TY - JOUR AU - Shih, David J H AU - Northcott, Paul A AU - Remke, Marc AU - Korshunov, Andrey AU - Ramaswamy, Vijay AU - Kool, Marcel AU - Luu, Betty AU - Yao, Yuan AU - Wang, Xin AU - Dubuc, Adrian M AU - Garzia, Livia AU - Peacock, John AU - Mack, Stephen C AU - Wu, Xiaochong AU - Rolider, Adi AU - Morrissy, A Sorana AU - Cavalli, Florence M G AU - Jones, David AU - Zitterbart, Karel AU - Faria, Claudia C AU - Schüller, Ulrich AU - Kren, Leos AU - Kumabe, Toshihiro AU - Tominaga, Teiji AU - Shin Ra, Young AU - Garami, Miklós AU - Hauser, Peter AU - Chan, Jennifer A AU - Robinson, Shenandoah AU - Bognár, László AU - Klekner, Almos AU - Saad, Ali G AU - Liau, Linda M AU - Albrecht, Steffen AU - Fontebasso, Adam AU - Cinalli, Giuseppe AU - De Antonellis, Pasqualino AU - Zollo, Massimo AU - Cooper, Michael K AU - Thompson, Reid C AU - Bailey, Simon AU - Lindsey, Janet C AU - Di Rocco, Concezio AU - Massimi, Luca AU - Michiels, Erna M C AU - Scherer, Stephen W AU - Phillips, Joanna J AU - Gupta, Nalin AU - Fan, Xing AU - Muraszko, Karin M AU - Vibhakar, Rajeev AU - Eberhart, Charles G AU - Fouladi, Maryam AU - Lach, Boleslaw AU - Jung, Shin AU - Wechsler-Reya, Robert J AU - Fèvre-Montange, Michelle AU - Jouvet, Anne AU - Jabado, Nada AU - Pollack, Ian F AU - Weiss, William A AU - Lee, Ji-Yeoun AU - Cho, Byung-Kyu AU - Kim, Seung-Ki AU - Wang, Kyu-Chang AU - Leonard, Jeffrey R AU - Rubin, Joshua B AU - de Torres, Carmen AU - Lavarino, Cinzia AU - Mora, Jaume AU - Cho, Yoon-Jae AU - Tabori, Uri AU - Olson, James M AU - Gajjar, Amar AU - Packer, Roger J AU - Rutkowski, Stefan AU - Pomeroy, Scott L AU - French, Pim J AU - Kloosterhof, Nanne K AU - Kros, Johan M AU - Van Meir, Erwin G AU - Clifford, Steven C AU - Bourdeaut, Franck AU - Delattre, Olivier AU - Doz, François F AU - Hawkins, Cynthia E AU - Malkin, David AU - Grajkowska, Wieslawa A AU - Perek-Polnik, Marta AU - Bouffet, Eric AU - Rutka, James T AU - Pfister, Stefan AU - Taylor, Michael D TI - Cytogenetic prognostication within medulloblastoma subgroups.g JO - Journal of clinical oncology VL - 32 IS - 9 SN - 1527-7755 CY - Alexandria, Va. PB - American Society of Clinical Oncology M1 - DKFZ-2018-00257 SP - 886 - 896 PY - 2014 AB - Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication.Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models.Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas.Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials. KW - Biomarkers, Tumor (NLM Chemicals) KW - GLI2 protein, human (NLM Chemicals) KW - Hedgehog Proteins (NLM Chemicals) KW - Kruppel-Like Transcription Factors (NLM Chemicals) KW - MYC protein, human (NLM Chemicals) KW - Nuclear Proteins (NLM Chemicals) KW - Proto-Oncogene Proteins c-myc (NLM Chemicals) KW - SHH protein, human (NLM Chemicals) KW - Wnt Proteins (NLM Chemicals) KW - Zinc Finger Protein Gli2 (NLM Chemicals) LB - PUB:(DE-HGF)16 C6 - pmid:24493713 C2 - pmc:PMC3948094 DO - DOI:10.1200/JCO.2013.50.9539 UR - https://inrepo02.dkfz.de/record/132593 ER -