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Cofano F, Bianconi A, De Marco R, Consoli E, Zeppa P, Bruno F, Pellerino A, Panico F, Salvati LF, Rizzo F, Morello A, Rudà R, Morana G, Melcarne A, Garbossa D. The Impact of Lateral Ventricular Opening in the Resection of Newly Diagnosed High-Grade Gliomas: A Single Center Experience. Cancers (Basel) 2024; 16:1574. [PMID: 38672655 PMCID: PMC11049264 DOI: 10.3390/cancers16081574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/02/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Given the importance of maximizing resection for prognosis in patients with HGG and the potential risks associated with ventricle opening, this study aimed to assess the actual increase in post-surgical complications related to lateral ventricle opening and its influence on OS and PFS. A retrospective study was conducted on newly diagnosed HGG, dividing the patients into two groups according to whether the lateral ventricle was opened (69 patients) or not opened (311 patients). PFS, OS, subependymal dissemination, distant parenchymal recurrences, the development of hydrocephalus and CSF leak were considered outcome measures. A cohort of 380 patients (154 females (40.5%) and 226 males (59.5%)) was involved in the study (median age 61 years). The PFS averaged 10.9 months (±13.3 SD), and OS averaged 16.6 months (± 16.3 SD). Among complications, subependymal dissemination was registered in 15 cases (3.9%), multifocal and multicentric progression in 56 cases (14.7%), leptomeningeal dissemination in 12 (3.2%) and hydrocephalus in 8 (2.1%). These occurrences could not be clearly justified by ventricular opening. The act of opening the lateral ventricles itself does not carry an elevated risk of dissemination, hydrocephalus or cerebrospinal fluid (CSF) leak. Therefore, if necessary, it should be pursued to achieve radical removal of the disease.
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Affiliation(s)
- Fabio Cofano
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
- Neurosurgery Unit, “Città della Salute e della Scienza” University Hospital, 10124 Turin, Italy
| | - Andrea Bianconi
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
| | - Raffaele De Marco
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
| | - Elena Consoli
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
| | - Pietro Zeppa
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
| | - Francesco Bruno
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
- Division of Neuro-Oncology, “Città della Salute e della Scienza” University Hospital, 10124 Turin, Italy
| | - Alessia Pellerino
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
- Division of Neuro-Oncology, “Città della Salute e della Scienza” University Hospital, 10124 Turin, Italy
| | - Flavio Panico
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
| | | | - Francesca Rizzo
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
| | - Alberto Morello
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
| | - Roberta Rudà
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
- Division of Neuro-Oncology, “Città della Salute e della Scienza” University Hospital, 10124 Turin, Italy
| | - Giovanni Morana
- Division of Neuroradiology, Department of Diagnostic Imaging and Radiotherapy, “Città della Salute e della Scienza” University Hospital, University of Turin, 10124 Turin, Italy
| | - Antonio Melcarne
- Neurosurgery Unit, “Città della Salute e della Scienza” University Hospital, 10124 Turin, Italy
| | - Diego Garbossa
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10124 Turin, Italy (E.C.); (A.P.); (F.P.)
- Neurosurgery Unit, “Città della Salute e della Scienza” University Hospital, 10124 Turin, Italy
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van der Meulen M, Ramos RC, Voisin MR, Patil V, Wei Q, Singh O, Climans SA, Kalidindi N, Or R, Aldape K, Diamandis P, Munoz DG, Zadeh G, Mason WP. Differences in methylation profiles between long-term survivors and short-term survivors of IDH-wild-type glioblastoma. Neurooncol Adv 2024; 6:vdae001. [PMID: 38312227 PMCID: PMC10838123 DOI: 10.1093/noajnl/vdae001] [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] [Indexed: 02/06/2024] Open
Abstract
Background Patients with glioblastoma (GBM) have a median overall survival (OS) of approximately 16 months. However, approximately 5% of patients survive >5 years. This study examines the differences in methylation profiles between long-term survivors (>5 years, LTS) and short-term survivors (<1 year, STS) with isocitrate dehydrogenase (IDH)-wild-type GBMs. Methods In a multicenter retrospective analysis, we identified 25 LTS with a histologically confirmed GBM. They were age- and sex-matched to an STS. The methylation profiles of all 50 samples were analyzed with EPIC 850k, classified according to the DKFZ methylation classifier, and the methylation profiles of LTS versus STS were compared. Results After methylation profiling, 16/25 LTS and 23/25 STS were confirmed to be IDH-wild-type GBMs, all with +7/-10 signature. LTS had significantly increased O6-methylguanine methyltransferase (MGMT) promoter methylation and higher prevalence of FGFR3-TACC3 fusion (P = .03). STS were more likely to exhibit CDKN2A/B loss (P = .01) and higher frequency of NF1 (P = .02) mutation. There were no significant CpGs identified between LTS versus STS at an adjusted P-value of .05. Unadjusted analyses identified key pathways involved in both LTS and STS. The most common pathways were the Hippo signaling pathway and the Wnt pathway in LTS, and GPCR ligand binding and cell-cell signaling in STS. Conclusions A small group of patients with IDH-wild-type GBM survive more than 5 years. While there are few differences in the global methylation profiles of LTS compared to STS, our study highlights potential pathways involved in GBMs with a good or poor prognosis.
