Skip to main content
Top
Published in: Acta Neuropathologica 5/2012

01-05-2012 | Original Paper

A prognostic gene expression signature in infratentorial ependymoma

Authors: Khalida Wani, Terri S. Armstrong, Elizabeth Vera-Bolanos, Aditya Raghunathan, David Ellison, Richard Gilbertson, Brian Vaillant, Stewart Goldman, Roger J. Packer, Maryam Fouladi, Ian Pollack, Tom Mikkelsen, Michael Prados, Antonio Omuro, Riccardo Soffietti, Alicia Ledoux, Charmaine Wilson, Lihong Long, Mark R. Gilbert, Ken Aldape, For the Collaborative Ependymoma Research Network

Published in: Acta Neuropathologica | Issue 5/2012

Login to get access

Abstract

Patients with ependymoma exhibit a wide range of clinical outcomes that are currently unexplained by clinical or histological factors. Little is known regarding molecular biomarkers that could predict clinical behavior. Since recent data suggest that these tumors display biological characteristics according to their location (cerebral vs. infratentorial vs. spinal cord), rather than explore a broad spectrum of ependymoma, we focused on molecular alterations in ependymomas arising in the infratentorial compartment. Unsupervised clustering of available gene expression microarray data revealed two major subgroups of infratentorial ependymoma. Group 1 tumors over expressed genes that were associated with mesenchyme, Group 2 tumors showed no distinct gene ontologies. To assess the prognostic significance of these gene expression subgroups, real-time reverse transcriptase polymerase chain reaction assays were performed on genes defining the subgroups in a training set. This resulted in a 10-gene prognostic signature. Multivariate analysis showed that the 10-gene signature was an independent predictor of recurrence-free survival after adjusting for clinical factors. Evaluation of an external dataset describing subgroups of infratentorial ependymomas showed concordance of subgroup definition, including validation of the mesenchymal subclass. Importantly, the 10-gene signature was validated as a predictor of recurrence-free survival in this dataset. Taken together, the results indicate a link between clinical outcome and biologically identified subsets of infratentorial ependymoma and offer the potential for prognostic testing to estimate clinical aggressiveness in these tumors.
Appendix
Available only for authorised users
Literature
1.
go back to reference Altura RA, Olshefski RS, Jiang Y, Boue DR (2003) Nuclear expression of survivin in paediatric ependymomas and choroid plexus tumours correlates with morphologic tumour grade. Br J Cancer 89:1743–1749PubMedCrossRef Altura RA, Olshefski RS, Jiang Y, Boue DR (2003) Nuclear expression of survivin in paediatric ependymomas and choroid plexus tumours correlates with morphologic tumour grade. Br J Cancer 89:1743–1749PubMedCrossRef
2.
go back to reference Armstrong TS, Vera-Bolanos E, Gilbert MR (2011) Clinical course of adult patients with ependymoma: results of the Adult Ependymoma Outcomes Project. Cancer 117:5133–5141PubMedCrossRef Armstrong TS, Vera-Bolanos E, Gilbert MR (2011) Clinical course of adult patients with ependymoma: results of the Adult Ependymoma Outcomes Project. Cancer 117:5133–5141PubMedCrossRef
3.
go back to reference Bennetto L, Foreman N, Harding B, Hayward R, Ironside J, Love S, Ellison D (1998) Ki-67 immunolabelling index is a prognostic indicator in childhood posterior fossa ependymomas. Neuropathol Appl Neurobiol 24:434–440PubMedCrossRef Bennetto L, Foreman N, Harding B, Hayward R, Ironside J, Love S, Ellison D (1998) Ki-67 immunolabelling index is a prognostic indicator in childhood posterior fossa ependymomas. Neuropathol Appl Neurobiol 24:434–440PubMedCrossRef
4.
go back to reference Brannon AR, Reddy A, Seiler M et al (2010) Molecular stratification of clear cell renal cell carcinoma by consensus clustering reveals distinct subtypes and survival patterns. Genes Cancer 1:152–163PubMedCrossRef Brannon AR, Reddy A, Seiler M et al (2010) Molecular stratification of clear cell renal cell carcinoma by consensus clustering reveals distinct subtypes and survival patterns. Genes Cancer 1:152–163PubMedCrossRef
