TY - JOUR A1 - Williams, Richard D. A1 - Chagtai, Tasnim A1 - Alcaide-German, Marisa A1 - Apps, John A1 - Wegert, Jenny A1 - Popov, Sergey A1 - Vujanic, Gordan A1 - Van Tinteren, Harm A1 - Van den Heuvel-Eibrink, Marry M A1 - Kool, Marcel A1 - De Kraker, Jan A1 - Gisselsson, David A1 - Graf, Norbert A1 - Gessler, Manfred A1 - Pritchard-Jones, Kathy T1 - Multiple mechanisms of MYCN dysregulation in Wilms tumour JF - Oncotarget N2 - Genomic gain of the proto-oncogene transcription factor gene MYCN is associated with poor prognosis in several childhood cancers. Here we present a comprehensive copy number analysis of MYCN in Wilms tumour (WT), demonstrating that gain of this gene is associated with anaplasia and with poorer relapse-free and overall survival, independent of histology. Using whole exome and gene-specific sequencing, together with methylation and expression profiling, we show that MYCN is targeted by other mechanisms, including a recurrent somatic mutation, P44L, and specific DNA hypomethylation events associated with MYCN overexpression in tumours with high risk histologies. We describe parallel evolution of genomic copy number gain and point mutation of MYCN in the contralateral tumours of a remarkable bilateral case in which independent contralateral mutations of TP53 also evolve over time. We report a second bilateral case in which MYCN gain is a germline aberration. Our results suggest a significant role for MYCN dysregulation in the molecular biology of Wilms tumour. We conclude that MYCN gain is prognostically significant, and suggest that the novel P44L somatic variant is likely to be an activating mutation. KW - integrative genomics viewer KW - oncogene amplification KW - sequencing data KW - gene KW - gain KW - copy number KW - somatic mutations KW - beta-catenin KW - histology KW - reveals KW - Wilms tumour KW - MYCN KW - DNA methylation KW - prognostic marker Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-143471 VL - 6 IS - 9 ER - TY - JOUR A1 - Wegert, Jenny A1 - Bausenwein, Sabrina A1 - Kneitz, Susanne A1 - Roth, Sabine A1 - Graf, Norbert A1 - Geissinger, Eva A1 - Gessler, Manfred T1 - Retinoic acid pathway activity in Wilms tumors and characterization of biological responses in vitro N2 - Background: Wilms tumor (WT) is one of the most common malignancies in childhood. With current therapy protocols up to 90% of patients can be cured, but there is still a need to improve therapy for patients with aggressive WT and to reduce treatment intensity where possible. Prior data suggested a deregulation of the retinoic acid (RA) signaling pathway in high-risk WT, but its mode of action remained unclear. Results: The association of retinoid signaling and clinical parameters could be validated in a large independent tumor set, but its relevance in primary nephrectomy tumors from very young children may be different. Reduced RA pathway activity and MYCN overexpression were found in high risk tumors as opposed to tumors with low/ intermediate risk, suggesting a beneficial impact of RA especially on advanced WT. To search for possible modes of action of retinoids as novel therapeutic options, primary tumor cell cultures were treated in vitro with all-trans-RA (ATRA), 9cis-RA, fenretinide and combinations of retinoids and a histone deacetylase (HDAC) inhibitor. Genes deregulated in high risk tumors showed opposite changes upon treatment suggesting a positive effect of retinoids. 6/7 primary cultures tested reduced proliferation, irrespective of prior RA signaling levels. The only variant culture was derived from mesoblastic nephroma, a distinct childhood kidney neoplasm. Retinoid/HDAC inhibitor combinations provided no synergistic effect. ATRA and 9cis-RA induced morphological changes suggestive of differentiation, while fenretinide induced apoptosis in several cultures tested. Microarray analysis of ATRA treated WT cells revealed differential expression of many genes involved in extracellular matrix formation and osteogenic, neuronal or muscle differentiation. The effects documented appear to be reversible upon drug withdrawal, however. Conclusions: Altered retinoic acid signaling has been validated especially in high risk Wilms tumors. In vitro testing of primary tumor cultures provided clear evidence of a potential utility of retinoids in Wilms tumor treatment based on the analysis of gene expression, proliferation, differentiation