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Buyukbayram ME, Hannarici Z, Yilmaz A, Turhan A, Caglar AA, Esdur PC, Bilici M, Tekin SB. Inflammatory parameters in NSCLC with driver mutation. Lung Cancer Manag 2024; 13:LMT66. [PMID: 38818368 PMCID: PMC11137794 DOI: 10.2217/lmt-2023-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/26/2024] [Indexed: 06/01/2024] Open
Abstract
Aim: The tumor microenvironment of NSCLC with driver mutations, such as EGFR, ALK and ROS, is less inflammatory. Materials & methods: This retrospective study included 38 patients with NSCLC driver mutations. The relationship between clinical and inflammatory markers concerning progression-free survival and overall survival was analyzed based on Kaplan-Meier curves. Results: The mean age of the patients was 59.8 ± 11.9. Progression-free survival and overall survival were significantly longer in patients under 65 years of age and with low neutrophil-lymphocyte ratio, low systemic immune-inflammation index and high lymphocyte count (p < 0.05). Conclusion: Unlike tumor biology, peripheral inflammatory parameters, such as neutrophil-lymphocyte ratio, systemic immune-inflammation index and lymphocyte count may be associated with survival in NSCLC patients with driver mutations.
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Affiliation(s)
- Mehmet Emin Buyukbayram
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, 25100, Turkey
| | | | - Ali Yilmaz
- Department of medical Oncology, Health Sciences University Yüksek İhtisas Training and Research Hospital, Bursa, 16350, Turkey
| | - Aykut Turhan
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, 25100, Turkey
| | - Alperen Akansel Caglar
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, 25100, Turkey
| | - Pınar Coban Esdur
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, 25100, Turkey
| | - Mehmet Bilici
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, 25100, Turkey
| | - Salim Basol Tekin
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, 25100, Turkey
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2
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Wang L, Wang H, D’Angelo F, Curtin L, Sereduk CP, Leon GD, Singleton KW, Urcuyo J, Hawkins-Daarud A, Jackson PR, Krishna C, Zimmerman RS, Patra DP, Bendok BR, Smith KA, Nakaji P, Donev K, Baxter LC, Mrugała MM, Ceccarelli M, Iavarone A, Swanson KR, Tran NL, Hu LS, Li J. Quantifying intra-tumoral genetic heterogeneity of glioblastoma toward precision medicine using MRI and a data-inclusive machine learning algorithm. PLoS One 2024; 19:e0299267. [PMID: 38568950 PMCID: PMC10990246 DOI: 10.1371/journal.pone.0299267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/06/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Glioblastoma (GBM) is one of the most aggressive and lethal human cancers. Intra-tumoral genetic heterogeneity poses a significant challenge for treatment. Biopsy is invasive, which motivates the development of non-invasive, MRI-based machine learning (ML) models to quantify intra-tumoral genetic heterogeneity for each patient. This capability holds great promise for enabling better therapeutic selection to improve patient outcome. METHODS We proposed a novel Weakly Supervised Ordinal Support Vector Machine (WSO-SVM) to predict regional genetic alteration status within each GBM tumor using MRI. WSO-SVM was applied to a unique dataset of 318 image-localized biopsies with spatially matched multiparametric MRI from 74 GBM patients. The model was trained to predict the regional genetic alteration of three GBM driver genes (EGFR, PDGFRA and PTEN) based on features extracted from the corresponding region of five MRI contrast images. For comparison, a variety of existing ML algorithms were also applied. Classification accuracy of each gene were compared between the different algorithms. The SHapley Additive exPlanations (SHAP) method was further applied to compute contribution scores of different contrast images. Finally, the trained WSO-SVM was used to generate prediction maps within the tumoral area of each patient to help visualize the intra-tumoral genetic heterogeneity. RESULTS WSO-SVM achieved 0.80 accuracy, 0.79 sensitivity, and 0.81 specificity for classifying EGFR; 0.71 accuracy, 0.70 sensitivity, and 0.72 specificity for classifying PDGFRA; 0.80 accuracy, 0.78 sensitivity, and 0.83 specificity for classifying PTEN; these results significantly outperformed the existing ML algorithms. Using SHAP, we found that the relative contributions of the five contrast images differ between genes, which are consistent with findings in the literature. The prediction maps revealed extensive intra-tumoral region-to-region heterogeneity within each individual tumor in terms of the alteration status of the three genes. CONCLUSIONS This study demonstrated the feasibility of using MRI and WSO-SVM to enable non-invasive prediction of intra-tumoral regional genetic alteration for each GBM patient, which can inform future adaptive therapies for individualized oncology.
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Affiliation(s)
- Lujia Wang
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Hairong Wang
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Fulvio D’Angelo
- Institute for Cancer Genetics, Columbia University Medical Center, New York City, New York, United States of America
| | - Lee Curtin
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Christopher P. Sereduk
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Gustavo De Leon
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Kyle W. Singleton
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Javier Urcuyo
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Andrea Hawkins-Daarud
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Pamela R. Jackson
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Chandan Krishna
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Richard S. Zimmerman
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Devi P. Patra
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Bernard R. Bendok
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Kris A. Smith
- Department of Neurosurgery, Barrow Neurological Institute—St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, United States of America
| | - Peter Nakaji
- Department of Neurosurgery, Barrow Neurological Institute—St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, United States of America
| | - Kliment Donev
- Department of Pathology, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Leslie C. Baxter
- Department of Neuropsychology, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Maciej M. Mrugała
- Department of Neuro-Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Michele Ceccarelli
- Department of Electrical Engineering and Information Technology, University of Naples “Federico II”, Naples, Italy
| | - Antonio Iavarone
- Institute for Cancer Genetics, Columbia University Medical Center, New York City, New York, United States of America
| | - Kristin R. Swanson
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Nhan L. Tran
- Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
- Department of Cancer Biology, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Leland S. Hu
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, United States of America
| | - Jing Li
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
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3
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Urcuyo JC, Curtin L, Langworthy JM, De Leon G, Anderies B, Singleton KW, Hawkins-Daarud A, Jackson PR, Bond KM, Ranjbar S, Lassiter-Morris Y, Clark-Swanson KR, Paulson LE, Sereduk C, Mrugala MM, Porter AB, Baxter L, Salomao M, Donev K, Hudson M, Meyer J, Zeeshan Q, Sattur M, Patra DP, Jones BA, Rahme RJ, Neal MT, Patel N, Kouloumberis P, Turkmani AH, Lyons M, Krishna C, Zimmerman RS, Bendok BR, Tran NL, Hu LS, Swanson KR. Image-localized biopsy mapping of brain tumor heterogeneity: A single-center study protocol. PLoS One 2023; 18:e0287767. [PMID: 38117803 PMCID: PMC10732423 DOI: 10.1371/journal.pone.0287767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/13/2023] [Indexed: 12/22/2023] Open
Abstract
Brain cancers pose a novel set of difficulties due to the limited accessibility of human brain tumor tissue. For this reason, clinical decision-making relies heavily on MR imaging interpretation, yet the mapping between MRI features and underlying biology remains ambiguous. Standard (clinical) tissue sampling fails to capture the full heterogeneity of the disease. Biopsies are required to obtain a pathological diagnosis and are predominantly taken from the tumor core, which often has different traits to the surrounding invasive tumor that typically leads to recurrent disease. One approach to solving this issue is to characterize the spatial heterogeneity of molecular, genetic, and cellular features of glioma through the intraoperative collection of multiple image-localized biopsy samples paired with multi-parametric MRIs. We have adopted this approach and are currently actively enrolling patients for our 'Image-Based Mapping of Brain Tumors' study. Patients are eligible for this research study (IRB #16-002424) if they are 18 years or older and undergoing surgical intervention for a brain lesion. Once identified, candidate patients receive dynamic susceptibility contrast (DSC) perfusion MRI and diffusion tensor imaging (DTI), in addition to standard sequences (T1, T1Gd, T2, T2-FLAIR) at their presurgical scan. During surgery, sample anatomical locations are tracked using neuronavigation. The collected specimens from this research study are used to capture the intra-tumoral heterogeneity across brain tumors including quantification of genetic aberrations through whole-exome and RNA sequencing as well as other tissue analysis techniques. To date, these data (made available through a public portal) have been used to generate, test, and validate predictive regional maps of the spatial distribution of tumor cell density and/or treatment-related key genetic marker status to identify biopsy and/or treatment targets based on insight from the entire tumor makeup. This type of methodology, when delivered within clinically feasible time frames, has the potential to further inform medical decision-making by improving surgical intervention, radiation, and targeted drug therapy for patients with glioma.
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Affiliation(s)
- Javier C Urcuyo
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Lee Curtin
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Jazlynn M. Langworthy
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Gustavo De Leon
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Barrett Anderies
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Kyle W. Singleton
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Andrea Hawkins-Daarud
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Pamela R. Jackson
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Kamila M. Bond
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Sara Ranjbar
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Yvette Lassiter-Morris
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Kamala R. Clark-Swanson
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Lisa E. Paulson
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Chris Sereduk
- Department of Cancer Biology, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Maciej M. Mrugala
- Department of Neurology, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Oncology, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Alyx B. Porter
- Department of Neurology, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Oncology, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Leslie Baxter
- Department of Neurophysiology, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Marcela Salomao
- Department of Pathology, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Kliment Donev
- Department of Pathology, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Miles Hudson
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Jenna Meyer
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Qazi Zeeshan
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Mithun Sattur
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Devi P. Patra
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Breck A. Jones
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Rudy J. Rahme
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Matthew T. Neal
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Naresh Patel
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Pelagia Kouloumberis
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Ali H. Turkmani
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Mark Lyons
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Chandan Krishna
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Richard S. Zimmerman
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Bernard R. Bendok
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Nhan L. Tran
- Department of Cancer Biology, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Leland S. Hu
- Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Kristin R. Swanson
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Cancer Biology, Mayo Clinic, Phoenix, Arizona, United States of America
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona, United States of America
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4
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Cao W, Xiong L, Meng L, Li Z, Hu Z, Lei H, Wu J, Song T, Liu C, Wei R, Shen L, Hong J. Prognostic analysis and nomogram construction for older patients with IDH-wild-type glioblastoma. Heliyon 2023; 9:e18310. [PMID: 37519736 PMCID: PMC10372674 DOI: 10.1016/j.heliyon.2023.e18310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023] Open
Abstract
As many countries face an ageing population, the number of older patients with glioblastoma (GB) is increasing. Thus, there is an urgent need for prognostic models to aid in treatment decision-making and life planning. A total of 98 patients with isocitrate dehydrogenase (IDH)-wild-type GB aged ≥65 years were analysed from January 2012 to January 2020. Independent prognostic factors were identified by prognostic analysis. Using the independent prognostic factors for overall survival (OS), a nomogram was constructed by R software to predict the prognosis of older patients with IDH-wild-type GB. The concordance index (C-index) and receiver operating characteristic (ROC) curve were used to assess model discrimination, and the calibration curve was used to assess model calibration. Prognostic analysis showed that the extent of resection (EOR), adjusted Charlson comorbidity index (ACCI), O6-methylguanine-DNA methyltransferase (MGMT) methylation status, postoperative radiotherapy, and postoperative temozolomide (TMZ) chemotherapy were independent prognostic factors for OS. MGMT methylation status and subventricular zone (SVZ) involvement were independent prognostic factors for progression-free survival (PFS). A nomogram was constructed based on EOR, ACCI, MGMT methylation status, postoperative radiotherapy and postoperative TMZ chemotherapy to predict the 6-month, 12-month and 18-month OS of older patients with IDH-wild-type GB. The C-index of the nomogram was 0.72, and the ROC curves showed that the areas under the curve (AUCs) at 6, 12 and 18 months were 0.874, 0.739 and 0.779, respectively. The calibration plots showed that the nomogram was in good agreement with the actual observations in predicting the OS of older patients with IDH-wild-type GB. Older patients with IDH-wild-type GB can benefit from gross total resection (GTR), postoperative radiotherapy and postoperative TMZ chemotherapy. A high ACCI score and MGMT nonmethylation are poor prognostic factors. We constructed a nomogram including the ACCI to facilitate clinical decision-making and follow-up interval selection.
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Affiliation(s)
- Wenjun Cao
- Department of Hematology and Oncology, The First Hospital of Changsha, People's Republic of China
| | - Luqi Xiong
- Department of Oncology, Xiangya Hospital, Central South University, People's Republic of China
| | - Li Meng
- Department of Radiology, Xiangya Hospital, Central South University, People's Republic of China
| | - Zhanzhan Li
- Department of Oncology, Xiangya Hospital, Central South University, People's Republic of China
| | - Zhongliang Hu
- Department of Pathology, Xiangya Hospital, Central South University, People's Republic of China
| | - Huo Lei
- Department of Neurosurgery, Xiangya Hospital, Central South University, People's Republic of China
| | - Jun Wu
- Department of Neurosurgery, Xiangya Hospital, Central South University, People's Republic of China
| | - Tao Song
- Department of Neurosurgery, Xiangya Hospital, Central South University, People's Republic of China
| | - Chao Liu
- Department of Oncology, Xiangya Hospital, Central South University, People's Republic of China
| | - Rui Wei
- Department of Oncology, Xiangya Hospital, Central South University, People's Republic of China
| | - Liangfang Shen
- Department of Oncology, Xiangya Hospital, Central South University, People's Republic of China
| | - Jidong Hong
- Department of Oncology, Xiangya Hospital, Central South University, People's Republic of China
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5
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Agosti E, Panciani PP, Zeppieri M, De Maria L, Pasqualetti F, Tel A, Zanin L, Fontanella MM, Ius T. Tumor Microenvironment and Glioblastoma Cell Interplay as Promoters of Therapeutic Resistance. BIOLOGY 2023; 12:736. [PMID: 37237548 PMCID: PMC10215375 DOI: 10.3390/biology12050736] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
The invasive nature of glioblastoma is problematic in a radical surgery approach and can be responsible for tumor recurrence. In order to create new therapeutic strategies, it is imperative to have a better understanding of the mechanisms behind tumor growth and invasion. The continuous cross-talk between glioma stem cells (GSCs) and the tumor microenvironment (TME) contributes to disease progression, which renders research in this field difficult and challenging. The main aim of the review was to assess the different possible mechanisms that could explain resistance to treatment promoted by TME and GSCs in glioblastoma, including the role of M2 macrophages, micro RNAs (miRNAs), and long non-coding RNAs (lncRNAs) from exosomes from the TME. A systematic review of the literature on the role of the TME in developing and promoting radioresistance and chemoresistance of GBM was performed according to PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. A dedicated literature review search was also performed on the immunotherapeutic agents against the immune TME. We identified 367 papers using the reported keywords. The final qualitative analysis was conducted on 25 studies. A growing amount of evidence in the current literature supports the role of M2 macrophages and non-coding RNAs in promoting the mechanisms of chemo and radioresistance. A better insight into how GBM cells interact with TME is an essential step towards comprehending the mechanisms that give rise to resistance to standard treatment, which can help to pave the way for the development of novel therapeutic strategies for GBM patients.
