Carbon ion radiotherapy eradicates medulloblastomas with chromothripsis in an orthotopic Li-Fraumeni patient-derived mouse model

• Verfasst von: Simovic, Milena [VerfasserIn]
• Verfasst von: Bolkestein, Michiel [VerfasserIn]
• Verfasst von: Moustafa, Mahmoud [VerfasserIn]
• Verfasst von: Wong, John K. L. [VerfasserIn]
• Verfasst von: Körber, Verena [VerfasserIn]
• Verfasst von: Benedetto, Sarah [VerfasserIn]
• Verfasst von: Khalid, Umar [VerfasserIn]
• Verfasst von: Schreiber, Hannah [VerfasserIn]
• Verfasst von: Jugold, Manfred [VerfasserIn]
• Verfasst von: Korshunov, Andrey [VerfasserIn]
• Verfasst von: Hübschmann, Daniel [VerfasserIn]
• Verfasst von: Mack, Norman [VerfasserIn]
• Verfasst von: Brons, Stephan [VerfasserIn]
• Verfasst von: Wei, Pei-Chi [VerfasserIn]
• Verfasst von: Breckwoldt, Michael O. [VerfasserIn]
• Verfasst von: Heiland, Sabine [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Verfasst von: Debus, Jürgen [VerfasserIn]
• Verfasst von: Höfer, Thomas [VerfasserIn]
• Verfasst von: Zapatka, Marc [VerfasserIn]
• Verfasst von: Kool, Marcel [VerfasserIn]
• Verfasst von: Pfister, Stefan [VerfasserIn]
• Verfasst von: Abdollahi, Amir [VerfasserIn]
• Verfasst von: Ernst, Aurélie [VerfasserIn]
• Titel: Carbon ion radiotherapy eradicates medulloblastomas with chromothripsis in an orthotopic Li-Fraumeni patient-derived mouse model
• Verf.angabe: Milena Simovic, Michiel Bolkestein, Mahmoud Moustafa, John K L Wong, Verena Körber, Sarah Benedetto, Umar Khalid, Hannah Sophia Schreiber, Manfred Jugold, Andrey Korshunov, Daniel Hübschmann, Norman Mack, Stephan Brons, Pei-Chi Wei, Michael O Breckwoldt, Sabine Heiland, Martin Bendszus, Jürgen Debus, Thomas Höfer, Marc Zapatka, Marcel Kool, Stefan M Pfister, Amir Abdollahi, and Aurélie Ernst
• E-Jahr: 2021
• Jahr: 28 May 2021
• Umfang: 14 S.
• Fussnoten: Gesehen am 13.12.2022
• Titel Quelle: Enthalten in: Neuro-Oncology
• Ort Quelle: Oxford : Oxford Univ. Press, 1999
• Jahr Quelle: 2021
• Band/Heft Quelle: 23(2021), 12, Seite 2028-2041
• ISSN Quelle: 1523-5866
• DOI: doi:10.1093/neuonc/noab127
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1826919449

Abstract

Medulloblastomas with chromothripsis developing in children with Li-Fraumeni Syndrome (germline TP53 mutations) are highly aggressive brain tumors with dismal prognosis. Conventional photon radiotherapy and DNA-damaging chemotherapy are not successful for these patients and raise the risk of secondary malignancies. We hypothesized that the pronounced homologous recombination deficiency in these tumors might offer vulnerabilities that can be therapeutically utilized in combination with high linear energy transfer carbon ion radiotherapy. We tested high-precision particle therapy with carbon ions and protons as well as topotecan with or without PARP inhibitor in orthotopic primary and matched relapsed patient-derived xenograft models. Tumor and normal tissue underwent longitudinal morphological MRI, cellular (markers of neurogenesis and DNA damage-repair), and molecular characterization (whole-genome sequencing).In the primary medulloblastoma model, carbon ions led to complete response in 79% of animals irrespective of PARP inhibitor within a follow-up period of 300 days postirradiation, as detected by MRI and histology. No sign of neurologic symptoms, impairment of neurogenesis or in-field carcinogenesis was detected in repair-deficient host mice. PARP inhibitors further enhanced the effect of proton irradiation. In the postradiotherapy relapsed tumor model, median survival was significantly increased after carbon ions (96 days) versus control (43 days, P < .0001). No major change in the clonal composition was detected in the relapsed model. The high efficacy and favorable toxicity profile of carbon ions warrants further investigation in primary medulloblastomas with chromothripsis. Postradiotherapy relapsed medulloblastomas exhibit relative resistance compared to treatment-naïve tumors, calling for exploration of multimodal strategies.