Significance of BRAFV600E mutation in intra-axial brain tumor in Malaysian patients: case series and literature review

Authors

  • A.A. Mohamed Yusoff Department of Neurosciences, School of Medical Sciences, University Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
  • S.M. Abd Radzak Department of Neurosciences, School of Medical Sciences, University Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
  • S.Z.N. Mohd Khair Department of Neurosciences, School of Medical Sciences, University Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
  • J.M. Abdullah Department of Neurosciences, School of Medical Sciences, University Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia

DOI:

https://doi.org/10.32471/exp-oncology.2312-8852.vol-43-no-2.16076

Keywords:

BRAFV600E mutation, brain tumor, intra-axial tumor, Malaysia

Abstract

Summary. Background: To date, BRAF mutations in brain tumor patients have not been characterized in the Malaysian population. Based on the numerous reported studies, there are main mutations that exist in BRAF gene in various types of cancers. A missense mutation in codon 600 of the BRAF nuclear oncogene (BRAFV600E) is the most prevalent hotspot point mutation that has been identified in multiple human malignancies. Aim: We here aimed to find out the frequency of BRAFV600E mutation in a series of Malaysian patients with brain tumors and if any association exists between BRAFV600E mutation and clinicopathological features of patients. Material and Methods: Fresh frozen tumor tissue samples from 50 Malaysian brain tumor patients were analyzed for BRAFV600E mutational status, and its correlation with clinicopathological features (including age, gender, and tumor localization such as intra-axial: within the brain substance or extra-axial: outside the brain substance) was examined. Results: The overall BRAFV600E mutation frequency was determined to be 22% (in 11 of 50 patients). BRAFV600E was significantly correlated with the tumor location group, which shows BRAFV600E was more frequent in the intra-axial tumor than the extra-axial tumor group. In this study, we also observed that male patients were slightly more susceptible to BRAFV600E mutation, and this mutation was predominant in patients of the age group < 40 years. However, these parameters did not translate to statistical significance. Conclusion: The data demonstrate that BRAFV600E mutation is observed significantly more often in intra-axial brain tumor patients, which can serve as baseline information for further research on genetic alteration that occurs during brain tumor progression in the Malaysian population.

References

GBD 2016 Brain and Other CNS Cancer Collaborators. Global, regional, and national burden of brain and other CNS cancer, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18: 376–93.

Kalan Farmanfarma KH, Mohammadian M, Shahabinia Z, et al. Brain cancer in the world: an epidemiology review. WCRJ 2019; 6: e1356.

Md Dzali NB, Zahary MN, Abu Bakar NH, et al. Distribution pattern of brain tumor in tertiary hospital in East Coast, Malaysia. MJPHM 2017; 2: 41–8.

Louis DN, Ohgaki H, Wiestler OD, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007; 114: 97–109.

Davies H, Bignell GR, Cox C, et al. Mutations of the BRAF gene in human cancer. Nature 2002; 417: 949–54.

Knobbe CB, Reifenberger J, Reifenberger G. Mutation analysis of the Ras pathway genes NRAS, HRAS, KRAS and BRAF in glioblastomas. Acta Neuropathol 2004; 108: 467–70.

Basto D, Trovisco V, Lopes JM, et al. Mutation analysis of B-RAF gene in human gliomas. Acta Neuropathol 2005; 109: 207–10.

Matallanas D, Birtwistle M, Romano D, et al. Raf family kinases: old dogs have learned new tricks. Genes Cancer 2011; 2: 232–60.

Inumaru JS, Gordo KI, Fraga Junior AC, et al. Analysis of the BRAF V600E mutation in primary cutaneous melanoma. Genet Mol Res 2014; 13: 2840–8.

Hugdahl E, Kalvenes MB, Puntervoll HE, et al. BRAF-V600E expression in primary nodular melanoma is associated with aggressive tumour features and reduced survival. Br J Cancer 2016; 114: 801–8.

Kang X, Zeng Y, Liang J, et al. Aberrations and clinical significance of BRAF in malignant melanoma: A series of 60 cases in Chinese Uyghur. Medicine (Baltimore) 2018; 97: e9509.

Tas F, Erturk K. BRAF V600E mutation as a prognostic factor in cutaneous melanoma patients. Dermatol Ther 2020; 33: e13270.

Ranjbari N, Almasi S, Mohammadi-Asl J, et al. BRAF mutations in Iranian patients with papillary thyroid carcinoma. Asian Pac J Cancer Prev 2013; 14: 2521–3.

