Nat Med. 2016 Nov;22(11):1314-1320. doi: 10.1038/nm.4204. Epub 2016 Oct 17.
Pediatric glioblastoma is one of the most common and most deadly brain tumors in childhood. Using an integrative genetic analysis of 53 pediatric glioblastomas and five in vitro model systems, we identified previously unidentified gene fusions involving the MET oncogene in ∼10% of cases. These MET fusions activated mitogen-activated protein kinase (MAPK) signaling and, in cooperation with lesions compromising cell cycle regulation, induced aggressive glial tumors in vivo. MET inhibitors suppressed MET tumor growth in xenograft models. Finally, we treated a pediatric patient bearing a MET-fusion-expressing glioblastoma with the targeted inhibitor crizotinib. This therapy led to substantial tumor shrinkage and associated relief of symptoms, but new treatment-resistant lesions appeared, indicating that combination therapies are likely necessary to achieve a durable clinical response.
儿童脑胶质瘤是儿童中最常见和最致命的脑瘤之一。通过对 53 例儿童脑胶质瘤和 5 种体外模型系统的综合遗传分析,我们在约 10%的病例中发现了先前未识别的涉及 MET 癌基因的基因融合。这些 MET 融合激活了丝裂原活化蛋白激酶(MAPK)信号通路,并与影响细胞周期调控的病变协同作用,导致体内侵袭性神经胶质瘤的发生。MET 抑制剂抑制了异种移植模型中 MET 肿瘤的生长。最后,我们用靶向抑制剂克唑替尼治疗了一名患有表达 MET 融合基因的脑胶质瘤的儿童患者。该治疗导致肿瘤显著缩小和相关症状缓解,但出现了新的耐药性病变,表明可能需要联合治疗才能实现持久的临床反应。