MYC Drives a Subset of High-Risk Pediatric Neuroblastomas and Is Activated through Mechanisms Including Enhancer Hijacking and Focal Enhancer Amplification

Cancer Discov. 2018 Mar;8(3):320-335. doi: 10.1158/2159-8290.CD-17-0993. Epub 2017 Dec 28.


The amplified MYCN gene serves as an oncogenic driver in approximately 20% of high-risk pediatric neuroblastomas. Here, we show that the family member MYC is a potent transforming gene in a separate subset of high-risk neuroblastoma cases (∼10%), based on (i) its upregulation by focal enhancer amplification or genomic rearrangements leading to enhancer hijacking, and (ii) its ability to transform neuroblastoma precursor cells in a transgenic animal model. The aberrant regulatory elements associated with oncogenic MYC activation include focally amplified distal enhancers and translocation of highly active enhancers from other genes to within topologically associating domains containing the MYC gene locus. The clinical outcome for patients with high levels of MYC expression is virtually identical to that of patients with amplification of the MYCN gene, a known high-risk feature of this disease. Together, these findings establish MYC as a bona fide oncogene in a clinically significant group of high-risk childhood neuroblastomas.Significance: Amplification of the MYCN oncogene is a recognized hallmark of high-risk pediatric neuroblastoma. Here, we demonstrate that MYC is also activated as a potent oncogene in a distinct subset of neuroblastoma cases through either focal amplification of distal enhancers or enhancer hijacking mediated by chromosomal translocation. Cancer Discov; 8(3); 320-35. ©2017 AACR.This article is highlighted in the In This Issue feature, p. 253.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Animals, Genetically Modified
  • Cell Line, Tumor
  • Child
  • Enhancer Elements, Genetic*
  • Gene Amplification
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Luminescent Proteins / genetics
  • N-Myc Proto-Oncogene Protein / genetics
  • Neoplasms, Experimental / genetics
  • Neuroblastoma / genetics*
  • Neuroblastoma / mortality
  • Neuroblastoma / pathology
  • Proto-Oncogene Proteins c-myc / genetics*
  • Red Fluorescent Protein
  • Survival Analysis
  • Translocation, Genetic
  • Zebrafish / genetics


  • Luminescent Proteins
  • MYC protein, human
  • MYCN protein, human
  • N-Myc Proto-Oncogene Protein
  • Proto-Oncogene Proteins c-myc