Hardee S, Prasad ML, Hui P, et al. Pathologic characteristics, natural history, and prognostic implications of BRAF(V600E) mutation in pediatric papillary thyroid carcinoma. Pediatr Dev Pathol 2017; 20: 206–12.

Li XJ, Mao XD, Chen GF, et al. High BRAFV600E mutation frequency in Chinese patients with papillary thyroid carcinoma increases diagnostic efficacy in cytologically indeterminate thyroid nodules. Medicine (Baltimore) 2019; 98: e16343.

Celik M, Bulbul BY, Ayturk S, et al. The relation between BRAFV600E mutation and clinicopathological characteristics of papillary thyroid cancer. Med Glas (Zenica) 2020; 17: 30–4.

Yalcin S, Onguru O. BRAF mutation in colorectal carcinomas with signet ring cell component. Cancer Biol Med 2017; 14: 287–92.

Eachkoti R, Farooq S, Syeed SI, et al. Prevalence and prognostic relevance of BrafV600E mutation in colorectal carcinomas from Kashmir (North India) valley. Mutagenesis 2018; 33: 225–30.

Wang J, Shen J, Huang C, et al. Clinicopathological significance of BRAFV600E mutation in colorectal cancer: An updated meta-analysis. J Cancer 2019; 10: 2332–41.

Cho NY, Choi M, Kim BH, et al. BRAF and KRAS mutations in prostatic adenocarcinoma. Int J Cancer 2006; 119: 1858–62.

Ikeda S, Elkin SK, Tomson BN, et al. Next-generation sequencing of prostate cancer: genomic and pathway alterations, potential actionability patterns, and relative rate of use of clinical-grade testing. Cancer Biol Ther 2019; 20: 219–26.

Suh J, Jeong CW, Choi S, et al. Targeted next-generation sequencing for locally advanced prostate cancer in the Korean population. Investig Clin Urol 2020; 61: 127–35.

Cho YH, Kim DY, Kim JH, et al. Mutational analysis of KRAS, BRAF, and TP53 genes of ovarian serous carcinomas in Korean women. Yonsei Med J 2009; 50: 266–72.

Gershenson DM, Sun CC, Wong KK. Impact of mutational status on survival in low-grade serous carcinoma of the ovary or peritoneum. Br J Cancer 2015; 113: 1254–8.

Turashvili G, Grisham RN, Chiang S, et al. BRAF(V)(600E) mutations and immunohistochemical expression of VE1 protein in low-grade serous neoplasms of the ovary. Histopathology 2018; 73: 438–43.

Maraka S, Janku F. BRAF alterations in primary brain tumors. Discov Med 2018; 26: 51–60.

Tan YH, Liu Y, Eu KW, et al. Detection of BRAF V600E mutation by pyrosequencing. Pathology 2008; 40: 295–8.

Wan PT, Garnett MJ, Roe SM, et al. Mechanism of activation of the RAF-ERK signaling pathway by oncogenic mutations of B-RAF. Cell 2004; 116: 855–67.

Jones DT, Kocialkowski S, Liu L, et al. Tandem duplication producing a novel oncogenic BRAF fusion gene defines the majority of pilocytic astrocytomas. Cancer Res 2008; 68: 8673–7.

Faulkner C, Ellis HP, Shaw A, et al. BRAF fusion analysis in pilocytic astrocytomas: KIAA1549-BRAF 15-9 fusions are more frequent in the midline than within the cerebellum. J Neuropathol Exp Neurol 2015; 74: 867–72.

Hawkins C, Walker E, Mohamed N, et al. BRAF-KIAA1549 fusion predicts better clinical outcome in pediatric low-grade astrocytoma. Clin Cancer Res 2011; 17: 4790–8.

Schindler G, Capper D, Meyer J, et al. Analysis of BRAF V600E mutation in 1,320 nervous system tumors reveals high mutation frequencies in pleomorphic xanthoastrocytoma, ganglioglioma and extra-cerebellar pilocytic astrocytoma. Acta Neuropathol 2011; 121: 397–405.

Behling F, Barrantes-Freer A, Skardelly M, et al. Frequency of BRAF V600E mutations in 969 central nervous system neoplasms. Diagn Pathol 2016; 11: 55.

Pfister S, Janzarik WG, Remke M, et al. BRAF gene duplication constitutes a mechanism of MAPK pathway activation in low-grade astrocytomas. J Clin Invest 2008; 118: 1739–49.

Horbinski C, Nikiforova MN, Hagenkord JM, et al. Interplay among BRAF, p16, p53, and MIB1 in pediatric low-grade gliomas. Neuro Oncol 2012; 14: 777–89.

