CNSC-08. PROTEOGENOMIC ANALYSIS OF LONGITUDINAL TRAJECTORY OF GLIOBLASTOMA EVOLUTION

Abstract

Abstract The evolutionary trajectory of glioblastoma after therapy is a multifaceted biological process that extends beyond discrete genetic alterations alone. Here, we performed a proteogenomic analysis of 123 longitudinal glioblastoma pairs, temporally separated by standard-of-care treatment. Integrative analyses identified a prevalence of a highly proliferative cellular state at diagnosis and its replacement by recurrent tumors sharing activation of neuronal differentiation and synaptogenicpathways. Proteomic and phosphoproteomic analyses revealed that the molecular transition from the proliferative to the neuronal state at recurrence is marked by coherent post-translational activation of the WNT/PCP signaling pathway and the BRAF protein kinase. Multi-omic analysis of the Patient-Derived Xenograft (PDX) model demonstrated similar patterns of evolutionary trajectory, marked by activation of neuronal signaling programs that were consistently observed in longitudinal patients. Inhibition of the BRAF kinase with small molecule inhibitors impaired both neuronal differentiation and migration capability of recurrent glioblastoma cells, which are the phenotypic hallmarks of glioblastoma progression after therapy. This work provides comprehensive insights into the biological mechanisms of glioblastoma evolution and treatment resistance and highlights new therapeutic opportunities to effectively counter them in the clinic.