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Affiliation(s)
- Edoardo Agosti
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Pier Paolo Panciani
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Lucio De Maria
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Francesco Pasqualetti
- Division of Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, 56100 Pisa, Italy
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - Alessandro Tel
- Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Luca Zanin
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Marco Maria Fontanella
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy
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Swati K, Agrawal K, Raj S, Kumar R, Prakash A, Kumar D. Molecular mechanism(s) of regulations of cancer stem cell in brain cancer propagation. Med Res Rev 2022; 43:441-463. [PMID: 36205299 DOI: 10.1002/med.21930] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 06/01/2022] [Accepted: 09/11/2022] [Indexed: 11/12/2022]
Abstract
Brain tumors are most often diagnosed with solid neoplasms and are the primary reason for cancer-related deaths in both children and adults worldwide. With recent developments in the progression of novel targeted chemotherapies, the prognosis of malignant glioma remains dismal. However, the high recurrence rate and high mortality rate remain unresolved and are closely linked to the biological features of cancer stem cells (CSCs). Research on tumor biology has reached a new age with more understanding of CSC features. CSCs, a subpopulation of whole tumor cells, are now regarded as candidate therapeutic targets. Therefore, in the diagnosis and treatment of tumors, recognizing the biological properties of CSCs is of considerable significance. Here, we have discussed the concept of CSCs and their significant role in brain cancer growth and propagation. We have also discussed personalized therapeutic development and immunotherapies for brain cancer by specifically targeting CSCs.
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Affiliation(s)
- Kumari Swati
- Department of Biotechnology, School of Life Science, Mahatma Gandhi Central University, Motihari, Bihar, India
| | - Kirti Agrawal
- School of Health Sciences and Technology (SoHST), UPES University, Dehradun, India.,Amity Institute of Molecular Medicine and Stem Cell Research, Amity University Uttar Pradesh, Noida, India
| | - Sibi Raj
- School of Health Sciences and Technology (SoHST), UPES University, Dehradun, India.,Amity Institute of Molecular Medicine and Stem Cell Research, Amity University Uttar Pradesh, Noida, India
| | - Rajeev Kumar
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Noida, India
| | - Anand Prakash
- Department of Biotechnology, School of Life Science, Mahatma Gandhi Central University, Motihari, Bihar, India
| | - Dhruv Kumar
- School of Health Sciences and Technology (SoHST), UPES University, Dehradun, India.,Amity Institute of Molecular Medicine and Stem Cell Research, Amity University Uttar Pradesh, Noida, India
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7
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Goodman AL, Velázquez Vega JE, Glenn C, Olson JJ. Congress of neurological surgeons systematic review and evidence-based guidelines update on the role of neuropathology in the management of progressive glioblastoma in adults. J Neurooncol 2022; 158:179-224. [PMID: 35648306 DOI: 10.1007/s11060-022-04005-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 04/04/2022] [Indexed: 12/28/2022]
Abstract
TARGET POPULATION These recommendations apply to adult patients with progressive or recurrent glioblastoma (GBM). QUESTION For adult patients with progressive glioblastoma does testing for Isocitrate Dehydrogenase (IDH) 1 or 2 mutations provide new additional management or prognostic information beyond that derived from the tumor at initial presentation? RECOMMENDATION Level III: Repeat IDH mutation testing is not necessary if the tumor is histologically similar to the primary tumor and the patient's clinical course is as expected. QUESTION For adult patients with progressive glioblastoma does repeat testing for MGMT promoter methylation provide new or additional management or prognostic information beyond that derived from the tumor at initial presentation and what methods of detection are optimal? RECOMMENDATION Level III: Repeat MGMT promoter methylation is not recommended. QUESTION For adult patients with progressive glioblastoma does EGFR amplification or mutation testing provide management or prognostic information beyond that provided by histologic analysis and if performed on previous tissue samples, does it need to be repeated? RECOMMENDATION Level III: In cases that are difficult to classify as glioblastoma on histologic features EGFR amplification testing may help in classification. If a previous EGFR amplification was detected, repeat testing is not necessary. Repeat EGFR amplification or mutational testing may be recommended in patients in which target therapy is being considered. QUESTION For adult patients with progressive glioblastoma does large panel or whole genome sequencing provide management or prognostic information beyond that derived from histologic analysis? RECOMMENDATION Level III: Primary or repeat large panel or whole genome sequencing may be considered in patients who are eligible or interested in molecularly guided therapy or clinical trials. QUESTION For adult patients with progressive glioblastoma should immune checkpoint biomarker testing be performed to provide management and prognostic information beyond that obtained from histologic analysis? RECOMMENDATION Level III: The current evidence does not support making PD-L1 or mismatch repair (MMR) enzyme activity a component of standard testing. QUESTION For adult patients with progressive glioblastoma are there meaningful biomarkers for bevacizumab responsiveness and does their assessment provide additional information for tumor management and prognosis beyond that learned by standard histologic analysis? RECOMMENDATION Level III: No established Bevacizumab biomarkers are currently available based upon the inclusion criteria of this guideline.
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Affiliation(s)
- Abigail L Goodman
- Carolinas Pathology, Atrium Health Carolinas Medical Center, Charlotte, NC, USA.
| | - José E Velázquez Vega
- Department of Pathology and Laboratory Medicine, Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA
| | - Chad Glenn
- Department of Neurosurgery, Stephenson Cancer Center, The University of Oklahoma, Oklahoma City, OK, USA
| | - Jeffrey J Olson
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA
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8
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Liu Q, Huang Q, Yu Z, Wu H. Clinical characteristics of non-small cell lung cancer patients with EGFR mutations and ALK&ROS1 fusions. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:216-225. [PMID: 35081265 PMCID: PMC9060101 DOI: 10.1111/crj.13472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/02/2021] [Accepted: 12/25/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To study the relationship between clinical characteristics and anaplastic lymphoma kinase (ALK) fusions, c-ros oncogene 1, receptor tyrosine kinase (ROS1) gene fusions, and epidermic growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) patients to distinguish these different types. METHODS Both ALK, ROS1 gene rearrangements and EGFR mutations testing were performed. The clinical characteristics and associated pulmonary abnormalities were investigated. RESULTS Four hundred fifty-three NSCLC patients were included for analysis. One hundred seventy (37.5%), 32 (7.1%), and 9 cases (2.0%) with EGFR mutations, ALK gene fusions, and ROS1 gene fusions were identified, respectively. The EGFR-positive and ALK&ROS1-positive were more common in female (χ2 = 61.934, P < 0.001 and χ2 = 28.152, P < 0.001), non-smoking (χ2 = 59.315, P < 0.001 and χ2 = 11.080, P = 0.001), and adenocarcinoma (χ2 = 44.864, P < 0.001 and χ2 = 12.318, P = 0.002) patients; proportion of patients with emphysema was lower (χ2 = 35.494, P < 0.001 and χ2 = 15.770, P < 0.001) than the wild-type patients. The results of logistic regression analysis indicated that female (adjusted odds ratio [OR] 1.834, 95% confidence interval [CI] 1.069-3.144, P = 0.028), non-smoking (adjusted OR 2.504, 95% CI 1.456-4.306, P = 0.001), lung adenocarcinoma (adjusted OR 4.512, 95% CI 2.465-8.260, P < 0.001), stage III-IV (adjusted OR 2.232, 95% CI 1.066-4.676, P = 0.033), and no symptoms of emphysema (adjusted OR 2.139, 95% CI 1.221-3.747, P = 0.008) were independent variables associated with EGFR mutations. Young (adjusted OR 3.947, 95% CI 1.873-8.314, P < 0.001) and lung adenocarcinoma (adjusted OR 2.950, 95% CI 0.998-8.719, P = 0.050) were associated with ALK/ROS1 fusions. CONCLUSIONS EGFR mutations were more likely to occur in non-smoking, stage III-IV, and female patients with lung adenocarcinoma, whereas ALK&ROS1 gene fusions were more likely to occur in young patients with lung adenocarcinoma. Emphysema was less common in patients with EGFR mutations.
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Affiliation(s)
- Qinghua Liu
- Center for Pathological Diagnostics, Meizhou People's Hospital (Huangtang Hospital)Meizhou Academy of Medical SciencesMeizhouP. R. China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital)Meizhou Academy of Medical SciencesMeizhouP. R. China
| | - Qingyan Huang
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital)Meizhou Academy of Medical SciencesMeizhouP. R. China
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital)Meizhou Academy of Medical SciencesMeizhouP. R. China
| | - Zhikang Yu
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital)Meizhou Academy of Medical SciencesMeizhouP. R. China
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital)Meizhou Academy of Medical SciencesMeizhouP. R. China
| | - Heming Wu
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital)Meizhou Academy of Medical SciencesMeizhouP. R. China
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital)Meizhou Academy of Medical SciencesMeizhouP. R. China
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9
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Sun R, Kim AH. The multifaceted mechanisms of malignant glioblastoma progression and clinical implications. Cancer Metastasis Rev 2022; 41:871-898. [PMID: 35920986 PMCID: PMC9758111 DOI: 10.1007/s10555-022-10051-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/20/2022] [Indexed: 02/06/2023]
Abstract
With the application of high throughput sequencing technologies at single-cell resolution, studies of the tumor microenvironment in glioblastoma, one of the most aggressive and invasive of all cancers, have revealed immense cellular and tissue heterogeneity. A unique extracellular scaffold system adapts to and supports progressive infiltration and migration of tumor cells, which is characterized by altered composition, effector delivery, and mechanical properties. The spatiotemporal interactions between malignant and immune cells generate an immunosuppressive microenvironment, contributing to the failure of effective anti-tumor immune attack. Among the heterogeneous tumor cell subpopulations of glioblastoma, glioma stem cells (GSCs), which exhibit tumorigenic properties and strong invasive capacity, are critical for tumor growth and are believed to contribute to therapeutic resistance and tumor recurrence. Here we discuss the role of extracellular matrix and immune cell populations, major components of the tumor ecosystem in glioblastoma, as well as signaling pathways that regulate GSC maintenance and invasion. We also highlight emerging advances in therapeutic targeting of these components.
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Affiliation(s)
- Rui Sun
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110 USA
| | - Albert H. Kim
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110 USA ,The Brain Tumor Center, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO 63110 USA
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10
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Zhou Z, Zheng X, Mei X, Li W, Qi S, Deng Y, Lei B. Hsa_circ_0080229 upregulates the expression of murine double minute-2 (MDM2) and promotes glioma tumorigenesis and invasion via the miR-1827 sponging mechanism. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:762. [PMID: 34268375 PMCID: PMC8246201 DOI: 10.21037/atm-20-7123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/21/2021] [Indexed: 12/17/2022]
Abstract
Background Glioma is the most common and fatal primary cranial tumor. The epidermal growth factor receptor (EGFR) plays an important role in the occurrence and treatment of glioma, which might function through a circular ribonucleic acid (circRNA)-related mechanism. Hsa_circ_0080229 (circ_0080229) has been identified as a circRNA arising from an EGFR gene in gliomas; however, little is known about its molecular mechanism to date. Methods To address this question, a series of experiments were conducted to confirm the effect of circ_0080229 in gliomas and identify the downstream mechanism. A quantitative real-time polymerase chain reaction (qRT-PCR) analysis and in-situ hybridization/fluorescence in-situ hybridization (ISH/FISH) testing were performed to identify the expression of circ_0080229 in patient samples. Bioinformatic analysis was carried out to explore the possible mechanism. Next, a series of in-vitro functional assays and in-vivo assays with a xenograft subcutaneous glioma model was carried out to confirm the effect of circ_0080229. Finally, qRT-PCR analysis and a Western Blot analysis were performed to verify the related mechanism. Results The expression of circ_0080229 was upregulated in both glioma tissues and cell lines related to unfavorable clinicopathologic characteristics. The expression of circ_0080229 was found to be inversely correlated with miR-1827, a micro-ribonucleic acid (miRNA) targeting murine double minute-2 (MDM2). The downregulation of circ_0080229 inhibited gliomas in vivo and suppressed U87 and U251 cell lines in vitro, which the transfection of the miR-1827 inhibitor could reverse. Concerning the mechanism, a block of circ_0080229 decreased MDM2 expression, while the inhibition of miR-1827 reversed this effect. Thus, circ_0080229 appears to target the downstream miR-1827/MDM2 signaling pathway. Conclusions Our results showed that the silencing of circ_0080229 upregulates the expression of miR-1827, which in turn resulted in the suppression of MDM2, and the mediation of the downstream P53 signaling pathway. Circ_0080229 exerted an effect in mediating tumor progression through the MDM2 signaling pathway by sponging miR-1827. Its importance as a potential prognostic biomarker in gliomas has thus been established.
