Distribution of EGFR amplification, combined chromosome 7 gain and chromosome 10 loss, and TERT promoter mutation in brain tumors and their potential for the reclassification of IDH wt astrocytoma to glioblastoma

Distribution of EGFR amplification, combined chromosome 7 gain and chromosome 10 loss, and TERT promoter mutation in brain tumors and their potential for the reclassification of IDH wt astrocytoma to glioblastoma

Damian Stichel;Azadeh Ebrahimi;David Reuss;Daniel Schrimpf;Takahiro Ono;Mitsuaki Shirahata;Guido Reifenberger;Michael Weller;Daniel Hänggi;Wolfgang Wick;Christel Herold-Mende;Manfred Westphal;Sebastian Brandner;Stefan M. Pfister;David Capper;Felix Sahm;Andreas von Deimling;Damian Stichel;Azadeh Ebrahimi;David Reuss;Daniel Schrimpf;Takahiro Ono;Mitsuaki Shirahata;Guido Reifenberger;Michael Weller;Daniel Hänggi;Wolfgang Wick;Christel Herold-Mende;Manfred Westphal;Sebastian Brandner;Stefan M. Pfister;David Capper;Felix Sahm;Andreas von Deimling;
acta neuropathologica 2018 Vol. 136 pp. 793-803
209
stichel2018actadistribution

Abstract

EGFR amplification (EGFRamp), the combination of gain of chromosome 7 and loss of chromosome 10 (7+/10−), and TERT promoter mutation (pTERTmut) are alterations frequently observed in adult IDH-wild-type (IDHwt) glioblastoma (GBM). In the absence of endothelial proliferation and/or necrosis, these alterations currently are considered to serve as a surrogate for upgrading IDHwt diffuse or anaplastic astrocytoma to GBM. Here, we set out to determine the distribution of EGFRamp, 7+/10−, and pTERTmut by analyzing high-resolution copy-number profiles and next-generation sequencing data of primary brain tumors. In addition, we addressed the question whether combinations of partial gains on chromosome 7 and partial losses on chromosome 10 exhibited a diagnostic and prognostic value similar to that of complete 7+/10−. Several such combinations proved relevant and were combined as the 7/10 signature. Our results demonstrate that EGFRamp and the 7/10 signature are closely associated with IDHwt GBM. In contrast, pTERTmut is less specific for IDHwt GBM. We conclude that, in the absence of endothelial proliferation and/or necrosis, the detection of EGFRamp is a very strong surrogate marker for the diagnosis of GBM in IDHwt diffuse astrocytic tumors. The 7/10 signature is also a strong surrogate marker. However, care should be taken to exclude pleomorphic xanthoastrocytoma. pTERTmut is less restricted to this entity and needs companion analysis by other molecular markers to serve as a surrogate for diagnosing IDHwt GBM. A combination of any two of EGFRamp, the 7/10 signature and pTERTmut, is highly specific for IDHwt GBM and the combination of all three alterations is frequent and exclusively seen in IDHwt GBM.

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