% 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{Delaidelli:299528, author = {A. Delaidelli and F. Burwag and S. Ben-Neriah and Y. Suk and T. Shyp and S. Kosteniuk and C. Dunham and S. Cheng and K. Okonechnikov$^*$ and D. Schrimpf$^*$ and A. von Deimling$^*$ and B. Ellezam and S. Perreault and S. Singh and C. Hawkins and M. Kool$^*$ and S. Pfister$^*$ and C. Steidl and C. Hughes and A. Korshunov$^*$ and P. H. Sorensen}, title = {{H}igh-resolution proteomic analysis of medulloblastoma clinical samples identifies therapy resistant subgroups and {MYC} immunohistochemistry as a powerful outcome predictor.}, journal = {Neuro-Oncology}, volume = {nn}, issn = {1522-8517}, address = {Oxford}, publisher = {Oxford Univ. Press}, reportid = {DKFZ-2025-00486}, pages = {nn}, year = {2025}, note = {epub}, abstract = {While international consensus and the 2021 WHO classification recognize multiple molecular medulloblastoma subgroups, these are difficult to identify in clinical practice utilizing routine approaches. As a result, biology-driven risk stratification and therapy assignment for medulloblastoma remains a major clinical challenge. Here, we report mass spectrometry-based analysis of clinical samples for medulloblastoma subgroup discovery, highlighting a MYC-driven prognostic signature and MYC immunohistochemistry (IHC) as a clinically tractable method for improved risk stratification.We analyzed 56 formalin fixed paraffin embedded (FFPE) medulloblastoma samples by data independent acquisition mass spectrometry identifying a MYC proteome signature in therapy resistant Group 3 medulloblastoma. We validated MYC IHC prognostic and predictive value across two Group 3/4 medulloblastoma clinical cohorts (n=362) treated with standard therapies.After exclusion of WNT tumors, MYC IHC was an independent predictor of therapy resistance and death [HRs 23.6 and 3.23; $95\%$ confidence interval (CI) 1.04-536.18 and 1.84-5.66; P = .047 and < .001]. Notably, only $~50\%$ of the MYC IHC positive tumors harbored MYC amplification. Accordingly, cross-validated survival models incorporating MYC IHC outperformed current risk stratification schemes including MYC amplification, and reclassified $~20\%$ of patients into a more appropriate very high-risk category.This study provides a high-resolution proteomic dataset that can be used as a reference for future biomarker discovery. Biology-driven clinical trials should consider MYC IHC status in their design. Integration of MYC IHC in classification algorithms for non-WNT tumors could be rapidly adopted on a global scale, independently of advanced but technically challenging molecular profiling techniques.}, keywords = {FFPE proteomics (Other) / MYC (Other) / Medulloblastoma (Other) / biomarker (Other) / risk-stratification (Other)}, cin = {B062 / HD01 / B300}, ddc = {610}, cid = {I:(DE-He78)B062-20160331 / I:(DE-He78)HD01-20160331 / I:(DE-He78)B300-20160331}, pnm = {312 - Funktionelle und strukturelle Genomforschung (POF4-312)}, pid = {G:(DE-HGF)POF4-312}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:40040502}, doi = {10.1093/neuonc/noaf046}, url = {https://inrepo02.dkfz.de/record/299528}, }