Abstract
Purpose: Pituitary adenomas are one of the most common benign neoplasms of the central nervous system. Although emerging evidence suggests roles for both genetic and epigenetic factors in tumorigenesis, the degree to which these factors contribute to disease remains poorly understood.Experimental Design: A multiplatform analysis was performed to identify the genomic and epigenomic underpinnings of disease among the three major subtypes of surgically resected pituitary adenomas in 48 patients: growth hormone (GH)-secreting (n = 17), adrenocorticotropic hormone (ACTH)-secreting (n = 13, including 3 silent-ACTH adenomas), and endocrine-inactive (n = 18). Whole-exome sequencing was used to profile the somatic mutational landscape, whole-transcriptome sequencing was used to identify disease-specific patterns of gene expression, and array-based DNA methylation profiling was used to examine genome-wide patterns of DNA methylation.Results: Recurrent single-nucleotide and small indel somatic mutations were infrequent among the three adenoma subtypes. However, somatic copy-number alterations (SCNA) were identified in all three pituitary adenoma subtypes. Methylation analysis revealed adenoma subtype-specific DNA methylation profiles, with GH-secreting adenomas being dominated by hypomethylated sites. Likewise, gene-expression patterns revealed adenoma subtype-specific profiles. Integrating DNA methylation and gene-expression data revealed that hypomethylation of promoter regions are related with increased expression of GH1 and SSTR5 genes in GH-secreting adenomas and POMC gene in ACTH-secreting adenomas. Finally, multispectral IHC staining of immune-related proteins showed abundant expression of PD-L1 among all three adenoma subtypes.Conclusions: Taken together, these data stress the contribution of epigenomic alterations to disease-specific etiology among adenoma subtypes and highlight potential targets for future immunotherapy-based treatments. This article reveals novel insights into the epigenomics underlying pituitary adenomas and highlights how differences in epigenomic states are related to important transcriptome alterations that define adenoma subtypes. Clin Cancer Res; 24(17); 4126-36. ©2018 AACR.
Highlights
Pituitary adenomas account for approximately 15% of all primary brain tumors [1]
Integrating DNA methylation and gene-expression data revealed that hypomethylation of promoter regions are related with increased expression of Growth Hormone 1 (GH1) and Somatostatin Receptor 5 (SSTR5) genes in growth hormone (GH)-secreting adenomas and POMC gene in adrenocorticotropic hormone (ACTH)-secreting adenomas
Multispectral IHC staining of immune-related proteins showed abundant expression of PD-L1 among all three adenoma subtypes. Taken together, these data stress the contribution of epigenomic alterations to disease-specific etiology among adenoma subtypes and highlight potential targets for future immunotherapy-based treatments
Summary
Pituitary adenomas account for approximately 15% of all primary brain tumors [1]. They can be differentiated onNote: Supplementary data for this article are available at Clinical Cancer Research Online (http://clincancerres.aacrjournals.org/).Ó2018 American Association for Cancer Research.the basis of the presence or absence of hormonal secretion (endocrine-active versus endocrine-inactive), clinical syndrome and manifestations, tumor size, and pathological features. Pituitary adenomas account for approximately 15% of all primary brain tumors [1]. Of the four most common adenoma subtypes, those associated with acromegaly (GH-secreting), Cushing's disease (ACTH-secreting) and endocrine-inactive adenomas are generally treated with transsphenoidal surgery as first-line therapy and are the focus of this analysis. Up to 40% of patients with acromegaly, Cushing's disease, or endocrine-inactive adenomas may need additional therapies beyond surgery. These treatments may include hormone-regulating medications or stereotactic radiosurgery to achieve tumor remission. 4126 Clin Cancer Res; 24(17) September 1, 2018
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