Abstract
Gliomas represent approximately 30% of all central nervous system tumors and 80% of malignant brain tumors1. To understand the molecular mechanisms underlying the malignant progression of low-grade gliomas with mutations in IDH1 (encoding isocitrate dehydrogenase 1), we studied paired tumor samples from 41 patients, comparing higher-grade, progressed samples to their lower-grade counterparts. Integrated genomic analyses, including whole-exome sequencing and copy number, gene expression and DNA methylation profiling, demonstrated nonlinear clonal expansion of the original tumors and identified oncogenic pathways driving progression. These include activation of the MYC and RTK-RAS-PI3K pathways and upregulation of the FOXM1- and E2F2-mediated cell cycle transitions, as well as epigenetic silencing of developmental transcription factor genes bound by Polycomb repressive complex 2 in human embryonic stem cells. Our results not only provide mechanistic insight into the genetic and epigenetic mechanisms driving glioma progression but also identify inhibition of the bromodomain and extraterminal (BET) family as a potential therapeutic approach.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
206,07 € per year
only 17,17 € per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout






Similar content being viewed by others
Accession codes
References
Ostrom, Q.T. et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007–2011. Neuro-oncol. 16 (suppl. 4), iv1–iv63 (2014).
Louis, D.N. et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114, 97–109 (2007).
Claus, E.B. & Black, P.M. Survival rates and patterns of care for patients diagnosed with supratentorial low-grade gliomas. Cancer 106, 1358–1363 (2006).
Stupp, R. et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N. Engl. J. Med. 352, 987–996 (2005).
Stupp, R. et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol. 10, 459–466 (2009).
Suzuki, H. et al. Mutational landscape and clonal architecture in grade II and III gliomas. Nat. Genet. 47, 458–468 (2015).
Cancer Genome Atlas Research Network. Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas. N. Engl. J. Med. 372, 2481–2498 (2015).
Eckel-Passow, J.E. et al. Glioma groups based on 1p/19q, IDH, and TERT promoter mutations in tumors. N. Engl. J. Med. 372, 2499–2508 (2015).
Turcan, S. et al. IDH1 mutation is sufficient to establish the glioma hypermethylator phenotype. Nature 483, 479–483 (2012).
Jaeckle, K.A. et al. Transformation of low grade glioma and correlation with outcome: an NCCTG database analysis. J. Neurooncol. 104, 253–259 (2011).
Artavanis-Tsakonas, S. Notch signaling: cell fate control and signal integration in development. Science 284, 770–776 (1999).
Stransky, N. et al. The mutational landscape of head and neck squamous cell carcinoma. Science 333, 1157–1160 (2011).
Agrawal, N. et al. Exome sequencing of head and neck squamous cell carcinoma reveals inactivating mutations in NOTCH1. Science 333, 1154–1157 (2011).
Pickering, C.R. et al. Mutational landscape of aggressive cutaneous squamous cell carcinoma. Clin. Cancer Res. 20, 6582–6592 (2014).
Cordle, J. et al. A conserved face of the Jagged/Serrate DSL domain is involved in Notch trans-activation and cis-inhibition. Nat. Struct. Mol. Biol. 15, 849–857 (2008).
Harvey, K.F., Zhang, X. & Thomas, D.M. The Hippo pathway and human cancer. Nat. Rev. Cancer 13, 246–257 (2013).
Johnson, B.E. et al. Mutational analysis reveals the origin and therapy-driven evolution of recurrent glioma. Science 343, 189–193 (2014).
Mäkinen, N. et al. MED12, the mediator complex subunit 12 gene, is mutated at high frequency in uterine leiomyomas. Science 334, 252–255 (2011).
Barbieri, C.E. et al. Exome sequencing identifies recurrent SPOP, FOXA1 and MED12 mutations in prostate cancer. Nat. Genet. 44, 685–689 (2012).
Lim, W.K. et al. Exome sequencing identifies highly recurrent MED12 somatic mutations in breast fibroadenoma. Nat. Genet. 46, 877–880 (2014).
Hill, D.A. et al. DICER1 mutations in familial pleuropulmonary blastoma. Science 325, 965 (2009).
Kumar, M.S. et al. Dicer1 functions as a haploinsufficient tumor suppressor. Genes Dev. 23, 2700–2704 (2009).
Labreche, K. et al. TCF12 is mutated in anaplastic oligodendroglioma. Nat. Commun. 6, 7207 (2015).
