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Molecular sub-groups of medulloblastomas and correlation with clinical characteristics


Genome wide expression profiling studies including our own study has demonstrated that medulloblastoma is comprised of 4 core molecular subgroups viz. WNT, SHH, Group 3 and Group 4. We have molecularly classified a set of 103 medulloblastomas from the Indian subcontinent. WNT, SHH, Group 3 and Group 4 accounted for 22 %, 29 %, 20 %% and 28 % of the tumor tissues respectively as against the reported incidences of 11%, 28%, 27% and 34% based on the meta-analysis of the medulloblastoma data from the American and European subcontinent. The higher incidence of the WNT subgroup and relatively lower incidence of Group 3 tumors is partly accounted by the higher representation of older children and adults who together account for 51% of the tumors in the present cohort. Nonetheless, frequency of WNT subgroup tumors is much higher than reported so far even for these age groups with as many as 40% older children and 35% adults in the present Indian cohort belonging to the WNT subgroup. Another striking feature of the Indian cohort is lack of Group 4 medulloblastomas in adult patients and Male to Female ratio of 9:1 that is substantially higher than the reported ratio of 2:1. We have also carried out Next Gen sequencing of WNT subgroup medulloblastomas that has identified several novel mutations including mutations in chromatin modifying genes.

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