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Affiliation(s)
- Zhiwei Zhou
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Faculty of Health Sciences, University of Macau, Taipa, Macau, China
| | - Xiuyuan Zheng
- Department of Rehabilitation Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xin Mei
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wengpeng Li
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Songtao Qi
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuefei Deng
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Bingxi Lei
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
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11
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Chagoya G, Kwatra SG, Nanni CW, Roberts CM, Phillips SM, Nullmeyergh S, Gilmore SP, Spasojevic I, Corcoran DL, Young CC, Ballman KV, Ramakrishna R, Cross DA, Markert JM, Lim M, Gilbert MR, Lesser GJ, Kwatra MM. Efficacy of osimertinib against EGFRvIII+ glioblastoma. Oncotarget 2020; 11:2074-2082. [PMID: 32547705 PMCID: PMC7275784 DOI: 10.18632/oncotarget.27599] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/27/2020] [Indexed: 11/25/2022] Open
Abstract
Epidermal Growth Factor Receptor variant III (EGFRvIII) is an active mutant form of EGFR that drives tumor growth in a subset of glioblastoma (GBM). It occurs in over 20% of GBMs, making it a promising receptor for small molecule targeted therapy. We hypothesize that poor penetration of the blood-brain barrier by previously tested EGFR-tyrosine kinase inhibitors (EGFR-TKIs) such as afateninb, erlotinib, gefitinib, and lapatinib played a role in their limited efficacy. The present study examined the effects of osimertinib (previously known as AZD9291) on EGFRvIII+ GBM models, both in vitro and in vivo. Therefore, a panel of six GBM stem cells (GSCs) expressing EGFRvIII+ was evaluated. The EGFRvIII+ GSC differed in the expression of EGFRvIII and other key genes. The GSC line D317, which expresses high levels of EGFRvIII and has robust tyrosine kinase activity, was selected for assessing osimertinib’s efficacy. Herein, we report that osimertinib inhibits the constitutive activity of EGFRvIII tyrosine kinase with high potency (<100 nM) while also inhibiting its downstream signaling. Further, osimertinib inhibited D317’s growth in vitro and in both heterotopic and orthotopic xenograft models. Additional preclinical studies are warranted to identify EGFRvIII+ GBM’s molecular signature most responsive to osimertinib.
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Affiliation(s)
- Gustavo Chagoya
- Department of Neurosurgery, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shawn G Kwatra
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cory W Nanni
- Departments of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Callie M Roberts
- Departments of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Samantha M Phillips
- Tri-Institutional MD-PhD Program, Weill Cornell Medical College, The Rockefeller University, Memorial Sloan Kettering Cancer Institute, New York, NY, USA
| | - Sarah Nullmeyergh
- Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, USA
| | - Samuel P Gilmore
- Departments of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Ivan Spasojevic
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - David L Corcoran
- Genomic and Computational Biology, Duke University Medical Center, Durham, NC, USA
| | - Christopher C Young
- Departments of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Karla V Ballman
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | | | - Darren A Cross
- IMED Oncology, Global Medical Affairs, AstraZeneca, Cambridge, UK
| | - James M Markert
- Department of Neurosurgery, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael Lim
- Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Glenn J Lesser
- Department of Internal Medicine, Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Madan M Kwatra
- Departments of Anesthesiology, Duke University Medical Center, Durham, NC, USA.,Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
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12
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Abstract
New discoveries in Glioblastoma (GBM) biology have been made using genomics data. Genomic markers are routinely integrated into clinical neurosurgical practice. In this manuscript, we review the fundamentals of genomics such as the differences between first, second, and third generation sequencing technology. We also review the impact of single cell genomics in understanding the complex heterogenous GBM microenvironment. Finally, we will discuss advances in epigenetics that have lent insights into treatment resistance. The integration of genomics into neuro-oncology clinical practice is routine and will continue to expand with the expansion of precision of medicine. We provide a primer for clinicians.
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Affiliation(s)
- John D Patterson
- Department of Neurological Surgery, University of Arkansas for Medical Sciences
| | | | - Analiz Rodriguez
- Department of Neurological Surgery, University of Arkansas for Medical Sciences
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13
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Ionizing radiation attracts tumor targeting and apoptosis by radiotropic lysyl oxidase traceable nanoparticles. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2019; 24:102141. [PMID: 31830613 DOI: 10.1016/j.nano.2019.102141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 10/23/2019] [Accepted: 11/29/2019] [Indexed: 02/05/2023]
Abstract
Lysyl oxidase (LOX) is a cell-secreted amine oxidase that crosslinks collagen and elastin in extracellular microenvironment. LOX-traceable nanoparticles (LOXab-NPs) consisting of LOX antibodies (LOXab) and paclitaxel, can accumulate at high concentrations at radiation-treated target sites, as a tumor-targeting drug carrier for chemotherapy. Tumor-targeting and anticancer effects of PLGA based LOXab-NPs in vitro and in vivo were evaluated at radiation-targeted site. In the in vivo A549 lung carcinoma xenograft model, we showed highly specific tumor targeting (above 7.0 times higher) of LOXab-NPs on irradiated tumors. Notably, systemically administered NPs delayed tumor growth, reducing tumor volumes by more than 2 times compared with non-irradiated groups (222% vs. >500%) over 2 weeks. Radiotropic LOXab-NPs can serve as chemotherapeutic vehicles for combined targeted chemo-radiotherapy in clinical oncology.
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14
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Christians A, Adel-Horowski A, Banan R, Lehmann U, Bartels S, Behling F, Barrantes-Freer A, Stadelmann C, Rohde V, Stockhammer F, Hartmann C. The prognostic role of IDH mutations in homogeneously treated patients with anaplastic astrocytomas and glioblastomas. Acta Neuropathol Commun 2019; 7:156. [PMID: 31623667 PMCID: PMC6798425 DOI: 10.1186/s40478-019-0817-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 09/23/2019] [Indexed: 12/25/2022] Open
Abstract
The detection of IDH mutations in patients with diffusely infiltrating malignant astrocytomas resulted in substantial modifications in the concept of WHO classification of these tumors. An important underlying observation was that patients with anaplastic astrocytomas (AA) without IDH mutation had a clinical course similar to that of patients with glioblastomas (GBM). The underlying observations of the German Glioma Network and NOA-04, however, were based on mixed patient cohorts. While most GBM patients received combined radiochemotherapy, patients with AA usually had radiotherapy or chemotherapy only. This intrinsic shortcoming of the study raised the question of whether patients with AA, IDH wildtype, WHO grade III, might have better prognosis if treated with combined radiochemotherapy than patients with GBM receiving the same combination therapy. Thus, the question remains whether the established histopathological grading criteria for malignant astrocytomas in the absence of an IDH mutation are still important if neither vascular proliferation nor necrosis are detectable. All patients in the cohort investigated here with the diagnosis of AA or GBM were subjected to a combined radiochemotherapy according to the Stupp protocol independently of the histopathological diagnosis. Thus, the analysis of these patients allows to clarify whether patients with AA, IDH wildtype, WHO grade III have a prognosis similar to that of GBM, IDH wildtype, WHO grade IV, even under equivalent therapeutic conditions. We determined the IDH1 and IDH2 status by sequencing, the MGMT status by pyrosequencing after bisulfite treatment and the EGFR status of the patients by FISH. In fact, the patients with the histopathological diagnosis of an AA IDH wild-type under similar aggressive therapy showed a comparable and therefore no better prognosis (median overall survival (mOS) 16 months) than patients with a GBM (mOS 13 months). Instead, patients with an AA and an IDH mutation receiving the same therapy had a mOS of 54 months. Thus, it can be concluded that in the absence of an IDH mutation, the established histopathological grading criteria 'necrosis' and 'vascular proliferation' actually lose their prognostic significance. If, on the other hand, patients with malignant astrocytomas and an IDH mutation are examined, there is still a difference between patients with necrosis and/or vascular proliferation and those whose tumors do not show such characteristics. Accordingly, in patients with malignant astrocytomas with IDH mutation it can be concluded that a histological differentiation between AA IDH mutated and GBM IDH mutated remains beneficial from a prognostic perspective.
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Affiliation(s)
- Arne Christians
- Department of Neuropathology, Institute of Pathology, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Antonia Adel-Horowski
- Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Rouzbeh Banan
- Department of Neuropathology, Institute of Pathology, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Stephan Bartels
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Felix Behling
- Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany
| | - Alonso Barrantes-Freer
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
- Department of Neuropathology, Institute of Pathology, University Medical Center Leipzig, Leipzig, Germany
| | - Christine Stadelmann
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - Veit Rohde
- Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
| | - Florian Stockhammer
- Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
- Department of Neurosurgery, Städtisches Klinikum Dresden, Dresden, Germany
| | - Christian Hartmann
- Department of Neuropathology, Institute of Pathology, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.
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15
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Molinaro AM, Phillips JJ. EGFR amplification status for clinical trial inclusion: where do we draw the line? Neuro Oncol 2019; 21:1215-1216. [PMID: 31504815 DOI: 10.1093/neuonc/noz146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Annette M Molinaro
- Departments of Neurological Surgery and Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Joanna J Phillips
- Departments of Neurological Surgery and Pathology, University of California, San Francisco, California
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16
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Ma Q, Long W, Xing C, Chu J, Luo M, Wang HY, Liu Q, Wang RF. Cancer Stem Cells and Immunosuppressive Microenvironment in Glioma. Front Immunol 2018; 9:2924. [PMID: 30619286 PMCID: PMC6308128 DOI: 10.3389/fimmu.2018.02924] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/28/2018] [Indexed: 12/22/2022] Open
Abstract
Glioma is one of the most common malignant tumors of the central nervous system and is characterized by extensive infiltrative growth, neovascularization, and resistance to various combined therapies. In addition to heterogenous populations of tumor cells, the glioma stem cells (GSCs) and other nontumor cells present in the glioma microenvironment serve as critical regulators of tumor progression and recurrence. In this review, we discuss the role of several resident or peripheral factors with distinct tumor-promoting features and their dynamic interactions in the development of glioma. Localized antitumor factors could be silenced or even converted to suppressive phenotypes, due to stemness-related cell reprogramming and immunosuppressive mediators in glioma-derived microenvironment. Furthermore, we summarize the latest knowledge on GSCs and key microenvironment components, and discuss the emerging immunotherapeutic strategies to cure this disease.
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Affiliation(s)
- Qianquan Ma
- Department of Neurosurgery in Xiangya Hospital, Central South University, Changsha, China.,Center for Inflammation and Epigenetics, Houston Methodist Research Institute, Houston, TX, United States
| | - Wenyong Long
- Department of Neurosurgery in Xiangya Hospital, Central South University, Changsha, China
| | - Changsheng Xing
- Center for Inflammation and Epigenetics, Houston Methodist Research Institute, Houston, TX, United States
| | - Junjun Chu
- Center for Inflammation and Epigenetics, Houston Methodist Research Institute, Houston, TX, United States
| | - Mei Luo
- Department of Neurosurgery in Xiangya Hospital, Central South University, Changsha, China.,Center for Inflammation and Epigenetics, Houston Methodist Research Institute, Houston, TX, United States
| | - Helen Y Wang
- Center for Inflammation and Epigenetics, Houston Methodist Research Institute, Houston, TX, United States
| | - Qing Liu
- Department of Neurosurgery in Xiangya Hospital, Central South University, Changsha, China
| | - Rong-Fu Wang
- Center for Inflammation and Epigenetics, Houston Methodist Research Institute, Houston, TX, United States.,Institute of Biosciences and Technology, College of Medicine, Texas A&M University, Houston, TX, United States.,Department of Microbiology and Immunology, Weill Cornell Medical College, Cornell University, New York, NY, United States
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17
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Dong F, Zeng Q, Jiang B, Yu X, Wang W, Xu J, Yu J, Li Q, Zhang M. Predicting epidermal growth factor receptor gene amplification status in glioblastoma multiforme by quantitative enhancement and necrosis features deriving from conventional magnetic resonance imaging. Medicine (Baltimore) 2018; 97:e10833. [PMID: 29794775 PMCID: PMC6392588 DOI: 10.1097/md.0000000000010833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To study whether some of the quantitative enhancement and necrosis features in preoperative conventional MRI (cMRI) had a predictive value for epidermal growth factor receptor (EGFR) gene amplification status in glioblastoma multiforme (GBM).Fifty-five patients with pathologically determined GBMs who underwent cMRI were retrospectively reviewed. The following cMRI features were quantitatively measured and recorded: long and short diameters of the enhanced portion (LDE and SDE), maximum and minimum thickness of the enhanced portion (MaxTE and MinTE), and long and short diameters of the necrotic portion (LDN and SDN). Univariate analysis of each feature and a decision tree model fed with all the features were performed. Area under the receiver operating characteristic (ROC) curve (AUC) was used to assess the performance of features, and predictive accuracy was used to assess the performance of the model.For single feature, MinTE showed the best performance in differentiating EGFR gene amplification negative (wild-type) (nEGFR) GBM from EGFR gene amplification positive (pEGFR) GBM, and it got an AUC of 0.68 with a cut-off value of 2.6 mm. The decision tree model included 2 features MinTE and SDN, and got an accuracy of 0.83 in validation dataset.Our results suggest that quantitative measurement of the features MinTE and SDN in preoperative cMRI had a high accuracy for predicting EGFR gene amplification status in GBM.