Ida CM, Lambert SR, Rodriguez FJ, et al. BRAF alterations are frequent in cerebellar low-grade astrocytomas with diffuse growth pattern. J Neuropathol Exp Neurol 2012; 71: 631–9.

Myung JK, Cho H, Park CK, et al. Analysis of the BRAF(V600E) mutation in central nervous system tumors. Transl Oncol 2012; 5: 430–6.

Chappé C, Padovani L, Scavarda D, et al. Dysembryoplastic neuroepithelial tumors share with pleomorphic xanthoastrocytomas and gangliogliomas BRAF(V600E) mutation and expression. Brain Pathol 2013; 23: 574–83.

Bannykh SI, Mirocha J, Nuno M, et al. V600E BRAF mutation in pilocytic astrocytoma is associated with a more diffuse growth pattern but does not confer a more aggressive clinical behavior. Clin Neuropathol 2014; 33: 388–98.

Donson AM, Kleinschmidt-DeMasters BK, Aisner DL, et al. Pediatric brainstem gangliogliomas show BRAF(V600E) mutation in a high percentage of cases. Brain Pathol 2014; 24:173–83.

Breton Q, Plouhinec H, Prunier-Mirebeau D, et al. BRAF-V600E immunohistochemistry in a large series of glial and glial-neuronal tumors. Brain Behav 2017; 7: e00641.

Hatae R, Hata N, Suzuki SO, et al. A comprehensive analysis identifies BRAF hotspot mutations associated with gliomas with peculiar epithelial morphology. Neuropathology 2017; 37: 191–9.

Lassaletta A, Zapotocky M, Mistry M, et al. Therapeutic and prognostic implications of BRAFV600E in pediatric low-grade gliomas. J Clin Oncol 2017; 35: 2934–41.

Frazão L, do Carmo Martins M, Nunes VM, et al. BRAF V600E mutation and 9p21: CDKN2A/B and MTAP co-deletions — Markers in the clinical stratification of pediatric gliomas. BMC Cancer 2018; 18: 1259.

Dougherty MJ, Santi M, Brose MS, et al. Activating mutations in BRAF characterize a spectrum of pediatric low-grade gliomas. Neuro Oncol 2010; 12: 621–30.

Dias-Santagata D, Lam Q, Vernovsky K, et al. BRAF V600E mutations are common in pleomorphic xanthoastrocytoma: diagnostic and therapeutic implications. PLoS One 2011; 6: e17948.

Ida CM, Vrana JA, Rodriguez FJ, et al. Immunohistochemistry is highly sensitive and specific for detection of BRAF V600E mutation in pleomorphic xanthoastrocytoma. Acta Neuropathol Commun 2013; 1: 20.

Lee D, Cho YH, Kang SY, et al. BRAF V600E mutations are frequent in dysembryoplastic neuroepithelial tumors and subependymal giant cell astrocytomas. J Surg Oncol 2015; 111: 359–64.

Tabouret E, Bequet C, Denicolaï E, et al. BRAF mutation and anaplasia may be predictive factors of progression-free survival in adult pleomorphic xanthoastrocytoma. Eur J Surg Oncol 2015; 41: 1685–90.

Lohkamp LN, Schinz M, Gehlhaar C, et al. MGMT promoter methylation and BRAF V600E mutations are helpful markers to discriminate pleomorphic xanthoastrocytoma from giant cell glioblastoma. PLoS One 2016; 11: e0156422.

Furuta T, Miyoshi H, Komaki S, et al. Clinicopathological and genetic association between epithelioid glioblastoma and pleomorphic xanthoastrocytoma. Neuropathology 2018; 38: 218–27.

Ma C, Feng R, Chen H, et al. BRAF V600E, TERT, and IDH2 mutations in pleomorphic xanthoastrocytoma: observations from a large case-series study. World Neurosurg 2018; 120: e1225–33.

Dahiya S, Haydon DH, Alvarado D, et al. BRAF(V600E) mutation is a negative prognosticator in pediatric ganglioglioma. Acta Neuropathol 2013; 125: 901–10.

Prabowo AS, Iyer AM, Veersema TJ, et al. BRAF V600E mutation is associated with mTOR signaling activation in glioneuronal tumors. Brain Pathol 2014; 24: 52–66.

Martinoni M, Marucci G, de Biase D, et al. BRAF V600E mutation in neocortical posterior temporal epileptogenic gangliogliomas. J Clin Neurosci 2015; 22: 1250–3.

Qaddoumi I, Orisme W, Wen J, et al. Genetic alterations in uncommon low-grade neuroepithelial tumors: BRAF, FGFR1, and MYB mutations occur at high frequency and align with morphology. Acta Neuropathol 2016; 131: 833–45.