Comino-Méndez, I. et al. Exome sequencing identifies MAX mutations as a cause of hereditary pheochromocytoma. Nat. Genet. 43, 663–667 (2011).
van Thuijl, H.F. et al. Spatial and temporal evolution of distal 10q deletion, a prognostically unfavorable event in diffuse low-grade gliomas. Genome Biol. 15, 471 (2014).
Laoukili, J., Stahl, M. & Medema, R.H. FoxM1: at the crossroads of ageing and cancer. Biochim. Biophys. Acta 1775, 92–102 (2007).
van den Boom, J. et al. Characterization of gene expression profiles associated with glioma progression using oligonucleotide-based microarray analysis and real-time reverse transcription–polymerase chain reaction. Am. J. Pathol. 163, 1033–1043 (2003).
Liu, M. et al. FoxM1B is overexpressed in human glioblastomas and critically regulates the tumorigenicity of glioma cells. Cancer Res. 66, 3593–3602 (2006).
Koo, C.-Y., Muir, K.W. & Lam, E.W.F. FOXM1: from cancer initiation to progression and treatment. Biochim. Biophys. Acta 1819, 28–37 (2012).
Wu, L. et al. The E2F1–3 transcription factors are essential for cellular proliferation. Nature 414, 457–462 (2001).
Hollern, D.P., Honeysett, J., Cardiff, R.D. & Andrechek, E.R. The E2F transcription factors regulate tumor development and metastasis in a mouse model of metastatic breast cancer. Mol. Cell. Biol. 34, 3229–3243 (2014).
Topham, C. et al. MYC is a major determinant of mitotic cell fate. Cancer Cell 28, 129–140 (2015).
Dang, C.V. et al. The c-Myc target gene network. Semin. Cancer Biol. 16, 253–264 (2006).
Wang, J. et al. c-Myc is required for maintenance of glioma cancer stem cells. PLoS ONE 3, e3769 (2008).
Zheng, H. et al. p53 and Pten control neural and glioma stem/progenitor cell renewal and differentiation. Nature 455, 1129–1133 (2008).
Kim, H.S. et al. Gliomagenesis arising from Pten- and Ink4a/Arf-deficient neural progenitor cells is mediated by the p53-Fbxw7/Cdc4 pathway, which controls c-Myc. Cancer Res. 72, 6065–6075 (2012).
McLean, C.Y. et al. GREAT improves functional interpretation of cis-regulatory regions. Nat. Biotechnol. 28, 495–501 (2010).
ENCODE Project Consortium. An integrated encyclopedia of DNA elements in the human genome. Nature 489, 57–74 (2012).
Schlesinger, Y. et al. Polycomb-mediated methylation on Lys27 of histone H3 pre-marks genes for de novo methylation in cancer. Nat. Genet. 39, 232–236 (2007).
Keshet, I. et al. Evidence for an instructive mechanism of de novo methylation in cancer cells. Nat. Genet. 38, 149–153 (2006).
Cedar, H. & Bergman, Y. Linking DNA methylation and histone modification: patterns and paradigms. Nat. Rev. Genet. 10, 295–304 (2009).
Viré, E. et al. The Polycomb group protein EZH2 directly controls DNA methylation. Nature 439, 871–874 (2006).
Varambally, S. et al. The polycomb group protein EZH2 is involved in progression of prostate cancer. Nature 419, 624–629 (2002).
Cheng, Z. et al. Inhibition of BET bromodomain targets genetically diverse glioblastoma. Clin. Cancer Res. 19, 1748–1759 (2013).
Pastori, C. et al. BET bromodomain proteins are required for glioblastoma cell proliferation. Epigenetics 9, 611–620 (2014).
Shi, J. & Vakoc, C.R. The mechanisms behind the therapeutic activity of BET bromodomain inhibition. Mol. Cell 54, 728–736 (2014).
Filippakopoulos, P. et al. Selective inhibition of BET bromodomains. Nature 468, 1067–1073 (2010).
Rohle, D. et al. An inhibitor of mutant IDH1 delays growth and promotes differentiation of glioma cells. Science 340, 626–630 (2013).
Mertz, J.A. et al. Targeting MYC dependence in cancer by inhibiting BET bromodomains. Proc. Natl. Acad. Sci. USA 108, 16669–16674 (2011).
