SUMMARY Medulloblastoma (MB) is the most common malignant brain tumor in children. Patients whose tumors exhibit overexpression or amplification of the MYC oncogene (c-MYC) usually have an extremely poor prognosis, but there are no animal models of this subtype of the disease. Here we show that cerebellar stem cells expressing Myc and mutant Trp53 (p53) generate aggressive tumors following orthotopic transplantation. These tumors consist of large, pleiomorphic cells and resemble human MYC-driven MB at a molecular level. Notably, antagonists of PI3K/mTOR signaling, but not Hedgehog signaling, inhibit growth of tumor cells. These findings suggest that cerebellar stem cells can give rise to MYC-driven MB, and identify a novel model that can be used to test therapies for this devastating disease.

PURPOSE Despite significant strides in the identification and characterization of potential therapeutic targets for medulloblastoma (MB), the role of the immune system and its interplay with the tumor microenvironment within these tumors are poorly understood. To address this, we adapted two syngeneic animal models of human Sonic Hedgehog (SHH)-driven and Group 3 MB for preclinical evaluation in immunocompetent C57BL/6 mice. METHODS AND RESULTS Multicolor flow cytometric analyses were used to phenotype and characterize immune infiltrating cells within established cerebellar tumors. We observed significantly higher percentages of dendritic cells, infiltrating lymphocytes, myeloid derived suppressor cells and tumor-associated macrophages in murine SHH model tumors compared with Group 3 tumors. However, murine Group 3 tumors had higher percentages of CD8+ PD-1+ T cells within the CD3 population. PD-1 blockade conferred superior antitumor efficacy in animals bearing intracranial Group 3 tumors compared to SHH group tumors, indicating that immunologic differences within the tumor microenvironment can be leveraged as potential targets to mediate antitumor efficacy. Further analysis of anti-PD-1 monoclonal antibody localization revealed binding to PD-1+ peripheral T cells, but not tumor infiltrating lymphocytes within the brain tumor microenvironment. Peripheral PD-1 blockade additionally resulted in a marked increase in CD3+ T cells within the tumor microenvironment. CONCLUSIONS This is the first immunologic characterization of preclinical models of molecular subtypes of MB and demonstration that response to immune checkpoint blockade differs across subtype classification. Our findings also suggest that effective anti-PD-1 blockade does not require that systemically administered antibodies penetrate the brain tumor microenvironment.

There is an urgent need to develop new combination therapies beyond existing surgery, radio- and chemo-therapy, perhaps initially combining chemotherapy with the targeting specificities of immunotherapy. For this, strategies to limit inflammation and immunosuppression and evasion in the tumour microenvironment are also needed. To devise effective new immunotherapies we must first understand tumour immunology, including the roles of T cells, macrophages, myeloid suppressor cells and of exosomes and microvesicles (EMVs) in promoting angiogenesis, tumour growth, drug resistance and metastasis. One promising cancer immunotherapy discussed uses cationic liposomes carrying tumour RNA (RNA-lipoplexes) to provoke a strong anti-viral-like (cytotoxic CD8 ) anti-tumour immune response. Mesenchymal stem cell-derived EMVs, with their capacity to migrate towards inflammatory areas including solid tumours, have also been used. As tumour EMVs clearly exacerbate the tumour microenvironment, another therapy option could involve EMV removal. Affinity-based methods to deplete EMVs, including an immunodepletion, antibody-based affinity substrate, are therefore considered. Finally EMV and exosome-mimetic nanovesicles (NVs) delivery of siRNA or chemotherapeutic drugs that target tumours using peptide ligands for cognate receptors on the tumour cells are discussed. We also touch upon the reversal of drug efflux in EMVs from cancer cells which can sensitize cells to chemotherapy. The use of immunotherapy in combination with the advent of EMVs provides potent therapies to various cancers.

Cerebellar granule neurons are the most abundant neurons in the brain, and a critical element of the circuitry that controls motor coordination and learning. In addition, granule neuron precursors (GNPs) are thought to represent cells of origin for medulloblastoma, the most common malignant brain tumor in children. Thus, understanding the signals that control the growth and differentiation of these cells has important implications for neurobiology and neuro-oncology. Our previous studies have shown that proliferation of GNPs is regulated by Sonic hedgehog (Shh), and that aberrant activation of the Shh pathway can lead to medulloblastoma. Moreover, we have demonstrated that Shh-dependent proliferation of GNPs and medulloblastoma cells can be blocked by basic fibroblast growth factor (bFGF). But while the mitogenic effects of Shh signaling have been confirmed in vivo, the inhibitory effects of bFGF have primarily been studied in culture. Here we demonstrate that mice lacking FGF signaling in GNPs exhibit no discernable changes in GNP proliferation or differentiation. In contrast, activation of FGF signaling has a potent effect on tumor growth: treatment of medulloblastoma cells with bFGF prevents them from forming tumors following transplantation, and inoculation of tumor-bearing mice with bFGF markedly inhibits tumor growth in vivo. These results suggest that activators of FGF signaling may be useful for targeting medulloblastoma and other Shh-dependent tumors.

A signal enhancement of two orders of magnitude was achieved when reactive desorption electrospray ionization (DESI) was used to investigate copper(II) dibutyl dithiocarbamate, Cu(II)(bu 2 dtc) 2 , found in a specialized polymer. Cu(II) was oxidized to Cu(III) during the DESI experiment by oxidants in the spray solvent. Such oxidants could be present or formed during electrospray (e.g., O 2 ) or deliberately added to the spray solvent (this approach is called reactive DESI). When a strong oxidizing agent (e.g., iodine) was added to the spray solvent, the signal increased by two orders of magnitude relative to the pure solvent spray. The correlation between the standard reduction potential of the oxidant and the signal intensity and signal to noise ratio of the product ion for various reagents, was tested and discussed. The observed DESI enhancements in rates of oxidation are not observed in homogeneous solution. The major peaks in the collision induced dissociation (CID) . DESI is a heterogeneous process involving charged solution-phase droplets interacting with a condensed phase sample to yield gas-phase ions. It is therefore straightforward to add solution-phase reagents to the spray solvent to mediate the interfacial chemistry. This capability, sometimes called reactive DESI, has been used to perform selective ligand/protein binding [1], to stereoselectively generate covalent cyclic boronates from 1,2-diols [11] and to perform Eberlin transacetalization of acylium ions (Eberlin, M. N., unpublished results). These instances emphasize the analogy between DESI and chemical ionization (CI), even though the former employs solution-phase rather than gas-phase reagents as is done in the conventional CI experiment.We demonstrate in this paper that redox reactions can be used to advantage in DESI analysis (as they have previously been so used in electrospray ionization [12,13]). We report a very large enhancement in the efficiency of ionization of a particular metal complex present in a specialized layered ethylene/propylene/ diene polymer [14] by using redox spray reagents to assist in ionization. The analyte investigated is the neutral copper(II) dibutyl dithiocarbamate complex, Cu(II)(bu 2 dtc) 2 , which is ionized to [Cu(III)(bu 2 dtc) 2 ] ϩ (m/z 471) during the DESI experiment (eq 1). Electrochemical processes accompanying electrospray ionization (ESI) were first recognized by Kebarle et al. [12] and thoroughly investigated by Van Berkel and co-