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Deciphering cellular interaction between malignant and normal brain cells in pediatric high-grade gliomas

Applicant Dr. Sina Neyazi
Subject Area Pediatric and Adolescent Medicine
Hematology, Oncology
Term from 2022 to 2024
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 508230354
 
Final Report Year 2025

Final Report Abstract

Pediatric high-grade gliomas (pHGGs) are a group of aggressive brain tumors and the leading cause of cancer-related death in children. pHGGs encompass clinically and biologically distinct subtypes characterized by specific anatomical localizations and typical ages of occurrence. In recent years, immense progress has been achieved in deciphering oncogenic alterations in pHGG. However, efforts to translate these findings into effective therapeutic options have not yet been successful. Previous single-cell RNA sequencing studies have revealed transcriptionally and functionally distinct malignant cell states within individual tumors of certain pHGG subtypes, such as H3K27-altered diffuse midline gliomas. Building on these recent findings, I hypothesized that, in addition to known genomic alterations, other factors may influence the growth and recurrence of pHGG. These factors include: (1) transcriptional differences of malignant cells within a single tumor (intratumoral heterogeneity) and across different tumors of distinct molecular pHGG subtypes (intertumoral heterogeneity); (2) unique developmental origins reflected in the developmental hierarchies of malignant cell states within pHGG subtypes; (3) the spatial composition and global structure of malignant cells within the tumor; and (4) interactions between malignant cells and normal cells in the tumor microenvironment. The aims of this project were (I) to decipher the transcriptional intra- and intertumoral heterogeneity and spatial landscape across pHGGs, including cell-cell interactions between malignant and non-malignant cells, and to (II) develop novel treatments targeting these transcriptional programs. In the first part of the project, I performed an in-depth single-nucleus and spatial transcriptomic characterization of pHGG leveraging an extensive cohort of 79 pHGG samples. I identified common and subtype-specific patterns of disease plasticity, characterized by distinct transcriptional programs and developmental hierarchies as well as unique spatial niches, with communicating malignant and normal cells of the tumor microenvironment, across pHGG subtypes. In the second part of the project, I aimed at therapeutically targeting these newly characterized transcriptional programs in pHGG. Using our genomic and single cell transcriptomic data sets, I identified an oncogenic receptor tyrosine kinase, PDGFRA, as a potential therapeutic target in pHGG. In a translational approach, I demonstrated that the PDGFRA inhibitor avapritinib exhibits in vitro and in vivo activity in patient-derived HGG models, effective blood-brain barrier penetration in mice and humans, and radiographic and clinical response in a subset of pHGG patients. Overall, this project provides a comprehensive landscape of the transcriptional heterogeneity of malignant and normal cells in pHGG and elucidates how these findings can be translated into novel targeted treatments for patients with this lethal disease.

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