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Decoding the transcriptional and evolutionary maps of diffuse midline glioma to overcome treatment resistance

Objective

In Europe, cancer is the leading cause of disease-related deaths in children. Among these, the pediatric brain tumor diffuse midline glioma (DMG) is the most lethal, with a median survival of only 9–11 months. Surgical resection is not possible due to its location, and radiation –the current standard of care– provides only temporary benefit before resistance develops. A hallmark of DMG is loss of the H3K27me3 epigenetic repressive mark, which stalls cancer cells into proliferative, stem-like states driven by transcription factor (TF) dysregulation. My research indicates that these TF-mediated programs not only sustain tumor growth but also influence treatment response, suggesting they represent actionable targets to both impair tumor progression and enhance the efficacy of targeted therapies.

RESET-DMG will investigate how TF-mediated transcriptional states cooperate with genetic alterations to drive treatment resistance in DMG. Aim 1 will establish proof-of-concept that disrupting these transcriptional states enhances the efficacy of TP53 reactivation– a therapeutic strategy with particular promise for the >40% of DMGs retaining wild-type TP53. This will be evaluated in patient-derived neurospheres, brain organoids, and orthotopic mouse xenograft models. Aim 2 will expand this question to eight clinically-relevant targeted therapies in DMG, generating resistant cell line models and profiling emerging cell populations with single-cell barcoding and multiome technologies across treatment modalities. Aim 3 will use predictive modelling to identify the features that contribute the most to treatment resistance in our generated cell line models, validating them in vitro and in a cohort of >70 human DMG samples, with the goal of informing therapeutic strategies for primary and relapsed disease.

Upon completion, I envision this interdisciplinary project will establish a framework for rational therapeutic combinations designed to overcome treatment resistance in DMG.

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Programme(s)

Topic(s)

Funding Scheme

HORIZON-ERC - HORIZON ERC Grants

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Call for proposal

(opens in new window) ERC-2026-STG

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Host institution

UPPSALA UNIVERSITET
Net EU contribution
€ 1 449 468,75
Address
VON KRAEMERS ALLE 4
751 05 Uppsala
Sweden
Region
Östra Sverige Östra Mellansverige Uppsala län
Activity type
Higher or Secondary Education Establishments
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Total cost
€ 1 449 468,75

Beneficiaries (1)