TERT promoter wild-type glioblastomas show distinct clinical features and frequent PI3K pathway mutations

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Erik A Williams - , Harvard Medical School (HMS) (Author)
  • Julie J Miller - , Harvard Medical School (HMS) (Author)
  • Shilpa S Tummala - , Harvard Medical School (HMS) (Author)
  • Tristan Penson - , Harvard Medical School (HMS) (Author)
  • A John Iafrate - , Harvard Medical School (HMS) (Author)
  • Tareq A Juratli - , Massachusetts General Hospital, Harvard Medical School (HMS) (Author)
  • Daniel P Cahill - , Harvard Medical School (HMS) (Author)

Abstract

TERT promoter (TERTp) mutations are found in the majority of World Health Organization (WHO) grade IV adult IDH wild-type glioblastoma (IDH-wt GBM). Here, we characterized the subset of IDH-wt GBMs that do not have TERTp mutations. In a cohort of 121 adult grade IV gliomas, we identified 109 IDH-wt GBMs, after excluding 11 IDH-mutant cases and one H3F3A -mutant case. Within the IDH-wt cases, 16 cases (14.7%) were TERTp wild-type (TERTp-wt). None of the 16 had BRAF V600E or H3F3A G34 hotspot mutations. When compared to TERTp mutants, patients with TERTp-wt GBMs, were significantly younger at first diagnosis (53.2 years vs. 60.7 years, p = 0.0096), and were more frequently found to have cerebellar location (p = 0.0027). Notably, 9 of 16 (56%) of TERTp-wt GBMs contained a PIK3CA or PIK3R1 mutation, while only 16/93 (17%) of TERTp-mutant GBMs harbored these alterations (p = 0.0018). As expected, 8/16 (50%) of TERTp-wt GBMs harbored mutations in the BAF complex gene family (ATRX, SMARCA4, SMARCB1, and ARID1A), compared with only 8/93 (9%) of TERTp-mutant GBMs (p = 0.0003). Mutations in BAF complex and PI3K pathway genes co-occurred more frequently in TERTp-wt GBMs (p = 0.0002), an association that has been observed in other cancers, suggesting a functional interaction indicative of a distinct pathway of gliomagenesis. Overall, our finding highlights heterogeneity within WHO-defined IDH wild-type GBMs and enrichment of the TERTp-wt subset for BAF/PI3K-altered tumors, potentially comprising a distinct clinical subtype of gliomas.

Details

Original languageEnglish
Article number106
JournalActa neuropathologica communications
Volume6
Issue number1
Publication statusPublished - 17 Oct 2018
Peer-reviewedYes
Externally publishedYes

External IDs

PubMedCentral PMC6193287
Scopus 85055077834

Keywords

Sustainable Development Goals

Keywords

  • Adolescent, Adult, Aged, Aged, 80 and over, Brain Neoplasms/genetics, Cohort Studies, DNA Modification Methylases/metabolism, DNA Repair Enzymes/metabolism, Female, Gene Expression Regulation, Neoplastic/genetics, Glioblastoma/genetics, Humans, Isocitrate Dehydrogenase/genetics, Male, Middle Aged, Mutation/genetics, Phosphatidylinositol 3-Kinases/genetics, Promoter Regions, Genetic/genetics, Signal Transduction/genetics, Telomerase/genetics, Tumor Suppressor Proteins/metabolism, Young Adult