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A mechanistic classification of clinical phenotypes in neuroblastoma.


ABSTRACT: Neuroblastoma is a pediatric tumor of the sympathetic nervous system. Its clinical course ranges from spontaneous tumor regression to fatal progression. To investigate the molecular features of the divergent tumor subtypes, we performed genome sequencing on 416 pretreatment neuroblastomas and assessed telomere maintenance mechanisms in 208 of these tumors. We found that patients whose tumors lacked telomere maintenance mechanisms had an excellent prognosis, whereas the prognosis of patients whose tumors harbored telomere maintenance mechanisms was substantially worse. Survival rates were lowest for neuroblastoma patients whose tumors harbored telomere maintenance mechanisms in combination with RAS and/or p53 pathway mutations. Spontaneous tumor regression occurred both in the presence and absence of these mutations in patients with telomere maintenance-negative tumors. On the basis of these data, we propose a mechanistic classification of neuroblastoma that may benefit the clinical management of patients.

SUBMITTER: Ackermann S 

PROVIDER: S-EPMC7875194 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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A mechanistic classification of clinical phenotypes in neuroblastoma.

Ackermann Sandra S   Cartolano Maria M   Hero Barbara B   Welte Anne A   Kahlert Yvonne Y   Roderwieser Andrea A   Bartenhagen Christoph C   Walter Esther E   Gecht Judith J   Kerschke Laura L   Volland Ruth R   Menon Roopika R   Heuckmann Johannes M JM   Gartlgruber Moritz M   Hartlieb Sabine S   Henrich Kai-Oliver KO   Okonechnikov Konstantin K   Altmüller Janine J   Nürnberg Peter P   Lefever Steve S   de Wilde Bram B   Sand Frederik F   Ikram Fakhera F   Rosswog Carolina C   Fischer Janina J   Theissen Jessica J   Hertwig Falk F   Singhi Aatur D AD   Simon Thorsten T   Vogel Wenzel W   Perner Sven S   Krug Barbara B   Schmidt Matthias M   Rahmann Sven S   Achter Viktor V   Lang Ulrich U   Vokuhl Christian C   Ortmann Monika M   Büttner Reinhard R   Eggert Angelika A   Speleman Frank F   O'Sullivan Roderick J RJ   Thomas Roman K RK   Berthold Frank F   Vandesompele Jo J   Schramm Alexander A   Westermann Frank F   Schulte Johannes H JH   Peifer Martin M   Fischer Matthias M  

Science (New York, N.Y.) 20181201 6419


Neuroblastoma is a pediatric tumor of the sympathetic nervous system. Its clinical course ranges from spontaneous tumor regression to fatal progression. To investigate the molecular features of the divergent tumor subtypes, we performed genome sequencing on 416 pretreatment neuroblastomas and assessed telomere maintenance mechanisms in 208 of these tumors. We found that patients whose tumors lacked telomere maintenance mechanisms had an excellent prognosis, whereas the prognosis of patients whos  ...[more]

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