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Supplemental Methods and Supplemental Figures 1-9 from Tumor-Associated Macrophages in SHH Subgroup of Medulloblastomas

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posted on 2023-03-31, 18:43 authored by Ashley S. Margol, Nathan J. Robison, Janahan Gnanachandran, Long T. Hung, Rebekah J. Kennedy, Marzieh Vali, Girish Dhall, Jonathan L. Finlay, Anat Erdreich-Epstein, Mark D. Krieger, Rachid Drissi, Maryam Fouladi, Floyd H. Gilles, Alexander R. Judkins, Richard Sposto, Shahab Asgharzadeh

Supplemental Methods and Supplemental Figures 1-9 Supplemental Figure 1. Overview of samples studies and 31-gene signature development Supplemental Figure. 2. Non-negative matrix factorization (NMF) analysis of the combined cohort of medulloblastoma samples (n=168) (A) Cophenetic correlation coefficient based on 2000 clustering runs for 2-10 clusters utilizing genes obtained at varying coefficients of variation; the data demonstrate that the highest cophenetic correlation coefficient was obtained at 4 clusters with 369 genes. (B) NMF consensus heatmap of 4 subgroups using the dataset containing 369 genes with high coefficient of variation. (C) Silhouette plot for identification of outliers. Outliers (n=31) were defined as samples with a silhouette width <0.15. Supplemental Figure 3. HuEx expression levels of CSF1R are significantly higher in SHH tumors compared to Group 3 or Group 4 subgroups (p<0.0001 respectively). Supplemental Figure 4. Progression free survival (PFS) and overall survival (OS) analyses using Kaplan-Meier plots and log rank tests for samples analyzed using TLDA 31-gene signature (A) PFS by molecular subgroup. (B) OS by molecular subgroup. Supplemental Figure 5. TLDA expression levels of CD163 are similar among histologic subtypes of SHH medulloblastomas Supplemental Figure 6. Progression free survival (PFS) and overall survival (OS) analyses using Kaplan-Meier plots and log rank tests for SHH tumors based on median TLDA expression of CD163.(A) PFS of high- vs low-expressers. (B) OS of high- vs low-expressers. Children who died of treatment-related toxicity without evidence of disease progression are excluded from the analyses (n=3). Supplemental Figure 8. Representative IHC images of SHH tumors with desmoplastic histology stained with anti-Ki-67 antibody demonstrating increased cell proliferation in internodular areas corresponding to the presence of macrophages. Supplemental Figure 7. Additional representative (2 per group) of CD163 IHC images of SHH with desmoplastic histology, SHH with classic histology, Group 3 and Group 4 tumors. Supplemental Figure 8. Representative IHC images of SHH tumors with desmoplastic histology stained with anti-Ki-67 antibody demonstrating increased cell proliferation in internodular areas corresponding to the presence of macrophages. Supplemental Figure 9. Unsupervised clustering of the 40 most variable macrophage related genes. Heatmap demonstrating clustering of SHH and WNT group of tumors compared to Group 3/4 tumors. Rows represent names of genes and HuEx probeset identification. White to red coloring indicates expression level of the gene (log2).

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ARTICLE ABSTRACT

Purpose: Medulloblastoma in children can be categorized into at least four molecular subgroups, offering the potential for targeted therapeutic approaches to reduce treatment-related morbidities. Little is known about the role of tumor microenvironment in medulloblastoma or its contribution to these molecular subgroups. Tumor microenvironment has been shown to be an important source for therapeutic targets in both adult and pediatric neoplasms. In this study, we investigated the hypothesis that expression of genes related to tumor-associated macrophages (TAM) correlates with the medulloblastoma molecular subgroups and contributes to a diagnostic signature.Methods: Gene-expression profiling using human exon array (n = 168) was analyzed to identify medulloblastoma molecular subgroups and expression of inflammation-related genes. Expression of 45 tumor-related and inflammation-related genes was analyzed in 83 medulloblastoma samples to build a gene signature predictive of molecular subgroups. TAMs in medulloblastomas (n = 54) comprising the four molecular subgroups were assessed by immunohistochemistry (IHC).Results: A 31-gene medulloblastoma subgroup classification score inclusive of TAM-related genes (CD163 and CSF1R) was developed with a misclassification rate of 2%. Tumors in the Sonic Hedgehog (SHH) subgroup had increased expression of inflammation-related genes and significantly higher infiltration of TAMs than tumors in the Group 3 or Group 4 subgroups (P < 0.0001 and P < 0.0001, respectively). IHC data revealed a strong association between location of TAMs and proliferating tumor cells.Conclusions: These data show that SHH tumors have a unique tumor microenvironment among medulloblastoma subgroups. The interactions of TAMs and SHH medulloblastoma cells may contribute to tumor growth revealing TAMs as a potential therapeutic target. Clin Cancer Res; 21(6); 1457–65. ©2014 AACR.