Les gliomes, tumeurs cérébrales primaires du système nerveux central, sont souvent de pronostic défavorable, d'autant plus que l'absence de critères indiscutables pour les identifier rend leur diagnostic et leur prise en charge particulièrement difficiles. L’analyse conjointe, d’une cohorte française de 64 patients porteurs de gliomes et d’une cohorte internationale de 671 patients issus du TCGA, a permis de mettre en évidence deux groupes pronostiques constitués par un panel d’expression différentielle de 26 gènes (p = 0,007). Cette stratification en deux groupes pronostiques a été confirmée quels que soient le grade et le groupe moléculaire de la tumeur (p < 0,0001). Nous avons établi une nouvelle stratégie diagnostique à partir de la classification moléculaire des gliomes en intégrant deux biomarqueurs pronostiques CHI3L1 et NTRK2. L’analyse multivariée confirme que ces biomarqueurs sont indépendants du statut IDH et du grade tumoral. Si nous avons mis en évidence par l’analyse protéique de CHI3L1 une concordance avec les transcrits, les résultats divergent pour TrkB. Ainsi, une expression élevée de TrkB et son corécepteur p75NTR serait liée à l’agressivité tumorale indépendamment du statut IDH. Enfin, TrkB et p75NTR sont présents aussi bien dans les exosomes issus du plasma de témoins sains et de patients atteints de gliomes mais leur expression augmente en fonction de l’agressivité de la tumeur / Gliomas, primary brain tumours of the central nervous system, are often of poor prognosis.The absence of clear criteria to identify them makes their diagnosis and management particularly difficult. The combined analysis of a cohort of 64 glioma patients and an international cohort of 671 patients from the TCGA revealed two prognostic groups of a differential expression panel of 26 genes (p = 0.007). This stratification into two prognostic groups was confirmed independently of the grade and molecular group of the tumor (p <0.0001). We have established a new diagnostic strategy based on the molecular classification of gliomas by integrating two prognostic biomarkers CHI3L1 and NTRK2. Multivariate analysis confirms that these biomarkers are independent of IDH status and tumor grade.While we have demonstrated by the protein analysis of CHI3L1 concordance with the transcripts, the results are different for TrkB. Therefore, a high expression of TrkB and its p75NTR co-receptor would be associated with tumor aggressiveness regardless of IDH status. Lastly, TrkB and p75NTR are present in exosomes from plasma of healthy controls and glioma patients, but their expression increases with the aggressiveness of tumor.

Glioblastoma Multiforme (GBM) is the most common brain cancer and one of the most fatal forms of cancer overall. The average survival time is 10-14 months, and less than 10% of patients survive more than 5 years after diagnosis. It is characterized by extreme vasculature, chemo/radioresistance, and invasiveness into the normal brain. The current standard of care, which includes surgical removal of tumor, radiation, and the chemotherapeutic agent temozolomide, initially stunt tumor growth. Nevertheless, the tumor invariably rebounds and the patient succumbs to the disease. Therefore, there is an urgent need to develop new therapies for this devastating disease. YKL-40 is one of the most over-expressed proteins by GBM cells, and is elevated in the serum of patients with GBM. YKL-40 is implicated in a host of inflammatory diseases and has been shown to play a major role in the maturation of some cells of the immune system, especially macrophages. Thus, it has been suggested that YKL-40 may act as a prognostic biomarker for cancer and inflammatory disease. However, little is known about the role of YKL-40 in relation to cancer development and progression, and more work needs to be done to validate it as a biomarker or as a therapeutic target. It was the goal of the work described herein to uncover some of the key molecular mechanisms of GBM development and progression in the hopes of offering new therapeutic targets. Using a wide variety of in vitro and in vivo techniques, the role of a secreted glycoprotein YKL-40 in GBM was probed. It was demonstrated that YKL-40 enhanced angiogenesis, radioresistance, and progression of GBM cells. Moreover, inhibition of YKL-40 in mouse models markedly arrested tumor growth and vascularization, lending support to the idea of YKL-40 as a therapeutic target. Finally, YKL-40 drove GBM cells into a mesenchymal phenotype, where the tumor cells act as mural-like cells, supporting tumor vasculature networks. Hopefully, the results from these studies will offer the rationale to develop drugs against YKL-40 and potentially extend the lives of patients with this terrible disease.

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