Bilgüvar, K. et al. Whole-exome sequencing identifies recessive WDR62 mutations in severe brain malformations. Nature 467, 207–210 (2010).
Martin, M. Cutadapt removes adapter sequences from high-throughput sequencing reads. EMBnet.journal 17, 10–12 (2011).
Lunter, G. & Goodson, M. Stampy: a statistical algorithm for sensitive and fast mapping of Illumina sequence reads. Genome Res. 21, 936–939 (2011).
Li, H. & Durbin, R. Fast and accurate short read alignment with Burrows-Wheeler transform. Bioinformatics 25, 1754–1760 (2009).
DePristo, M.A. et al. A framework for variation discovery and genotyping using next-generation DNA sequencing data. Nat. Genet. 43, 491–498 (2011).
Li, H. A statistical framework for SNP calling, mutation discovery, association mapping and population genetical parameter estimation from sequencing data. Bioinformatics 27, 2987–2993 (2011).
McLaren, W. et al. Deriving the consequences of genomic variants with the Ensembl API and SNP Effect Predictor. Bioinformatics 26, 2069–2070 (2010).
Clark, V.E. et al. Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO. Science 339, 1077–1080 (2013).
Erson-Omay, E.Z. et al. Somatic POLE mutations cause an ultramutated giant cell high-grade glioma subtype with better prognosis. Neuro-oncol. 17, 1356–1364 (2015).
1000 Genomes Project Consortium. An integrated map of genetic variation from 1,092 human genomes. Nature 491, 56–65 (2012).
Forbes, S.A. et al. COSMIC: mining complete cancer genomes in the Catalogue of Somatic Mutations in Cancer. Nucleic Acids Res. 39, D945–D950 (2011).
Van der Auwera, G.A. et al. From FastQ data to high confidence variant calls: the Genome Analysis Toolkit best practices pipeline. Curr. Protoc. Bioinformatics 11, 11.10.1–11.10.33 (2013).
Wang, K., Li, M. & Hakonarson, H. ANNOVAR: functional annotation of genetic variants from high-throughput sequencing data. Nucleic Acids Res. 38, e164 (2010).
Song, S. et al. qpure: a tool to estimate tumor cellularity from genome-wide single-nucleotide polymorphism profiles. PLoS ONE 7, e45835 (2012).
Zack, T.I. et al. Pan-cancer patterns of somatic copy number alteration. Nat. Genet. 45, 1134–1140 (2013).
Bolli, N. et al. Heterogeneity of genomic evolution and mutational profiles in multiple myeloma. Nat. Commun. 5, 2997 (2014).
Therneau, T.M. & Grambsch, P.M. Modeling Survival Data: Extending the Cox Model (Springer Science & Business Media, 2000).
Shi, W., Oshlack, A. & Smyth, G.K. Optimizing the noise versus bias trade-off for Illumina whole genome expression BeadChips. Nucleic Acids Res. 38, e204 (2010).
Leek, J.T., Johnson, W.E., Parker, H.S., Jaffe, A.E. & Storey, J.D. The sva package for removing batch effects and other unwanted variation in high-throughput experiments. Bioinformatics 28, 882–883 (2012).
Wilkerson, M.D. & Hayes, D.N. ConsensusClusterPlus: a class discovery tool with confidence assessments and item tracking. Bioinformatics 26, 1572–1573 (2010).
Subramanian, A. et al. Gene set enrichment analysis: a knowledge-based approach for interpreting genome-wide expression profiles. Proc. Natl. Acad. Sci. USA 102, 15545–15550 (2005).
Efron, B. & Tibshirani, R. On testing the significance of sets of genes. Ann. Appl. Stat. 1, 107–129 (2007).
Smyth, G.K. Linear models and empirical Bayes methods for assessing differential expression in microarray experiments. Stat. Appl. Genet. Mol. Biol. 3, Article3 (2004).
Croft, D. et al. Reactome: a database of reactions, pathways and biological processes. Nucleic Acids Res. 39, D691–D697 (2011).
Saito, R. et al. A travel guide to Cytoscape plugins. Nat. Methods 9, 1069–1076 (2012).
Langfelder, P. & Horvath, S. WGCNA: an R package for weighted correlation network analysis. BMC Bioinformatics 9, 559 (2008).
Triche, T.J., Weisenberger, D.J., Van Den Berg, D., Laird, P.W. & Siegmund, K.D. Low-level processing of Illumina Infinium DNA Methylation BeadArrays. Nucleic Acids Res. 41, e90 (2013).