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Affiliation(s)
- Matthijs van der Meulen
- Department of Medicine, Divisions of Neurology and Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Ronald C Ramos
- Department of Medicine, Divisions of Neurology and Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mathew R Voisin
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Vikas Patil
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Qingxia Wei
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Olivia Singh
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Seth A Climans
- Department of Medicine, Divisions of Neurology and Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Oncology, London Regional Cancer Program, London, Ontario, Canada
| | - Navya Kalidindi
- Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Rosemarylin Or
- Department of Neurology, The Medical City, Pasig, Philippines
| | - Ken Aldape
- Neuro-Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA
| | - Phedias Diamandis
- Department of Laboratory Medicine and Pathobiology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - David G Munoz
- Department of Laboratory Medicine, St. Michaels Hospital, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Warren P Mason
- Department of Medicine, Divisions of Neurology and Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
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Häger W, Toma-Dașu I, Astaraki M, Lazzeroni M. Overall survival prediction for high-grade glioma patients using mathematical modeling of tumor cell infiltration. Phys Med 2023; 113:102669. [PMID: 37603907 DOI: 10.1016/j.ejmp.2023.102669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023] Open
Abstract
PURPOSE This study aimed at applying a mathematical framework for the prediction of high-grade gliomas (HGGs) cell invasion into normal tissues for guiding the clinical target delineation, and at investigating the possibility of using tumor infiltration maps for patient overall survival (OS) prediction. MATERIAL & METHODS A model describing tumor infiltration into normal tissue was applied to 93 HGG cases. Tumor infiltration maps and corresponding isocontours with different cell densities were produced. ROC curves were used to seek correlations between the patient OS and the volume encompassed by a particular isocontour. Area-Under-the-Curve (AUC) values were used to determine the isocontour having the highest predictive ability. The optimal cut-off volume, having the highest sensitivity and specificity, for each isocontour was used to divide the patients in two groups for a Kaplan-Meier survival analysis. RESULTS The highest AUC value was obtained for the isocontour of cell densities 1000 cells/mm3 and 2000 cells/mm3, equal to 0.77 (p < 0.05). Correlation with the GTV yielded an AUC of 0.73 (p < 0.05). The Kaplan-Meier survival analysis using the 1000 cells/mm3 isocontour and the ROC optimal cut-off volume for patient group selection rendered a hazard ratio (HR) of 2.7 (p < 0.05), while the GTV rendered a HR = 1.6 (p < 0.05). CONCLUSION The simulated tumor cell invasion is a stronger predictor of overall survival than the segmented GTV, indicating the importance of using mathematical models for cell invasion to assist in the definition of the target for HGG patients.
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Affiliation(s)
- Wille Häger
- Department of Physics, Stockholm University, Stockholm, Sweden; Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden.
| | - Iuliana Toma-Dașu
- Department of Physics, Stockholm University, Stockholm, Sweden; Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - Mehdi Astaraki
- Department of Biomedical Engineering and Health Systems, Royal Institute of Technology, Huddinge, Sweden; Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - Marta Lazzeroni
- Department of Physics, Stockholm University, Stockholm, Sweden; Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
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Gibson D, Ravi A, Rodriguez E, Chang S, Oberheim Bush N, Taylor J, Clarke J, Solomon D, Scheffler A, Witte J, Lambing H, Okada H, Berger M, Chehab F, Butowski NA. Quantitative analysis of MGMT promoter methylation in glioblastoma suggests nonlinear prognostic effect. Neurooncol Adv 2023; 5:vdad115. [PMID: 37899778 PMCID: PMC10611422 DOI: 10.1093/noajnl/vdad115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Abstract
Background Epigenetic inhibition of the O6-methylguanine-DNA-methyltransferase (MGMT) gene has emerged as a clinically relevant prognostic marker in glioblastoma (GBM). Methylation of the MGMT promoter has been shown to increase chemotherapy efficacy. While traditionally reported as a binary marker, recent methodological advancements have led to quantitative methods of measuring promoter methylation, providing clearer insight into its functional relationship with survival. Methods A CLIA assay and bisulfite sequencing was utilized to develop a quantitative, 17-point, MGMT promoter methylation index. GBMs of 240 newly diagnosed patients were sequenced and risk for mortality was assessed. Nonlinearities were captured by fitting splines to Cox proportional hazard models and plotting smoothed residuals. Covariates included age, Karnofsky performance status, IDH1 mutation, and extent of resection. Results Median follow-up time and progression-free survival were 16 and 9 months, respectively. A total of 176 subjects experienced death. A one-unit increase in promoter CpG methylation resulted in a 4% reduction in hazard (95% CI 0.93-0.99, P < .005). GBM patients with low levels of promoter methylation (1-6 CpG sites) fared markedly worse (HR = 1.62, 95% CI 1.03-2.54, P < .036) than individuals who were unmethylated. Subjects with medium levels of promoter methylation (7-12 sites) had the greatest reduction in hazard (HR = 0.48, 95% CI 0.29-0.80, P < .004), followed by individuals in the highest promoter methylation tertile (HR = 0.62, 95% CI 0.40-0.97, P < .035). Conclusions Our findings suggest that the relationship between the extent of MGMT promoter methylation and survival in GBM may be nonlinear. These findings challenge the current understanding of MGMT and underlines the clinical importance of determining its prognostic utility. Potential limitations include censoring, sample size, and extraneous mutations.
