Spinal Pleomorphic Xanthoastrocytoma With a QKI-RAF1 Fusion

Elena V. Daoud, Megan Wachsmann, Timothy E. Richardson, Divya Mella, Edward Pan, Anna Schwarzbach, Dwight Oliver, Kimmo J Hatanpaa

Research output: Contribution to journalArticle

Abstract

Pleomorphic xanthoastrocytoma (PXA) is a slow-growing neoplasm that predominantly affects the pediatric and young adult population. This neoplasm has a good prognosis, with a median 10-year survival rate of 70%. The majority of tumors are supratentorial and arise in the temporal lobe, while spinal tumors are extremely rare, with only 8 reported cases. Molecular perturbations involving the MAPK/ERK signaling pathway have been described in PXAs. The most common mutation is BRAF V600E in 60%-80% of cases. Other mechanisms activating this pathway in the absence of this mutation are rare and include CRAF (RAF1) fusion genes. We report a PXA case in the cervical spinal cord of a 49-year-old man with slowly progressive coordination difficulties and extremity numbness. The tumor was negative for the V600E mutation, but 2 RNA sequencing platforms detected a QKI-RAF1 fusion (t(6; 3)(q26; p25)), which has not been previously reported in PXAs. This fusion is known to activate MAPK/ERK and PI3K/mTOR signaling. Although first- and second-generation RAF inhibitors are predicted to be ineffective, this fusion may be targetable by the novel RAF inhibitor LY3009120 and to some extent by the MEK inhibitor trametinib. Genetic analysis to screen for MAPK/ERK pathway mutations is warranted on PXAs negative for the V600E mutation.

LanguageEnglish (US)
Pages10-14
Number of pages5
JournalJournal of neuropathology and experimental neurology
Volume78
Issue number1
DOIs
StatePublished - Jan 1 2019

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Mutation
MAP Kinase Signaling System
Neoplasms
Supratentorial Neoplasms
RNA Sequence Analysis
Hypesthesia
Gene Fusion
Mitogen-Activated Protein Kinase Kinases
Temporal Lobe
Phosphatidylinositol 3-Kinases
Young Adult
Survival Rate
Extremities
Pediatrics
Population

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Neurology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience

Cite this

Spinal Pleomorphic Xanthoastrocytoma With a QKI-RAF1 Fusion. / Daoud, Elena V.; Wachsmann, Megan; Richardson, Timothy E.; Mella, Divya; Pan, Edward; Schwarzbach, Anna; Oliver, Dwight; Hatanpaa, Kimmo J.

In: Journal of neuropathology and experimental neurology, Vol. 78, No. 1, 01.01.2019, p. 10-14.

Research output: Contribution to journalArticle

Daoud, EV, Wachsmann, M, Richardson, TE, Mella, D, Pan, E, Schwarzbach, A, Oliver, D & Hatanpaa, KJ 2019, 'Spinal Pleomorphic Xanthoastrocytoma With a QKI-RAF1 Fusion' Journal of neuropathology and experimental neurology, vol. 78, no. 1, pp. 10-14. https://doi.org/10.1093/jnen/nly112
Daoud, Elena V. ; Wachsmann, Megan ; Richardson, Timothy E. ; Mella, Divya ; Pan, Edward ; Schwarzbach, Anna ; Oliver, Dwight ; Hatanpaa, Kimmo J. / Spinal Pleomorphic Xanthoastrocytoma With a QKI-RAF1 Fusion. In: Journal of neuropathology and experimental neurology. 2019 ; Vol. 78, No. 1. pp. 10-14.
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