American Association for Cancer Research
mct-22-0335_supplementary_data_suppsm.docx (2.46 MB)

Supplementary Data from Identification of IGF2 as Genomic Driver and Actionable Therapeutic Target in Hepatoblastoma

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journal contribution
posted on 2023-04-03, 08:41 authored by Jordi Abril-Fornaguera, Laura Torrens, Carmen Andreu-Oller, Juan Carrillo-Reixach, Alex Rialdi, Ugne Balaseviciute, Roser Pinyol, Carla Montironi, Philipp K. Haber, Álvaro Del Río-Álvarez, Montserrat Domingo-Sàbat, Laura Royo, Nicholas K. Akers, Catherine E. Willoughby, Judit Peix, Miguel Torres-Martin, Marc Puigvehi, Stefano Cairo, Margaret Childs, Rudolf Maibach, Rita Alaggio, Piotr Czauderna, Bruce Morland, Bojan Losic, Vincenzo Mazzaferro, Ernesto Guccione, Daniela Sia, Carolina Armengol, Josep M. Llovet

Supplementary Figures and Tables


Instituto de Salud Carlos III (ISCIII)

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)

Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR)

Ministerio de Ciencia e Innovación (MICINN)

Samuel Waxman Cancer Research Foundation (SWCRF)

National Cancer Institute (NCI)

United States Department of Health and Human Services

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Cancer Research UK (CRUK)

Fundación Científica Asociación Española Contra el Cáncer (AECC)

Alex's Lemonade Stand Foundation for Childhood Cancer (ALSF)



Management of hepatoblastoma (HB), the most frequent pediatric liver cancer, is based on surgical resection and perioperative chemotherapy regimens. In this study, we aimed to identify actionable targets in HB and assess the efficacy of molecular therapies in preclinical models of HB. Paired tumor and adjacent tissues from 31 HBs and a validation set of 50 HBs were analyzed using RNA-seq, SNP, and methylation arrays. IGF2 overexpression was identified as the top targetable HB driver, present in 71% of HBs (22/31). IGF2high tumors displayed progenitor cell features and shorter recurrence-free survival. IGF2 overexpression was associated in 91% of cases with fetal promoter hypomethylation, ICR1 deregulation, 11p15.5 loss of heterozygosity or miR483-5p overexpression. The antitumor effect of xentuzumab (a monoclonal antibody targeting IGF1/2) alone or in combination with the conventional therapeutic agent cisplatin was assessed in HB cell lines, in PDX-derived HB organoids and in a xenograft HB murine model. The combination of xentuzumab with cisplatin showed strong synergistic antitumor effects in organoids and in IGF2high cell lines. In mice (n = 55), the combination induced a significant decrease in tumor volume and improved survival compared with cisplatin alone. These results suggest that IGF2 is an HB actionable driver and that, in preclinical models of HB, the combination of IGF1/2 inhibition with cisplatin induces superior antitumor effects than cisplatin monotherapy. Overall, our study provides a rationale for testing IGF2 inhibitors in combination with cisplatin in HB patients with IGF2 overexpression.

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