title: Loss of caspase-8 protein expression correlates with unfavorable survival outcome in childhood medulloblastoma.
abstract: OBJECTIVE
  Escaping apoptosis is a hallmark of cancer. In medulloblastoma (MB) cell lines, resistance to tumor necrosis factor-related apoptosis-inducing ligand-induced apoptosis was recently shown to correlate with loss of caspase-8 mRNA expression, because of aberrant gene methylation (M. A. Grotzer et al., Oncogene, 19: 4604-4610, 2000). Loss of caspase-8 mRNA expression has been demonstrated in a subset of primary MB (T. J. Zuzak et al., Eur. J. Cancer, 38: 83-91, 2002). In this study, we analyzed primary MB samples to test whether loss of caspases correlates with survival outcome.
  
  
  METHODS
  We used immunohistochemistry to analyze the protein expression of the key initiator caspase-8 and caspase-9 in paraffin-embedded tumor samples from 77 well characterized MB patients and compared the expression levels of caspase-8 and caspase-9 with apoptosis indices, clinical variables, and survival outcomes.
  
  
  RESULTS
  Weak expression of caspase-8 and caspase-9 was found in 16 and 24% of the MB samples evaluated, respectively. Weak expression of caspase-8 was an independent significant prognostic factor for unfavorable progression-free survival outcome and was more predictive than standard clinical factors. In contrast, caspase-9 expression was not a prognostic factor. Treatment of caspase-8-deficient MB cells with IFN-gamma resulted in dose-dependent restoration of caspase-8 mRNA and protein expression and restoration of tumor necrosis factor-related apoptosis-inducing ligand sensitivity.
  
  
  CONCLUSIONS
  Loss of initiator caspase-8 is associated with an unfavorable survival outcome. Restoration of caspase-8 (e.g., by treatment with IFN-gamma) might, therefore, represent a novel experimental therapy in childhood MB.
authors.affiliation: Neuro-Oncology Program, Department of Oncology, University Children's Hospital of Zurich, Zurich, Switzerland.
authors.forename: Carmen
authors.initials: C
authors.lastname: Pingoud-Meier
authors.forename: Doris
authors.initials: D
authors.lastname: Lang
authors.forename: Anna J
authors.initials: AJ
authors.lastname: Janss
authors.forename: Lucy B
authors.initials: LB
authors.lastname: Rorke
authors.forename: Peter C
authors.initials: PC
authors.lastname: Phillips
authors.forename: Tarek
authors.initials: T
authors.lastname: Shalaby
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grotzer
mesh_terms: D017209:Apoptosis; D015153:Blotting, Western; D053181:Caspase 8; D053453:Caspase 9; D020169:Caspases / Q000096:biosynthesis*; D002675:Child, Preschool; D019175:DNA Methylation; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007371:Interferon-gamma / Q000378:metabolism; D008297:Male; D008527:Medulloblastoma / Q000201:enzymology* / Q000401:mortality*; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011379:Prognosis; D012333:RNA, Messenger / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D012333:RNA, Messenger; D007371:Interferon-gamma; C505530:CASP8 protein, human; C506433:CASP9 protein, human; D053181:Caspase 8; D053453:Caspase 9; D020169:Caspases