5.
go back to reference Brase JC, Schmidt M, Fischbach T, Sultmann H, Bojar H, Koelbl H, Hellwig B, Rahnenfuhrer J, Hengstler JG, Gehrmann MC (2010) ERBB2 and TOP2A in breast cancer: a comprehensive analysis of gene amplification, RNA levels, and protein expression and their influence on prognosis and prediction. Clin Cancer Res 16:2391–2401PubMedCrossRef Brase JC, Schmidt M, Fischbach T, Sultmann H, Bojar H, Koelbl H, Hellwig B, Rahnenfuhrer J, Hengstler JG, Gehrmann MC (2010) ERBB2 and TOP2A in breast cancer: a comprehensive analysis of gene amplification, RNA levels, and protein expression and their influence on prognosis and prediction. Clin Cancer Res 16:2391–2401PubMedCrossRef
6.
go back to reference Colman H, Zhang L, Sulman EP et al (2010) A multigene predictor of outcome in glioblastoma. Neuro Oncol 12:49–57PubMedCrossRef Colman H, Zhang L, Sulman EP et al (2010) A multigene predictor of outcome in glioblastoma. Neuro Oncol 12:49–57PubMedCrossRef
7.
go back to reference Diaz-Moralli S, Tarrado-Castellarnau M, Alenda C, Castells A, Cascante M (2011) Transketolase-like 1 expression is modulated during colorectal cancer progression and metastasis formation. PLoS One 6:e25323PubMedCrossRef Diaz-Moralli S, Tarrado-Castellarnau M, Alenda C, Castells A, Cascante M (2011) Transketolase-like 1 expression is modulated during colorectal cancer progression and metastasis formation. PLoS One 6:e25323PubMedCrossRef
8.
go back to reference Donson AM, Birks DK, Barton VN, Wei Q, Kleinschmidt-Demasters BK, Handler MH, Waziri AE, Wang M, Foreman NK (2009) Immune gene and cell enrichment is associated with a good prognosis in ependymoma. J Immunol 183:7428–7440PubMedCrossRef Donson AM, Birks DK, Barton VN, Wei Q, Kleinschmidt-Demasters BK, Handler MH, Waziri AE, Wang M, Foreman NK (2009) Immune gene and cell enrichment is associated with a good prognosis in ependymoma. J Immunol 183:7428–7440PubMedCrossRef
9.
go back to reference Ebert C, von Haken M, Meyer-Puttlitz B, Wiestler OD, Reifenberger G, Pietsch T, von Deimling A (1999) Molecular genetic analysis of ependymal tumors. NF2 mutations and chromosome 22q loss occur preferentially in intramedullary spinal ependymomas. Am J Pathol 155:627–632PubMedCrossRef Ebert C, von Haken M, Meyer-Puttlitz B, Wiestler OD, Reifenberger G, Pietsch T, von Deimling A (1999) Molecular genetic analysis of ependymal tumors. NF2 mutations and chromosome 22q loss occur preferentially in intramedullary spinal ependymomas. Am J Pathol 155:627–632PubMedCrossRef
10.
go back to reference Freije WA, Castro-Vargas FE, Fang Z, Horvath S, Cloughesy T, Liau LM, Mischel PS, Nelson SF (2004) Gene expression profiling of gliomas strongly predicts survival. Cancer Res 64:6503–6510PubMedCrossRef Freije WA, Castro-Vargas FE, Fang Z, Horvath S, Cloughesy T, Liau LM, Mischel PS, Nelson SF (2004) Gene expression profiling of gliomas strongly predicts survival. Cancer Res 64:6503–6510PubMedCrossRef
11.
go back to reference Gilbertson RJ, Bentley L, Hernan R, Junttila TT, Frank AJ, Haapasalo H, Connelly M, Wetmore C, Curran T, Elenius K, Ellison DW (2002) ERBB receptor signaling promotes ependymoma cell proliferation and represents a potential novel therapeutic target for this disease. Clin Cancer Res 8:3054–3064PubMed Gilbertson RJ, Bentley L, Hernan R, Junttila TT, Frank AJ, Haapasalo H, Connelly M, Wetmore C, Curran T, Elenius K, Ellison DW (2002) ERBB receptor signaling promotes ependymoma cell proliferation and represents a potential novel therapeutic target for this disease. Clin Cancer Res 8:3054–3064PubMed
12.