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Affiliation(s)
| | | | | | | | - Weiwei Wang
- Department of Pathology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
| | | | - Jinna Yu
- Department of Radiology, Shaoxing Second Hospital, Shaoxing, China
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18
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Ding Z, Roos A, Kloss J, Dhruv H, Peng S, Pirrotte P, Eschbacher JM, Tran NL, Loftus JC. A Novel Signaling Complex between TROY and EGFR Mediates Glioblastoma Cell Invasion. Mol Cancer Res 2017; 16:322-332. [PMID: 29117939 DOI: 10.1158/1541-7786.mcr-17-0454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 10/13/2017] [Accepted: 10/27/2017] [Indexed: 12/30/2022]
Abstract
Glioblastoma is the most frequent primary brain tumor in adults and a highly lethal malignancy with a median survival of about 15 months. The aggressive invasion of the surrounding normal brain makes complete surgical resection impossible, increases the resistance to radiation and chemotherapy, and assures tumor recurrence. Thus, there is an urgent need to develop innovative therapeutics to target the invasive tumor cells for improved treatment outcomes of this disease. Expression of TROY (TNFRSF19), a member of the tumor necrosis factor (TNF) receptor family, increases with increasing glial tumor grade and inversely correlates with patient survival. Increased expression of TROY stimulates glioblastoma cell invasion in vitro and in vivo and increases resistance to temozolomide and radiation therapy. Conversely, silencing TROY expression inhibits glioblastoma cell invasion, increases temozolomide sensitivity, and prolongs survival in an intracranial xenograft model. Here, a novel complex is identified between TROY and EGFR, which is mediated predominantly by the cysteine-rich CRD3 domain of TROY. Glioblastoma tumors with elevated TROY expression have a statistically positive correlation with increased EGFR expression. TROY expression significantly increases the capacity of EGF to stimulate glioblastoma cell invasion, whereas depletion of TROY expression blocks EGF stimulation of glioblastoma cell invasion. Mechanistically, TROY expression modulates EGFR signaling by facilitating EGFR activation and delaying EGFR receptor internalization. Moreover, the association of EGFR with TROY increases TROY-induced NF-κB activation. These findings substantiate a critical role for the TROY-EGFR complex in regulation of glioblastoma cell invasion.Implications: The TROY-EGFR signaling complex emerges as a potential therapeutic target to inhibit glioblastoma cell invasion. Mol Cancer Res; 16(2); 322-32. ©2017 AACR.
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Affiliation(s)
- Zonghui Ding
- Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Alison Roos
- Departments of Cancer Biology and Neurosurgery, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Jean Kloss
- Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Harshil Dhruv
- Cancer and Cell Biology Division, Translational Genomics Research Institute, Phoenix, Arizona
| | - Sen Peng
- Cancer and Cell Biology Division, Translational Genomics Research Institute, Phoenix, Arizona
| | - Patrick Pirrotte
- Cancer and Cell Biology Division, Translational Genomics Research Institute, Phoenix, Arizona.,Center for Proteomics, Translational Genomics Research Institute, Phoenix, Arizona
| | - Jennifer M Eschbacher
- Department of Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Nhan L Tran
- Departments of Cancer Biology and Neurosurgery, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Joseph C Loftus
- Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale, Arizona.
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19
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Khan AR, Liu M, Khan MW, Zhai G. Progress in brain targeting drug delivery system by nasal route. J Control Release 2017; 268:364-389. [PMID: 28887135 DOI: 10.1016/j.jconrel.2017.09.001] [Citation(s) in RCA: 233] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 12/13/2022]
Abstract
The blood-brain barrier (BBB) restricts the transport of potential therapeutic moieties to the brain. Direct targeting the brain via olfactory and trigeminal neural pathways by passing the BBB has gained an important consideration for delivery of wide range of therapeutics to brain. Intranasal route of transportation directly delivers the drugs to brain without systemic absorption, thus avoiding the side effects and enhancing the efficacy of neurotherapeutics. Over the last several decades, different drug delivery systems (DDSs) have been studied for targeting the brain by the nasal route. Novel DDSs such as nanoparticles (NPs), liposomes and polymeric micelles have gained potential as useful tools for targeting the brain without toxicity in nasal mucosa and central nervous system (CNS). Complex geometry of the nasal cavity presented a big challenge to effective delivery of drugs beyond the nasal valve. Recently, pharmaceutical firms utilized latest and emerging nasal drug delivery technologies to overcome these barriers. This review aims to describe the latest development of brain targeted DDSs via nasal administration. CHEMICAL COMPOUNDS STUDIED IN THIS ARTICLE Carbopol 934p (PubChem CID: 6581) Carboxy methylcellulose (PubChem CID: 24748) Penetratin (PubChem CID: 101111470) Poly lactic-co-glycolic acid (PubChem CID: 23111554) Tween 80 (PubChem CID: 5284448).
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Affiliation(s)
- Abdur Rauf Khan
- Department of Pharmaceutics, College of Pharmacy, Shandong University, 44 Wenhua Xilu, Jinan 250012, China
| | - Mengrui Liu
- Department of Pharmaceutics, College of Pharmacy, Shandong University, 44 Wenhua Xilu, Jinan 250012, China
| | - Muhammad Wasim Khan
- Department of Pharmaceutics, College of Pharmacy, Shandong University, 44 Wenhua Xilu, Jinan 250012, China
| | - Guangxi Zhai
- Department of Pharmaceutics, College of Pharmacy, Shandong University, 44 Wenhua Xilu, Jinan 250012, China.
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20
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Recombinant Immunotoxin Therapy of Glioblastoma: Smart Design, Key Findings, and Specific Challenges. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7929286. [PMID: 28752098 PMCID: PMC5511670 DOI: 10.1155/2017/7929286] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 05/29/2017] [Indexed: 12/23/2022]
Abstract
Recombinant immunotoxins (RITs) refer to a group of recombinant protein-based therapeutics, which consists of two components: an antibody variable fragment or a specific ligand that allows RITs to bind specifically to target cells and an engineered toxin fragment that kills the target cells upon internalization. To date, over 1,000 RITs have been generated and significant success has been achieved in the therapy of hematological malignancies. However, the immunogenicity and off-target toxicities of RITs remain as significant barriers for their application to solid tumor therapy. A group of RITs have also been generated for the treatment of glioblastoma multiforme, and some have demonstrated evidence of tumor response and an acceptable profile of toxicity and safety in early clinical trials. Different from other solid tumors, how to efficiently deliver the RITs to intracranial tumors is more critical and needs to be solved urgently. In this article, we first review the design and expression of RITs, then summarize the key findings in the preclinical and clinical development of RIT therapy of glioblastoma multiforme, and lastly discuss the specific issues that still remain to forward RIT therapy to clinical practice.
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21
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Abstract
Primary brain tumors, particularly glioblastoma, are associated with significant morbidity and are often recalcitrant to standard therapies. In recent years, brain tumors have been the focus of large-scale genomic sequencing efforts, providing unprecedented insight into the genomic aberrations and cellular signaling mechanisms that drive these cancers. Discoveries from these efforts have translated into novel diagnostic algorithms, biomarkers, and therapeutic strategies in Neuro-Oncology. However, the cellular mechanisms that drive brain tumors are heterogeneous and complex: applying this new knowledge to improve patient outcomes remains a challenge. Efforts to characterize and target these molecular vulnerabilities are evolving.
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Affiliation(s)
- Rebecca A Harrison
- Department of Neuro-Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX
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22
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Lan Q, Wang A, Cheng Y, Mukasa A, Ma J, Hong L, Yu S, Sun L, Huang Q, Purow B, Li M. Guanylate binding protein-1 mediates EGFRvIII and promotes glioblastoma growth in vivo but not in vitro. Oncotarget 2016; 7:9680-91. [PMID: 26848767 PMCID: PMC4891076 DOI: 10.18632/oncotarget.7109] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 01/22/2016] [Indexed: 12/24/2022] Open
Abstract
Glioblastoma multiforme (GBM) is the most common and deadly primary brain tumor in adults. Epidermal growth factor receptor (EGFR) is frequently amplified and mutated in GBM. We previously reported that Guanylate binding protein-1 (GBP1) is a novel transcriptional target gene of EGFR and plays a role in GBM invasion. Here we demonstrate that GBP1 can also be induced by EGFRvIII at the transcriptional level through the p38 MAPK/Yin Yang 1 (YY1) signaling pathway. Silencing of GBP1 by RNA interference significantly inhibits EGFRvIII-mediated GBM cell proliferation in vitro and in a mouse model. Overexpression of GBP1 has no obvious effect on glioblastoma cell proliferation in vitro. In contrast, in an orthotopic glioma mouse model GBP1 overexpression significantly promotes glioma growth and reduces survival rate of glioma-bearing mice by increasing cell proliferation and decreasing cell apoptosis in tumor. Clinically, GBP1 expression is elevated in human GBM tumors and positively correlates with EGFRvIII status in GBM specimens, and its expression is inversely correlated with the survival rate of GBM patients. Taken together, these results reveal that GBP1 may serve as a potential therapeutic target for GBMs with EGFRvIII mutation.
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Affiliation(s)
- Qing Lan
- Department of Neurosurgery, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Aidong Wang
- The Experimental Center, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Yanwei Cheng
- Department of Life Sciences, Luoyang Normal University, Luoyang, Henan Province, China
| | - Akitaki Mukasa
- Department of Neurosurgery, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Jiawei Ma
- Department of Neurosurgery, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Lei Hong
- The Experimental Center, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Shuye Yu
- The Experimental Center, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.,Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Lili Sun
- The Experimental Center, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Qiang Huang
- Department of Neurosurgery, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Benjamin Purow
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Ming Li
- The Experimental Center, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.,Department of Neurosurgery, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.,Department of Neurology, University of Virginia, Charlottesville, VA, USA
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23
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Reifenberger G, Wirsching HG, Knobbe-Thomsen CB, Weller M. Advances in the molecular genetics of gliomas - implications for classification and therapy. Nat Rev Clin Oncol 2016; 14:434-452. [PMID: 28031556 DOI: 10.1038/nrclinonc.2016.204] [Citation(s) in RCA: 455] [Impact Index Per Article: 50.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Genome-wide molecular-profiling studies have revealed the characteristic genetic alterations and epigenetic profiles associated with different types of gliomas. These molecular characteristics can be used to refine glioma classification, to improve prediction of patient outcomes, and to guide individualized treatment. Thus, the WHO Classification of Tumours of the Central Nervous System was revised in 2016 to incorporate molecular biomarkers - together with classic histological features - in an integrated diagnosis, in order to define distinct glioma entities as precisely as possible. This paradigm shift is markedly changing how glioma is diagnosed, and has important implications for future clinical trials and patient management in daily practice. Herein, we highlight the developments in our understanding of the molecular genetics of gliomas, and review the current landscape of clinically relevant molecular biomarkers for use in classification of the disease subtypes. Novel approaches to the genetic characterization of gliomas based on large-scale DNA-methylation profiling and next-generation sequencing are also discussed. In addition, we illustrate how advances in the molecular genetics of gliomas can promote the development and clinical translation of novel pathogenesis-based therapeutic approaches, thereby paving the way towards precision medicine in neuro-oncology.
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Affiliation(s)
- Guido Reifenberger
- Department of Neuropathology, Heinrich Heine University Düsseldorf, Moorenstrasse. 5, D-40225 Düsseldorf, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) Heidelberg, partner site Essen/Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany
| | - Hans-Georg Wirsching
- Department of Neurology and Brain Tumour Centre, Cancer Centre Zürich, University Hospital and University of Zürich, Frauenklinikstrasse 26, CH-8091 Zürich, Switzerland.,Human Biology Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, C3-111, PO Box 19024, Seattle, Washington 98109-1024, USA
| | - Christiane B Knobbe-Thomsen
- Department of Neuropathology, Heinrich Heine University Düsseldorf, Moorenstrasse. 5, D-40225 Düsseldorf, Germany
| | - Michael Weller
- Department of Neurology and Brain Tumour Centre, Cancer Centre Zürich, University Hospital and University of Zürich, Frauenklinikstrasse 26, CH-8091 Zürich, Switzerland
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24
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Fan X, Wang Y, Zhang C, Liu L, Yang S, Wang Y, Liu X, Qian Z, Fang S, Qiao H, Jiang T. ADAM9 Expression Is Associate with Glioma Tumor Grade and Histological Type, and Acts as a Prognostic Factor in Lower-Grade Gliomas. Int J Mol Sci 2016; 17:ijms17091276. [PMID: 27571068 PMCID: PMC5037653 DOI: 10.3390/ijms17091276] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/23/2016] [Accepted: 07/25/2016] [Indexed: 11/25/2022] Open
Abstract
The A disintegrin and metalloproteinase 9 (ADAM9) protein has been suggested to promote carcinoma invasion and appears to be overexpressed in various human cancers. However, its role has rarely been investigated in gliomas and, thus, in the current study we have evaluated ADAM9 expression in gliomas and examined the relevance of its expression in the prognosis of glioma patients. Clinical characteristics, RNA sequence data, and the case follow-ups were reviewed for 303 patients who had histological, confirmed gliomas. The ADAM9 expression between lower-grade glioma (LGG) and glioblastoma (GBM) patients was compared and its association with progression-free survival (PFS) and overall survival (OS) was assessed to evaluate its prognostic value. Our data suggested that GBM patients had significantly higher expression of ADAM9 in comparison to LGG patients (p < 0.001, t-test). In addition, among the LGG patients, aggressive astrocytic tumors displayed significantly higher ADAM9 expression than oligodendroglial tumors (p < 0.001, t-test). Moreover, high ADAM9 expression also correlated with poor clinical outcome (p < 0.001 and p < 0.001, log-rank test, for PFS and OS, respectively) in LGG patients. Further, multivariate analysis suggested ADAM9 expression to be an independent marker of poor survival (p = 0.002 and p = 0.003, for PFS and OS, respectively). These results suggest that ADAM9 mRNA expression is associated with tumor grade and histological type in gliomas and can serve as an independent prognostic factor, specifically in LGG patients.
