Single Cell-Derived Clonal Analysis of Human Glioblastoma Links Functional and Genomic Heterogeneity

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Single Cell-Derived Clonal Analysis of Human Glioblastoma Links Functional and Genomic Heterogeneity Single cell-derived clonal analysis of human glioblastoma links functional and genomic heterogeneity Mona Meyera,1, Jüri Reimandb,c,1, Xiaoyang Lana,b, Renee Heada, Xueming Zhua, Michelle Kushidaa, Jane Bayanid, Jessica C. Presseye, Anath C. Lionelb,f, Ian D. Clarkea,g, Michael Cusimanoh, Jeremy A. Squirei, Stephen W. Schererb,f, Mark Bernsteinj, Melanie A. Woodine, Gary D. Baderb,c,2, and Peter B. Dirksa,b,k,2 aDivision of Neurosurgery, Program in Developmental and Stem Cell Biology, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, ON, Canada M5G 1X8; bDepartment of Molecular Genetics, University of Toronto, Toronto, ON, Canada M5S 1A8; cThe Donnelly Centre, University of Toronto, Toronto, ON, Canada M5S 3E1 Canada; dDepartment of Transformative Pathology at the Ontario Institute for Cancer Research, Ontario Institute for Cancer Research, Toronto, ON, Canada M5G 0A3; eDepartment of Cell and Systems Biology, University of Toronto, Toronto, ON, Canada M5S 3G5; fThe Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada M5G 1L7; gOntario College of Art and Design, Toronto, ON, Canada M5T 1W1; hDivision of Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada M5B 1W8; iDepartment of Pathology, Queen’s University, Kingston, ON, Canada K7L 3N6; jDivision of Neurosurgery, Toronto Western Hospital, Toronto, ON, Canada M5T 2S8; and kDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada M5S 1A8 Edited by Robert A. Weinberg, Whitehead Institute for Biomedical Research; Department of Biology, Massachusetts Institute of Technology, and Ludwig MIT Center for Molecular Oncology, Cambridge, Cambridge, MA, and approved November 24, 2014 (received for review November 7, 2013) Glioblastoma (GBM) is a cancer comprised of morphologically, Understanding the links between genetic and functional genetically, and phenotypically diverse cells. However, an un- behavior of individual GBM clones, derived from single pa- derstanding of the functional significance of intratumoral hetero- tient samples, will be essential to decipher patient-specific geneity is lacking. We devised a method to isolate and functionally molecular mechanisms of GBM progression and therapeutic profile tumorigenic clones from patient glioblastoma samples. resistance. The study of bulk tumors provides a mixture of Individual clones demonstrated unique proliferation and differen- different signals from a heterogeneous set of clones and cur- tiation abilities. Importantly, naïve patient tumors included clones rent single cell approaches are amenable to genomics but not MEDICAL SCIENCES that were temozolomide resistant, indicating that resistance to functional studies. Here, we provide a detailed analysis of single conventional GBM therapy can preexist in untreated tumors at cell derived clones from patient GBM samples using a method a clonal level. Further, candidate therapies for resistant clones were that directly links clonal molecular changes with functional detected with clone-specific drug screening. Genomic analyses properties. Parallel phenotypic and genomic analysis of these revealed genes and pathways that associate with specific functional clones reveals a diverse landscape of functional and genetic behavior of single clones. Our results suggest that functional clonal heterogeneity, as well as insights into drug sensitivity pathways profiling used to identify tumorigenic and drug-resistant tumor in glioblastoma. clones will lead to the discovery of new GBM clone-specific treat- ment strategies. Significance cancer | glioblastoma | clonal heterogeneity | genomic analysis | functional analysis Glioblastoma is an incurable brain tumor. It is characterized by intratumoral phenotypic and genetic heterogeneity, but the functional significance of this heterogeneity is unclear. We lioblastoma (GBM) is the most common and most aggres- devised an integrated functional and genomic strategy to ob- Gsive primary malignant brain tumor in adults. Despite major tain single cell-derived tumor clones directly from patient efforts to improve GBM survival, radiation therapy with concurrent tumors to identify mechanisms of aggressive clone behavior temozolomide (TMZ) chemotherapy achieves only a median sur- and drug resistance. Genomic analysis of single clones iden- vival of 15 months with few long-term survivors. Many patients fail tified genes associated with clonal phenotypes. We predict to respond to TMZ, and treatment of all patients at disease pro- that integration of functional and genomic analysis at a clonal gression uniformly fails. level will be essential for understanding evolution and