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Affiliation(s)
- David Gibson
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
| | - Akshay Ravi
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
| | - Eduardo Rodriguez
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
| | - Susan Chang
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
| | - Nancy Oberheim Bush
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
| | - Jennie Taylor
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
| | - Jennifer Clarke
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
| | - David Solomon
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
- Department of Pathology, University of California, San Francisco, California, USA
| | - Aaron Scheffler
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - John Witte
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Hannah Lambing
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Hideho Okada
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
| | - Mitchel Berger
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
| | - Farid Chehab
- Institute for Human Genetics, University of California, San Francisco, California, USA
| | - Nicholas A Butowski
- Department of Neurological Surgery, Division of Neuro-Oncology, University of California, San Francisco, California, USA
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Multidisciplinary tumor board behavior consistency in the management of glioblastoma: A multi-center study. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2022.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Mendez Valdez MJ, Lu VM, Kim E, Rivas SR, Govindarajan V, Ivan M, Komotar R, Nath A, Heiss JD, Shah AH. Glioblastoma multiforme in patients with human immunodeficiency virus: an integrated review and analysis. J Neurooncol 2022; 159:571-579. [PMID: 35857248 DOI: 10.1007/s11060-022-04095-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/09/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION As lifespans for persons living with HIV (PLWH) have improved over the last decade, there has been a simultaneous increase in non-AIDS-related cancer in that group. However, there is a paucity of data regarding the incidence of glioblastoma multiforme (GBM) in PLWH. Better understanding of the oncogenesis, natural history, and treatment outcomes of GBM in PLWH should lead to improved treatment strategies. METHODS We performed a comprehensive literature search of six electronic databases to identify eligible cases of GBM among PLWH. Kaplan-Meier estimates, Fisher's exact test, and logistic regression were used to interrogate the data. Epidemiologic data on global HIV prevalence was obtained from the 2016 UNAIDS incidence report, and CNS cancer incidence was obtained from the GDB 2016 Brain and Other CNS Cancer Collaborators. RESULTS There is an inverse relationship between the incidence of HIV and CNS cancer globally. Median overall survival (OS) from GBM diagnosis was 8 months. Estimates for survival at 1 and 2 years were 28 and 5%, respectively. There were no statistically significant predictors of OS in this setting. There was a significant difference (p < 0.01) in OS in PLWH and GBM when compared to TCGA age matched cohorts. CONCLUSION The diagnosis of GBM in PLWH is severely underreported in the literature. Despite maximal treatment, OS in this patient population is significantly less than in HIV-negative people. There was a poor prognosis of GBM in PLWH, which is inconsistent with previous reports. Further investigation is required for PLWH and concomitant GBM. Analyses must consider if HAART is maintained in PLWH during GBM treatment.
