Previous reports have implicated an induction of genes in IFN/STAT1 (Interferon/STAT1) signaling in radiation resistant and prosurvival tumor phenotypes in a number of cancer cell lines, and we have hypothesized that upregulation of these genes may be predictive of poor survival outcome and/or treatment response in Glioblastoma Multiforme (GBM) patients. We have developed a list of 8 genes related to IFN/STAT1 that we hypothesize to be predictive of poor survival in GBM patients. Our working hypothesis that over-expression of this gene signature predicts poor survival outcome in GBM patients was confirmed, and in addition, it was demonstrated that the survival model was highly subtype-dependent, with strong dependence in the Proneural subtype and no detected dependence in the Classical and Mesenchymal subtypes. We developed a specific multi-gene survival model for the Proneural subtype in the TCGA (the Cancer Genome Atlas) discovery set which we have validated in the TCGA validation set. In addition, we have performed network analysis in the form of Bayesian Network discovery and Ingenuity Pathway Analysis to further dissect the underlying biology of this gene signature in the etiology of GBM. We theorize that the strong predictive value of the IFN/STAT1 gene signature in the Proneural subtype may be due to chemotherapy and/or radiation resistance induced through prolonged constitutive signaling of these genes during the course of the illness. The results of this study have implications both for better prediction models for survival outcome in GBM and for improved understanding of the underlying subtype-specific molecular mechanisms for GBM tumor progression and treatment response.
References
[1]
Chandana SR, Movva S, Arora M, Singh T (2008) Primary brain tumors in adults. Am Fam Physician 77: 1423–1430.
[2]
Hegi ME, Diserens AC, Gorlia T, Hamou MF, de Tribolet N, et al. (2005) MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 352: 997–1003.
[3]
Rivera AL, Pelloski CE, Gilbert MR, Colman H, De La Cruz C, et al. (2010) MGMT promoter methylation is predictive of response to radiotherapy and prognostic in the absence of adjuvant alkylating chemotherapy for glioblastoma. Neuro Oncol 12: 116–121.
[4]
Khodarev NN, Beckett M, Labay E, Darga T, Roizman B, et al. (2004) STAT1 is overexpressed in tumors selected for radioresistance and confers protection from radiation in transduced sensitive cells. Proc Natl Acad Sci U S A 101: 1714–1719.
[5]
Khodarev NN, Minn AJ, Efimova EV, Darga TE, Labay E, et al. (2007) Signal transducer and activator of transcription 1 regulates both cytotoxic and prosurvival functions in tumor cells. Cancer Res 67: 9214–9220.
[6]
Tsai MH, Cook JA, Chandramouli GV, DeGraff W, Yan H, et al. (2007) Gene expression profiling of breast, prostate, and glioma cells following single versus fractionated doses of radiation. Cancer Res 67: 3845–3852.
[7]
Khodarev NN, Roach P, Pitroda SP, Golden DW, Bhayani M, et al. (2009) STAT1 pathway mediates amplification of metastatic potential and resistance to therapy. PLoS One 4: e5821.
[8]
Weichselbaum RR, Ishwaran H, Yoon T, Nuyten DS, Baker SW, et al. (2008) An interferon-related gene signature for DNA damage resistance is a predictive marker for chemotherapy and radiation for breast cancer. Proc Natl Acad Sci U S A 105: 18490–18495.
[9]
Verhaak RG, Hoadley KA, Purdom E, Wang V, Qi Y, et al. (2010) Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1. Cancer Cell 17: 98–110.
[10]
Potu H, Sgorbissa A, Brancolini C (2010) Identification of USP18 as an important regulator of the susceptibility to IFN-alpha and drug-induced apoptosis. Cancer Res 70: 655–665.
[11]
Duex JE, Comeau L, Sorkin A, Purow B, Kefas B (2011) USP18 regulates EGF receptor expression and cancer cell survival via microrna-7. J Biol Chem.
[12]
Dimco G, Knight RA, Latchman DS, Stephanou A (2010) STAT1 interacts directly with cyclin D1/Cdk4 and mediates cell cycle arrest. Cell Cycle 9: 4638–4649.
[13]
Adamkova L, Souckova K, Kovarik J (2007) Transcription protein STAT1: biology and relation to cancer. Folia Biol (Praha) 53: 1–6.
[14]
Pitroda SP, Wakim BT, Sood RF, Beveridge MG, Beckett MA, et al. (2009) STAT1-dependent expression of energy metabolic pathways links tumour growth and radioresistance to the Warburg effect. BMC Med 7: 68.
[15]
Dobelbower MC, Burnett OL Iii, Nordal RA, Nabors LB, Markert JM, et al. (2011) Patterns of failure for glioblastoma multiforme following concurrent radiation and temozolomide. J Med Imaging Radiat Oncol 55: 77–81.
[16]
Stupp R, Roila F (2009) Malignant glioma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 20: Suppl 4126–128.
[17]
Markert JM, Medlock MD, Rabkin SD, Gillespie GY, Todo T, et al. (2000) Conditionally replicating herpes simplex virus mutant, G207 for the treatment of malignant glioma: results of a phase I trial. Gene Ther 7: 867–874.
[18]
Markert JM, Liechty PG, Wang W, Gaston S, Braz E, et al. (2009) Phase Ib trial of mutant herpes simplex virus G207 inoculated pre-and post-tumor resection for recurrent GBM. Mol Ther 17: 199–207.
[19]
Parker JN, Bauer DF, Cody JJ, Markert JM (2009) Oncolytic viral therapy of malignant glioma. Neurotherapeutics 6: 558–569.
[20]
van Wieringen WN, Kun D, Hampel R, Boulesteix AL (2009) Survival prediction using gene expression data: A review and comparison. Computational Statistics & Data Analysis 53: 1590–1603.
[21]
Grambsch PM, Therneau TM (1994) Proportional Hazards Tests and Diagnostics Based on Weighted Residuals. Biometrika 81: 515–526.
[22]
Bender R, Augustin T, Blettner M (2005) Generating survival times to simulate Cox proportional hazards models. Stat Med 24: 1713–1723.