Abstract

IntroductionIsocitrate dehydrogenase (IDH) mutation status and grade define subgroups of diffuse gliomas differing based on age, tumor location, presentation, and prognosis. While some biologic differences between IDH mutated (IDHmut) and wild-type (IDHwt) gliomas are clear, the distinct alterations associated with progression of the two subtypes to glioblastoma (GBM, Grade IV) have not been well described. We analyzed copy number alterations (CNAs) across grades (Grade II–III and GBM) in both IDHmut and IDHwt infiltrating gliomas using molecular inversion probe arrays.ResultsNinety four patient samples were divided into four groups: Grade II–III IDHwt (n = 17), Grade II–III IDHmut (n = 28), GBM IDHwt (n = 25), and GBM IDHmut (n = 24). We validated prior observations that IDHwt GBM have a high frequency of chromosome 7 gain (including EGFR) and chromosome 10 loss (including PTEN) compared with IDHmut GBM. Hierarchical clustering of IDHmut gliomas demonstrated distinct CNA patterns distinguishing lower grade gliomas versus GBM. However, similar hierarchical clustering of IDHwt gliomas demonstrated no CNA distinction between lower grade glioma and GBM. Functional analyses showed that IDHwt gliomas had more chromosome gains in regions containing receptor tyrosine kinase pathways. In contrast, IDHmut gliomas more commonly demonstrated amplification of cyclins and cyclin dependent kinase genes. One of the most common alterations associated with transformation of lower grade to GBM IDHmut gliomas was the loss of chromosomal regions surrounding PTEN. IDHmut GBM tumors demonstrated significantly higher levels of overall CNAs compared to lower grade IDHmut tumors and all grades of IDHwt tumors, and IDHmut GBMs also demonstrated significant increase in incidence of chromothripsis.ConclusionsTaken together, these analyses demonstrate distinct molecular ontogeny between IDHwt and IDHmut gliomas. Our data also support the novel findings that malignant progression of IDHmut gliomas to GBM involves increased genomic instability and genomic catastrophe, while IDHwt lower grade tumors are virtually identical to GBMs at the level of DNA copy number alterations.Electronic supplementary materialThe online version of this article (doi:10.1186/s40478-015-0213-3) contains supplementary material, which is available to authorized users.

Highlights

  • Isocitrate dehydrogenase (IDH) mutation status and grade define subgroups of diffuse gliomas differing based on age, tumor location, presentation, and prognosis

  • Population The cohort included a total of 94 diffuse gliomas: 17 Grade II–III IDH1 wild type (IDH1wt), 28 Grade II–III IDH1 mutant (IDH1mut), 25 Grade IV IDH1wt, and 24 Grade IV IDH1mut

  • IDH mutation status was a stronger prognostic factor than grade, as IDHwt lower grade gliomas had a worse prognosis than IDH mutated (IDHmut) grade IV gliomas, a finding previously observed in independent datasets [48, 11]

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Summary

Introduction

Isocitrate dehydrogenase (IDH) mutation status and grade define subgroups of diffuse gliomas differing based on age, tumor location, presentation, and prognosis. While some biologic differences between IDH mutated (IDHmut) and wild-type (IDHwt) gliomas are clear, the distinct alterations associated with progression of the two subtypes to glioblastoma (GBM, Grade IV) have not been well described. Glioblastoma (GBM) is the most common glioma and remains nearly uniformly fatal, with a median survival under 16 months in aggressively treated patients [17] While these tumors are currently diagnosed by histopathology alone and generally treated based on histology and grade, recent findings identifying distinct molecular subgroups within these tumor types strongly suggest that improving treatments and patient survival will require detailed understanding of the biological and clinical differences between these subgroups. The strongest prognostic factor for all glioma histologies is mutation in one of the isocitrate dehydrogenase genes (IDH1 or IDH2) [48], and mutation of these genes is seen at higher frequencies in lower grade gliomas and secondary GBMs

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