Multiomic neuropathology improves diagnostic accuracy in pediatric neuro-oncology
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Multiomic neuropathology improves diagnostic accuracy in pediatric neuro-oncology. / Sturm, Dominik; Capper, David; Andreiuolo, Felipe; Gessi, Marco; Kölsche, Christian; Reinhardt, Annekathrin; Sievers, Philipp; Wefers, Annika K; Ebrahimi, Azadeh; Suwala, Abigail K; Gielen, Gerrit H; Sill, Martin; Schrimpf, Daniel; Stichel, Damian; Hovestadt, Volker; Daenekas, Bjarne; Rode, Agata; Hamelmann, Stefan; Previti, Christopher; Jäger, Natalie; Buchhalter, Ivo; Blattner-Johnson, Mirjam; Jones, Barbara C; Warmuth-Metz, Monika; Bison, Brigitte; Grund, Kerstin; Sutter, Christian; Hirsch, Steffen; Dikow, Nicola; Hasselblatt, Martin; Schüller, Ulrich; Gerber, Nicolas U; White, Christine L; Buntine, Molly K; Kinross, Kathryn; Algar, Elizabeth M; Hansford, Jordan R; Gottardo, Nicholas G; Hernáiz Driever, Pablo; Gnekow, Astrid; Witt, Olaf; Müller, Hermann L; Calaminus, Gabriele; Fleischhack, Gudrun; Kordes, Uwe; Mynarek, Martin; Rutkowski, Stefan; Frühwald, Michael C; Kramm, Christof M; von Deimling, Andreas; Pietsch, Torsten; Sahm, Felix; Pfister, Stefan M; Jones, David T W.
In: NAT MED, Vol. 29, No. 4, 04.2023, p. 917-926.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Multiomic neuropathology improves diagnostic accuracy in pediatric neuro-oncology
AU - Sturm, Dominik
AU - Capper, David
AU - Andreiuolo, Felipe
AU - Gessi, Marco
AU - Kölsche, Christian
AU - Reinhardt, Annekathrin
AU - Sievers, Philipp
AU - Wefers, Annika K
AU - Ebrahimi, Azadeh
AU - Suwala, Abigail K
AU - Gielen, Gerrit H
AU - Sill, Martin
AU - Schrimpf, Daniel
AU - Stichel, Damian
AU - Hovestadt, Volker
AU - Daenekas, Bjarne
AU - Rode, Agata
AU - Hamelmann, Stefan
AU - Previti, Christopher
AU - Jäger, Natalie
AU - Buchhalter, Ivo
AU - Blattner-Johnson, Mirjam
AU - Jones, Barbara C
AU - Warmuth-Metz, Monika
AU - Bison, Brigitte
AU - Grund, Kerstin
AU - Sutter, Christian
AU - Hirsch, Steffen
AU - Dikow, Nicola
AU - Hasselblatt, Martin
AU - Schüller, Ulrich
AU - Gerber, Nicolas U
AU - White, Christine L
AU - Buntine, Molly K
AU - Kinross, Kathryn
AU - Algar, Elizabeth M
AU - Hansford, Jordan R
AU - Gottardo, Nicholas G
AU - Hernáiz Driever, Pablo
AU - Gnekow, Astrid
AU - Witt, Olaf
AU - Müller, Hermann L
AU - Calaminus, Gabriele
AU - Fleischhack, Gudrun
AU - Kordes, Uwe
AU - Mynarek, Martin
AU - Rutkowski, Stefan
AU - Frühwald, Michael C
AU - Kramm, Christof M
AU - von Deimling, Andreas
AU - Pietsch, Torsten
AU - Sahm, Felix
AU - Pfister, Stefan M
AU - Jones, David T W
N1 - © 2023. The Author(s).
PY - 2023/4
Y1 - 2023/4
N2 - The large diversity of central nervous system (CNS) tumor types in children and adolescents results in disparate patient outcomes and renders accurate diagnosis challenging. In this study, we prospectively integrated DNA methylation profiling and targeted gene panel sequencing with blinded neuropathological reference diagnostics for a population-based cohort of more than 1,200 newly diagnosed pediatric patients with CNS tumors, to assess their utility in routine neuropathology. We show that the multi-omic integration increased diagnostic accuracy in a substantial proportion of patients through annotation to a refining DNA methylation class (50%), detection of diagnostic or therapeutically relevant genetic alterations (47%) or identification of cancer predisposition syndromes (10%). Discrepant results by neuropathological WHO-based and DNA methylation-based classification (30%) were enriched in histological high-grade gliomas, implicating relevance for current clinical patient management in 5% of all patients. Follow-up (median 2.5 years) suggests improved survival for patients with histological high-grade gliomas displaying lower-grade molecular profiles. These results provide preliminary evidence of the utility of integrating multi-omics in neuropathology for pediatric neuro-oncology.
AB - The large diversity of central nervous system (CNS) tumor types in children and adolescents results in disparate patient outcomes and renders accurate diagnosis challenging. In this study, we prospectively integrated DNA methylation profiling and targeted gene panel sequencing with blinded neuropathological reference diagnostics for a population-based cohort of more than 1,200 newly diagnosed pediatric patients with CNS tumors, to assess their utility in routine neuropathology. We show that the multi-omic integration increased diagnostic accuracy in a substantial proportion of patients through annotation to a refining DNA methylation class (50%), detection of diagnostic or therapeutically relevant genetic alterations (47%) or identification of cancer predisposition syndromes (10%). Discrepant results by neuropathological WHO-based and DNA methylation-based classification (30%) were enriched in histological high-grade gliomas, implicating relevance for current clinical patient management in 5% of all patients. Follow-up (median 2.5 years) suggests improved survival for patients with histological high-grade gliomas displaying lower-grade molecular profiles. These results provide preliminary evidence of the utility of integrating multi-omics in neuropathology for pediatric neuro-oncology.
KW - Adolescent
KW - Humans
KW - Child
KW - Multiomics
KW - Glioma/diagnosis
KW - Neuropathology
KW - DNA Methylation/genetics
KW - Mutation
KW - Brain Neoplasms/diagnosis
U2 - 10.1038/s41591-023-02255-1
DO - 10.1038/s41591-023-02255-1
M3 - SCORING: Journal article
C2 - 36928815
VL - 29
SP - 917
EP - 926
JO - NAT MED
JF - NAT MED
SN - 1078-8956
IS - 4
ER -