Provided are methods of targeting patient-specific oncogenes in extrachromosomal
DNA (ecDNA) to treat
glioma in a human. The present methods include identifying a
drug that targets against an
oncogene present in ecDNA of a human suffering from
glioma, such as
glioblastoma. The identified oncogenes present in ecDNA include MET, MET / CAPZA2, MDM2, CDK4, SOX2, PIK3CA, MECOM,
PDGFRA, EGFR, MYCN, MYC, TERT, SMARCA4, RP56, FBXW7, CDK6, CCND2,
ERBB2, BRCA1, and BAP1. The present methods include identifying a
drug targeted against the ecDNA
oncogene, which
drug inhibits the function of the identified
oncogene, so as to inhibit
tumor growth or progression of the
glioma in the human. Also provided are PDX mouse models to further identify and / or confirm patient-specific drugs that target the identified oncogene(s) present in ecDNA. Also provided are methods of diagnosing gliomas or recurrent gliomas and methods of screening or monitoring for recurrence of gliomas. Further provided are methods of validating a predicted presence of ecDNA in a
brain tumor using
fluorescence in situ hybridization (FISH). Also provided are methods of screening drug candidates for a patient by implanting different identified drugs that target an identified oncogene into PDX mouse models.