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FältnamnIndikatorerMetadata
00008846naa a2201453 4500
001oai:gup.ub.gu.se/268501
003SwePub
008240528s2018 | |||||||||||000 ||eng|
024a https://gup.ub.gu.se/publication/2685012 URI
024a https://doi.org/10.1016/s1470-2045(18)30242-02 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
100a Waszak, S. M.4 aut
2451 0a Spectrum and prevalence of genetic predisposition in medulloblastoma: a retrospective genetic study and prospective validation in a clinical trial cohort
264 1b Elsevier BV,c 2018
520 a Background Medulloblastoma is associated with rare hereditary cancer predisposition syndromes; however, consensus medulloblastoma predisposition genes have not been defined and screening guidelines for genetic counselling and testing for paediatric patients are not available. We aimed to assess and define these genes to provide evidence for future screening guidelines. Methods In this international, multicentre study, we analysed patients with medulloblastoma from retrospective cohorts (International Cancer Genome Consortium [ICGC] PedBrain, Medulloblastoma Advanced Genomics International Consortium [MAGIC], and the CEFALO series) and from prospective cohorts from four clinical studies (SJMB03, SJMB12, SJYC07, and I-HIT-MED). Whole-genome sequences and exome sequences from blood and tumour samples were analysed for rare damaging germline mutations in cancer predisposition genes. DNA methylation profiling was done to determine consensus molecular subgroups: WNT (MBWNT), SHH (MBSHH), group 3 (MBGroup3), and group 4 (MBGroup4). Medulloblastoma predisposition genes were predicted on the basis of rare variant burden tests against controls without a cancer diagnosis from the Exome Aggregation Consortium (ExAC). Previously defined somatic mutational signatures were used to further classify medulloblastoma genomes into two groups, a clock-like group (signatures 1 and 5) and a homologous recombination repair deficiency-like group (signatures 3 and 8), and chromothripsis was investigated using previously established criteria. Progression-free survival and overall survival were modelled for patients with a genetic predisposition to medulloblastoma. Findings We included a total of 1022 patients with medulloblastoma from the retrospective cohorts (n=673) and the four prospective studies (n=349), from whom blood samples (n=1022) and tumour samples (n=800) were analysed for germline mutations in 110 cancer predisposition genes. In our rare variant burden analysis, we compared these against 53 105 sequenced controls from ExAC and identified APC, BRCA2, PALB2, PTCH1, SUFU, and TP53 as consensus medulloblastoma predisposition genes according to our rare variant burden analysis and estimated that germline mutations accounted for 6% of medulloblastoma diagnoses in the retrospective cohort. The prevalence of genetic predispositions differed between molecular subgroups in the retrospective cohort and was highest for patients in the MBSHH subgroup (20% in the retrospective cohort). These estimates were replicated in the prospective clinical cohort (germline mutations accounted for 5% of medulloblastoma diagnoses, with the highest prevalence [14%] in the MBSHH subgroup). Patients with germline APC mutations developed MBWNT and accounted for most (five [71%] of seven) cases of MBWNT that had no somatic CTNNB1 exon 3 mutations. Patients with germline mutations in SUFU and PTCH1 mostly developed infant MBSHH. Germline TP53 mutations presented only in childhood patients in the MBSHH subgroup and explained more than half (eight [57%] of 14) of all chromothripsis events in this subgroup. Germline mutations in PALB2 and BRCA2 were observed across the MBSHH, MBGroup3, and MBGroup4 