% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Korshunov:167482, author = {A. Korshunov$^*$ and K. Okonechnikov$^*$ and D. Stichel$^*$ and M. Ryzhova and D. Schrimpf$^*$ and F. Sahm$^*$ and P. Sievers$^*$ and O. Absalyamova and O. Zheludkova and A. Golanov and D. T. W. Jones$^*$ and S. M. Pfister$^*$ and A. von Deimling$^*$ and M. Kool$^*$}, title = {{I}ntegrated molecular analysis of adult {S}onic {H}edgehog ({SHH})-activated medulloblastomas reveals two clinically relevant tumor subsets with {VEGFA} as potent prognostic indicator.}, journal = {Neuro-Oncology}, volume = {23}, number = {9}, issn = {1523-5866}, address = {Oxford}, publisher = {Oxford Univ. Press}, reportid = {DKFZ-2021-00383}, pages = {1576-1585}, year = {2021}, note = {#EA:B300#B062#LA:B062# / 2021 Sep 1;23(9):1576-1585}, abstract = {Up to now, adult medulloblastoma (MB) patients are treated according to the protocols elaborated for pediatric MB although these tumors are different in terms of clinical outcomes and biology. Approximately $70\%$ of adult MB disclose a Sonic Hedgehog (SHH) molecular signature in contrast to about $30\%$ in pediatric cohorts. In addition, adult SHH-MB (aSHH-MB) are clinically heterogeneous but there is consensus neither on their optimal treatment nor on risk stratification. Thus, the identification of clinically relevant molecular subsets of aSHH-MB and identification of potential treatment targets remains inconclusive.We analyzed 96 samples of institutionally diagnosed aSHH-MB through genome-wide DNA methylation profiling, targeted DNA sequencing and RNA sequencing to identify molecular subcategories of these tumors and assess their prognostic significance.We defined two aSHH-MB numerically comparable epigenetic subsets with clinical and molecular variability. The subset 'aSHH-MBI' $(46/48\%)$ was associated with PTCH1/SMO $(54\%/46\%)$ mutations, 'neuronal' transcriptional signatures, and favorable outcomes after combined radio-chemotherapy (5-year PFS = $80\%$ and OS = $92\%).$ The clinically unfavorable 'aSHH-MBII' subset $(50/52\%;$ 5-year PFS = $24\%$ and OS = $45\%)$ disclosed GLI2 amplifications $(8\%),$ loss of 10q $(22\%),$ and gene expression signatures associated with angiogenesis and embryonal development. aSHH-MBII tumors revealed strong and ubiquitous expression of VEGFA both at transcript and protein levels that was correlated with unfavorable outcome.1. The histologically uniform aSHH-MB cohort exhibits clear molecular heterogeneity separating these tumors into two molecular subsets (aSHH-MBI and aSHH-MBII), which are associated with different cytogenetics, mutational landscapes, gene expression signatures, and clinical course. 2. VEGFA appears to be a promising biomarker to predict clinical course, which needs further prospective validation as its potential role in the pathogenesis of this subset.}, keywords = {Adult (Other) / Medulloblastoma (Other) / SHH (Other) / VEGFA (Other) / prognosis (Other) / transcriptome (Other)}, cin = {B300 / B062 / HD01 / B360}, ddc = {610}, cid = {I:(DE-He78)B300-20160331 / I:(DE-He78)B062-20160331 / I:(DE-He78)HD01-20160331 / I:(DE-He78)B360-20160331}, pnm = {312 - Funktionelle und strukturelle Genomforschung (POF4-312)}, pid = {G:(DE-HGF)POF4-312}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:33589929}, doi = {10.1093/neuonc/noab031}, url = {https://inrepo02.dkfz.de/record/167482}, }