Teschendorff, A.E. et al. A beta-mixture quantile normalization method for correcting probe design bias in Illumina Infinium 450 k DNA methylation data. Bioinformatics 29, 189–196 (2013).
Wang, D. et al. IMA: an R package for high-throughput analysis of Illumina's 450K Infinium methylation data. Bioinformatics 28, 729–730 (2012).
Shin, H., Liu, T., Manrai, A.K. & Liu, X.S. CEAS: cis-regulatory element annotation system. Bioinformatics 25, 2605–2606 (2009).
Gao, J. et al. Integrative analysis of complex cancer genomics and clinical profiles using the cBioPortal. Sci. Signal. 6, pl1 (2013).
Cerami, E. et al. The cBio Cancer Genomics Portal: an open platform for exploring multidimensional cancer genomics data. Cancer Discov. 2, 401–404 (2012).
Azari, H. et al. Isolation and expansion of human glioblastoma multiforme tumor cells using the neurosphere assay. J. Vis. Exp. 56, e3633 (2011).
Ritz, C. & Streibig, J.C. Bioassay analysis using R. J. Stat. Softw. 12, 1–22 (2005).
Acknowledgements
We are grateful to the patients and their families for donating tissues for this research. This study was supported by the Gregory M. Kiez and Mehmet Kutman Foundation and the Yale University Department of Neurosurgery. Partial funding was provided through a research agreement between Gilead Sciences, Inc., and Yale University.
Author information
Authors and Affiliations
Contributions
H.B., E.Z.E.-O., K.Y. and A.S.H. performed whole-exome sequencing analysis. H.B. and A.S.H. performed exome CNA, SNP array, DNA methylation array and ChIP-seq aggregation analyses. H.B., A.S.H. and K.Y. performed gene expression analysis. H.B. and E.Z.E.-O. performed tumor clonal evolution analysis. H.B. performed trinucleotide mutation signature and oncogenic network analyses. H.B. and K.Y. performed statistical association analysis. A.G.E.-S. and J.K. performed mutation validation. P.B.M. performed NOTCH1 structural analyses. M.S., B.K., M.B., M.N.P., K.Ö., J.S. and M.T. provided samples and clinical data. J.L. and A.O.V. conducted neuropathological evaluations. J.L., H.B., V.E.C. and G.C.-G. prepared samples. K.M.-G., L.S. and O.H. generated patient-derived glioma cultures. S.C., S.B.O., E.A.S., S.L.T. and Ş.T. conducted in vitro drug testing. H.B., S.C., S.B.O., E.A.S., S.L.T., Ş.T. and T.A.C. analyzed drug testing results. K.M.-G., S.A., L.D.K. and B.G. performed RT-qPCR. A.G.E.-S. performed genomic DNA qPCR. K.B. supervised genomic experiments. H.B., M.G., J.M. and A.L. wrote the manuscript, which was reviewed and edited by the other co-authors. M.G. designed and oversaw the project.
Corresponding author
Ethics declarations
Competing interests
This study was partly supported through a research agreement between Gilead Sciences, Inc., and Yale University. GS-626510 was provided by Gilead. E.A.S. and S.L.T. are employees of Gilead.
Supplementary information
Supplementary Text and Figures
Supplementary Figures 1–23. (PDF 5939 kb)
Supplementary Tables 1–12
Supplementary Tables 1–12. (XLSX 4691 kb)
Rights and permissions
About this article
Cite this article
Bai, H., Harmancı, A., Erson-Omay, E. et al. Integrated genomic characterization of IDH1-mutant glioma malignant progression. Nat Genet 48, 59–66 (2016). https://doi.org/10.1038/ng.3457
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ng.3457
This article is cited by
-
Forkhead box transcription factors (FOXOs and FOXM1) in glioma: from molecular mechanisms to therapeutics
Cancer Cell International (2023)
-
Genetic alterations that deregulate RB and PDGFRA signaling pathways drive tumor progression in IDH2-mutant astrocytoma
Acta Neuropathologica Communications (2023)
-
High expression of PCOLCE gene indicate poor prognosis in patients and are associated with immune infiltration in glioma
Scientific Reports (2023)
-
Distinct aneuploid evolution of astrocytoma and glioblastoma during recurrence
npj Precision Oncology (2023)
-
Widespread redundancy in -omics profiles of cancer mutation states
Genome Biology (2022)