go back to reference Guyotat J, Metellus P, Giorgi R, Barrie M, Jouvet A, Fevre-Montange M, Chinot O, Durand A, Figarella-Branger D (2009) Infratentorial ependymomas: prognostic factors and outcome analysis in a multi-center retrospective series of 106 adult patients. Acta Neurochir (Wien) 151:947–960CrossRef Guyotat J, Metellus P, Giorgi R, Barrie M, Jouvet A, Fevre-Montange M, Chinot O, Durand A, Figarella-Branger D (2009) Infratentorial ependymomas: prognostic factors and outcome analysis in a multi-center retrospective series of 106 adult patients. Acta Neurochir (Wien) 151:947–960CrossRef
14.
go back to reference Healey EA, Barnes PD, Kupsky WJ, Scott RM, Sallan SE, Black PM, Tarbell NJ (1991) The prognostic significance of postoperative residual tumor in ependymoma. Neurosurgery 28:666–671PubMedCrossRef Healey EA, Barnes PD, Kupsky WJ, Scott RM, Sallan SE, Black PM, Tarbell NJ (1991) The prognostic significance of postoperative residual tumor in ependymoma. Neurosurgery 28:666–671PubMedCrossRef
15.
go back to reference Jeuken JW, Sprenger SH, Gilhuis J, Teepen HL, Grotenhuis AJ, Wesseling P (2002) Correlation between localization, age, and chromosomal imbalances in ependymal tumours as detected by CGH. J Pathol 197:238–244PubMedCrossRef Jeuken JW, Sprenger SH, Gilhuis J, Teepen HL, Grotenhuis AJ, Wesseling P (2002) Correlation between localization, age, and chromosomal imbalances in ependymal tumours as detected by CGH. J Pathol 197:238–244PubMedCrossRef
16.
go back to reference Johnson RA, Wright KD, Poppleton H et al (2010) Cross-species genomics matches driver mutations and cell compartments to model ependymoma. Nature 466:632–636PubMedCrossRef Johnson RA, Wright KD, Poppleton H et al (2010) Cross-species genomics matches driver mutations and cell compartments to model ependymoma. Nature 466:632–636PubMedCrossRef
17.
go back to reference Korshunov A, Golanov A, Timirgaz V (2001) p14ARF protein (FL-132) immunoreactivity in intracranial ependymomas and its prognostic significance: an analysis of 103 cases. Acta Neuropathol 102:271–277PubMed Korshunov A, Golanov A, Timirgaz V (2001) p14ARF protein (FL-132) immunoreactivity in intracranial ependymomas and its prognostic significance: an analysis of 103 cases. Acta Neuropathol 102:271–277PubMed
18.
go back to reference Korshunov A, Golanov A, Timirgaz V (2002) Immunohistochemical markers for prognosis of ependymal neoplasms. J Neurooncol 58:255–270PubMedCrossRef Korshunov A, Golanov A, Timirgaz V (2002) Immunohistochemical markers for prognosis of ependymal neoplasms. J Neurooncol 58:255–270PubMedCrossRef
19.
go back to reference Korshunov A, Neben K, Wrobel G, Tews B, Benner A, Hahn M, Golanov A, Lichter P (2003) Gene expression patterns in ependymomas correlate with tumor location, grade, and patient age. Am J Pathol 163:1721–1727PubMedCrossRef Korshunov A, Neben K, Wrobel G, Tews B, Benner A, Hahn M, Golanov A, Lichter P (2003) Gene expression patterns in ependymomas correlate with tumor location, grade, and patient age. Am J Pathol 163:1721–1727PubMedCrossRef
20.
go back to reference Korshunov A, Witt H, Hielscher T et al (2010) Molecular staging of intracranial ependymoma in children and adults. J Clin Oncol 28:3182–3190PubMedCrossRef Korshunov A, Witt H, Hielscher T et al (2010) Molecular staging of intracranial ependymoma in children and adults. J Clin Oncol 28:3182–3190PubMedCrossRef
21.
go back to reference Kuncova K, Janda A, Kasal P, Zamecnik J (2009) Immunohistochemical prognostic markers in intracranial ependymomas: systematic review and meta-analysis. Pathol Oncol Res 15:605–614PubMedCrossRef Kuncova K, Janda A, Kasal P, Zamecnik J (2009) Immunohistochemical prognostic markers in intracranial ependymomas: systematic review and meta-analysis. Pathol Oncol Res 15:605–614PubMedCrossRef
22.
go back to reference Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109PubMedCrossRef Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109PubMedCrossRef
23.
go back to reference Massimino M, Buttarelli FR, Antonelli M, Gandola L, Modena P, Giangaspero F (2009) Intracranial ependymoma: factors affecting outcome. Future Oncol 5:207–216PubMedCrossRef Massimino M, Buttarelli FR, Antonelli M, Gandola L, Modena P, Giangaspero F (2009) Intracranial ependymoma: factors affecting outcome. Future Oncol 5:207–216PubMedCrossRef