Ballester LY, Fuller GN, Powell SZ, et al. Retrospective analysis of molecular and immunohistochemical characterization of 381 primary brain tumors. J Neuropathol Exp Neurol 2017; 76: 179–88.

Chen X, Pan C, Zhang P, et al. BRAF V600E mutation is a significant prognosticator of the tumour regrowth rate in brainstem gangliogliomas. J Clin Neurosci 2017; 46: 50–7.

Kakkar A, Majumdar A, Pathak P, et al. BRAF gene alterations and enhanced mammalian target of rapamycin signaling in gangliogliomas. Neurol India 2017; 65: 1076–82.

Zhang YX, Shen CH, Guo Y, et al. BRAF V600E mutation in epilepsy-associated glioneuronal tumors: Prevalence and correlation with clinical features in a Chinese population. Seizure 2017; 45: 102–6.

Koh HY, Kim SH, Jang J, et al. BRAF somatic mutation contributes to intrinsic epileptogenicity in pediatric brain tumors. Nat Med 2018; 24: 1662–8.

Schiffman JD, Hodgson JG, VandenBerg SR, et al. Oncogenic BRAF mutation with CDKN2A inactivation is characteristic of a subset of pediatric malignant astrocytomas. Cancer Res 2010; 70: 512–9.

Chi AS, Batchelor TT, Yang D, et al. BRAF V600E mutation identifies a subset of low-grade diffusely infiltrating gliomas in adults. J Clin Oncol 2013; 31: e233–6.

Chan AK, Zhang RR, Aibaidula A, et al. BRAF mutation marks out specific subgroups of glioma. Glioma 2018; 1: 168–74.

Dahiya S, Emnett RJ, Haydon DH, et al. BRAF-V600E mutation in pediatric and adult glioblastoma. Neuro Oncol 2014; 16: 318–9.

Nicolaides TP, Li H, Solomon DA, et al. Targeted therapy for BRAFV600E malignant astrocytoma. Clin Cancer Res 2011; 17: 7595–604.

Takahashi Y, Akahane T, Sawada T, et al. Adult classical glioblastoma with a BRAF V600E mutation. World J Surg Oncol 2015; 13: 100.

Tosuner Z, Geçer MÖ, Hatiboğlu MA, et al. BRAF V600E mutation and BRAF VE1 immunoexpression profiles in different types of glioblastoma. Oncol Lett 2018; 16: 2402–8.

Broniscer A, Tatevossian RG, Sabin ND, et al. Clinical, radiological, histological and molecular characteristics of paediatric epithelioid glioblastoma. Neuropathol Appl Neurobiol 2014; 40: 327–36.

Khanna G, Pathak P, Suri V, et al. Immunohistochemical and molecular genetic study on epithelioid glioblastoma: Series of seven cases with review of literature. Pathol Res Pract 2018; 214: 679–85.

Kleinschmidt-DeMasters BK, Aisner DL, Birks DK, et al. Epithelioid GBMs show a high percentage of BRAF V600E mutation. Am J Surg Pathol 2013; 37: 685–98.

Kleinschmidt-DeMasters BK, Aisner DL, Foreman NK. BRAF VE1 immunoreactivity patterns in epithelioid glioblastomas positive for BRAF V600E mutation. Am J Surg Pathol 2015; 39: 528–40.

Nakajima N, Nobusawa S, Nakata et al. BRAF V600E, TERT promoter mutations and CDKN2A/B homozygous deletions are frequent in epithelioid glioblastomas: a histological and molecular analysis focusing on intratumoral heterogeneity. Brain Pathol 2018; 28: 663–73.

Gessi M, Zur Mühlen A, Hammes J, et al. Genome-wide DNA copy number analysis of desmoplastic infantile astrocytomas and desmoplastic infantile gangliogliomas. J Neuropathol Exp Neurol 2013; 72: 807–15.

Koelsche C, Sahm F, Paulus W, et al. BRAF V600E expression and distribution in desmoplastic infantile astrocytoma/ganglioglioma. Neuropathol Appl Neurobiol 2014; 40: 337–44.

Wang AC, Jones DTW, Abecassis IJ, et al. Desmoplastic infantile ganglioglioma/astrocytoma (DIG/DIA) are distinct entities with frequent BRAFV600 mutations. Mol Cancer Res 2018; 16: 1491–8.

Brastianos PK, Taylor-Weiner A, Manley PE, et al. Exome sequencing identifies BRAF mutations in papillary craniopharyngiomas. Nat Genet 2014; 46: 161–5.

