One of the hallmarks of glioblastoma is its inherent tendency to recur. At this point patients with relapsed GBM show a survival
time of only few months. The molecular basis of the recurrence process in GBM is still poorly understood. The aim of the present
study was to investigate the genetic profile of relapsed GBM compared to their respective primary tumors. We have included
20 paired GBMs. In all tumor samples, we have analyzed
p53 and
PTEN status by sequencing analysis,
EGFR amplification by semiquantitative PCR and a wide-genome fingerprinting was performed by microsatellite analysis. Among primary
GBM, we observed twelve type 2 GBM, four type 1 GBM and four further GBM showing neither
p53 mutations nor
EGFR amplification (non-type 1–non-type 2 GBM). Upon recurrence, we have detected two molecular patterns of tumor progression:
GBM initially showing either type 1 or type 2 profiles conserved them at the time of relapse. In contrast, non-type 1–non-type
2 GBM acquired the typical pattern of type 2 GBM and harbor
EGFR amplification without
p53 mutation. New
PTEN mutations upon relapse were only detected in type 2 GBM. Additional LOH were more frequently identified in relapses of type
2 GBM than in those showing the type 1 signature. Taken together, our results strongly suggest that recurrences of GBM may
display two distinct pattern of accumulation of molecular alterations depending on the profile of the original tumor.
Keywords Glioblastoma - Relapse -
p53
-
PTEN
- Microsatellite - Mutation