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Affiliation(s)
- Xing Fan
- Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
| | - Yongheng Wang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
- Department of Neurosurgery, Qinhuangdao First Hospital, Qinhuangdao 066000, China.
| | - Chuanbao Zhang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
| | - Li Liu
- Department of Ophthalmology, Qinhuangdao First Hospital, Qinhuangdao 066000, China.
| | - Sen Yang
- Department of Radiotherapy, Qinhuangdao First Hospital, Qinhuangdao 066000, China.
| | - Yinyan Wang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing100050, China.
| | - Xing Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
| | - Zenghui Qian
- Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
| | - Shengyu Fang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
| | - Hui Qiao
- Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
| | - Tao Jiang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing100050, China.
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25
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Serkova NJ, Eckhardt SG. Metabolic Imaging to Assess Treatment Response to Cytotoxic and Cytostatic Agents. Front Oncol 2016; 6:152. [PMID: 27471678 PMCID: PMC4946377 DOI: 10.3389/fonc.2016.00152] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/07/2016] [Indexed: 12/24/2022] Open
Abstract
For several decades, cytotoxic chemotherapeutic agents were considered the basis of anticancer treatment for patients with metastatic tumors. A decrease in tumor burden, assessed by volumetric computed tomography and magnetic resonance imaging, according to the response evaluation criteria in solid tumors (RECIST), was considered as a radiological response to cytotoxic chemotherapies. In addition to RECIST-based dimensional measurements, a metabolic response to cytotoxic drugs can be assessed by positron emission tomography (PET) using (18)F-fluoro-thymidine (FLT) as a radioactive tracer for drug-disrupted DNA synthesis. The decreased (18)FLT-PET uptake is often seen concurrently with increased apparent diffusion coefficients by diffusion-weighted imaging due to chemotherapy-induced changes in tumor cellularity. Recently, the discovery of molecular origins of tumorogenesis led to the introduction of novel signal transduction inhibitors (STIs). STIs are targeted cytostatic agents; their effect is based on a specific biological inhibition with no immediate cell death. As such, tumor size is not anymore a sensitive end point for a treatment response to STIs; novel physiological imaging end points are desirable. For receptor tyrosine kinase inhibitors as well as modulators of the downstream signaling pathways, an almost immediate inhibition in glycolytic activity (the Warburg effect) and phospholipid turnover (the Kennedy pathway) has been seen by metabolic imaging in the first 24 h of treatment. The quantitative imaging end points by magnetic resonance spectroscopy and metabolic PET (including 18F-fluoro-deoxy-glucose, FDG, and total choline) provide an early treatment response to targeted STIs, before a reduction in tumor burden can be seen.
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Affiliation(s)
- Natalie J. Serkova
- Department of Anesthesiology, University of Colorado Comprehensive Cancer Center, Aurora, CO, USA
- Developmental Therapeutics Program, University of Colorado Comprehensive Cancer Center, Aurora, CO, USA
| | - S. Gail Eckhardt
- Developmental Therapeutics Program, University of Colorado Comprehensive Cancer Center, Aurora, CO, USA
- Division of Medical Oncology, Anschutz Medical Center, University of Colorado Denver, Aurora, CO, USA
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26
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Sharma N, Jha S. NLR-regulated pathways in cancer: opportunities and obstacles for therapeutic interventions. Cell Mol Life Sci 2016; 73:1741-64. [PMID: 26708292 PMCID: PMC11108278 DOI: 10.1007/s00018-015-2123-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/09/2015] [Accepted: 12/15/2015] [Indexed: 02/08/2023]
Abstract
NLRs (nucleotide-binding domain, leucine-rich repeat containing receptors) are pattern recognition receptors associated with immunity and inflammation in response to endogenous and exogenous pathogen and damage associated molecular patterns (PAMPs and DAMPs respectively). Dysregulated NLR function is associated with several diseases including cancers, metabolic diseases, autoimmune disorders and autoinflammatory syndromes. In the last decade, distinct cell and organ specific roles for NLRs have been identified however; their roles in cancer initiation, development and progression remain controversial. This review summarizes the emerging role of NLRs in cancer and their possible future as targets for cancer therapeutics.
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Affiliation(s)
- Nidhi Sharma
- Department of Biology, Indian Institute of Technology Jodhpur, Old Residency Road, Ratanada, Jodhpur, Rajasthan, 342011, India
| | - Sushmita Jha
- Department of Biology, Indian Institute of Technology Jodhpur, Old Residency Road, Ratanada, Jodhpur, Rajasthan, 342011, India.
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27
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Mock A, Warta R, Geisenberger C, Bischoff R, Schulte A, Lamszus K, Stadler V, Felgenhauer T, Schichor C, Schwartz C, Matschke J, Jungk C, Ahmadi R, Sahm F, Capper D, Glass R, Tonn JC, Westphal M, von Deimling A, Unterberg A, Bermejo JL, Herold-Mende C. Printed peptide arrays identify prognostic TNC serumantibodies in glioblastoma patients. Oncotarget 2016; 6:13579-90. [PMID: 25944688 PMCID: PMC4537035 DOI: 10.18632/oncotarget.3791] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/18/2015] [Indexed: 01/11/2023] Open
Abstract
Liquid biopsies come of age offering unexploited potential to monitor and react to tumor evolution. We developed a cost-effective assay to non-invasively determine the immune status of glioblastoma (GBM) patients. Employing newly developed printed peptide microarrays we assessed the B-cell response against tumor-associated antigens (TAAs) in 214 patients. Firstly, sera of long-term (36+ months, LTS, n=10) and short-term (6-10 months, STS, n=14) surviving patients were screened for prognostic antibodies against 1745 13-mer peptides covering known TAAs (TNC, EGFR, GLEA2, PHF3, FABP5, MAGEA3). Next, survival associations were investigated in two retrospective independent multicenter validation sets (n=61, n=129, all IDH1-wildtype). Reliability of measurements was tested using a second array technology (spotted arrays). LTS/STS screening analyses identified 106 differential antibody responses. Evaluating the Top30 peptides in validation set 1 revealed three prognostic peptides. Prediction of TNC peptide VCEDGFTGPDCAE was confirmed in a second set (p=0.043, HR=0.66 [0.44-0.99]) and was unrelated to TNC protein expression. Median signals of printed arrays correlated with pre-synthesized spotted microarrays (p<0.0002, R=0.33). Multiple survival analysis revealed independence of age, gender, KPI and MGMT status. We present a novel peptide microarray immune assay that identified increased anti-TNC VCEDGFTGPDCAE serum antibody titer as a promising non-invasive biomarker for prolonged survival.
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Affiliation(s)
- Andreas Mock
- Department of Neurosurgery, Experimental Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Rolf Warta
- Department of Neurosurgery, Experimental Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Christoph Geisenberger
- Department of Neurosurgery, Experimental Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Ralf Bischoff
- PEPperPRINT GmbH, Heidelberg, Germany.,Division of Functional Genome Analysis, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Alexander Schulte
- Department of Neurosurgery, Laboratory for Brain Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Lamszus
- Department of Neurosurgery, Laboratory for Brain Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Christian Schichor
- Department of Neurosurgery, Klinikum Grosshadern, Ludwigs-Maximilians-University, Munich, Germany
| | - Christoph Schwartz
- Department of Neurosurgery, Klinikum Grosshadern, Ludwigs-Maximilians-University, Munich, Germany
| | - Jakob Matschke
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Jungk
- Department of Neurosurgery, Experimental Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Rezvan Ahmadi
- Department of Neurosurgery, Experimental Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David Capper
- Department of Neuropathology, Institute of Pathology, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rainer Glass
- Department of Neurosurgery, Klinikum Grosshadern, Ludwigs-Maximilians-University, Munich, Germany
| | - Jörg-Christian Tonn
- Department of Neurosurgery, Klinikum Grosshadern, Ludwigs-Maximilians-University, Munich, Germany
| | - Manfred Westphal
- Department of Neurosurgery, Laboratory for Brain Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Institute of Pathology, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas Unterberg
- Department of Neurosurgery, Experimental Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Justo Lorenzo Bermejo
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.,Research Group Molecular Genetics of Breast Cancer, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Christel Herold-Mende
- Department of Neurosurgery, Experimental Neurosurgery, University of Heidelberg, Heidelberg, Germany
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28
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Zorzan M, Giordan E, Redaelli M, Caretta A, Mucignat-Caretta C. Molecular targets in glioblastoma. Future Oncol 2016; 11:1407-20. [PMID: 25952786 DOI: 10.2217/fon.15.22] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Glioblastoma is the most lethal brain tumor. The poor prognosis results from lack of defined tumor margins, critical location of the tumor mass and presence of chemo- and radio-resistant tumor stem cells. The current treatment for glioblastoma consists of neurosurgery, followed by radiotherapy and temozolomide chemotherapy. A better understanding of the role of molecular and genetic heterogeneity in glioblastoma pathogenesis allowed the design of novel targeted therapies. New targets include different key-role signaling molecules and specifically altered pathways. The new approaches include interference through small molecules or monoclonal antibodies and RNA-based strategies mediated by siRNA, antisense oligonucleotides and ribozymes. Most of these treatments are still being tested yet they stay as solid promises for a clinically relevant success.
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Affiliation(s)
- Maira Zorzan
- Department of Molecular Medicine, University of Padova, Padova, Italy
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29
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Hong Y, Shi Y, Shang C, Xue Y, Liu Y. Influence of far upstream element binding protein 1 gene on chemotherapy sensitivity in human U251 glioblastoma cells. Arch Med Sci 2016; 12:156-62. [PMID: 26925132 PMCID: PMC4754377 DOI: 10.5114/aoms.2016.57592] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 04/02/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The aim of this study was to determine the influence of the far upstream element binding protein 1 gene (FUBP1) on chemotherapy sensitivity in human U251 glioblastoma cells. MATERIAL AND METHODS Real-time polymerase chain reaction (PCR) was used to determine the expression of the FUBP1 gene in 43 cases of human brain gliomas. Western blot analysis was used to determine the inhibitory effect of RNA interference on FUBP1 gene expression. Methyl thiazolyl tetrazolium assay (MTT) and flow cytometry methods were used to determine the growth inhibitory rate and apoptosis rate of the U251 cells with FUBP1 silencing. The growth inhibitory rate and apoptosis rate were further determined after treatment of those U251 cells with cisplatin (DDP). RESULTS The expression of FUBP1 mRNA was up-regulated significantly in gliomas, 177.65% as much as in peri-cancerous tissues (p < 0.05). The expression of FUBP1 protein was inhibited significantly with siRNA-FUBP1 (p < 0.05). In FUBP1-silenced cells, the growth inhibitory rate increased from 1.4% to 29.5%, and the apoptosis rate increased from 2.68% to 5.84% (p < 0.05 for both). After treating with DDP at various concentrations (1, 3, 5 µg/ml), the growth inhibitory rate of FUBP1-silenced cells increased from 14.42%, 17.46% and 23.55% to 21.69%, 27.51% and 37.57%; the apoptosis rate increased from 8.85%, 14.37% and 18.21% to 13.25%, 18.46% and 26.52%. CONCLUSIONS The up-regulation of FUBP1 relates to the carcinogenesis of gliomas. FUBP1 silencing increases the growth inhibitory rate and apoptosis rate of the U251 cells, and enhances the chemotherapy sensitivity of U251 cells to DDP.
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Affiliation(s)
- Yang Hong
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Yu Shi
- Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Chao Shang
- Department of Neurobiology, China Medical University, Shenyang, China
| | - Yixue Xue
- Department of Neurobiology, China Medical University, Shenyang, China
| | - Yunhui Liu
- Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, China
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30
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Priyanka P, Arun AB, Ashwini P, Rekha PD. Functional and cell proliferative properties of an exopolysaccharide produced by Nitratireductor sp. PRIM-31. Int J Biol Macromol 2016; 85:400-4. [PMID: 26772917 DOI: 10.1016/j.ijbiomac.2015.12.091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 12/21/2015] [Accepted: 12/31/2015] [Indexed: 10/22/2022]
Abstract
Exopolysaccharides (EPS) produced by bacteria are important source of natural biomolecules with therapeutic applications. In this study EPS produced by a strain PRIM-31 isolated from seawater from south west coast of India identified by 16S rRNA gene sequencing as Nitratireductor sp. was investigated for its biotechnological applications. The isolate produced 650 mg L(-1) EPS under optimum growth conditions. The purified EPS contained 58.3% carbohydrates with 7.08% uronic acid containing sugars, functional groups such as sulfate (2.68%) and trace amounts of proteins (0.65%). Molecular weight of the EPS was 90 kDa and monosaccharide composition was arabinose, glucose, xylose, glucuronic acid and galactose (6.6: 3.5: 2.1: 1.3: 1). The EPS displayed antioxidant activity in terms of total antioxidant capacity, ferric reducing power, scavenging of DPPH (IC50 390 μg mL(-1)) and superoxide radicals (IC50 340 μg mL(-1)). Cell proliferative activity of the EPS was evidenced by significant improvement in human dermal fibroblast (HDF) proliferation compared to control. Further, significant improvement (41%) in HDF cell migration was observed in in vitro scratch assay with EPS treatment. The EPS also showed antiproliferative activity against glioblastoma cells with an IC50 of 234.04 μg mL(-1). These functional properties of the EPS prospect its biotechnological applications.
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Affiliation(s)
- P Priyanka
- Yenepoya Research Centre, Yenepoya University, Mangalore, India
| | - A B Arun
- Yenepoya Research Centre, Yenepoya University, Mangalore, India
| | - P Ashwini
- Yenepoya Research Centre, Yenepoya University, Mangalore, India
| | - P D Rekha
- Yenepoya Research Centre, Yenepoya University, Mangalore, India.
