Institute of Cancer and Genomic Sciences, Edgbaston Campus, University of Birmingham, Birmingham, B15 2TT, UK.
Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Acta Neuropathol Commun. 2024 Aug 10;12(1):127. doi: 10.1186/s40478-024-01838-4.
The two types of craniopharyngioma, adamantinomatous (ACP) and papillary (PCP), are clinically relevant tumours in children and adults. Although the biology of primary craniopharyngioma is starting to be unravelled, little is known about the biology of recurrence. To fill this gap in knowledge, we have analysed through methylation array, RNA sequencing and pERK1/2 immunohistochemistry a cohort of paired primary and recurrent samples (32 samples from 14 cases of ACP and 4 cases of PCP). We show the presence of copy number alterations and clonal evolution across recurrence in 6 cases of ACP, and analysis of additional whole genome sequencing data from the Children's Brain Tumour Network confirms chromosomal arm copy number changes in at least 7/67 ACP cases. The activation of the MAPK/ERK pathway, a feature previously shown in primary ACP, is observed in all but one recurrent cases of ACP. The only ACP without MAPK activation is an aggressive case of recurrent malignant human craniopharyngioma harbouring a CTNNB1 mutation and loss of TP53. Providing support for a functional role of this TP53 mutation, we show that Trp53 loss in a murine model of ACP results in aggressive tumours and reduced mouse survival. Finally, we characterise the tumour immune infiltrate showing differences in the cellular composition and spatial distribution between ACP and PCP. Together, these analyses have revealed novel insights into recurrent craniopharyngioma and provided preclinical evidence supporting the evaluation of MAPK pathway inhibitors and immunomodulatory approaches in clinical trials in against recurrent ACP.
两种颅咽管瘤,造釉细胞瘤型(ACP)和乳头型(PCP),在儿童和成人中都是具有临床相关性的肿瘤。尽管原发性颅咽管瘤的生物学特性开始被揭示,但对复发的生物学特性知之甚少。为了填补这一知识空白,我们通过甲基化阵列、RNA 测序和 pERK1/2 免疫组化分析了一组配对的原发性和复发性样本(32 个样本来自 14 例 ACP 和 4 例 PCP)。我们展示了 6 例 ACP 中存在的拷贝数改变和克隆进化,并且来自儿童脑肿瘤网络的额外全基因组测序数据的分析证实了至少 7/67 ACP 病例中染色体臂拷贝数的变化。MAPK/ERK 通路的激活,这是以前在原发性 ACP 中观察到的特征,在所有除了一个复发的 ACP 病例中都观察到。唯一没有 MAPK 激活的 ACP 是一个具有 CTNNB1 突变和 TP53 缺失的侵袭性复发性恶性人类颅咽管瘤病例。为了支持这种 TP53 突变的功能作用,我们表明在 ACP 的小鼠模型中 Trp53 的缺失导致了侵袭性肿瘤和小鼠存活率降低。最后,我们对肿瘤免疫浸润进行了特征描述,显示了 ACP 和 PCP 之间细胞组成和空间分布的差异。总之,这些分析揭示了复发性颅咽管瘤的新见解,并提供了临床前证据,支持在临床试验中评估 MAPK 通路抑制剂和免疫调节方法治疗复发性 ACP。