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Affiliation(s)
| | - Victor M Lu
- Miller School of Medicine, University of Miami, Miami, USA
| | - Enoch Kim
- College of Osteopathic Medicine, Nova Southeastern University, Davie, USA
| | - Sarah R Rivas
- National Institutes of Health/National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | | | - Michael Ivan
- Miller School of Medicine, University of Miami, Miami, USA
| | | | - Avindra Nath
- National Institutes of Health/National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - John D Heiss
- National Institutes of Health/National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Ashish H Shah
- Miller School of Medicine, University of Miami, Miami, USA
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Translational landscape of glioblastoma immunotherapy for physicians: guiding clinical practice with basic scientific evidence. J Hematol Oncol 2022; 15:80. [PMID: 35690784 PMCID: PMC9188021 DOI: 10.1186/s13045-022-01298-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/10/2022] [Indexed: 02/06/2023] Open
Abstract
Despite recent advances in cancer therapeutics, glioblastoma (GBM) remains one of the most difficult cancers to treat in both the primary and recurrent settings. GBM presents a unique therapeutic challenge given the immune-privileged environment of the brain and the aggressive nature of the disease. Furthermore, it can change phenotypes throughout the course of disease—switching between mesenchymal, neural, and classic gene signatures, each with specific markers and mechanisms of resistance. Recent advancements in the field of immunotherapy—which utilizes strategies to reenergize or alter the immune system to target cancer—have shown striking results in patients with many types of malignancy. Immune checkpoint inhibitors, adoptive cellular therapy, cellular and peptide vaccines, and other technologies provide clinicians with a vast array of tools to design highly individualized treatment and potential for combination strategies. There are currently over 80 active clinical trials evaluating immunotherapies for GBM, often in combination with standard secondary treatment options including re-resection and anti-angiogenic agents, such as bevacizumab. This review will provide a clinically focused overview of the immune environment present in GBM, which is frequently immunosuppressive and characterized by M2 macrophages, T cell exhaustion, enhanced transforming growth factor-β signaling, and others. We will also outline existing immunotherapeutic strategies, with a special focus on immune checkpoint inhibitors, chimeric antigen receptor therapy, and dendritic cell vaccines. Finally, we will summarize key discoveries in the field and discuss currently active clinical trials, including combination strategies, burgeoning technology like nucleic acid and nanoparticle therapy, and novel anticancer vaccines. This review aims to provide the most updated summary of the field of immunotherapy for GBM and offer both historical perspective and future directions to help inform clinical practice.
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Corr F, Grimm D, Saß B, Pojskić M, Bartsch JW, Carl B, Nimsky C, Bopp MHA. Radiogenomic Predictors of Recurrence in Glioblastoma—A Systematic Review. J Pers Med 2022; 12:jpm12030402. [PMID: 35330402 PMCID: PMC8952807 DOI: 10.3390/jpm12030402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 12/10/2022] Open
Abstract
Glioblastoma, as the most aggressive brain tumor, is associated with a poor prognosis and outcome. To optimize prognosis and clinical therapy decisions, there is an urgent need to stratify patients with increased risk for recurrent tumors and low therapeutic success to optimize individual treatment. Radiogenomics establishes a link between radiological and pathological information. This review provides a state-of-the-art picture illustrating the latest developments in the use of radiogenomic markers regarding prognosis and their potential for monitoring recurrence. Databases PubMed, Google Scholar, and Cochrane Library were searched. Inclusion criteria were defined as diagnosis of glioblastoma with histopathological and radiological follow-up. Out of 321 reviewed articles, 43 articles met these inclusion criteria. Included studies were analyzed for the frequency of radiological and molecular tumor markers whereby radiogenomic associations were analyzed. Six main associations were described: radiogenomic prognosis, MGMT status, IDH, EGFR status, molecular subgroups, and tumor location. Prospective studies analyzing prognostic features of glioblastoma together with radiological features are lacking. By reviewing the progress in the development of radiogenomic markers, we provide insights into the potential efficacy of such an approach for clinical routine use eventually enabling early identification of glioblastoma recurrence and therefore supporting a further personalized monitoring and treatment strategy.
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Affiliation(s)
- Felix Corr
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (D.G.); (B.S.); (M.P.); (J.W.B.); (B.C.); (C.N.); (M.H.A.B.)
- EDU Institute of Higher Education, Villa Bighi, Chaplain’s House, KKR 1320 Kalkara, Malta
- Correspondence:
| | - Dustin Grimm
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (D.G.); (B.S.); (M.P.); (J.W.B.); (B.C.); (C.N.); (M.H.A.B.)
- EDU Institute of Higher Education, Villa Bighi, Chaplain’s House, KKR 1320 Kalkara, Malta
| | - Benjamin Saß
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (D.G.); (B.S.); (M.P.); (J.W.B.); (B.C.); (C.N.); (M.H.A.B.)
| | - Mirza Pojskić
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (D.G.); (B.S.); (M.P.); (J.W.B.); (B.C.); (C.N.); (M.H.A.B.)
| | - Jörg W. Bartsch
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (D.G.); (B.S.); (M.P.); (J.W.B.); (B.C.); (C.N.); (M.H.A.B.)
- Center for Mind, Brain and Behavior (CMBB), 35043 Marburg, Germany
| | - Barbara Carl
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (D.G.); (B.S.); (M.P.); (J.W.B.); (B.C.); (C.N.); (M.H.A.B.)