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31
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Abstract
Glioblastoma is the most common and aggressive primary brain tumor in adults. Defining histopathologic features are necrosis and endothelial proliferation, resulting in the assignment of grade IV, the highest grade in the World Health Organization (WHO) classification of brain tumors. The classic clinical term "secondary glioblastoma" refers to a minority of glioblastomas that evolve from previously diagnosed WHO grade II or grade III gliomas. Specific point mutations of the genes encoding isocitrate dehydrogenase (IDH) 1 or 2 appear to define molecularly these tumors that are associated with younger age and more favorable outcome; the vast majority of glioblastomas are IDH wild-type. Typical molecular changes in glioblastoma include mutations in genes regulating receptor tyrosine kinase (RTK)/rat sarcoma (RAS)/phosphoinositide 3-kinase (PI3K), p53, and retinoblastoma protein (RB) signaling. Standard treatment of glioblastoma includes surgery, radiotherapy, and alkylating chemotherapy. Promoter methylation of the gene encoding the DNA repair protein, O(6)-methylguanyl DNA methyltransferase (MGMT), predicts benefit from alkylating chemotherapy with temozolomide and guides choice of first-line treatment in elderly patients. Current developments focus on targeting the molecular characteristics that drive the malignant phenotype, including altered signal transduction and angiogenesis, and more recently, various approaches of immunotherapy.
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32
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Ali IU, Chen X. Penetrating the Blood-Brain Barrier: Promise of Novel Nanoplatforms and Delivery Vehicles. ACS NANO 2015; 9:9470-4. [PMID: 26406936 PMCID: PMC5226403 DOI: 10.1021/acsnano.5b05341] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Multifunctional nanoplatforms combining versatile therapeutic modalities with a variety of imaging options have the potential to diagnose, monitor, and treat brain diseases. The promise of nanotechnology can only be realized by the simultaneous development of innovative brain-targeting delivery vehicles capable of penetrating the blood-brain barrier without compromising its structural integrity.
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Miura T, Nagamune T, Kawahara M. Ligand-inducible dimeric antibody for selecting antibodies against a membrane protein based on mammalian cell proliferation. Biotechnol Bioeng 2015; 113:1113-23. [DOI: 10.1002/bit.25858] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 09/23/2015] [Accepted: 10/13/2015] [Indexed: 12/26/2022]
Affiliation(s)
- Tomohiro Miura
- Department of Bioengineering; Graduate School of Engineering, The University of Tokyo; Tokyo Japan
| | - Teruyuki Nagamune
- Department of Bioengineering; Graduate School of Engineering, The University of Tokyo; Tokyo Japan
- Department of Chemistry and Biotechnology; Graduate School of Engineering, The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku; Tokyo 113-8656 Japan
| | - Masahiro Kawahara
- Department of Chemistry and Biotechnology; Graduate School of Engineering, The University of Tokyo; 7-3-1 Hongo, Bunkyo-ku; Tokyo 113-8656 Japan
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Weller M, Wick W, Aldape K, Brada M, Berger M, Pfister SM, Nishikawa R, Rosenthal M, Wen PY, Stupp R, Reifenberger G. Glioma. Nat Rev Dis Primers 2015; 1:15017. [PMID: 27188790 DOI: 10.1038/nrdp.2015.17] [Citation(s) in RCA: 752] [Impact Index Per Article: 75.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gliomas are primary brain tumours that are thought to derive from neuroglial stem or progenitor cells. On the basis of their histological appearance, they have been traditionally classified as astrocytic, oligodendroglial or ependymal tumours and assigned WHO grades I-IV, which indicate different degrees of malignancy. Tremendous progress in genomic, transcriptomic and epigenetic profiling has resulted in new concepts of classifying and treating gliomas. Diffusely infiltrating gliomas in adults are now separated into three overarching tumour groups with distinct natural histories, responses to treatment and outcomes: isocitrate dehydrogenase (IDH)-mutant, 1p/19q co-deleted tumours with mostly oligodendroglial morphology that are associated with the best prognosis; IDH-mutant, 1p/19q non-co-deleted tumours with mostly astrocytic histology that are associated with intermediate outcome; and IDH wild-type, mostly higher WHO grade (III or IV) tumours that are associated with poor prognosis. Gliomas in children are molecularly distinct from those in adults, the majority being WHO grade I pilocytic astrocytomas characterized by circumscribed growth, favourable prognosis and frequent BRAF gene fusions or mutations. Ependymal tumours can be molecularly subdivided into distinct epigenetic subgroups according to location and prognosis. Although surgery, radiotherapy and alkylating agent chemotherapy are still the mainstay of treatment, individually tailored strategies based on tumour-intrinsic dominant signalling pathways and antigenic tumour profiles may ultimately improve outcome. For an illustrated summary of this Primer, visit: http://go.nature.com/TXY7Ri.
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Affiliation(s)
- Michael Weller
- Department of Neurology and Brain Tumor Center, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 26, CH-8091 Zurich, Switzerland
| | - Wolfgang Wick
- Neurology Clinic, University of Heidelberg and German Cancer Research Center, Heidelberg, Germany
| | - Ken Aldape
- Department of Pathology, University Health Network, Toronto, Ontario, Canada
| | - Michael Brada
- Department of Molecular and Clinical Cancer Medicine and Department of Radiation Oncology, University of Liverpool and Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Mitchell Berger
- Department of Neurological Surgery and Brain Tumor Research Center, University of California, San Francisco, California, USA
| | - Stefan M Pfister
- Division of Pediatric Neuro-Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Pediatric Haematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Ryo Nishikawa
- Department of Neuro-Oncology and Neurosurgery, Saitama Medical University, Saitama, Japan
| | - Mark Rosenthal
- Department of Medical Oncology, The Royal Melbourne Hospital, Victoria 3050, Australia
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts, USA
| | - Roger Stupp
- Department of Oncology and Brain Tumor Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Guido Reifenberger
- Department of Neuropathology, Heinrich Heine University Düsseldorf, and German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) Heidelberg, partner site Essen/Düsseldorf, Germany
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35
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Chantaravisoot N, Wongkongkathep P, Loo JA, Mischel PS, Tamanoi F. Significance of filamin A in mTORC2 function in glioblastoma. Mol Cancer 2015; 14:127. [PMID: 26134617 PMCID: PMC4489161 DOI: 10.1186/s12943-015-0396-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 06/02/2015] [Indexed: 01/10/2023] Open
Abstract
Background Glioblastoma multiforme (GBM) is one of the most highly metastatic cancers. GBM has been associated with a high level of the mechanistic target of rapamycin complex 2 (mTORC2) activity. We aimed to observe roles of mTORC2 in GBM cells especially on actin cytoskeleton reorganization, cell migration and invasion, and further determine new important players involved in the regulation of these cellular processes. Methods To further investigate the significance of mTORC2 in GBM, we treated GBM cells with PP242, an ATP-competitive inhibitor of mTOR, and used RICTOR siRNA to knock down mTORC2 activity. Effects on actin cytoskeleton, focal adhesion, migration, and invasion of GBM cells were examined. To gain insight into molecular basis of the mTORC2 effects on cellular cytoskeletal arrangement and motility/invasion, we affinity purified mTORC2 from GBM cells and identified proteins of interest by mass spectrometry. Characterization of the protein of interest was performed. Results In addition to the inhibition of mTORC2 activity, we demonstrated significant alteration of actin distribution as revealed by the use of phalloidin staining. Furthermore, vinculin staining was altered which suggests changes in focal adhesion. Inhibition of cell migration and invasion was observed with PP242. Two major proteins that are associated with this mTORC2 multiprotein complex were found. Mass spectrometry identified one of them as Filamin A (FLNA). Association of FLNA with RICTOR but not mTOR was demonstrated. Moreover, in vitro, purified mTORC2 can phosphorylate FLNA likewise its known substrate, AKT. In GBM cells, colocalization of FLNA with RICTOR was observed, and the overall amounts of FLNA protein as well as phosphorylated FLNA are high. Upon treatments of RICTOR siRNA or PP242, phosphorylated FLNA levels at the regulatory residue (Ser2152) decreased. This treatment also disrupted colocalization of Actin filaments and FLNA. Conclusions Our results support FLNA as a new downstream effector of mTORC2 controlling GBM cell motility. This new mTORC2-FLNA signaling pathway plays important roles in motility and invasion of glioblastoma cells. Electronic supplementary material The online version of this article (doi:10.1186/s12943-015-0396-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Naphat Chantaravisoot
- Department of Microbiology, Immunology & Molecular Genetics, University of California, Los Angeles, CA, 90095, USA
| | - Piriya Wongkongkathep
- Department of Chemistry and Biochemistry, University of California, Los Angeles, CA, 90095, USA
| | - Joseph A Loo
- Department of Chemistry and Biochemistry, University of California, Los Angeles, CA, 90095, USA.,Department of Biological Chemistry, University of California, Los Angeles, CA, 90095, USA.,UCLA/DOE Institute of Genomics and Proteomics, University of California, Los Angeles, CA, 90095, USA
| | - Paul S Mischel
- Ludwig Institute for Cancer research, University of California, San Diego, CA, 92093, USA
| | - Fuyuhiko Tamanoi
- Department of Microbiology, Immunology & Molecular Genetics, University of California, Los Angeles, CA, 90095, USA. .,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, 90095, USA.
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EGFR Amplification and Glioblastoma Stem-Like Cells. Stem Cells Int 2015; 2015:427518. [PMID: 26136784 PMCID: PMC4468289 DOI: 10.1155/2015/427518] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 05/21/2015] [Accepted: 05/25/2015] [Indexed: 02/07/2023] Open
Abstract
Glioblastoma (GBM), the most common malignant brain tumor in adults, contains a subpopulation of cells with a stem-like phenotype (GS-cells). GS-cells can be maintained in vitro using serum-free medium supplemented with epidermal growth factor, basic fibroblast growth factor-2, and heparin. However, this method does not conserve amplification of the Epidermal Growth Factor Receptor (EGFR) gene, which is present in over 50% of all newly diagnosed GBM cases. GS-cells with retained EGFR amplification could overcome the limitations of current in vitro model systems and contribute significantly to preclinical research on EGFR-targeted therapy. This review recapitulates recent methodological approaches to expand stem-like cells from GBM with different EGFR status in order to maintain EGFR-dependent intratumoral heterogeneity in vitro. Further, it will summarize the current knowledge about the impact of EGFR amplification and overexpression on the stem-like phenotype of GBM-derived GS-cells and different approaches to target the EGFR-dependent GS-cell compartment of GBM.
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Kiviniemi A, Gardberg M, Frantzén J, Parkkola R, Vuorinen V, Pesola M, Minn H. Serum levels of GFAP and EGFR in primary and recurrent high-grade gliomas: correlation to tumor volume, molecular markers, and progression-free survival. J Neurooncol 2015; 124:237-45. [PMID: 26033547 DOI: 10.1007/s11060-015-1829-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/25/2015] [Indexed: 11/28/2022]
Abstract
Our aim was to study the association of two potential serum biomarkers glial fibrillary acidic protein (GFAP) and epidermal growth factor receptor (EGFR) with prognostic markers such as IDH1 mutation, tumor burden, and survival in patients with high-grade gliomas (HGG). Additionally, our objective was to evaluate the potential of serum EGFR as a surrogate marker for EGFR status in the tumor. Pre-operative serum samples were prospectively collected from patients with primary (n = 17) or recurrent (n = 10) HGG. Serum GFAP and EGFR levels were determined by ELISA and studied for correlation with molecular markers including EGFR amplification, tumor volume in contrast-enhanced T1-weighted MRI, and progression-free survival (PFS). Pre-operative serum GFAP level of ≥0.014 ng/ml was 86 % sensitive and 85 % specific for the diagnosis of glioblastoma. High GFAP was related to the lack of IDH1 mutation (P = 0.016), high Ki67 proliferation index (P < 0.001), and poor PFS (HR 5.9, CI 1.2-29.9, P = 0.032). Serum GFAP correlated with enhancing tumor volume in primary (r = 0.64 P = 0.005), but also in recurrent HGGs (r = 0.76 P = 0.011). In contrast, serum EGFR levels did not differ between HGG patients and 13 healthy controls, and were not related to EGFR status in the tumor. We conclude that high serum GFAP associates with IDH1 mutation-negative HGG, and poor PFS. Correlation with tumor burden in recurrent HGG implicates the potential of serum GFAP for detection of tumor recurrence. Our results suggest that circulating EGFR is not derived from glioma cells and cannot be used as a marker for EGFR status in the tumor.
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Affiliation(s)
- Aida Kiviniemi
- Department of Radiology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
| | - Maria Gardberg
- Department of Pathology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Janek Frantzén
- Department of Neurosurgery, Turku University Hospital, Hämeentie 11, 20521, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Ville Vuorinen
- Department of Neurosurgery, Turku University Hospital, Hämeentie 11, 20521, Turku, Finland
| | - Marko Pesola
- Department of Radiology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Heikki Minn
- Department of Oncology and Radiotherapy, Turku University Hospital, Hämeentie 11, 20521, Turku, Finland
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Affiliation(s)
- Simone P Niclou
- NorLux Neuro-Oncology Laboratory, Department of Oncology, Luxembourg Institute of Health, Luxembourg and K.G. Jebsen Brain Tumor Research Center, Department of Biomedicine, University of Bergen, Norway
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39
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Khaksarian M, Mostafavi H, Soleimani M, Karimian SM, Ghahremani MH, Joghataee MT, Khorashadizadeh M, Aligholi H, Attari F, Hassanzadeh G. Regulation of connexin 43 and microRNA expression via β2-adrenoceptor signaling in 1321N1 astrocytoma cells. Mol Med Rep 2015; 12:1941-50. [PMID: 25873300 DOI: 10.3892/mmr.2015.3609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 12/12/2014] [Indexed: 11/06/2022] Open
Abstract
Connexin 43 (Cx43) is the main gap junction protein in astrocytes and exerts the same effects on growth inhibition in astrocytoma and glioma as microRNA-146a (miR-146a) in glioma. β2-adrenergic receptor (AR) signaling modulates Cx43 expression in myocytes via components downstream of protein kinase A (PKA) and exchange protein directly activated by cAMP (Epac). However, it remains to be elucidated how expression of Cx43 is modulated in astrocytes. In the present study, 1321N1 astrocytoma cells were treated with β2-AR signaling agents in order to evaluate the expression of Cx43 and miRNAs. RNA and protein were extracted from the cells for use in reverse transcription-quantitative polymerase chain reaction and western blot analysis, respectively. The results revealed that clenbuterol increased miR-146a level and upregulated Cx43 expression via cAMP/PKA at the mRNA and protein level. Pre-inhibition of adenyl cyclase decreased expression of Cx43 and miR-146a. PKA activation and overexpression of miR-146a in A-1321N1 cells increased the expression of Cx43. β2-AR stimulation and 6Bnz, a PKA activator, suppressed oncomiRs miR-155 and miR-27a, while 8-(4-chlorophenylthio)-2'-O-methyladenosine-3',5'-cyclic monophosphate, an Epac activator, increased their levels. The current findings demonstrated that β2-AR signaling has growth inhibitory effects via modulation of the cAMP/PKA pathway in A-1321N1 cells through increasing the expression level of Cx43 and miR-146a as well as decreasing miR-155 and miR-27a levels. Thus, stimulation of the β2-AR and PKA signaling pathway may be a useful approach for astrocytoma therapy.
