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Gerhard-Domagk-Institut
für Pathologie

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Translationale Tumorforschung

Malignant Tumors of Soft Tissue and Bone

More than 70 types of soft tissue neoplasms have been defined by the WHO classification. Morphologically, sarcomas can be subdivided into two major subgroups: tumors with a non-pleomorphic morphology and those with a pleomorphic phenotype. Non-pleomorphic sarcomas more often carry specific molecular aberrations whereas pleomorphic sarcomas frequently display complex karyotypes.

Three major types of genomic alterations occur in sarcomas

  • Reciprocal translocations (~15%)
  • Specific mutations (~25%) 
  • Amplifications (~10%)

While chromosomal translocations lead to the formation of chimeric fusion genes, the resulting fusion proteins function frequently as transcription factors. Specific mutations are often found in genes encoding tyrosine kinases. Amplifications mainly affect genes which encode important modulators in cell cycle control.

Our research projects in the field of soft tissue and bone pathology focus on

  • The diagnostic, prognostic and/or predictive value of specific markers and genomic alterations in malignant tumors of soft tissue and bone
  • The translational exploration of signaling pathways in particular subgroups of soft tissue sarcomas aiming at a better understanding of the underlying tumor biology and the definition of novel therapeutic approaches.

Selected research projects:

Synovial sarcomas (SySa) account for 5-10% of all soft tissue sarcomas. In the majority, SySa arise mainly in adolescents and young adults with predominance in male gender. They are molecularly characterized by a reciprocal t(X;18) translocation which juxtaposes the SS18 gene on chromosome 18 to either the SSX1, the SSX2, or rarely to the SSX4 gene on the X chromosome. The SS18-SSX chimeric proteins act as transcriptional co-activators, leading to deregulation of oncogenic pathways. Current treatment protocols for synovial sarcoma are based on radical surgery and standardized chemo- and radiotherapy; however, prognosis is still poor in advanced disease. Targeted therapeutic approaches, which have significantly improved the clinical course of patients with e.g. GIST or dermato- fibrosarcoma protuberans, are still lacking for SySa. Several receptor tyrosine kinases have been shown to be expressed in SySa, including the EGF receptor, and the IGF-IR, leading to an activation of the PI3K/AKT signaling pathway. Beyond kinase signals, we have shown an essential role of WNT/ß-catenin signals in SySa.

Our current studies analyze the functional relevance of diverse oncogenic signaling pathways in synovial sarcoma, aiming at a better understanding of tumor biology as a basis for the definition of innovative therapeutic approaches.

Accounting for ~5-10% of all soft tissue sarcomas, myxoid liposarcoma (MLS) represent ~20% of all malignant adipocytic tumors. In the majority of cases, MLS arise in younger adults, defining the most frequent LS subtype in patients <20 years of age. Clinically, MLS are characterized by a high rate of local recurrences and development of metastases affecting in total ~40% of patients. Morphologically, MLS comprise a large spectrum ranging from paucicellular myxoid tumors to hypercellular round cell sarcomas associated with a more aggressive clinical course. Genetically, the vast majority of MLS is characterized by a chromosomal t(12;16)(q13;p11) translocation, juxtaposing the FUS and DDIT3 genes. About 5% of all MLS display an alternative chromosomal t(12;22) rearrangement leading to an EWSR1-DDIT3 gene fusion. The resulting FUS‑DDIT3 and EWSR1-DDIT3 fusion proteins are thought to play an essential role in MLS pathogenesis, acting as transcriptional (dys-)regulators; however, the functional details and the specific impact of the chimeric fusion protein on oncogenic signaling pathways known to be activated in MLS is incompletely understood. It has been shown recently that MLS are characterized by EGFR, PDGFRB, RET, and MET as well as VEGFR1 activation sustained by autocrine/paracrine loops and receptor tyrosine kinase (RTK) cross-talk, resulting in activation of the downstream PI3K/AKT signaling pathway. PI3K/AKT signaling is a central hub in the transduction of different RTK inputs involving diverse growth-controlling effectors such as GSK-3ß and the cell cycle regulator Cyclin D1. Current therapeutic approaches in high-grade MLS complement radical surgery with radiotherapy and/or conventional chemotherapy based on anthracyclines and ifosfamide. However, though MLS display higher chemosensitivity than other LS, the high rate of recurrences and metastases in MLS underlines the urgent need of novel therapeutic options.

Our current studies analyze the functional relevance of diverse oncogenic signaling pathways in myxoid liposarcoma, aiming at a better understanding of tumor biology as a basis for the definition of innovative therapeutic approaches.

