Atypical Teratoid Rhabdoid Tumors

  • Lucie Lafay-Cousin
  • Douglas R. Strother
  • Jennifer A. Chan
  • Jonathon Torchia
  • Annie Huang

Abstract

Atypical teratoid rhabdoid tumor of the brain is a rare embryonal tumor of infancy which has become more widely recognized due to specific immunostaining now more routinely available. These tumors still carry a poor prognosis and no standard therapy is currently available. However, the recent development of aggressive multimodality strategies seems to be associated with improved survival rates. In this chapter, we provide a review of our current knowledge on the demographics and epidemiology, pathology, and molecular characteristics. We review each individual therapeutic modality used (surgery, conventional chemotherapy, high-dose chemotherapy with stem cell rescue, intrathecal chemotherapy, and radiation) and the contribution of each to outcome when available. We provide an overview of the most recent therapeutic trials published and discuss the future options in development.

Keywords

Atypical teratoid rhabdoid tumor Embryonal tumor Infancy INI1 High-dose chemotherapy Radiation 

References

  1. 1.
    Rorke LB, Packer RJ, Biegel JA. Central nervous system atypical teratoid/rhabdoid tumors of infancy and childhood: definition of an entity. J Neurosurg. 1996;85(1):56–65.CrossRefPubMedGoogle Scholar
  2. 2.
    Packer RJ, et al. Atypical teratoid/rhabdoid tumor of the central nervous system: report on workshop. J Pediatr Hematol Oncol. 2002;24(5):337–42.CrossRefPubMedGoogle Scholar
  3. 3.
    Squire SE, Chan MD, Marcus KJ. Atypical teratoid/rhabdoid tumor: the controversy behind radiation therapy. J Neurooncol. 2007;81(1):97–111.CrossRefPubMedGoogle Scholar
  4. 4.
    Fleming AJ, et al. Atypical teratoid rhabdoid tumors (ATRTs): the British Columbia’s Children’s Hospital’s experience, 1986–2006. Brain Pathol. 2012;22(5): 625–35.CrossRefPubMedGoogle Scholar
  5. 5.
    Annual incidence of rhabdoid tumors among children <15, 2000–2008. Volume SEER 17. Bethesda: Surveillance, Epidemiology, and End Results (SEER) Program, SEER Stat version 7.06;2011.Google Scholar
  6. 6.
    Woehrer A, et al. Incidence of atypical teratoid/rhabdoid tumors in children: a population-based study by the Austrian Brain Tumor Registry, 1996–2006. Cancer. 2010;116(24):5725–32.CrossRefPubMedGoogle Scholar
  7. 7.
    Tekautz TM, et al. Atypical teratoid/rhabdoid tumors (ATRT): improved survival in children 3 years of age and older with radiation therapy and high-dose alkylator-based chemotherapy. J Clin Oncol. 2005; 23(7):1491–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Lafay-Cousin L, et al. Central nervous system atypical teratoid rhabdoid tumours: the Canadian Paediatric Brain Tumour Consortium experience. Eur J Cancer. 2012;48(3):353–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Hilden JM, et al. Central nervous system atypical teratoid/rhabdoid tumor: results of therapy in children enrolled in a registry. J Clin Oncol. 2004;22(14): 2877–84.CrossRefPubMedGoogle Scholar
  10. 10.
    Heck JE, et al. Epidemiology of rhabdoid tumors of early childhood. Pediatr Blood Cancer. 2013; 60(1):77–81.CrossRefPubMedCentralPubMedGoogle Scholar
  11. 11.
    Chi SN, et al. Intensive multimodality treatment for children with newly diagnosed CNS atypical teratoid rhabdoid tumor. J Clin Oncol. 2009;27(3):385–9.CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Pai Panandiker AS, et al. Sequencing of local therapy affects the pattern of treatment failure and survival in children with atypical teratoid rhabdoid tumors of the central nervous system. Int J Radiat Oncol Biol Phys. 2012;82(5):1756–63.CrossRefPubMedCentralPubMedGoogle Scholar
  13. 13.