- Department of Neurosurgery, Helios Dr. Horst Schmidt Kliniken, Ludwig-Erhard-Strasse 100, 65199 Wiesbaden, Germany
| | - Christopher Nimsky
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (D.G.); (B.S.); (M.P.); (J.W.B.); (B.C.); (C.N.); (M.H.A.B.)
- Center for Mind, Brain and Behavior (CMBB), 35043 Marburg, Germany
| | - Miriam H. A. Bopp
- Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; (D.G.); (B.S.); (M.P.); (J.W.B.); (B.C.); (C.N.); (M.H.A.B.)
- Center for Mind, Brain and Behavior (CMBB), 35043 Marburg, Germany
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Crooms RC, Johnson MO, Leeper H, Mehta A, McWhirter M, Sharma A. Easing the Journey-an Updated Review of Palliative Care for the Patient with High-Grade Glioma. Curr Oncol Rep 2022; 24:501-515. [PMID: 35192120 DOI: 10.1007/s11912-022-01210-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW High-grade gliomas (HGG) are rare brain tumors that cause disproportionate suffering and mortality. Palliative care, whose aim is to relieve the symptoms and stressors of serious illness, may benefit patients with HGG and their families. In this review, we summarize the extant literature and provide recommendations for addressing the symptom management and communication needs of brain tumor patients and their caregivers at key points in the illness trajectory: initial diagnosis; during upfront treatment; disease recurrence; end-of-life period; and after death during bereavement. RECENT FINDINGS Patients with HGG experience highly intrusive symptoms, cognitive and functional decline, and emotional and existential distress throughout the disease course. The caregiver burden is also substantial during the patient's illness and after death. There is limited evidence to guide the palliative management of these issues. Palliative care is likely to benefit patients with HGG, yet further research is needed to optimize the delivery of palliative care in neuro-oncology.
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Affiliation(s)
- Rita C Crooms
- Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Ave, 1052, NY, 10029, New York, USA.,Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret O Johnson
- Department of Neurosurgery, Duke University Medical Center, Trent Drive 047 Baker House, Durham, NC, 27710, USA.,The Preston Robert Tirsch Brain Tumor Center, Duke University Medical Center, Trent Drive 047 Baker House, NC, 27710, Durham, USA
| | - Heather Leeper
- Neuro-Oncology Branch, National Institutes of Health, National Cancer Institute, 9030 Old Georgetown Rd, Bloch Bldg 82, Bethesda, MD, 20892, USA
| | - Ambereen Mehta
- Palliative Care Program, Division of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, 21224, MD, USA.,Division of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, 21224, MD, USA
| | - Michelle McWhirter
- Palliative Care Program, Division of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, 21224, MD, USA.,Department of Social Work, Johns Hopkins Bayview Medical Center, Baltimore, 21224, MD, USA
| | - Akanksha Sharma
- Department of Translational Neurosciences, Pacific Neuroscience Institute/Saint John's Cancer Institute, 2200 Santa Monica Blvd, Santa Monica, CA, 90404, USA.
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Sprugnoli G, Rigolo L, Faria M, Juvekar P, Tie Y, Rossi S, Sverzellati N, Golby AJ, Santarnecchi E. Tumor BOLD connectivity profile correlates with glioma patients' survival. Neurooncol Adv 2022; 4:vdac153. [PMID: 36532508 PMCID: PMC9753902 DOI: 10.1093/noajnl/vdac153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Presence of residual neurovascular activity within glioma lesions have been recently demonstrated via functional MRI (fMRI) along with active electrical synapses between glioma cells and healthy neurons that influence survival. In this study, we aimed to investigate whether gliomas demonstrate synchronized neurovascular activity with the rest of the brain, by measuring Blood Oxygen Level Dependent (BOLD) signal synchronization, that is, functional connectivity (FC), while also testing whether the strength of such connectivity might predict patients' overall survival (OS). METHODS Resting-state fMRI scans of patients who underwent pre-surgical brain mapping were analyzed (total sample, n = 54; newly diagnosed patients, n = 18; recurrent glioma group, n = 36). A seed-to-voxel analysis was conducted to estimate the FC signal profile of the tumor mass. A regression model was then built to investigate the potential correlation between tumor FC and individual OS. Finally, an unsupervised, cross-validated clustering analysis was performed including tumor FC and clinical OS predictors (e.g., Karnofsky Performance Status - KPS - score, tumor volume, and genetic profile) to verify the performance of tumor FC in predicting OS with respect to validated radiological, demographic, genetic and clinical prognostic factors. RESULTS In both newly diagnosed and recurrent glioma patients a significant pattern of BOLD synchronization between the solid tumor and distant brain regions was found. Crucially, glioma-brain FC positively correlated with variance in individual survival in both newly diagnosed glioma group (r = 0.90-0.96; P < .001; R 2 = 81-92%) and in the recurrent glioma group (r = 0.72; P < .001; R 2 = 52%), outperforming standard clinical, radiological and genetic predictors. CONCLUSIONS Results suggest glioma's synchronization with distant brain regions should be further explored as a possible diagnostic and prognostic biomarker.
