Pediatric brainstem gangliogliomas show BRAF V600E mutation in a high percentage of cases

Andrew M. Donson, Bette K. Kleinschmidt-Demasters, Dara L. Aisner, Lynne T Bemis, Diane K. Birks, Jean M.Mulcahy Levy, Amy A. Smith, Michael H. Handler, Nicholas K. Foreman, Sarah Z. Rush

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Brainstem gangliogliomas (GGs), often cannot be resected, have a much poorer prognosis than those located in more common supratentorial sites and may benefit from novel therapeutic approaches. Therapeutically targetable BRAF c.1799T>A (p.V600E) (BRAF V600E ) mutations are harbored in roughly 50% of collective GGs taken from all anatomical sites. Large numbers of pediatric brainstem GGs, however, have not been specifically assessed and anatomic - and age-restricted assessment of genetic and biological factors are becoming increasingly important. Pediatric brainstem GGs (n = 13), non-brainstem GGs (n = 11) and brainstem pilocytic astrocytomas (PAs) (n = 8) were screened by standard Sanger DNA sequencing of BRAF exon 15. Five of 13 (38%) pediatric GG harbored a definitive BRAF V600E mutation, with two others exhibiting an equivocal result by this method. BRAF V600E was also seen in five of 11 (45%) non-brainstem GGs and one of eight (13%) brainstem PAs. VE1 immunostaining for BRAF V600E showed concordance with sequencing in nine of nine brainstem GGs including the two cases equivocal by Sanger. The equivocal brainstem GGs were subsequently shown to harbor BRAF V600E using a novel, more sensitive, RNA-sequencing approach, yielding a final BRAF V600E mutation frequency of 54% (seven of 13) in brainstem GGs. BRAF V600E -targeted therapeutics should be a consideration for the high percentage of pediatric brainstem GGs refractory to conventional therapies.

Original languageEnglish (US)
Pages (from-to)173-183
Number of pages11
JournalBrain Pathology
Volume24
Issue number2
DOIs
StatePublished - Mar 1 2014

Fingerprint

Ganglioglioma
Brain Stem
Pediatrics
Mutation
Astrocytoma
RNA Sequence Analysis
Biological Factors
Mutation Rate
DNA Sequence Analysis
Exons

Keywords

  • BRAF
  • brainstem
  • brainstem pilocytic astrocytomas
  • ganglioglioma
  • pediatric

Cite this

Donson, A. M., Kleinschmidt-Demasters, B. K., Aisner, D. L., Bemis, L. T., Birks, D. K., Levy, J. M. M., ... Rush, S. Z. (2014). Pediatric brainstem gangliogliomas show BRAF V600E mutation in a high percentage of cases Brain Pathology, 24(2), 173-183. https://doi.org/10.1111/bpa.12103

Pediatric brainstem gangliogliomas show BRAF V600E mutation in a high percentage of cases . / Donson, Andrew M.; Kleinschmidt-Demasters, Bette K.; Aisner, Dara L.; Bemis, Lynne T; Birks, Diane K.; Levy, Jean M.Mulcahy; Smith, Amy A.; Handler, Michael H.; Foreman, Nicholas K.; Rush, Sarah Z.

In: Brain Pathology, Vol. 24, No. 2, 01.03.2014, p. 173-183.

Research output: Contribution to journalArticle

Donson, AM, Kleinschmidt-Demasters, BK, Aisner, DL, Bemis, LT, Birks, DK, Levy, JMM, Smith, AA, Handler, MH, Foreman, NK & Rush, SZ 2014, ' Pediatric brainstem gangliogliomas show BRAF V600E mutation in a high percentage of cases ', Brain Pathology, vol. 24, no. 2, pp. 173-183. https://doi.org/10.1111/bpa.12103
Donson AM, Kleinschmidt-Demasters BK, Aisner DL, Bemis LT, Birks DK, Levy JMM et al. Pediatric brainstem gangliogliomas show BRAF V600E mutation in a high percentage of cases Brain Pathology. 2014 Mar 1;24(2):173-183. https://doi.org/10.1111/bpa.12103
Donson, Andrew M. ; Kleinschmidt-Demasters, Bette K. ; Aisner, Dara L. ; Bemis, Lynne T ; Birks, Diane K. ; Levy, Jean M.Mulcahy ; Smith, Amy A. ; Handler, Michael H. ; Foreman, Nicholas K. ; Rush, Sarah Z. / Pediatric brainstem gangliogliomas show BRAF V600E mutation in a high percentage of cases In: Brain Pathology. 2014 ; Vol. 24, No. 2. pp. 173-183.
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abstract = "Brainstem gangliogliomas (GGs), often cannot be resected, have a much poorer prognosis than those located in more common supratentorial sites and may benefit from novel therapeutic approaches. Therapeutically targetable BRAF c.1799T>A (p.V600E) (BRAF V600E ) mutations are harbored in roughly 50{\%} of collective GGs taken from all anatomical sites. Large numbers of pediatric brainstem GGs, however, have not been specifically assessed and anatomic - and age-restricted assessment of genetic and biological factors are becoming increasingly important. Pediatric brainstem GGs (n = 13), non-brainstem GGs (n = 11) and brainstem pilocytic astrocytomas (PAs) (n = 8) were screened by standard Sanger DNA sequencing of BRAF exon 15. Five of 13 (38{\%}) pediatric GG harbored a definitive BRAF V600E mutation, with two others exhibiting an equivocal result by this method. BRAF V600E was also seen in five of 11 (45{\%}) non-brainstem GGs and one of eight (13{\%}) brainstem PAs. VE1 immunostaining for BRAF V600E showed concordance with sequencing in nine of nine brainstem GGs including the two cases equivocal by Sanger. The equivocal brainstem GGs were subsequently shown to harbor BRAF V600E using a novel, more sensitive, RNA-sequencing approach, yielding a final BRAF V600E mutation frequency of 54{\%} (seven of 13) in brainstem GGs. BRAF V600E -targeted therapeutics should be a consideration for the high percentage of pediatric brainstem GGs refractory to conventional therapies.",
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