<p>Studying the early stages of cancer can provide important insight into the molecular basis of the disease. In many human cancers, such as prostate, pancreatic, and colon cancer, a pre-neoplastic, or intermediate, stage of the disease has been identified. The pre-neoplastic stage is presumed to be a transition during which normal cells undergo malignant transformation. However, the link between the pre-neoplastic cells and end-stage disease has never been formally established. To investigate the fate of such cells, the patched (ptc) mutant mouse, a model for the brain tumor medulloblastoma was used. Pre-neoplastic cells (PNCs) are found in most ptc mutants during early adulthood, but only 15% of these animals develop tumors. Although PNCs are found in mice that develop tumors, the ability of PNCs to give rise to tumors has never been demonstrated directly, and the fate of cells that do not form tumors remains unknown. Genetic fate mapping and orthotopic transplantation provided definitive evidence that PNCs give rise to tumors and showed that the predominant fate of PNCs that do not form tumors is differentiation. Moreover, N-myc, a gene commonly amplified in medulloblastoma, can dramatically alter the fate of PNCs, preventing differentiation and driving progression to tumors. Importantly, N-myc allows PNCs to grow independently of hedgehog signaling, making the resulting tumors resistant to hedgehog antagonists. These studies provide the first direct evidence that PNCs can give rise to tumors, and demonstrate that identification of genetic changes that promote tumor progression is critical for designing effective therapies for cancer.</p> / Dissertation

Les médulloblastomes (MB) sont les tumeurs cérébrales les plus fréquentes en pédiatrie. Ils apparaissent le plus souvent au niveau du cervelet. Ils peuvent être stratifiés en quatre groupes : les groupes WNT et SHH, où ces voies de signalisation sont altérées, et les groupes 3 et 4, présentant des anomalies chromosomiques et amplifications multiples, dont c-Myc (groupe 3) et N-Myc (groupe 4). L’une des altérations génétiques les plus retrouvées dans les MB est la surexpression du facteur de transcription OTX2. Ce facteur est exprimé dans les précurseurs des cellules granulaires (GCP) du cervelet, cellules d’origine de la majorité des MB. Pendant la période périnatale, les GCP subissent une phase de prolifération très intense en réponse au mitogène Sonic Hedgehog (SHH), ce qui les rendrait particulièrement sensibles à la tumorigenèse. Au cours de cette thèse, nous nous sommes intéressé à la fonction d’Otx2 dans ces GCP. Nous avons montré que l’ablation conditionnelle d’Otx2 conduit à un défaut de prolifération des ces cellules. L’analyse approfondie de ce phénotype a permis de révéler qu’Otx2 stimule la prolifération des GCP parallèlement à la voie de signalisation Shh. Par ailleurs, l’ablation d’Otx2 dans un modèle murin mimant la formation de MB Shh-dépendants a montré qu’Otx2 s’avère indispensable pour leur maintien à long terme. En parallèle, nous avons tenté de créer un nouveau modèle murin mimant la formation de MB de groupe 3 en induisant l’expression, pendant la période postnatale, d’un dominant actif de c-Myc dans les cellules exprimant Otx2. Cette approche a donné des résultats inattendus : des carcinomes de plexus choroïdes, et non des MB, ont été obtenus. / Medulloblastomas (MB) are the most common brain tumors in paediatrics. They appear during development in the posterior part of the brain, mainly in cerebellum. MB can be stratified in four groups: the WNT and SHH groups, where these signalling pathways are aberrantly activated, and the groups 3 and 4, which display chromosomal abnormalities and multiple amplifications, including c-Myc (group 3) and N-Myc (group 4). One of the most frequent genetic alterations in MB is the overexpression of the Otx2 transcription factor (in 75% of cases). This factor, which is essential for central nervous system development, is expressed in granule cell precursors (GCP) of the cerebellum, which represent the cell of origin of the majority of MB. During the perinatal period, GCPs undergo intense proliferation in response to Sonic Hedgegog (SHH), making them particularly susceptible to tumorigenesis. During this thesis, we were interested in examining the function of Otx2 in GCPs. We have shown that conditional ablation of Otx2 leads to a GCP proliferation defect and that Otx2 stimulates the proliferation of these cells independently of the Shh signaling pathway. Moreover, ablation of Otx2 in a mice model of Shh-dependent medulloblastomas yielded very interesting results: while Otx2 does not seem to be required for the initiation of these tumors, it is essential for their long-term maintenance. In parallel, we tried to create a new murine model for the MB group 3 by inducing the expression, during the postnatal period, of an active dominant of c-Myc in cells expressing Otx2. This approach yielded unexpected results: choroid plexus carcinomas, instead of MB, were obtained.