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Affiliation(s)
- Mojtaba Khaksarian
- Department of Physiology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad 6814993165, Iran
| | - Hossein Mostafavi
- Department of Molecular Biology and Genetic Engineering, Stem Cell Technology Research Center, Tehran 1997775555, Iran
| | - Masoud Soleimani
- Department of Molecular Biology and Genetic Engineering, Stem Cell Technology Research Center, Tehran 1997775555, Iran
| | - Seid Morteza Karimian
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran
| | - Mohammad Hassan Ghahremani
- Department of Molecular Medicine, School of Advanced Medical Technologies, Tehran University of Medical Sciences, Tehran 1417743371, Iran
| | - Mohammad Taghee Joghataee
- Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran 1417755469, Iran
| | - Mohsen Khorashadizadeh
- Department of Medical Biotechnologies, School of Advanced Medical Technologies, Tehran University of Medical Sciences, Tehran 1417743371, Iran
| | - Hadi Aligholi
- Department of Neuroscience, School of Advanced Medical Technologies, Tehran University of Medical Sciences, Tehran 1417743371, Iran
| | - Fatemeh Attari
- Department of Neuroscience, School of Advanced Medical Technologies, Tehran University of Medical Sciences, Tehran 1417743371, Iran
| | - Gholamreza Hassanzadeh
- Department of Neuroscience, School of Advanced Medical Technologies, Tehran University of Medical Sciences, Tehran 1417743371, Iran
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Grant R, Kolb L, Moliterno J. Molecular and genetic pathways in gliomas: the future of personalized therapeutics. CNS Oncol 2015; 3:123-36. [PMID: 25055018 DOI: 10.2217/cns.14.7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In the last few decades, we have seen significant advances in brain imaging, which have resulted in more detailed anatomic and functional localization of gliomas in relation to the eloquent cortex, as well as improvements in microsurgical techniques and enhanced delivery of adjuvant stereotactic radiation. While these advancements have led to a relatively modest improvement in clinical outcomes for patients with malignant gliomas, much more work remains to be done. As with other types of cancer, we are now rapidly moving past the era of histopathology dictating treatment for brain tumors and into the realm of molecular diagnostics and associated targeted therapies, specifically based on the genomic architecture of individual gliomas. In this review, we discuss the current era of molecular glioma characterization and how these profiles will allow for individualized, patient-specific targeted treatments.
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Affiliation(s)
- Ryan Grant
- Department of Neurosurgery, Yale University School of Medicine, Yale-New Haven Hospital, 333 Cedar Street, TMP4, New Haven, CT 06510, USA
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41
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Broome AM, Ramamurthy G, Lavik K, Liggett A, Kinstlinger I, Basilion J. Optical imaging of targeted β-galactosidase in brain tumors to detect EGFR levels. Bioconjug Chem 2015; 26:660-8. [PMID: 25775241 DOI: 10.1021/bc500597y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A current limitation in molecular imaging is that it often requires genetic manipulation of cancer cells for noninvasive imaging. Other methods to detect tumor cells in vivo using exogenously delivered and functionally active reporters, such as β-gal, are required. We report the development of a platform system for linking β-gal to any number of different ligands or antibodies for in vivo targeting to tissue or cells, without the requirement for genetic engineering of the target cells prior to imaging. Our studies demonstrate significant uptake in vitro and in vivo of an EGFR-targeted β-gal complex. We were then able to image orthotopic brain tumor accumulation and localization of the targeted enzyme when a fluorophore was added to the complex, as well as validate the internalization of the intravenously administered β-gal reporter complex ex vivo. After fluorescence imaging localized the β-gal complexes to the brain tumor, we topically applied a bioluminescent β-gal substrate to serial sections of the brain to evaluate the delivery and integrity of the enzyme. Finally, robust bioluminescence of the EGFR-targeted β-gal complex was captured within the tumor during noninvasive in vivo imaging.
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Affiliation(s)
- Ann-Marie Broome
- †Department of Radiology and Radiological Sciences, ‡Center of Biomedical Imaging, and §Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, United States.,∥Department of Biomedical Engineering, ⊥Case Center for Imaging Research, and #The NFCR Center for Molecular Imaging, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Gopal Ramamurthy
- †Department of Radiology and Radiological Sciences, ‡Center of Biomedical Imaging, and §Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, United States.,∥Department of Biomedical Engineering, ⊥Case Center for Imaging Research, and #The NFCR Center for Molecular Imaging, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Kari Lavik
- †Department of Radiology and Radiological Sciences, ‡Center of Biomedical Imaging, and §Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, United States.,∥Department of Biomedical Engineering, ⊥Case Center for Imaging Research, and #The NFCR Center for Molecular Imaging, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Alexander Liggett
- †Department of Radiology and Radiological Sciences, ‡Center of Biomedical Imaging, and §Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, United States.,∥Department of Biomedical Engineering, ⊥Case Center for Imaging Research, and #The NFCR Center for Molecular Imaging, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Ian Kinstlinger
- †Department of Radiology and Radiological Sciences, ‡Center of Biomedical Imaging, and §Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, United States.,∥Department of Biomedical Engineering, ⊥Case Center for Imaging Research, and #The NFCR Center for Molecular Imaging, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - James Basilion
- †Department of Radiology and Radiological Sciences, ‡Center of Biomedical Imaging, and §Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, United States.,∥Department of Biomedical Engineering, ⊥Case Center for Imaging Research, and #The NFCR Center for Molecular Imaging, Case Western Reserve University, Cleveland, Ohio 44106, United States
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Parker NR, Khong P, Parkinson JF, Howell VM, Wheeler HR. Molecular heterogeneity in glioblastoma: potential clinical implications. Front Oncol 2015; 5:55. [PMID: 25785247 PMCID: PMC4347445 DOI: 10.3389/fonc.2015.00055] [Citation(s) in RCA: 185] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 02/18/2015] [Indexed: 01/08/2023] Open
Abstract
Glioblastomas, (grade 4 astrocytomas), are aggressive primary brain tumors characterized by histopathological heterogeneity. High-resolution sequencing technologies have shown that these tumors also feature significant inter-tumoral molecular heterogeneity. Molecular subtyping of these tumors has revealed several predictive and prognostic biomarkers. However, intra-tumoral heterogeneity may undermine the use of single biopsy analysis for determining tumor genotype and has implications for potential targeted therapies. The clinical relevance and theories of tumoral molecular heterogeneity in glioblastoma are discussed.
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Affiliation(s)
- Nicole Renee Parker
- Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney , St Leonards, NSW , Australia
| | - Peter Khong
- Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney , St Leonards, NSW , Australia
| | - Jonathon Fergus Parkinson
- Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney , St Leonards, NSW , Australia ; Department of Neurosurgery, Royal North Shore Hospital , St Leonards, NSW , Australia
| | - Viive Maarika Howell
- Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney , St Leonards, NSW , Australia
| | - Helen Ruth Wheeler
- Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney , St Leonards, NSW , Australia ; Department of Medical Oncology, Royal North Shore Hospital , St Leonards, NSW , Australia
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Westphal M, Heese O, Steinbach JP, Schnell O, Schackert G, Mehdorn M, Schulz D, Simon M, Schlegel U, Senft C, Geletneky K, Braun C, Hartung JG, Reuter D, Metz MW, Bach F, Pietsch T. A randomised, open label phase III trial with nimotuzumab, an anti-epidermal growth factor receptor monoclonal antibody in the treatment of newly diagnosed adult glioblastoma. Eur J Cancer 2015; 51:522-532. [PMID: 25616647 DOI: 10.1016/j.ejca.2014.12.019] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/11/2014] [Accepted: 12/20/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE A randomised, open label phase III trial was conducted to evaluate efficacy of nimotuzumab, a monoclonal antibody against epidermal growth factor receptor (EGF-R) added to standard therapy for newly diagnosed glioblastoma. PATIENTS AND METHODS 149 glioblastoma patients stratified as with or without residual tumour were randomly assigned to receive either intravenous nimotuzumab 400mg weekly added to standard radiochemotherapy followed by 400mg biweekly after twelve weeks or standard radiochemotherapy. Progression status after 52 weeks (12moPFS) and progression-free survival (PFS) based on Macdonald criteria were co-primary and overall survival (OS), toxicity and quality of life secondary end-points. RESULTS 142 patients were evaluated for efficacy (per protocol cohort). 12 moPFS was 25.6% in the experimental arm and 20.3% in the control group. In residual tumour patients (n=81) median PFS was 5.6 versus 4.0 months, (hazard ratio (HR), 0.87; 95% confidence interval (CI), 0.55-1.37), for patients without residual tumour (n=61) it was 10.6 versus 9.9 months, (HR, 1.01; 95% CI, 0.57-1.77). Median OS in patients with residual tumour was 19.5 versus 16.7 months, (HR, 0.90; 95% CI, 0.52-1.57; P=0.7061), for patients without 23.3 versus 21.0 months (HR, 0.77; 95% CI, 0.41-1.44; P=0.4068). A small cohort of MGMT non-methylated patients with residual tumour showed PFS of 6.2 versus 4.0 months (HR, 0.77; 95% CI, 0.35-1.67; P=0.4997) and OS of 19.0 versus 13.8 months (HR, 0.66; 95% CI, 0.27-1.64; P=0.3648). EGF-R amplification did not correlate with clinical efficacy of nimotuzumab. Nimotuzumab was well tolerated. CONCLUSION This study, albeit negative, contains hypothesis generating signals supporting evaluation of correlative, efficacy-predicting tumour parameters for nimotuzumab in the treatment of glioblastoma.
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Affiliation(s)
- Manfred Westphal
- Department of Neurosurgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
| | - Oliver Heese
- Department of Neurosurgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
| | - Joachim P Steinbach
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany.
| | - Oliver Schnell
- Department of Neurosurgery, Ludwig Maximilian University München-Grosshadern, Marchioninistrasse 15, 81377 München, Germany.
| | - Gabriele Schackert
- Department of Neurosurgery, Carus University Dresden, Fetscherstrasse 74, 01307 Dresden, Germany.
| | - Maximilian Mehdorn
- Department of Neurosurgery, Christian Albrecht Universität Kiel, Schittenhelmstrasse 10, 24106 Kiel, Germany.
| | - Dirk Schulz
- Department of Neurosurgery, Justus Liebig University Giessen, Klinikstrasse 33, 35392 Gießen, Germany.
| | - Matthias Simon
- Department of Neurosurgery, University Hospital Bonn, Sigmund-Freud Strasse 25, 53105 Bonn, Germany.
| | - Uwe Schlegel
- Department of Neurology, Ruhr Universität Bochum, In der Schornau 23-25, 44892 Bochum, Germany.
| | - Christian Senft
- Department of Neurosurgery, University Hospital Frankfurt, Schleusenweg 2-16 (Haus 95), 60528 Frankfurt am Main, Germany.
| | - Karsten Geletneky
- Department of Neurosurgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
| | - Christian Braun
- Department of Neurology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany.
| | - Joachim G Hartung
- Universität Dortmund, Fachbereich Statistik, 44221 Dortmund, Germany.
| | - Dirk Reuter
- Oncoscience AG, Wedel, Hafenstrasse 32, 22880 Wedel, Germany.
| | - Monika Warmuth Metz
- Department of Neuroradiology, University Hospital Würzburg, Josef-Schneiderstrasse 11, 97080 Würzburg, Germany.
| | - Ferdinand Bach
- Oncoscience AG, Wedel, Hafenstrasse 32, 22880 Wedel, Germany.
| | - Torsten Pietsch
- Institute for Neuropathology, University Hospital Bonn, Sigmund-Freud Strasse 25, 53105 Bonn, Germany.
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Zhang J, Zhou Q, Gao G, Wang Y, Fang Z, Li G, Yu M, Kong L, Xing Y, Gao X. The effects of ponatinib, a multi-targeted tyrosine kinase inhibitor, against human U87 malignant glioblastoma cells. Onco Targets Ther 2014; 7:2013-9. [PMID: 25378936 PMCID: PMC4218911 DOI: 10.2147/ott.s67556] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Glioblastoma is one of the most common malignant tumors in the nervous system in both adult and pediatric patients. Studies suggest that abnormal activation of receptor tyrosine kinases contributes to pathological development of glioblastoma. However, current therapies targeting tyrosine kinase receptors have poor therapeutic outcomes. Here, we examined anticancer effects of ponatinib, a multi-targeted tyrosine kinase inhibitor, on glioblastoma cells both in the U87MG cell line and in the mouse xenograft model. We showed that ponatinib treatment reduced cell viability and induced cell apoptosis in a dose-dependent manner in U87MG cells. In addition, ponatinib suppressed migration and invasion of U87MG cells effectively. Furthermore, ponatinib-treated tumors showed an obvious reduction of tumor volume and an increase of apoptosis as compared with vehicle-treated tumors in the mouse xenograft model. These findings support a potential application of ponatinib as a chemotherapeutic option against glioblastoma cells.