24.
go back to reference Modena P, Lualdi E, Facchinetti F et al (2006) Identification of tumor-specific molecular signatures in intracranial ependymoma and association with clinical characteristics. J Clin Oncol 24:5223–5233PubMedCrossRef Modena P, Lualdi E, Facchinetti F et al (2006) Identification of tumor-specific molecular signatures in intracranial ependymoma and association with clinical characteristics. J Clin Oncol 24:5223–5233PubMedCrossRef
25.
go back to reference Palm T, Figarella-Branger D, Chapon F, Lacroix C, Gray F, Scaravilli F, Ellison DW, Salmon I, Vikkula M, Godfraind C (2009) Expression profiling of ependymomas unravels localization and tumor grade-specific tumorigenesis. Cancer 115:3955–3968PubMedCrossRef Palm T, Figarella-Branger D, Chapon F, Lacroix C, Gray F, Scaravilli F, Ellison DW, Salmon I, Vikkula M, Godfraind C (2009) Expression profiling of ependymomas unravels localization and tumor grade-specific tumorigenesis. Cancer 115:3955–3968PubMedCrossRef
26.
go back to reference Paulino AC (2002) Radiotherapeutic management of intracranial ependymoma. Pediatr Hematol Oncol 19:295–308PubMedCrossRef Paulino AC (2002) Radiotherapeutic management of intracranial ependymoma. Pediatr Hematol Oncol 19:295–308PubMedCrossRef
27.
go back to reference Peyre M, Commo F, Dantas-Barbosa C et al (2010) Portrait of ependymoma recurrence in children: biomarkers of tumor progression identified by dual-color microarray-based gene expression analysis. PLoS One 5:e12932PubMedCrossRef Peyre M, Commo F, Dantas-Barbosa C et al (2010) Portrait of ependymoma recurrence in children: biomarkers of tumor progression identified by dual-color microarray-based gene expression analysis. PLoS One 5:e12932PubMedCrossRef
28.
go back to reference Pezzolo A, Capra V, Raso A, Morandi F, Parodi F, Gambini C, Nozza P, Giangaspero F, Cama A, Pistoia V, Garre ML (2008) Identification of novel chromosomal abnormalities and prognostic cytogenetics markers in intracranial pediatric ependymoma. Cancer Lett 261:235–243PubMedCrossRef Pezzolo A, Capra V, Raso A, Morandi F, Parodi F, Gambini C, Nozza P, Giangaspero F, Cama A, Pistoia V, Garre ML (2008) Identification of novel chromosomal abnormalities and prognostic cytogenetics markers in intracranial pediatric ependymoma. Cancer Lett 261:235–243PubMedCrossRef
29.
go back to reference Phillips HS, Kharbanda S, Chen R et al (2006) Molecular subclasses of high-grade glioma predict prognosis, delineate a pattern of disease progression, and resemble stages in neurogenesis. Cancer Cell 9:157–173PubMedCrossRef Phillips HS, Kharbanda S, Chen R et al (2006) Molecular subclasses of high-grade glioma predict prognosis, delineate a pattern of disease progression, and resemble stages in neurogenesis. Cancer Cell 9:157–173PubMedCrossRef
30.
go back to reference Ridley L, Rahman R, Brundler MA et al (2008) Multifactorial analysis of predictors of outcome in pediatric intracranial ependymoma. Neuro Oncol 10:675–689PubMedCrossRef Ridley L, Rahman R, Brundler MA et al (2008) Multifactorial analysis of predictors of outcome in pediatric intracranial ependymoma. Neuro Oncol 10:675–689PubMedCrossRef
31.
go back to reference Robertson PL, Zeltzer PM, Boyett JM et al (1998) Survival and prognostic factors following radiation therapy and chemotherapy for ependymomas in children: a report of the Children’s Cancer Group. J Neurosurg 88:695–703PubMedCrossRef Robertson PL, Zeltzer PM, Boyett JM et al (1998) Survival and prognostic factors following radiation therapy and chemotherapy for ependymomas in children: a report of the Children’s Cancer Group. J Neurosurg 88:695–703PubMedCrossRef
32.
