Logo image
Divergent clonal selection dominates medulloblastoma at recurrence
Journal article   Open access   Peer reviewed

Divergent clonal selection dominates medulloblastoma at recurrence

A Sorana Morrissy, Livia Garzia, David J H Shih, Scott Zuyderduyn, Xi Huang, Patryk Skowron, Yuan Y Thompson, Xiaochong Wu, Trevor Pugh, Adrian Ally, …
Nature (London), Vol.529(7586), pp.351-357
01/21/2016
DOI: 10.1038/nature16478
PMCID: PMC4936195
PMID: 26760213
url
http://doi.org/10.1038/nature16478View
Open Access

Abstract

The development of targeted anti-cancer therapies through the study of cancer genomes is intended to increase survival rates and decrease treatment-related toxicity. We treated a transposon-driven, functional genomic mouse model of medulloblastoma with 'humanized' in vivo therapy (microneurosurgical tumour resection followed by multi-fractionated, image-guided radiotherapy). Genetic events in recurrent murine medulloblastoma exhibit a very poor overlap with those in matched murine diagnostic samples (<5%). Whole-genome sequencing of 33 pairs of human diagnostic and post-therapy medulloblastomas demonstrated substantial genetic divergence of the dominant clone after therapy (<12% diagnostic events were retained at recurrence). In both mice and humans, the dominant clone at recurrence arose through clonal selection of a pre-existing minor clone present at diagnosis. Targeted therapy is unlikely to be effective in the absence of the target, therefore our results offer a simple, proximal, and remediable explanation for the failure of prior clinical trials of targeted therapy.
Medicine & health Medical Clinic

Details

Metrics

Logo image