Abstract 5341: Mechanisms driving resistance in Group 3 and recurrent/disseminated medulloblastoma
Authors: Huang Shiying , Pan Jie-Ling , Lin Qi , Du YuChen , Su Jack , Major Angela , Elghetany M. Tarek , Hui Kam-Man , Li Xiaonan , Teo Wan-Yee 
Published: June 2022

Abstract
Background: Medulloblastoma (MB) is the most common malignant brain tumor in children and accounts for 20% of childhood brain tumors. Among the 4 molecular MB subtypes, Group 3 and 4 MBs have the worst prognosis. The biology of recurrence and dissemination in MB is less understood. Overexpression of platelet-derived growth factor receptor (PDGFR) has been associated with metastatic MB, and PDGFR activity promotes MB migration. PDGFR-induced migration is regulated by Src kinase. Src kinase activity is high in MB and Src kinase inhibition restricts tumor growth. Group 3 MB demonstrates high PDGFRA expression.
Aim: Our objective was to evaluate if molecular inhibition of PDGFR or Src kinase will control metastatic progression/dissemination in Group 3 MB.
Methods: We treated a panel of 4 patient-derived MB cell lines with dasatinib, which can inhibit BCRABL, c-KIT, PDGFR and Src kinase. Dasatinib dose required to inhibit c-KIT and PDGFR is higher (50-100 nM) than that needed for Src inhibition (1-10 nM).
Results: Proliferation assay with dasatinib (1-10000nM) performed on all 4 cell lines did not demonstrate any inhibition of proliferation except at 10000nM dose. We treated all 4 MB cell lines with higher dose range of dasatinib (625-10000nM). One cell line did not respond to dasatinib, remaining cell lines demonstrated proliferation inhibition over 13 days between 625-5000nM. There were 2 interesting observations. Firstly, cell line which required lowest dose (625nM) was a recurrent MB, while paradoxically, its paired parental cell line (non-recurrent/treatment-naïve) responded to proliferation inhibition only at higher 5000nM dose. IC50 of parental cell line was 38-times higher than recurrent cell line. We postulated that recurrent MB may be responsive to dasatinib. However, dasatinib-treated recurrent cells demonstrated minimal changes in cell cycle phases (IC50 day 4 dose 187.4nM) and apoptotic cell death (187.4nM and 293.2nM) compared to DMSO-treated control. Since Group 3 MB demonstrates high PDGFRA expression, we employed a patient-derived orthotopic xenograft (PDOX) model of Group 3 MB to investigate the in-vivo response to dasatinib. The 2nd interesting observation was that dasatinib-treated mice exhibited earlier neuro-symptoms, more rapid tumor growth and clinical deterioration compared to control mice. However, overall animal survival time was not statistically significant between treated versus untreated groups (p=0.24 Log-rank test).
Conclusions: Recurrent cells were more sensitive to dasatinib in-vitro compared to paired parental cells. In-vivo, mice treated with dasatinib developed neuro-symptoms faster than controls. It is currently not known if recurrent MB cells demonstrating early dasatinib-sensitivity to proliferation inhibition, escaping cell death, can formulate an in-vivo mechanism to drive more rapid tumor progression/dissemination as observed in our Group 3 MB Model.
Citation Format: Shiying Huang, Jie-Ling Pan, Qi Lin, YuChen Du, Jack Su, Angela Major, M. Tarek Elghetany, Kam-Man Hui, Xiaonan Li, Wan-Yee Teo. Mechanisms driving resistance in Group 3 and recurrent/disseminated medulloblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5341.