ther- Glioblastoma is one of the first cancer types systematically apeutic resistance of human cancer, and will lead to the dis- – studied at a genomic and transcriptomic level (1 3). Tran- covery of novel driver mechanisms and clone-specific cancer scriptional profiling of GBM samples has revealed a landscape treatment. of intertumoral heterogeneity with distinct molecular tumor subtypes, although only slight prognostic differences are ap- Author contributions: M.M., J.R., X.L., I.D.C., J.A.S., M.A.W., G.D.B., and P.B.D. designed parent in patients except for a clearly better prognosis in the research; M.M., J.R., X.L., R.H., X.Z., M.K., J.B., J.C.P., I.D.C., M.A.W., and G.D.B. performed CIMP+/IDH1 mutant subgroup (1, 4–6). Increasing evidence research; M.M., J.R., X.L., M.C., M.B., and G.D.B. contributed new reagents/analytic tools; M.M., J.R., X.L., M.K., J.B., J.C.P., A.C.L., I.D.C., J.A.S., S.W.S., M.A.W., G.D.B., and P.B.D. suggests that cancer tissues are more complex than previously analyzed data; M.M., J.R., X.L., G.D.B., and P.B.D. wrote the paper; and P.B.D. originated thought, as tumors comprise considerable intratumoral het- and supervised the study at all stages. erogeneity with mixtures of genetically distinct subclones that The authors declare no conflict of interest. – likely escape therapy and cause disease progression (4, 7 10). This article is a PNAS Direct Submission. In particular, GBM is a cancer type comprised of morpholog- Freely available online through the PNAS open access option. ically and phenotypically diverse cells (11). Recent studies have Data deposition: Gene expression profiles and copy number data are available at ArrayEx- also uncovered genetic diversity apparent in subsamples of in- press, www.ebi.ac.uk/arrayexpress/ (accession nos. E-MTAB-2693 and E-MTAB-2694). – dividual patient GBMs (12 15), and more recently in single 1M.M. and J.R. contributed equally to this work. GBM cells (9). Disease recurrence is associated with muta- 2To whom correspondence may be addressed. Email: [email protected] or peter. tional events that are not shared with the primary tumor sug- [email protected]. gesting evolution from minority populations present at time of This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10. initial diagnosis (10). 1073/pnas.1320611111/-/DCSupplemental. www.pnas.org/cgi/doi/10.1073/pnas.1320611111 PNAS Early Edition | 1of6 Downloaded by guest on September 26, 2021 Results independent experiments with clones of different passages, the Single Cell-Derived Clones of Human Glioblastoma Exhibit Functional clones exhibited wide and independent variation in proliferation B SI Appendix Heterogeneity. To enable functional characterization of hetero- and differentiation abilities (Fig. 2 and , Figs. S3 and A–C geneous clones in glioblastoma, we devised a method to isolate S4 ), demonstrating intrinsic distinct functional properties. and grow individual clones from patient tumors using flow We then assessed clonal population response to the conven- cytometry sorting (FACS) and single cell plating in stem cell tional GBM chemotherapeutic agent TMZ (17), in at least three culture conditions (Fig. 1A). We generated 44 individual single independent experiments with clones of different passages. Two tumors contained clones with heterogeneous TMZ responses: 2 cell derived clones from four patient tumors. All tested clones of 8 tested populations in the naïve tumor GBM-472 showed established typical GBM tumors after orthotopic injection in significantly increased resistance to TMZ (P = 0.0011, t test with mice, indicating their tumorigenic potential (SI Appendix, Table Welch correction; clones 472_8, 472_18), whereas 1 clone of 10 in A–D B − S1 and Fig. S1 and Fig. 1 ). the recurrent tumor GBM-482 was relatively sensitive (P < 10 4; We next functionally characterized individual clones. We 482_9; Fig. 2C). We observed only TMZ-resistant clones from identified heterogeneous expression of key GBM proteins phos- the two additional naïve and recurrent tumors. TMZ response phatase and tensin homolog (PTEN), epidermal growth factor and proliferation ability was not significantly correlated (SI Ap- receptor (EGFR), and the constitutively active EGFR deletion pendix, Figs. S5 and S6). Clonal analysis of O6-methylguanin- mutant, EGFRvIII (2, 3, 10, 16), in three tumors, indicating that DNA methyltransferase (MGMT), a common biomarker of TMZ distinct known molecular GBM drivers vary at a clonal level (Fig. resistance in GBM (18), showed variable promoter methylation 2A and SI Appendix,Fig.S2) and suggesting limitations to targeted and protein expression levels that were inconsistent with TMZ therapies based solely on bulk GBM analysis. In identical cul- response (Fig. 2 D and E and SI Appendix,Fig.S7). These data ture conditions
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