and apoptosis. KW - Krebs KW - Wilms tumor KW - nephroblastoma KW - primary tumor cell culture KW - tumor model KW - retinoic acid Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-69137 ER - TY - THES A1 - Wegert, Jenny T1 - WTX-Mutationsscreen und funktionelle Analyse des Retinsäure-Signalwegs in Wilms Tumoren T1 - WTX-mutation screening and functional analysis of the retinoic acid signaling pathway in Wilms tumors N2 - Der Wilms Tumor (WT), auch Nephroblastom genannt, ist einer der häufigsten bösartigen Tumoren im Kindesalter. Er entsteht aus embryonalem undifferenziertem Nierengewebe und tritt meist als unilateraler und sporadischer Tumor auf. In 10-15% der Wilms Tumoren finden sich WT1- und/oder CTNNB1-Mutationen. Während diese schon länger als genetische Ursachen des Nephroblastoms bekannt sind, wurde erst kürzlich WTX als drittes Gen beschrieben, welches eine Rolle in der Tumorentstehung spielt. Für einen Großteil der WT ist die genetische Ursache jedoch unklar. Da die bisher publizierten WTX-Mutationsraten auf Untersuchungen kleiner Gruppen basieren und sich stark unterscheiden, sollten in dieser Arbeit WTX-, CTNNB1- und WT1-Mutationen in einem großen WT-Set bestimmt werden. Verluste genetischen Materials in der WTX-Region traten in 17% der Fälle auf und waren zwischen den Geschlechtern gleich verteilt. Die Sequenzierung von WT-Proben zeigte, dass nur 2% von WTX-Punktmutationen betroffen sind. In weiteren 11,5% der Proben konnte keine WTX-Expression nachgewiesen werden. Die WTX-Veränderungen traten z. T. gemeinsam mit WT1- und/oder CTNNB1-Mutationen auf. Die unvollständige WTX-Deletion in einigen WT legte die Vermutung nahe, dass innerhalb eines Tumors eine Heterogenität in Bezug auf den WTX-Status möglich ist. Dieser Verdacht konnte durch die detaillierte Untersuchung verschiedener Regionen solcher Tumoren erhärtet werden: Hierzu wurden histologisch unterschiedliche Bereiche auf den Anteil einer WTX-Mutation bzw. eines WTX-LOH hin untersucht. Obwohl alle Regionen des jeweiligen Tumors einen kompletten LOH auf Chromosom 11 aufwiesen, waren die WTX-Veränderungen unterschiedlich stark ausgeprägt. Diese Ergebnisse deuten darauf hin, dass WTX-Veränderungen keine notwendigen und frühen Ereignisse in der Tumorentstehung sind, sondern erst später auftreten und nur einen Teil der Tumorzellen betreffen können. Die Vermutung, dass WTX-Mutationen keinen direkten Einfluss auf die Tumorentwicklung und prognose haben, wird durch das Fehlen eines signifikanten Zusammenhangs zwischen WTX-Deletion bzw. WTX-Expression und den klinischen Eigenschaften der WT gestützt. Um die Rolle von Genen, die potentiell an der Entstehung und Entwicklung des Nephroblastoms beteiligt sind, zu untersuchen oder mögliche neue Therapiestrategien zu überprüfen, sind in vitro-Modelle nötig. Da ein solches für Wilms Tumoren nicht etabliert ist, wurden Primärkulturen aus verschiedenen WT-Proben angelegt. Kulturen aus Tumorgewebe von 12 Patienten mit unterschiedlichen genetischen Veränderungen konnten als echte Tumorzellen validiert werden. Zwei Zelltypen ließen sich morphologisch und immunhistochemisch unterscheiden: Zum einen runde, langsam wachsende Zellen mit Epithelcharakter und zum anderen fibroblastenähnliche Zellen, welche weniger differenziert waren und häufig für viele Passagen kultiviert werden konnten. Somit wurde ein Set verschiedener WT-Primärkulturen etabliert, welches nun für in vitro-Experimente zur Untersuchung grundlegender Mechanismen der WT-Entstehung oder zum Test neuer Therapieansätze eingesetzt werden kann. Frühere Microarray-Analysen deuteten auf eine Deregulation des Retinsäure (RA)-Signalwegs in fortgeschrittenen Wilms Tumoren hin. Diese Ergebnisse sollten in einem großen unabhängigen Proben-Set mittels Realtime-RT-PCR validiert werden. Eine Deregulation des RA-Signalwegs und die Überexpression von NMYC wurden für Tumoren der Hochrisikogruppe im Vergleich zu Tumoren mit geringem/mittlerem Risiko nachgewiesen. So stellte sich die Frage, ob Patienten mit fortgeschrittenem WT von einem Retinsäure-Einsatz in der Therapie profitieren könnten. Um dies zu beantworten, wurde der Effekt von verschiedenen Retinoiden auf WT-Primärkulturen untersucht. Die WT-Zellen wurden mit all-trans RA (ATRA), 9cisRA, dem synthetischen Retinoid Fenretinid (4HPR) und Kombinationen von ATRA bzw. 4HPR und einem HDAC-Inhibitor (SAHA) behandelt. Gene, welche in Hochrisiko-WT differenziell