molecular subgroups and were associated with mutational signatures typical of homologous recombination repair deficiency. In patients with a genetic predisposition to medulloblastoma, 5-year progression-free survival was 52% (95% CI 4069) and 5-year overall survival was 65% (95% CI 5281); these survival estimates differed significantly across patients with germline mutations in different medulloblastoma predisposition genes. Interpretation Genetic counselling and testing should be used as a standard-of-care procedure in patients with MBWNT and MBSHH because these patients have the highest prevalence of damaging germline mutations in known cancer predisposition genes. We propose criteria for routine genetic screening for patients with medulloblastoma based on clinical and molecular tumour characteristics. Copyright (c) 2018 The Author(s). Published by Elsevier Ltd.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Cancer och onkologi0 (SwePub)302032 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cancer and Oncology0 (SwePub)302032 hsv//eng
653 a breast-cancer
653 a somatic mutations
653 a childhood-cancer
653 a fanconi-anemia
653 a tp53
653 a mutation
653 a brain-tumors
653 a subgroups
653 a palb2
653 a children
653 a landscape
653 a Oncology
700a Northcott, P. A.4 aut
700a Buchhalter, I.4 aut
700a Robinson, G. W.4 aut
700a Sutter, C.4 aut
700a Groebner, S.4 aut
700a Grund, K. B.4 aut
700a Brugieres, L.4 aut
700a Jones, D. T. W.4 aut
700a Pajtler, K. W.4 aut
700a Morrissy, A. S.4 aut
700a Kool, M.4 aut
700a Sturm, D.4 aut
700a Chavez, L.4 aut
700a Ernst, A.4 aut
700a Brabetz, S.4 aut
700a Hain, M.4 aut
700a Zichner, T.4 aut
700a Segura-Wang, M.4 aut
700a Weischenfeldt, J.4 aut
700a Rausch, T.4 aut
700a Mardin, B. R.4 aut
700a Zhou, X.4 aut
700a Baciu, C.4 aut
700a Lawerenz, C.4 aut
700a Chan, J. A.4 aut
700a Varlet, P.4 aut
700a Guerrini-Rousseau, L.4 aut
700a Fults, D. W.4 aut
700a Grajkowska, W.4 aut
700a Hauser, P.4 aut
700a Jabado, N.4 aut
700a Ra, Y. S.4 aut
700a Zitterbart, K.4 aut
700a Shringarpure, S. S.4 aut
700a De La Vega, F. M.4 aut
700a Bustamante, C. D.4 aut
700a Ng, H. K.4 aut
700a Perry, A.4 aut
700a MacDonald, T. J.4 aut
700a Driever, P. H.4 aut
700a Bendel, A. E.4 aut
700a Bowers, D. C.4 aut
700a McCowage, G.4 aut
700a Chintagumpala, M. M.4 aut
700a Cohn, R.4 aut
700a Hassall, T.4 aut
700a Fleischhack, G.4 aut
700a Eggen, T.4 aut
700a Wesenberg, F.4 aut
700a Feychting, M.4 aut
700a Lannering, Birgitta,d 1948u Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics4 aut0 (Swepub:gu)xlabir
700a Schuz, J.4 aut
700a Johansen, C.4 aut
700a Andersen, T. V.4 aut
700a Roosli, M.4 aut
700a Kuehni, C. E.4 aut
700a Grotzer, M.4 aut
700a Kjaerheim, K.4 aut
700a Monoranu, C. M.4 aut
700a Archer, T. C.4 aut
700a Duke, E.4 aut
700a Pomeroy, S. L.4 aut
700a Shelagh, R.4 aut
700a Frank, S.4 aut
700a Sumerauer, D.4 aut
700a Scheurlen, W.4 aut
700a Ryzhova, M. V.4 aut
700a Milde, T.4 aut
700a Kratz, C. P.4 aut
700a Samuel, D.4 aut
700a Zhang, J. H.4 aut
700a Solomon, D. A.4 aut
700a Marra, M.4 aut
700a Eils, R.4 aut
700a Bartram, C. R.4 aut
700a von Hoff, K.4 aut
700a Rutkowski, S.4 aut
700a Ramaswamy, V.4 aut
700a Gilbertson, R. J.4 aut
700a Korshunov, A.4 aut
700a Taylor, M. D.4 aut
700a Lichter, P.4 aut
700a Malkin, D.4 aut
700a Gajjar, A.4 aut
700a Korbel, J. O.4 aut
700a Pfister, S. M.4 aut
710a Göteborgs universitetb Institutionen för kliniska vetenskaper, Avdelningen för pediatrik4 org
773t Lancet Oncologyd : Elsevier BVg 19:6, s. 785-798q 19:6<785-798x 1470-2045
856u http://www.thelancet.com/article/S1470204518302420/pdf
8564 8u https://gup.ub.gu.se/publication/268501
8564 8u https://doi.org/10.1016/s1470-2045(18)30242-0

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