Synovial sarcoma (SySa) and dedifferentiated liposarcoma (DDLS) represent major cytogenetically well-defined soft tissue sarcoma (STS) subgroups, both being associated with limited effects of conventional cytotoxic drugs and a poor prognosis in advanced disease. Though the molecular understanding of these tumors has improved significantly in the recent years, standardized individualized therapeutic concepts have not entered clinical routine yet. Starting from the growing insight that mono-directed therapeutic approaches are of limited effect and sustainability, we aim at the delineation of tumor-driving protein kinase activation patterns, including the detailed analysis of signaling pathway inter-dependencies and the systematic preclinical evaluation of innovative therapeutic concepts in SySa and DDLS, based on a comprehensive library of well-characterized sarcoma cell lines. The project is based on a phosphor kinome screen of primary tumor tissues, cell lines and in vitro cell model systems of SySa and DDLS. For analysis, results are integrated with available data from the comprehensive genomic screens in STS by the competencenetwork sarcoma (KoSar). Recurrent kinase activation profiles detected in the primary tumor tissues are functionally characterized by RNA interference and pharmacological inhibition in SySa and DDLS cell lines, primary tumor cell cultures and in vitro cell model systems. Particular emphasis is put on potential synergistic effects of different kinase signals and kinase/non-kinase pathway interactions.

The results of the project are expected to improve our biological understanding of cytogentically well-defined STS, to identify novel therapeutic concepts for patients with SySa and DDLS and to provide convincing evidence for future clinical trials.

Ewing sarcoma is an aggressive small round blue cell tumor occurring from birth to late adulthood with a peak incidence in adolescents and an overall incidence of 1 case per 1 million. Ewing sarcoma mainly arises in the bones of the pelvis, chest wall and the extremities. While primary disease most frequently is local, in a subset of patients metastases develop in lung, bone, and bone marrow. For patients with disseminated disease at multiple sites at primary diagnosis (25% of the patients) prognosis is particularly dismal with a 5-year overall survival between 10% and 30%. Genetically, classic Ewing sarcoma is defined by specific balanced chromosomal TET-ETS translocations that give rise to oncogenic chimeric proteins, the most common being EWS-FLI1 as a consequence of the t(11;22)(q24;q12) translocation. TET-ETS chimeric proteins promote cell transformation through abnormal regulation of specific target genes involved in the control of a variety of cellular processes. However, many details of the molecular pathogenesis of Ewing sarcoma remain enigmatic. Recently, novel non-TET-ETS gene fusions involving the CIC and BCOR genes have been identified in "atypical" Ewing tumors, but their downstream pathogenic mechanisms have not been understood.

Our current studies analyze the functional impact of the oncogenic fusion proteins in Ewing sarcomas on oncogenic processes in Ewing sarcomas, aiming at a better understanding of tumor biology as a basis for the definition of innovative therapeutic approaches.

Group Members

Wolfgang Hartmann, Prof. Dr. med.
Deputy director of the Gerhard-Domagk-Institute of Pathology, Principal Investigator

ORCID: 0000-0002-7609-5021
ResearcherID: G-1893-2017

+49 251 83-58479
+49 251 83-57559
wolfgang.hartmann(at)ukmuenster.de

Marcel Trautmann, PD Dr.
Research group leader, Principal Investigator

ORCID: 0000-0002-5842-1196
ResearcherID: B-4627-2015

+49 251 83-57623
+49 251 83-57559
marcel.trautmann(at)ukmuenster.de

In alphabetical order

  • Anna Lüttmann, Dr. med., Clinician scientist
  • Carl Phillip Schmitthenner, DKH/MedK-PhD student (Dr. med.)
  • Charlotte Brockhoff, Technical assistant
  • Charlotte Pünt, PhD student (Dr. rer. nat.)
  • Esther-Pia Jansen, Technical assistant
  • Franziska Evelt, Master student (M.Sc.)
  • Henning Flath, MedK-PhD student (Dr. med.)
  • Ilka Isfort, Dr. rer. nat., Postdoctoral researcher
  • Johanna Nienau, MedK-PhD student (Dr. med.)
  • Leona Ide, Master student (M.Sc.)
  • Lucas Sebastian Scholl, PhD student (Dr. rer. nat.)
  • Marcel Trautmann, PD Dr. rer. nat., Principal investigator
  • Pascal Hauser, PhD student (Dr. rer. nat.)
  • Ruth Berthold, Dr. rer. nat., Postdoctoral researcher
  • Wolfgang Hartmann, Prof. Dr. med., Group leader

Alumni

  • Alina Hildebrand, MedK-PhD student (Dr. med.)
  • Anna Soiron, PhD student (Dr. med.)
  • Birte Jeiler, M.Sc.
  • Christian Bertling, M.Sc.
  • Danielle Brandes, M.Sc.
  • Hanna Wattendorff, Dr. med.
  • Isabeau Draxler, PhD student (Dr. med.)
  • Jan Rehkämper, Dr. med.
  • Jasmin Menzel, M.Sc.
  • Jessica Janke, M.Sc.
  • Jonas Breuer, Dr. med.
  • Katharina Stock, Dr. rer. nat.
  • Lina Francke, MedK-PhD student (Dr. med.)
  • Lorena Heinst, Dr. rer. nat.
  • Magdalene Alice Cyra, Dr. rer. nat.
  • Miriam Schulte, Dr. med.
  • Svenja Wosnig, Dr. med.