reguliert waren, wurden untersucht und zeigten nach RA-Behandlung eine entgegengesetzte Expression. In sechs der sieben verwendeten Primärkulturen wurde eine RA-vermittelte Proliferationsreduktion nachgewiesen. Für die Kombinationen von Retinoiden mit SAHA wurden keine synergistischen Effekte beobachtet. Während Fenretinid in den meisten Kulturen Apoptose induzierte, verursachten ATRA und 9cisRA morphologische Veränderungen, welche auf Differenzierungsvorgänge hindeuteten. Eine Microarray-Analyse ATRA-behandelter WT-Zellen zeigte die differenzielle Regulation vieler Gene, welche eine Rolle in der Bildung der extrazellulären Matrix oder bei Differenzierungsvorgängen von Knochen-, Knorpel-, Nerven- oder Muskelgewebe spielen. Diese Befunde bieten einen weiteren Hinweis darauf, dass Retinoide für den Einsatz in der Therapie des Nephroblastoms geeignet sein könnten. N2 - Wilms tumor (WT) – or nephroblastoma – is one of the most common solid tumors in childhood. It arises from embryonal blastema and most frequently presents as a unilateral and sporadic tumor. Mutations in WT1 and CTNNB1 are well established as causal alterations in about 10-15 % of cases. Recently, WTX (Wilms tumor gene on the X-chromosome), a gene implicated in WNT signaling, has been identified as a third WT gene, but for the majority of nephroblastomas the genetic etiology is still unclear. Published WTX mutation rates in Wilms tumors are still based on smaller cohorts and differ significantly. Therefore, the WTX, CTNNB1 and WT1 mutation state was determined in a large set of 429 Wilms tumors. Genomic WTX alterations were identified in 17% of WT, equally distributed between males and females. Analysis of 104 WT samples for WTX point mutations revealed a frequency of only 2%. An additional 11,5% of tumor samples lacked expression of WTX mRNA. These WTX alterations can occur in parallel to WT1 or CTNNB1 mutations. Incomplete deletion of WTX in several cases suggested heterogeneity of WTX alterations in tumors and this was corroborated by analysis of different regions of such tumors. In cases with heterozygous point mutations or LOH, separate tumor fragments or microdissected regions with different histology were analyzed. Despite complete allele losses at chromosome 11 varying ratios of WTX mutation were detected. This suggests that WTX alteration is not an essential and early mutation needed to drive tumorigenesis, but rather a late event that may affect only a fraction of cells with unclear clinical relevance. This hypothesis is supported by the fact that there is no significant correlation between WTX deletion status or expression level and clinical parameters suggesting that WTX mutations apparently have little direct impact on tumor behavior and presentation. As there is no in vitro model for nephroblastoma that could be used to investigate genes playing a role in development and progression of WT or to test new treatment strategies, primary cultures were generated from fresh tumor tissue. Cultures from tumor samples of 12 patients with different genetic alterations could be validated as tumor derived cells. Two different cell types could be distinguished by immunohistochemistry and cell morphology: large round, slowly growing cells with epithelial characteristics and fibroblast-like cells that are less differentiated and some of which could be kept in culture for many passages before getting senescent. In this way a set of primary WT-cells could be established that is suitable for in vitro approaches to study mechanisms of nephroblastoma development or to test new therapy strategies. Prior microarray analyses suggested a deregulation of the retinoic acid (RA) pathway in advanced Wilms tumors. This should be validated in a large independent tumor set of 163 WT by realtime-RT-PCR. Deregulation of RA signaling and overexpression of NMYC was found in high risk tumors as opposed to tumors with low/intermediate risk and suggested a beneficial impact of retinoic acid on advanced nephroblastoma. To investigate whether retinoids could be employed as a novel therapeutic agent in WT primary WT-cells were treated with all-trans-RA (ATRA), 9cisRA, the synthetic retinoid fenretinide and combinations of retinoids and the HDAC inhibitor SAHA. Expression of genes deregulated in high risk tumors were analyzed and showed opposite changes upon treatment suggesting a positive effect of retinoids. For