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Affiliation(s)
- Junxia Zhang
- Department of Anatomy, Basic Medical College, Zhengzhou University, Henan, People's Republic of China
| | - Qiang Zhou
- Department of Pathology, Children's Hospital of Zhengzhou City, Henan, People's Republic of China
| | - Ge Gao
- Department of Physiology, Basic Medical College, Zhengzhou University, Henan, People's Republic of China
| | - Yanfen Wang
- Department of Anatomy, Basic Medical College, Zhengzhou University, Henan, People's Republic of China
| | - Zhihui Fang
- Department of Anatomy, Basic Medical College, Zhengzhou University, Henan, People's Republic of China
| | - Guanlin Li
- Department of Laboratory, The First Affiliated Hospital of Zhengzhou University, Henan, People's Republic of China
| | - Mengfei Yu
- Department of Pharmacy, Zhengzhou Central Hospital, Zhengzhou University, Henan, People's Republic of China
| | - Lingfei Kong
- Department of Pathology, Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Ying Xing
- Department of Physiology, Basic Medical College, Zhengzhou University, Henan, People's Republic of China
| | - Xiaoqun Gao
- Department of Anatomy, Basic Medical College, Zhengzhou University, Henan, People's Republic of China
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Paye A, Truong A, Yip C, Cimino J, Blacher S, Munaut C, Cataldo D, Foidart JM, Maquoi E, Collignon J, Delvenne P, Jerusalem G, Noel A, Sounni NE. EGFR Activation and Signaling in Cancer Cells Are Enhanced by the Membrane-Bound Metalloprotease MT4-MMP. Cancer Res 2014; 74:6758-70. [DOI: 10.1158/0008-5472.can-13-2994] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bleeker FE, Lamba S, Zanon C, Molenaar RJ, Hulsebos TJM, Troost D, van Tilborg AA, Vandertop WP, Leenstra S, van Noorden CJF, Bardelli A. Mutational profiling of kinases in glioblastoma. BMC Cancer 2014; 14:718. [PMID: 25256166 PMCID: PMC4192443 DOI: 10.1186/1471-2407-14-718] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 09/17/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Glioblastoma is a highly malignant brain tumor for which no cure is available. To identify new therapeutic targets, we performed a mutation analysis of kinase genes in glioblastoma. METHODS Database mining and a literature search identified 76 kinases that have been found to be mutated at least twice in multiple cancer types before. Among those we selected 34 kinase genes for mutation analysis. We also included IDH1, IDH2, PTEN, TP53 and NRAS, genes that are known to be mutated at considerable frequencies in glioblastoma. In total, 174 exons of 39 genes in 113 glioblastoma samples from 109 patients and 16 high-grade glioma (HGG) cell lines were sequenced. RESULTS Our mutation analysis led to the identification of 148 non-synonymous somatic mutations, of which 25 have not been reported before in glioblastoma. Somatic mutations were found in TP53, PTEN, IDH1, PIK3CA, EGFR, BRAF, EPHA3, NRAS, TGFBR2, FLT3 and RPS6KC1. Mapping the mutated genes into known signaling pathways revealed that the large majority of them plays a central role in the PI3K-AKT pathway. CONCLUSIONS The knowledge that at least 50% of glioblastoma tumors display mutational activation of the PI3K-AKT pathway should offer new opportunities for the rational development of therapeutic approaches for glioblastomas. However, due to the development of resistance mechanisms, kinase inhibition studies targeting the PI3K-AKT pathway for relapsing glioblastoma have mostly failed thus far. Other therapies should be investigated, targeting early events in gliomagenesis that involve both kinases and non-kinases.
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Affiliation(s)
- Fonnet E Bleeker
- />Department of Oncology, University of Torino, SP 142, Km 3.95, Candiolo, Torino, 10060, Italy, Candiolo Cancer Institute – FPO, IRCCS, Candiolo, Torino, Italy
- />Neurosurgical Center Amsterdam, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- />Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Simona Lamba
- />Department of Oncology, University of Torino, SP 142, Km 3.95, Candiolo, Torino, 10060, Italy, Candiolo Cancer Institute – FPO, IRCCS, Candiolo, Torino, Italy
| | - Carlo Zanon
- />Department of Oncology, University of Torino, SP 142, Km 3.95, Candiolo, Torino, 10060, Italy, Candiolo Cancer Institute – FPO, IRCCS, Candiolo, Torino, Italy
- />Neuroblastoma Laboratory, Pediatric Research Institute, Fondazione Città della Speranza, Corso Stati Uniti 4, 35127 Padua, Italy
| | - Remco J Molenaar
- />Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Theo JM Hulsebos
- />Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Dirk Troost
- />Department of Neuropathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Angela A van Tilborg
- />Department of Neuropathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- />Department of Pathology, UMC St. Radboud, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - W Peter Vandertop
- />Neurosurgical Center Amsterdam, Location Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- />Neurosurgical Center Amsterdam, Location Vrije Universiteit Medical Center, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Sieger Leenstra
- />Department of Neurosurgery, St. Elisabeth Ziekenhuis, Hilvarenbeekse Weg 60, 5022 GC Tilburg, The Netherlands
- />Department of Neurosurgery, Erasmus Medical Center, ’s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Cornelis JF van Noorden
- />Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Alberto Bardelli
- />Department of Oncology, University of Torino, SP 142, Km 3.95, Candiolo, Torino, 10060, Italy, Candiolo Cancer Institute – FPO, IRCCS, Candiolo, Torino, Italy
- />FIRC Institute of Molecular Oncology, Via Adamello 16, 20139 Milan, Italy
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Wang Y, Fan X, Zhang C, Zhang T, Peng X, Qian T, Ma J, Wang L, Li S, Jiang T. Identifying radiographic specificity for phosphatase and tensin homolog and epidermal growth factor receptor changes: a quantitative analysis of glioblastomas. Neuroradiology 2014; 56:1113-20. [PMID: 25228449 DOI: 10.1007/s00234-014-1427-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/01/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Phosphatase and tensin homolog (PTEN) loss and epidermal growth factor receptor (EGFR) amplification are common genetic alterations in malignant gliomas. This study aimed to investigate the anatomical relationship of tumor-related PTEN and EGFR expression in 140 patients with histologically confirmed de novo glioblastoma. METHODS Preoperative magnetic resonance images were retrospectively analyzed. The lesions of each patient were segmented manually and registered to a standard brain space. Overlaying of the lesions was performed, and specific brain regions associated with PTEN loss and EGFR amplification were identified by voxel-based lesion-symptom mapping analyses. RESULTS A cluster located in the right frontal lobe was found to be associated with high occurrence of PTEN loss, whereas a cluster in the right parietal lobe was demonstrated to be specifically associated with high occurrence of EGFR amplification. An overlap of the two clusters was observed at the posterior portion of the right parietal lobe. CONCLUSIONS Based on voxel-based imaging analyses, our results suggest that genetic changes during the tumorigenic process may have anatomical specificity. We hope that this identified correlation between these biomarkers and the anatomical distribution of glioblastomas will help enhance our understanding of the molecular mechanisms underlying glioblastoma development and progression.
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Affiliation(s)
- Yinyan Wang
- Beijing Neurosurgical Institute, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China
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Zahonero C, Sánchez-Gómez P. EGFR-dependent mechanisms in glioblastoma: towards a better therapeutic strategy. Cell Mol Life Sci 2014; 71:3465-88. [PMID: 24671641 PMCID: PMC11113227 DOI: 10.1007/s00018-014-1608-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 02/06/2014] [Accepted: 03/11/2014] [Indexed: 12/11/2022]
Abstract
Glioblastoma is a particularly resilient cancer, and while therapies may be able to reach the brain by crossing the blood-brain barrier, they then have to deal with a highly invasive tumor that is very resistant to DNA damage. It seems clear that in order to kill aggressive glioma cells more efficiently and with fewer side effects on normal tissue, there must be a shift from classical cytotoxic chemotherapy to more targeted therapies. Since the epidermal growth factor receptor (EGFR) is altered in almost 50% of glioblastomas, it currently represents one of the most promising therapeutic targets. In fact, it has been associated with several distinct steps in tumorigenesis, from tumor initiation to tumor growth and survival, and also with the regulation of cell migration and angiogenesis. However, inhibitors of the EGFR kinase have produced poor results with this type of cancer in clinical trials, with no clear explanation for the tumor resistance observed. Here we will review what we know about the expression and function of EGFR in cancer and in particular in gliomas. We will also evaluate which are the possible molecular and cellular escape mechanisms. As a result, we hope that this review will help improve the design of future EGFR-targeted therapies for glioblastomas.
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Affiliation(s)
- Cristina Zahonero
- Neuro-Oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain
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49
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Faulkner C, Palmer A, Williams H, Wragg C, Haynes HR, White P, DeSouza RM, Williams M, Hopkins K, Kurian KM. EGFR and EGFRvIII analysis in glioblastoma as therapeutic biomarkers. Br J Neurosurg 2014; 29:23-29. [PMID: 25141189 DOI: 10.3109/02688697.2014.950631] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION EGFR and EGFRvIII analysis is of current interest because of new EGFRvIII vaccine trials opened in the UK. EGFR activation promotes cellular proliferation via activation of MAPK and PI3K-Akt pathways. EGFRvIII is the most common variant resulting from an in-frame deletion of 801bp, leading to constitutively active EGFR. METHOD 51 glioblastoma samples from a cohort of 50 patients were tested for EGFR amplification by FISH and immunohistochemistry and EGFRvIII expression by reverse-transcriptase PCR (RT-PCR), and immunohistochemistry. EGFR and EGFRvIII expression was compared with Overall Survival in the cohort. RESULTS Overall 22/51 samples (43%) were positive for EGFR, 16/51 (31%) were positive for EGFRvIII and 13/51 (25%) were positive for both. 9/51 cases (18%) were positive for EGFR alone, and 3/51 (6%) were positive for EGFRvIII alone. Of the EGFR positive cases, 22/51 (43%) were positive by FISH, 24/51 (47%) were positive by IHC and 2/51 (4%) were discrepant between methods (positive by IHC but non-amplified by FISH). Of the EGFRvIII positive cases, 16/51 (31%) were positive by RT-PCR, 17/51 (33%) were positive by IHC and 1/51 (2%) sample was discrepant (positive by IHC but not by RT-PCR). Neither EGFRvIII or EGFR are predictive of overall survival in this cohort. CONCLUSION In our cohort, 25/51 (49%) of GBM showed EGFR alterations, including 16/51 (31%) with EGFRvIII. There was high concordance between IHC and FISH (96%) and IHC and RT-PCR (98%) as diagnostic methods. Neither EGFR or EGFRvIII is predictive of overall survival in this cohort. These results are key for selecting patients for novel individualised anti-EGFR therapies.
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Affiliation(s)
- Claire Faulkner
- a Bristol Genetics Laboratory, Southmead Hospital, North Bristol NHS Trust , Bristol , UK
| | - Abigail Palmer
- a Bristol Genetics Laboratory, Southmead Hospital, North Bristol NHS Trust , Bristol , UK
| | - Hannah Williams
- b Department of Neuropathology , Brain Tumour Research Group, Frenchay Hospital, North Bristol NHS Trust Bristol , Bristol , UK
| | - Christopher Wragg
- a Bristol Genetics Laboratory, Southmead Hospital, North Bristol NHS Trust , Bristol , UK
| | - Harry R Haynes
- b Department of Neuropathology , Brain Tumour Research Group, Frenchay Hospital, North Bristol NHS Trust Bristol , Bristol , UK
| | - Paul White
- d Department of Biostatistics , University of West of England , Bristol , UK
| | - Ruth-Mary DeSouza
- c Department of Neurosurgery , King's College Hospital , London , UK
| | - Maggie Williams
- a Bristol Genetics Laboratory, Southmead Hospital, North Bristol NHS Trust , Bristol , UK
| | - Kirsten Hopkins
- d Department of Biostatistics , University of West of England , Bristol , UK.,e Department of Neuro-oncology , Bristol Haematology and Oncology Centre , Bristol , UK
| | - Kathreena M Kurian
- b Department of Neuropathology , Brain Tumour Research Group, Frenchay Hospital, North Bristol NHS Trust Bristol , Bristol , UK
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Abstract
The treatment of patients with intrinsic brain tumors is radically changing. This change is currently not (yet) signified by the use of targeted therapy in clinical practice but more by the definition of molecular markers as predictors for response to therapy which have been used for a long time. While in the past the choice of treatment has been based solely on the tumor entity and its degree of malignancy derived from histological analyses, large randomized trials have now provided a solid basis for personalized molecular-guided treatment decisions. For instance, in the German NOA-08 trial a benefit of chemotherapy with temozolomide alone was only demonstrated in a subgroup of elderly patients with malignant gliomas displaying promoter hypermethylation of the DNA repair enzyme MGMT. This is only one of several examples where molecular analysis of tumor tissue becomes clinically relevant as these analyses can and should be taken into account for treatment decisions and not, as previously, just as an additional parameter for estimating prognosis. This article illustrates the current developments in the area of personalized neurooncology and critically reviews the impact on clinical decision-making in daily practice.
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Affiliation(s)
- M Platten
- Abteilung Neuroonkologie, Neurologische Klinik und Nationales Zentrum für Tumorerkrankungen, Universitätsklinikum Heidelberg, INF 400, 69120, Heidelberg, Deutschland.
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