Genomic Profiling Can Aid In the Treatment of Brain Tumors in Children

In children has identified genetic alterations in 96% of cases, a type of brain tumor known as glioma when the largest genomic profiling study ever conducted. Hopefully improving the prognosis for what is currently the leading cause of death for children with cancer in the United States, the information could help to identify the most effective treatments for specific cases of glioma.

Corresponding author Shakti Ramkissoon, associate medical director at Foundation Medicine, a genomic profiling organization situated in Cambridge, Mass says, “This study additionally shows that genomic profiling can be promptly coordinated into the routine clinical work process for children with brain tumors. We trust that the gathering of objective genomic information will one day progress toward becoming ‘standard of care’ for children with mind tumors.”

Pediatric gliomas are a diverse collection of brain tumors affecting children that emerge from glial cells in the brain and spinal cord. Pediatric gliomas categorized into two wide classes; they are low-grade gliomas (LGGs) and high-grade gliomas (HGGs), with LGGs more benign and less dangerous than HGGs. In any case, treatment alternatives for both LGGs and HGGs are limited, and the long-term prognosis for children with threatening gliomas isn’t great. Anything that can enhance this prognosis is in this way invited.

In view of this point, Ramkissoon and a group of researchers from Foundation Medicine and a few universities and medical centers in the United States directed genomic profiling of 125 LGGs and 157 HGGs taken from children varying in age from under 1 to 18. To do this, they utilized a technique named hybridization- captured, ligation-based sequencing. This procedure includes extracting DNA from every tumor test and after that introducing it with a chip covered in short strands of manufactured DNA ready to capture sequences from 315 cancer-related genes and 28 genes generally rearranged in cancer.

Captured DNA is then sequenced on the chip to figure out which of these genes are changed and how they are changed. The changes can incorporate mutations to single genes, where DNA sequences are rearranged, erased, or embedded, and the fusing together of few genes.

Ramkissoon and his group identified genetic alterations in 96% of the tumor tests, with the most frequently altered genes varying amongst LGGs and HGGs. They found that qualities genes as BRAF, FGRFR1, and NF1 were most frequently changed in LGGs, while genes known as TP53 and H3F3A, together with NF1 once again, were most much of the time changed in HGGs. Additionally, it affirms that genomic profiling can help distinguish the best treatments for those different gliomas.

Ramkissoon says, “Our discoveries feature the significance of recognizing mutations that have been appeared to be analytically and prognostically significant. For instance, there is strong confirmation to demonstrate that LGGs harboring BRAF fusions have altogether better results compared with LGGs with BRAF mutations. Therefore, determining the BRAF status for all pediatric LGGs is vital for clinical management. Furthermore, our discoveries recognize targets for targeted treatments and feature the utility of small molecule inhibitors for the treatment of intermittent pediatric gliomas.”

The Foundation Medicine study demonstrates that BRAF inhibitors, for example, dabrafenib, which are at present experiencing clinical trials for treating pediatric gliomas, are probably going to be more successful against LGGs than HGGs. It additionally demonstrates that targeting on H3F3A mutations could offer an effective way to treat HGGs. Moreover, Ramkissoon and his group found that nine of the HGGs had an especially high number of mutations, known as a high tumor mutation burden, which past research has demonstrated reacts well to immunotherapy. Expanding on this work, in young adults, aged between 18 and 40, Ramkissoon and his group are next planning to direct a genomic profiling study of a kind of glioma known as a glioblastoma.

Priscilla K. Brastianos, MD, director of the central nervous system metastasis program at Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School says, “Pediatric gliomas represent a truly unmet clinical need in oncology. He is a section editor of The Oncologist and was not involved in the study. This work exhibits that molecular profiling of these tumors gives potential therapeutic chances to these patients, including targeted on treatments and immune checkpoint inhibitors.”


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