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Affiliation(s)
- Giulia Sprugnoli
- Precision Neuroscience & Neuromodulation Program and Network Control Laboratory, Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Radiology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
- Image Guided Neurosurgery Laboratory, Department of Neurosurgery and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Laura Rigolo
- Image Guided Neurosurgery Laboratory, Department of Neurosurgery and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Meghan Faria
- Image Guided Neurosurgery Laboratory, Department of Neurosurgery and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Parikshit Juvekar
- Image Guided Neurosurgery Laboratory, Department of Neurosurgery and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yanmei Tie
- Image Guided Neurosurgery Laboratory, Department of Neurosurgery and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Simone Rossi
- Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), University of Siena, Italy
| | - Nicola Sverzellati
- Radiology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Alexandra J Golby
- Alexandra J. Golby, MD, Image Guided Neurosurgery Laboratory, Department of Neurosurgery and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Neurosciences Center, 60 Fenwood Road, 1st Floor, Hale Building for Transformative Medicine, Boston, MA, 02115, USA ()
| | - Emiliano Santarnecchi
- Corresponding Authors: Emiliano Santarnecchi, PhD, PhD, Precision Neuroscience & Neuromodulation Program and Network Control Laboratory, Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA ()
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11
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Shah AH, Suter R, Gudoor P, Doucet-O’Hare TT, Stathias V, Cajigas I, de la Fuente M, Govindarajan V, Morell AA, Eichberg DG, Luther E, Lu VM, Heiss J, Komotar RJ, Ivan ME, Schurer S, Gilbert MR, Ayad NG. A Multiparametric Pharmacogenomic Strategy for Drug Repositioning predicts Therapeutic Efficacy for Glioblastoma Cell Lines. Neurooncol Adv 2021; 4:vdab192. [DOI: 10.1093/noajnl/vdab192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Poor prognosis of glioblastoma patients and the extensive heterogeneity of glioblastoma at both the molecular and cellular level necessitates developing novel individualized treatment modalities via genomics-driven approaches.
Methods
This study leverages numerous pharmacogenomic and tissue databases to examine drug repositioning for glioblastoma. RNAseq of glioblastoma tumor samples from The Cancer Genome Atlas (TCGA, n=117) were compared to “normal” frontal lobe samples from Genotype-Tissue Expression Portal (GTEX, n=120) to find differentially expressed genes (DEGs). Using compound-gene expression data and drug activity data from the Library of Integrated Network-Based Cellular Signatures (LINCS, n=66,512 compounds) CCLE (71 glioma cell lines), and Chemical European Molecular Biology Laboratory (ChEMBL) platforms, we employed a summarized reversal gene expression metric (sRGES) to “reverse” the resultant disease signature for GBM and its subtypes. A multi-parametric strategy was employed to stratify compounds capable of blood brain barrier penetrance with a favorable pharmacokinetic profile (CNS-MPO).
Results
Significant correlations were identified between sRGES and drug efficacy in GBM cell lines in both ChEMBL(r=0.37,p<.001) and Cancer Therapeutic Response Portal (CTRP) databases (r=0.35, p<0.001). Our multiparametric algorithm identified two classes of drugs with highest sRGES and CNS-MPO: HDAC inhibitors (vorinostat and entinostat) and topoisomerase inhibitors suitable for drug repurposing.
Conclusions
Our studies suggest that reversal of glioblastoma disease signature correlates with drug potency for various GBM subtypes. This multiparametric approach may set the foundation for an early-phase personalized -omics clinical trial for glioblastoma by effectively identifying drugs that are capable of reversing the disease signature and have favorable pharmacokinetic and safety profiles.