go back to reference Rousseau E, Ruchoux MM, Scaravilli F, Chapon F, Vinchon M, De Smet C, Godfraind C, Vikkula M (2003) CDKN2A, CDKN2B and p14ARF are frequently and differentially methylated in ependymal tumours. Neuropathol Appl Neurobiol 29:574–583PubMedCrossRef Rousseau E, Ruchoux MM, Scaravilli F, Chapon F, Vinchon M, De Smet C, Godfraind C, Vikkula M (2003) CDKN2A, CDKN2B and p14ARF are frequently and differentially methylated in ependymal tumours. Neuropathol Appl Neurobiol 29:574–583PubMedCrossRef
33.
go back to reference Sparano JA, Paik S (2008) Development of the 21-gene assay and its application in clinical practice and clinical trials. J Clin Oncol 26:721–728PubMedCrossRef Sparano JA, Paik S (2008) Development of the 21-gene assay and its application in clinical practice and clinical trials. J Clin Oncol 26:721–728PubMedCrossRef
34.
go back to reference Suarez-Merino B, Hubank M, Revesz T, Harkness W, Hayward R, Thompson D, Darling JL, Thomas DG, Warr TJ (2005) Microarray analysis of pediatric ependymoma identifies a cluster of 112 candidate genes including four transcripts at 22q12.1-q13.3. Neuro Oncol 7:20–31PubMedCrossRef Suarez-Merino B, Hubank M, Revesz T, Harkness W, Hayward R, Thompson D, Darling JL, Thomas DG, Warr TJ (2005) Microarray analysis of pediatric ependymoma identifies a cluster of 112 candidate genes including four transcripts at 22q12.1-q13.3. Neuro Oncol 7:20–31PubMedCrossRef
35.
go back to reference Taylor MD, Poppleton H, Fuller C et al (2005) Radial glia cells are candidate stem cells of ependymoma. Cancer Cell 8:323–335PubMedCrossRef Taylor MD, Poppleton H, Fuller C et al (2005) Radial glia cells are candidate stem cells of ependymoma. Cancer Cell 8:323–335PubMedCrossRef
36.
go back to reference Verhaak RG, Hoadley KA, Purdom E et al (2010) Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1. Cancer Cell 17:98–110PubMedCrossRef Verhaak RG, Hoadley KA, Purdom E et al (2010) Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1. Cancer Cell 17:98–110PubMedCrossRef
37.
go back to reference Witt H, Mack SC, Ryzhova M et al (2011) Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. Cancer Cell 20:143–157PubMedCrossRef Witt H, Mack SC, Ryzhova M et al (2011) Delineation of two clinically and molecularly distinct subgroups of posterior fossa ependymoma. Cancer Cell 20:143–157PubMedCrossRef
38.
go back to reference Wolfsberger S, Fischer I, Hoftberger R, Birner P, Slavc I, Dieckmann K, Czech T, Budka H, Hainfellner J (2004) Ki-67 immunolabeling index is an accurate predictor of outcome in patients with intracranial ependymoma. Am J Surg Pathol 28:914–920PubMedCrossRef Wolfsberger S, Fischer I, Hoftberger R, Birner P, Slavc I, Dieckmann K, Czech T, Budka H, Hainfellner J (2004) Ki-67 immunolabeling index is an accurate predictor of outcome in patients with intracranial ependymoma. Am J Surg Pathol 28:914–920PubMedCrossRef
39.
go back to reference Zamecnik J, Snuderl M, Eckschlager T, Chanova M, Hladikova M, Tichy M, Kodet R (2003) Pediatric intracranial ependymomas: prognostic relevance of histological, immunohistochemical, and flow cytometric factors. Mod Pathol 16:980–991PubMedCrossRef Zamecnik J, Snuderl M, Eckschlager T, Chanova M, Hladikova M, Tichy M, Kodet R (2003) Pediatric intracranial ependymomas: prognostic relevance of histological, immunohistochemical, and flow cytometric factors. Mod Pathol 16:980–991PubMedCrossRef
Metadata
Title
A prognostic gene expression signature in infratentorial ependymoma
Authors
Khalida Wani
Terri S. Armstrong
Elizabeth Vera-Bolanos
Aditya Raghunathan
David Ellison
Richard Gilbertson
Brian Vaillant
Stewart Goldman
Roger J. Packer
Maryam Fouladi
Ian Pollack
Tom Mikkelsen
Michael Prados
Antonio Omuro
Riccardo Soffietti
Alicia Ledoux
Charmaine Wilson
Lihong Long
Mark R. Gilbert
Ken Aldape
For the Collaborative Ependymoma Research Network
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
Acta Neuropathologica / Issue 5/2012
Print ISSN: 0001-6322
Electronic ISSN: 1432-0533
DOI
https://doi.org/10.1007/s00401-012-0941-4

Other articles of this Issue 5/2012

Acta Neuropathologica 5/2012 Go to the issue