six of seven primary cultures tested cell growth was reduced upon retinoid administration. No additional synergistic effect could be observed for the combination of retinoids with the HDAC inhibitor SAHA. While fenretinide induced apoptosis in several cultures tested, ATRA and 9cisRA caused morphological changes suggesting differentiation upon treatment. Microarray analysis of ATRA treated WT-cells revealed differential expression of many genes involved in the formation of the extracellular matrix and osteogenic, neuronal or muscle differentiation processes. These findings provide further evidence of a potential utility of retinoids in Wilms tumor treatment. KW - Nephroblastom KW - Genmutation KW - Retinoesaeure KW - Signaltransduktion KW - Wilms Tumor KW - WTX KW - Primärkultur KW - Nephroblastoma KW - Wilms tumor KW - WTX KW - primary cell culture KW - retinoic acid Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-52822 ER - TY - JOUR A1 - Wegert, Jenny A1 - Vokuh, Christian A1 - Ziegler, Barbara A1 - Ernestus, Karen A1 - Leuschner, Ivo A1 - Furtwängler, Rhoikos A1 - Graf, Norbert A1 - Gessler, Manfred T1 - TP53 alterations in Wilms tumour represent progression events with strong intratumour heterogeneity that are closely linked but not limited to anaplasia JF - The Journal of Pathology: Clinical Research N2 - TP53 mutations have been associated with anaplasia in Wilms tumour, which conveys a high risk for relapse and fatal outcome. Nevertheless, TP53 alterations have been reported in no more than 60% of anaplastic tumours, and recent data have suggested their presence in tumours that do not fulfil the criteria for anaplasia, questioning the clinical utility of TP53 analysis. Therefore, we characterized the TP53 status in 84 fatal cases of Wilms tumour, irrespective of histological subtype. We identified TP53 alterations in at least 90% of fatal cases of anaplastic Wilms tumour, and even more when diffuse anaplasia was present, indicating a very strong if not absolute coupling between anaplasia and deregulation of p53 function. Unfortunately, TP53 mutations do not provide additional predictive value in anaplastic tumours since the same mutation rate was found in a cohort of non-fatal anaplastic tumours. When classified according to tumour stage, patients with stage I diffuse anaplastic tumours still had a high chance of survival (87%), but this rate dropped to 26% for stages II–IV. Thus, volume of anaplasia or possible spread may turn out to be critical parameters. Importantly, among non-anaplastic fatal tumours, 26% had TP53 alterations, indicating that TP53 screening may identify additional cases at risk. Several of these non-anaplastic tumours fulfilled some criteria for anaplasia, for example nuclear unrest, suggesting that such partial phenotypes should be under special scrutiny to enhance detection of high-risk tumours via TP53 screening. A major drawback is that these alterations are secondary changes that occur only later in tumour development, leading to striking intratumour heterogeneity that requires multiple biopsies and analysis guided by histological criteria. In conclusion, we found a very close correlation between histological signs of anaplasia and TP53 alterations. The latter may precede development of anaplasia and thereby provide diagnostic value pointing towards aggressive disease. KW - tumour heterogeneity KW - Wilms tumour KW - nephroblastoma KW - anaplasia KW - TP53 Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158302 VL - 3 ER - TY - JOUR A1 - Martín, Ovidio Jiménez A1 - Schlosser, Andreas A1 - Furtwängler, Rhoikos A1 - Wegert, Jenny A1 - Gessler, Manfred T1 - MYCN and MAX alterations in Wilms tumor and identification of novel N-MYC interaction partners as biomarker candidates JF - Cancer Cell International N2 - Background Wilms tumor (WT) is the most common renal tumor in childhood. Among others, MYCN copy number gain and MYCN P44L and MAX R60Q mutations have been identified in WT. MYCN encodes a transcription factor that requires dimerization with MAX to activate transcription of numerous target genes. MYCN gain has been associated with adverse prognosis in different childhood tumors including WT. The MYCN P44L and MAX R60Q mutations, located in either the transactivating or basic helix-loop-helix domain, respectively, are predicted to be damaging by different pathogenicity prediction tools, but the