Fujio S, Juratli TA, Arita K, et al. A clinical rule for preoperative prediction of BRAF mutation status in craniopharyngiomas. Neurosurgery 2019; 85: 204–10.

Malgulwar PB, Nambirajan A, Pathak P, et al. Study of β-catenin and BRAF alterations in adamantinomatous and papillary craniopharyngiomas: mutation analysis with immunohistochemical correlation in 54 cases. J Neurooncol 2017; 133: 487–95.

Yue Q, Yu Y, Shi Z, et al. Prediction of BRAF mutation status of craniopharyngioma using magnetic resonance imaging features. J Neurosurg 2018; 129: 27–34.

Lehman NL, Hattab EM, Mobley BC, et al. Morphological and molecular features of astroblastoma, including BRAFV600E mutations, suggest an ontological relationship to other cortical-based gliomas of children and young adults. Neuro Oncol 2017; 19: 31–42.

Pepe F, Pisapia P, Del Basso de Caro ML, et al. Next generation sequencing identifies novel potential actionable mutations for grade I meningioma treatment. Histol Histopathol 2019; 24: 18195.

Chatterjee D, Garg C, Singla N, et al. Desmoplastic non-infantile astrocytoma/ganglioglioma: rare low-grade tumor with frequent BRAF V600E mutation. Hum Pathol 2018; 80: 186–91.

Dimitriadis E, Alexiou GA, Tsotsou P, et al. BRAF alterations in pediatric low grade gliomas and mixed neuronal-glial tumors. J Neurooncol 2013; 113: 353–8.

Chatterjee D, Radotra BD, Kumar N, et al. IDH1, ATRX, and BRAFV600E mutation in astrocytic tumors and their significance in patient outcome in north Indian population. Surg Neurol Int 2018; 9: 29.

Serrano C, Simonetti S, Hernandez J, et al. BRAF V600E mutations in benign and malignant peripheral nerve sheath tumors. J Clin Oncol 2010; 28: 10043.

Schreck KC, Grossman SA, Pratilas CA. BRAF mutations and the utility of RAF and MEK inhibitors in primary brain tumors. Cancers (Basel) 2019; 11: pii: E1262.

Ho CY, Mobley BC, Gordish-Dressman H, et al. A clinicopathologic study of diencephalic pediatric low-grade gliomas with BRAF V600 mutation. Acta Neuropathol 2015; 130: 575–85.

Mistry M, Zhukova N, Merico D, et al. BRAF mutation and CDKN2A deletion define a clinically distinct subgroup of childhood secondary high-grade glioma. J Clin Oncol 2015; 33: 1015–22.

Murakami C, Yoshida Y, Yamazaki T, et al. Clinicopathological characteristics of circumscribed high-grade astrocytomas with an unusual combination of BRAF V600E, ATRX, and CDKN2A/B alternations. Brain Tumor Pathol 2019; 36: 103–11.

Smith-Cohn M, Davidson C, Colman H, et al. Challenges of targeting BRAF V600E mutations in adult primary brain tumor patients: a report of two cases. CNS Oncology 2019; 8: CNS48.

Behling F, Schittenhelm J. Oncogenic BRAF alterations and their role in brain tumors. Cancers (Basel) 2019; 11: 794.

Kowalewski A, Durślewicz J, Zdrenka M, et al. Clinical relevance of BRAF V600E mutation status in brain tumors with a focus on a novel management algorithm. Target Oncol 2020; 15: 531–40.

Hauschild A, Grob JJ, Demidov LV, et al. Dabrafenib in BRAF-mutated metastatic melanoma: a multicentre, open-label, phase 3 randomised controlled trial. Lancet 2012; 380: 358–65.

Burger MC, Ronellenfitsch MW, Lorenz NI, et al. Dabrafenib in patients with recurrent, BRAF V600E mutated malignant glioma and leptomeningeal disease. Oncol Rep 2017; 38: 3291–6.

Kaley T, Touat M, Subbiah V, et al. BRAF inhibition in BRAFV600-mutant gliomas: Results from the VE-BASKET study. J Clin Oncol 2018; 36: 3477–84.

Downloads

Published

26.05.2023

How to Cite

Mohamed Yusoff , A., Abd Radzak, S., Mohd Khair, S., & Abdullah, J. (2023). Significance of BRAFV600E mutation in intra-axial brain tumor in Malaysian patients: case series and literature review. Experimental Oncology, 43(2), 159–167. https://doi.org/10.32471/exp-oncology.2312-8852.vol-43-no-2.16076

Issue

Section

Original contributions