the term glioneuronal tumor with ATRX alteration, kinase fusion and anaplastic features (GTAKA) to describe these tumors. In summary, our findings highlight a novel type of glioneuronal tumor driven by different RTK fusions accompanied by recurrent alterations in ATRX and homozygous deletions of CDKN2A/B. Targeted approaches such as NTRK inhibition might represent a therapeutic option for patients suffering from these tumors.

Details

Original languageEnglish
Pages (from-to)667-680
Number of pages14
JournalActa neuropathologica
Volume145
Issue number5
Publication statusPublished - May 2023
Peer-reviewedYes

External IDs

PubMedCentral PMC10119244
Scopus 85150217489

Keywords

Keywords

  • Humans, Young Adult, Biomarkers, Tumor/genetics, Brain/pathology, Brain Neoplasms/genetics, Central Nervous System Neoplasms, Gene Fusion, Neoplasms, Neuroepithelial/genetics, Receptor Protein-Tyrosine Kinases/genetics, X-linked Nuclear Protein/genetics