functional consequences remain to be characterized. Methods We screened a large cohort of unselected WTs for MYCN and MAX alterations. Wild-type and mutant protein function were characterized biochemically, and we analyzed the N-MYC protein interactome by mass spectrometric analysis of N-MYC containing protein complexes. Results Mutation screening revealed mutation frequencies of 3% for MYCN P44L and 0.9% for MAX R60Q that are associated with a higher risk of relapse. Biochemical characterization identified a reduced transcriptional activation potential for MAX R60Q, while the MYCN P44L mutation did not change activation potential or protein stability. The protein interactome of N-MYC-P44L was likewise not altered as shown by mass spectrometric analyses of purified N-MYC complexes. Nevertheless, we could identify a number of novel N-MYC partner proteins, e.g. PEG10, YEATS2, FOXK1, CBLL1 and MCRS1, whose expression is correlated with MYCN in WT samples and several of these are known for their own oncogenic potential. Conclusions The strongly elevated risk of relapse associated with mutant MYCN and MAX or elevated MYCN expression corroborates their role in WT oncogenesis. Together with the newly identified co-expressed interactors they expand the range of potential biomarkers for WT stratification and targeting, especially for high-risk WT. KW - Wilms tumor KW - MYCN KW - MAX KW - interactome KW - mutation screening Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-265542 VL - 21 ER - TY - JOUR A1 - Chagtai, Tasnim A1 - Zill, Christina A1 - Dainese, Linda A1 - Wegert, Jenny A1 - Savola, Suvi A1 - Popov, Sergey A1 - Mifsud, William A1 - Vujanic, Gordan A1 - Sebire, Neil A1 - Le Bouc, Yves A1 - Ambros, Peter F. A1 - Kager, Leo A1 - O`Sullivan, Maureen J. A1 - Blaise, Annick A1 - Bergeron, Christophe A1 - Holmquist Mengelbier, Linda A1 - Gisselsson, David A1 - Kool, Marcel A1 - Tytgat, Godelieve A.M. A1 - van den Heuvel-Eibrink, Marry M. A1 - Graf, Norbert A1 - van Tinteren, Harm A1 - Coulomb, Aurore A1 - Gessler, Manfred A1 - Williams, Richard Dafydd A1 - Pritchard-Jones, Kathy T1 - Gain of 1q As a Prognostic Biomarker in Wilms Tumors (WTs) Treated With Preoperative Chemotherapy in the International Society of Paediatric Oncology (SIOP) WT 2001 Trial: a SIOP Renal Tumours Biology Consortium Study JF - Journal of Clinical Oncology N2 - Purpose Wilms tumor (WT) is the most common pediatric renal tumor. Treatment planning under International Society of Paediatric Oncology (SIOP) protocols is based on staging and histologic assessment of response to preoperative chemotherapy. Despite high overall survival (OS), many relapses occur in patients without specific risk factors, and many successfully treated patients are exposed to treatments with significant risks of late effects. To investigate whether molecular biomarkers could improve risk stratification, we assessed 1q status and other potential copy number biomarkers in a large WT series. Materials and Methods WT nephrectomy samples from 586 SIOP WT 2001 patients were analyzed using a multiplex ligation-dependent probe amplification (MLPA) assay that measured the copy number of 1q and other regions of interest. Results One hundred sixty-seven (28%) of 586 WTs had 1q gain. Five-year event-free survival (EFS) was 75.0% in patients with 1q gain (95% CI, 68.5% to 82.0%) and 88.2% in patients without gain (95% CI, 85.0% to 91.4%). OS was 88.4% with gain (95% CI, 83.5% to 93.6%) and 94.4% without gain (95% CI, 92.1% to 96.7%). In univariable analysis, 1q gain was associated with poorer EFS (P<.001; hazard ratio, 2.33) and OS (P=.01; hazard ratio, 2.16). The association of 1q gain with poorer EFS retained significance in multivariable analysis adjusted for 1p and 16q loss, sex, stage, age, and histologic risk group. Gain of 1q remained associated with poorer EFS in tumor subsets limited to either intermediate-risk localized disease or nonanaplastic localized disease. Other notable aberrations associated with poorer EFS included MYCN gain and TP53 loss. Conclusion Gain of 1q is a potentially valuable prognostic biomarker in WT, in addition to histologic response to preoperative chemotherapy and tumor stage. KW - Poor-prognosis KW - Mutations KW - Gene KW - Drosha KW - MYCN KW - Mechanisms KW - Reveals KW - Event KW - Relapse KW - Locus Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-187478 VL - 34 IS - 26 ER -