Experimentelle Medizin

  • Anna Soiron
  • Carl Philipp Schmitthenner
  • Dajana Karaj 
  • Jannis Richter
  • Jonas Franz
  • Julia Ebbinghaus
  • Malik Bidzan 
  • Stefanie Bobe
  • Vincent Leonard Holstein 

Gastrointestinale Stromatumoren (GIST)

Gastrointestinale Stromatumoren sind die häufigsten mesenchymalen Tumoren des Gastrointestinaltraktes. Ihre Inzidenz liegt bei 11-15 pro 100.000. Als häufigste onkogene Treibermutationen bei GIST gelten Mutationen in den Genen KIT und PDGFRA, welche jeweils für Rezeptortyrosinkinasen kodieren.  Die Mutationen führen zu einer Liganden-unabhängigen Autoaktivierung der enzymatischen Tyrosinkinaseaktivität. Bei ca. 85% der GIST kommen aktivierende Mutationen in einem der beiden genannten Genen vor, mit Mutationshotspots in den KIT-Exonen 9, 11, 13 und 17 sowie in den PDGFRA-Exonen 12, 14 und 18. Bestimmte Mutationssubtypen werden als prädiktiv für ein Therapieansprechen angesehen. Am häufigsten kommen Mutationen in KIT Exon 11 vor (ca. 65%). Diese gelten i.d.R. als gut responsiv gegenüber einer Imatinib-Therapie in der Standarddosierung. Im Gegensatz dazu ist die häufig vorkommende Punktmutation p.D842V in PDGFRA Exon 18 (ca. 10-15% der Fälle) mit einem Nichtansprechen auf eine Imatinib-Therapie assoziiert.

Prognosefaktoren von Desmoidfibromatosen

Desmoidfibromatosen stellen fibroblastische Tumore mit einem unklaren biologischen Verhalten dar. Sie metastasieren zwar nicht, neigen jedoch durch ihr lokal infiltratives Wuchsmuster zu Rezidiven. Dies kann zu komplizierten, und bei entsprechendem Sitz auch zu letalen Verläufen führen. Man unterscheidet abdominelle (Rektusscheide), intra-abdominelle (mesenterische) und extra-abdominelle Manifestationsorte (z.B. Extremitäten).  Die Wahl des therapeutischen Vorgehens wird bislang in erster Linie vom klinischen Verlauf abhängig gemacht. Primär kommt eine chirurgische Resektion in Betracht, bei asymtomatischen Verläufen können auch „wait and see“-Strategien verfolgt werden. Als prognostisch ungünstig wurden große Tumoren, ein jüngeres Manifestationsalter und eine extra-abdominelle Lokalisation beschrieben.

Pathogenetisch liegen der Erkrankung Dysregulationen im WNT-Signalweg, bei erblichen Fällen im APC-Gen und bei den weitaus häufiger vorkommenden sporadischen Fällen im CTNNB1-Gen zugrunde. Bei letzteren Mutationen findet man ein limitiertes Spektrum von unterschiedlichen Punktmutationen (vor allem im Codon 41 und 45). In einer eigenen Vorarbeit konnten wir zeigen, dass ein bestimmter Mutationssubtyp überzufällig häufig in abdominellen Desmoidfibromatosen, verglichen mit denen anderer Lokalisationen vorkommt.

In unserer Arbeitsgruppe erforschen wir molekulare Prognosefaktoren für das Aggressivitätspotential dieses seltenen mesenchmalen Tumors, welche trotz bekannten Genotyp-Phänotyp-Assoziationen bislang noch nicht etabliert sind.

Onkologischer Förderpreis der Maria-Möller-Stiftung (05/2013) 
Antragsteller: PD Dr. med. Sebastian Huss

Gerhard-Domagk-Institut für Pathologie

Univ.-Prof. Dr. med. Eva Wardelmann, Direktorin

Univ.-Prof. Dr. med. Wolfgang Hartmann, Direktor

Albert-Schweitzer-Campus 1, Gebäude D17

Anfahrtsadresse: Domagkstraße 17

48149 Münster