    Dufour C, et al. Clinicopathologic prognostic factors in childhood atypical teratoid and rhabdoid tumor of the central nervous system: a multicenter study. Cancer. 2012;118(15):3812–21.CrossRefPubMedGoogle Scholar
  14. 14.
    Athale UH, et al. Childhood atypical teratoid rhabdoid tumor of the central nervous system: a meta-analysis of observational studies. J Pediatr Hematol Oncol. 2009;31(9):651–63.CrossRefPubMedGoogle Scholar
  15. 15.
    Bruggers CS, et al. Clinicopathologic comparison of familial versus sporadic atypical teratoid/rhabdoid tumors (AT/RT) of the central nervous system. Pediatr Blood Cancer. 2011;56(7):1026–31.CrossRefPubMedCentralPubMedGoogle Scholar
  16. 16.
    Reddy AT. Atypical teratoid/rhabdoid tumors of the central nervous system. J Neurooncol. 2005;75(3): 309–13.CrossRefPubMedGoogle Scholar
  17. 17.
    Koral K, et al. Imaging characteristics of atypical teratoid-rhabdoid tumor in children compared with medulloblastoma. AJR Am J Roentgenol. 2008; 190(3):809–14.CrossRefPubMedGoogle Scholar
  18. 18.
    Au Yong KJ, et al. How specific is the MRI appearance of supratentorial atypical teratoid rhabdoid tumors? Pediatr Radiol. 2013;43(3):347–54.CrossRefPubMedGoogle Scholar
  19. 19.
    Judkins AR, et al. Immunohistochemical analysis of hSNF5/INI1 in pediatric CNS neoplasms. Am J Surg Pathol. 2004;28(5):644–50.CrossRefPubMedGoogle Scholar
  20. 20.
    Hasselblatt M, et al. Cribriform neuroepithelial tumor (CRINET): a nonrhabdoid ventricular tumor with INI1 loss and relatively favorable prognosis. J Neuropathol Exp Neurol. 2009;68(12):1249–55.CrossRefPubMedGoogle Scholar
  21. 21.
    Biegel JA, et al. Monosomy 22 in rhabdoid or atypical tumors of the brain. J Neurosurg. 1990;73(5):710–4.CrossRefPubMedGoogle Scholar
  22. 22.
    Roberts CW, Orkin SH. The SWI/SNF complex–chromatin and cancer. Nat Rev Cancer. 2004;4(2): 133–42.CrossRefPubMedGoogle Scholar
  23. 23.
    Lee RS, et al. A remarkably simple genome underlies highly malignant pediatric rhabdoid cancers. J Clin Invest. 2012;122(8):2983–8.CrossRefPubMedCentralPubMedGoogle Scholar
  24. 24.
    Fujisawa H, et al. Cyclin D1 is overexpressed in atypical teratoid/rhabdoid tumor with hSNF5/INI1 gene inactivation. J Neurooncol. 2005;73(2):117–24.CrossRefPubMedGoogle Scholar
  25. 25.
    Wilson BG, et al. Epigenetic antagonism between polycomb and SWI/SNF complexes during oncogenic transformation. Cancer Cell. 2010;18(4):316–28.CrossRefPubMedCentralPubMedGoogle Scholar
  26. 26.
    Klochendler-Yeivin A, Picarsky E, Yaniv M. Increased DNA damage sensitivity and apoptosis in cells lacking the Snf5/Ini1 subunit of the SWI/SNF chromatin remodeling complex. Mol Cell Biol. 2006;26(7):2661–74.CrossRefPubMedCentralPubMedGoogle Scholar
  27. 27.
    Hasselblatt M, et al. Nonsense mutation and inactivation of SMARCA4 (BRG1) in an atypical teratoid/rhabdoid tumor showing retained SMARCB1 (INI1) expression. Am J Surg Pathol. 2011;35(6):933–5.CrossRefPubMedGoogle Scholar
  28. 28.
    Kieran MW, et al. Absence of oncogenic canonical pathway mutations in aggressive pediatric rhabdoid tumors. Pediatr Blood Cancer. 2012;59(7):1155–7.CrossRefPubMedCentralPubMedGoogle Scholar
  29. 29.
    Birks DK, et al. High expression of BMP pathway genes distinguishes a subset of atypical teratoid/rhabdoid tumors associated with shorter survival. Neuro Oncol. 2011;13(12):1296–307.CrossRefPubMedCentralPubMedGoogle Scholar
  30. 30.
    Bourdeaut F, et al. Frequent hSNF5/INI1 germline mutations in patients with rhabdoid tumor. Clin Cancer Res. 2011;17(1):31–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Biegel JA. Molecular genetics of atypical teratoid/rhabdoid tumor. Neurosurg Focus. 2006;20(1):E11.CrossRefPubMedGoogle Scholar
  32. 32.
