Comprehensive analysis of diverse low-grade neuroepithelial tumors with FGFR1 alterations reveals a distinct molecular signature of rosette-forming glioneuronal tumor

Calixto Hope G. Lucas, Rohit Gupta, Pamela Doo, Julieann C. Lee, Cathryn R. Cadwell, Biswarathan Ramani, Jeffrey W. Hofmann, Emily A. Sloan, Bette K. Kleinschmidt-Demasters, Han S. Lee, Matthew D. Wood, Marjorie Grafe, Donald Born, Hannes Vogel, Shahriar Salamat, Diane Puccetti, David Scharnhorst, David Samuel, Tabitha Cooney, Elaine ChamLee Way Jin, Ziad Khatib, Ossama Maher, Gabriel Chamyan, Carole Brathwaite, Serguei Bannykh, Sabine Mueller, Cassie N. Kline, Anu Banerjee, Alyssa Reddy, Jennie W. Taylor, Jennifer L. Clarke, Nancy Ann Oberheim Bush, Nicholas Butowski, Nalin Gupta, Kurtis I. Auguste, Peter P. Sun, Jarod L. Roland, Corey Raffel, Manish K. Aghi, Philip Theodosopoulos, Edward Chang, Shawn Hervey-Jumper, Joanna J. Phillips, Melike Pekmezci, Andrew W. Bollen, Tarik Tihan, Susan Chang, Mitchel S. Berger, Arie Perry, David A. Solomon

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


The FGFR1 gene encoding fibroblast growth factor receptor 1 has emerged as a frequently altered oncogene in the pathogenesis of multiple low-grade neuroepithelial tumor (LGNET) subtypes including pilocytic astrocytoma, dysembryoplastic neuroepithelial tumor (DNT), rosette-forming glioneuronal tumor (RGNT), and extraventricular neurocytoma (EVN). These activating FGFR1 alterations in LGNET can include tandem duplication of the exons encoding the intracellular tyrosine kinase domain, in-frame gene fusions most often with TACC1 as the partner, or hotspot missense mutations within the tyrosine kinase domain (either at p.N546 or p.K656). However, the specificity of these different FGFR1 events for the various LGNET subtypes and accompanying genetic alterations are not well defined. Here we performed comprehensive genomic and epigenomic characterization on a diverse cohort of 30 LGNET with FGFR1 alterations. We identified that RGNT harbors a distinct epigenetic signature compared to other LGNET with FGFR1 alterations, and is uniquely characterized by FGFR1 kinase domain hotspot missense mutations in combination with either PIK3CA or PIK3R1 mutation, often with accompanying NF1 or PTPN11 mutation. In contrast, EVN harbors its own distinct epigenetic signature and is characterized by FGFR1-TACC1 fusion as the solitary pathogenic alteration. Additionally, DNT and pilocytic astrocytoma are characterized by either kinase domain tandem duplication or hotspot missense mutations, occasionally with accompanying NF1 or PTPN11 mutation, but lacking the accompanying PIK3CA or PIK3R1 mutation that characterizes RGNT. The glial component of LGNET with FGFR1 alterations typically has a predominantly oligodendroglial morphology, and many of the pilocytic astrocytomas with FGFR1 alterations lack the biphasic pattern, piloid processes, and Rosenthal fibers that characterize pilocytic astrocytomas with BRAF mutation or fusion. Together, this analysis improves the classification and histopathologic stratification of LGNET with FGFR1 alterations.

Original languageEnglish (US)
Article number151
JournalActa Neuropathologica Communications
Issue number1
StatePublished - Aug 28 2020


  • DNA methylation profiling
  • Dysembryoplastic neuroepithelial tumor (DNT)
  • Extraventricular neurocytoma (EVN)
  • FGFR1
  • Molecular neuropathology
  • PIK3CA
  • PIK3R1
  • Pilocytic astrocytoma
  • Rosette-forming glioneuronal tumor (RGNT)

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Clinical Neurology
  • Cellular and Molecular Neuroscience


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