    Schneppenheim R, et al. Germline nonsense mutation and somatic inactivation of SMARCA4/BRG1 in a family with rhabdoid tumor predisposition syndrome. Am J Hum Genet. 2010;86(2):279–84.CrossRefPubMedCentralPubMedGoogle Scholar
  33. 33.
    Gardner SL, et al. Intensive induction chemotherapy followed by high dose chemotherapy with autologous hematopoietic progenitor cell rescue in young children newly diagnosed with central nervous system atypical teratoid rhabdoid tumors. Pediatr Blood Cancer. 2008;51(2):235–40.CrossRefPubMedGoogle Scholar
  34. 34.
    Geyer JR, et al. Multiagent chemotherapy and deferred radiotherapy in infants with malignant brain tumors: a report from the Children’s Cancer Group. J Clin Oncol. 2005;23(30):7621–31.CrossRefPubMedGoogle Scholar
  35. 35.
    Zimmerman MA, et al. Continuous remission of newly diagnosed and relapsed central nervous system atypical teratoid/rhabdoid tumor. J Neurooncol. 2005; 72(1):77–84.CrossRefPubMedGoogle Scholar
  36. 36.
    Finkelstein-Shechter T, et al. Atypical teratoid or rhabdoid tumors: improved outcome with high-dose chemotherapy. J Pediatr Hematol Oncol. 2010;32(5): e182–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Nicolaides T, et al. High-dose chemotherapy and autologous stem cell rescue for atypical teratoid/rhabdoid tumor of the central nervous system. J Neurooncol. 2010;98(1):117–23.CrossRefPubMedCentralPubMedGoogle Scholar
  38. 38.
    Ginn KF, Gajjar A. Atypical teratoid rhabdoid tumor: current therapy and future directions. Front Oncol. 2012;2:114.CrossRefPubMedCentralPubMedGoogle Scholar
  39. 39.
    von Hoff K, et al. Frequency, risk-factors and survival of children with atypical teratoid rhabdoid tumors (AT/RT) of the CNS diagnosed between 1988 and 2004, and registered to the German HIT database. Pediatr Blood Cancer. 2011;57(6):978–85.CrossRefGoogle Scholar
  40. 40.
    Chen YW, et al. Impact of radiotherapy for pediatric CNS atypical teratoid/rhabdoid tumor (single institute experience). Int J Radiat Oncol Biol Phys. 2006; 64(4):1038–43.CrossRefPubMedGoogle Scholar
  41. 41.
    Kordes U, et al. Clinical and molecular features in patients with atypical teratoid rhabdoid tumor or malignant rhabdoid tumor. Genes Chromosomes Cancer. 2010;49(2):176–81.PubMedGoogle Scholar
  42. 42.
    Lafay-Cousin L, Hawkins C, Fryer C, Bouffet E. Some infants with CNS ATRT can be cured without radiation. Neuro Oncol. 2012;14 Suppl 1:2.Google Scholar
  43. 43.
    Frühwald MC, Graf N. European Rhabdoid Registry. EU-RHAB. V2010. 29/07/2010; Available from: http:// www.kinderkrebsstiftung.de/fileadmin/kinderkrebsinfo. de/EURHAB100729MS_ger.pdf. Accessed on 29 August 2013.
  44. 44.
    Clinical Trials (PDQ®). Combination Chemotherapy, Radiation Therapy, and an Autologous Peripheral Blood Stem Cell Transplant in Treating Young Patients With Atypical Teratoid/Rhabdoid Tumor of the Central Nervous System. National Cancer Institute. June 10, 2013. Available from: http://www.cancer.gov/clinicaltrials/search/view?cdrid=592812&version=HealthProfessional. Accessed on 29 August 2013.

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Lucie Lafay-Cousin
    • 1
  • Douglas R. Strother
    • 2
  • Jennifer A. Chan
    • 3
  • Jonathon Torchia
    • 4
  • Annie Huang
    • 5
  1. 1.Department of Pediatrics, Division of OncologyAlberta Children’s HospitalCalgaryCanada
  2. 2.Departments of Oncology and Pediatrics, Section of Oncology and Blood and Marrow TransplantCumming School of Medicine and Alberta Children’s HospitalCalgaryCanada
  3. 3.Department of Pathology & Laboratory MedicineUniversity of CalgaryCalgaryCanada
  4. 4.Department of Lab Medicine and Pathobiology, Labatt’s Brain Tumour Centre, SickKidsUniversity of TorontoTorontoCanada
  5. 5.Department of Cell BiologyThe Hospital for Sick ChildrenTorontoCanada

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