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Affiliation(s)
- Ashish H Shah
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | - Robert Suter
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | - Pavan Gudoor
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | | | | | - Iahn Cajigas
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | | | - Vaidya Govindarajan
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | - Alexis A Morell
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | - Daniel G Eichberg
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | - Evan Luther
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | - Victor M Lu
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | - John Heiss
- Surgical Neurology Division, NINDS National Institute of Health
| | - Ricardo J Komotar
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | - Michael E Ivan
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
| | | | | | - Nagi G Ayad
- Department of Neurological Surgery, Sylvester Comprehensive Cancer Center, Miami
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12
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Wang T, Zhu C, Zheng S, Liao Z, Chen B, Liao K, Yang X, Zhou Z, Bai Y, Wang Z, Hou Y, Qiu Y, Huang R. A Novel Nomogram for Predicting the Risk of Short-Term Recurrence After Surgery in Glioma Patients. Front Oncol 2021; 11:740413. [PMID: 34778058 PMCID: PMC8578709 DOI: 10.3389/fonc.2021.740413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of this study was to establish a nomogram model for predicting the risk of short-term recurrence in glioma patients. Methods The clinical data of recurrent glioma patients were summarized and analyzed in this study. Univariate and multivariate logistic regression analyses were performed to analyze the correlation between clinical data and the risk of short-term recurrence after operation. A nomogram was established based on the multivariate logistic regression model results. Results A total of 175 patients with recurrent glioma were enrolled, with 53 patients in the short-term recurrence (STR) group (recurrent time ≤6 months) and 122 patients in the long-term recurrence (LTR) group (recurrent time ≥36 months). Univariate analysis revealed that age at diagnosis, Karnofsky performance scores (KPSs), tumor location, glioma grade, glioma type, extent of resection (EOR), adjuvant chemotherapy (ad-CT), concurrent chemotherapy (co-CT), and isocitrate dehydrogenase (IDH) status were significantly associated with the short-term glioma recurrence. Multivariate analyses revealed that age at diagnosis, KPS, glioma grade, EOR, and IDH were independent risk factors for short-term glioma recurrence. A risk nomogram for the short-term recurrence of glioma was established, with the concordance index (C-index) of 0.971. The findings of calibration and receiver operating characteristic (ROC) curves showed that our nomogram model had good performance and discrimination to estimate short-term recurrence probability. Conclusion This nomogram model provides reliable information about the risk of short-term glioma recurrence for oncologists and neurosurgeons. This model can predict the short-term recurrence probability and give assistance to decide the interval of follow-up or formulate individualized treatment strategies based on the predicted results. A free online prediction risk tool for this nomogram is provided: https://rj2021.shinyapps.io/Nomogram_ recurrence-risk/.
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Affiliation(s)
- Tianwei Wang
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chihao Zhu
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuyu Zheng
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhijun Liao
- Department of Oncology Radiation, Shanghai International Medical Center, Shanghai, China
| | - Binghong Chen
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Keman Liao
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Yang
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyi Zhou
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongrui Bai
- Department of Radiation, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenwei Wang
- Department of Radiation, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanli Hou
- Department of Radiation, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongming Qiu
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Renhua Huang
- Department of Radiation, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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13
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Reimunde P, Pensado-López A, Carreira Crende M, Lombao Iglesias V, Sánchez L, Torrecilla-Parra M, Ramírez CM, Anfray C, Torres Andón F. Cellular and Molecular Mechanisms Underlying Glioblastoma and Zebrafish Models for the Discovery of New Treatments. Cancers (Basel) 2021; 13:1087. [PMID: 33802571 PMCID: PMC7961726 DOI: 10.3390/cancers13051087] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 12/11/2022] Open
Abstract
Glioblastoma (GBM) is the most common of all brain malignant tumors; it displays a median survival of 14.6 months with current complete standard treatment. High heterogeneity, aggressive and invasive behavior, the impossibility of completing tumor resection, limitations for drug administration and therapeutic resistance to current treatments are the main problems presented by this pathology. In recent years, our knowledge of GBM physiopathology has advanced significantly, generating relevant information on the cellular heterogeneity of GBM tumors, including cancer and immune cells such as macrophages/microglia, genetic, epigenetic and metabolic alterations, comprising changes in miRNA expression. In this scenario, the zebrafish has arisen as a promising animal model to progress further due to its unique characteristics, such as transparency, ease of genetic manipulation, ethical and economic advantages and also conservation of the major brain regions and blood-brain-barrier (BBB) which are similar to a human structure. A few papers described in this review, using genetic and xenotransplantation zebrafish models have been used to study GBM as well as to test the anti-tumoral efficacy of new drugs, their ability to interact with target cells, modulate the tumor microenvironment, cross the BBB and/or their toxicity. Prospective studies following these lines of research may lead to a better diagnosis, prognosis and treatment of patients with GBM.
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Affiliation(s)
- Pedro Reimunde
- Department of Medicine, Campus de Oza, Universidade da Coruña, 15006 A Coruña, Spain
- Department of Neurosurgery, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain
| | - Alba Pensado-López
- Department of Zoology, Genetics and Physical Anthropology, Campus de Lugo, Universidade de Santiago de Compostela, 27002 Lugo, Spain; (A.P.-L.); (M.C.C.); (V.L.I.); (L.S.)
- Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Martín Carreira Crende
- Department of Zoology, Genetics and Physical Anthropology, Campus de Lugo, Universidade de Santiago de Compostela, 27002 Lugo, Spain; (A.P.-L.); (M.C.C.); (V.L.I.); (L.S.)
| | - Vanesa Lombao Iglesias
- Department of Zoology, Genetics and Physical Anthropology, Campus de Lugo, Universidade de Santiago de Compostela, 27002 Lugo, Spain; (A.P.-L.); (M.C.C.); (V.L.I.); (L.S.)
| | - Laura Sánchez
- Department of Zoology, Genetics and Physical Anthropology, Campus de Lugo, Universidade de Santiago de Compostela, 27002 Lugo, Spain; (A.P.-L.); (M.C.C.); (V.L.I.); (L.S.)
| | - Marta Torrecilla-Parra
- IMDEA Research Institute of Food and Health Sciences, 28049 Madrid, Spain; (M.T.-P.); (C.M.R.)
| | - Cristina M. Ramírez
- IMDEA Research Institute of Food and Health Sciences, 28049 Madrid, Spain; (M.T.-P.); (C.M.R.)
| | - Clément Anfray
- IRCCS Istituto Clinico Humanitas, Via A. Manzoni 56, 20089 Rozzano, Milan, Italy;
| | - Fernando Torres Andón
- Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
- IRCCS Istituto Clinico Humanitas, Via A. Manzoni 56, 20089 Rozzano, Milan, Italy;
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14
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Sacko O, Benouaich-Amiel A, Brandicourt P, Niaré M, Charni S, Cavandoli C, Brauge D, Catalaa I, Brenner A, Moyal ECJ, Roux FE. The Impact of Surgery on the Survival of Patients with Recurrent Glioblastoma. Asian J Neurosurg 2021; 16:1-7. [PMID: 34211860 PMCID: PMC8202372 DOI: 10.4103/ajns.ajns_180_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/06/2020] [Accepted: 09/16/2020] [Indexed: 11/24/2022] Open
Abstract
Objective: The purpose of this study was to investigate the possible benefit of repeat surgery on overall survival for patients with recurrent glioblastoma multiforme (GBM). Methods: We performed a retrospective analysis of data from patients who presented with recurrent GBM over a 5-year period (n = 157), comparing baseline characteristics and survival for patients who had at least 1 new tumor resection followed by chemotherapy (reoperation group, n = 59) and those who received medical treatment only (no-reoperation group, n = 98) for recurrence. Results: The baseline characteristics of the two groups differed in terms of WHO performance status (better in the reoperation group), mean age (60 years in the reoperation group vs. 65 years in the no-reoperation group), mean interval to recurrence (3 months later in the reoperation group than in the no-reoperation group) and more gross total resections in the reoperation group. Nevertheless, the patients in the reoperation group had a higher rate [32.8%] of sensorimotor deficits than those of the no-reoperation group [14.2]. There was no significant difference in sex; tumor localization, side, or extent; MGMT status; MIB-1 labeling index; or Karnofsky Performance Status [KPS] score. After adjustment for age, the WHO performance status, interval of recurrence, and extent of resection at the first operation, multivariate analysis showed that median survival was significantly better in the reoperation group than in the no-reoperation group (22.9 vs. 14.61 months, P < 0.05). After a total of 69 repeat operations in 59 patients (10 had 2 repeat surgeries), we noted 13 temporary and 20 permanent adverse postoperative events, yielding a permanent complication rate of 28.99% (20/69). There was also a statistically significant (P = 0.029, Student's t-test) decrease in the mean KPS score after reoperation (mean preoperative KPS score of 89.34 vs. mean postoperative score of 84.91). Conclusion: Our retrospective study suggests that repeat surgery may be beneficial for patients with GBM recurrence who have good functional status (WHO performance status 0 and 1), although the potential benefits must be weighed against the risk of permanent complications, which occurred in almost 30% of the patients who underwent repeat resection in this series.
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Affiliation(s)
- Oumar Sacko
- Pôle Neurosciences, Neurochirurgie, PPR, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,Université Paul-Sabatier, Toulouse, France
| | - Alexandra Benouaich-Amiel
- Pôle Neurosciences, Neurochirurgie, PPR, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,Université Paul-Sabatier, Toulouse, France
| | - Pierre Brandicourt
- Pôle Neurosciences, Neurochirurgie, PPR, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,Université Paul-Sabatier, Toulouse, France
| | - Mahamadou Niaré
- Pôle Neurosciences, Neurochirurgie, PPR, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,Université Paul-Sabatier, Toulouse, France.,CNRS (Centre Recherche et Cognition), Toulouse, France
| | - Saloua Charni
- Pôle Neurosciences, Neurochirurgie, PPR, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,Université Paul-Sabatier, Toulouse, France.,CNRS (Centre Recherche et Cognition), Toulouse, France
| | - Clarissa Cavandoli
- Pôle Neurosciences, Neurochirurgie, PPR, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,Université Paul-Sabatier, Toulouse, France
| | - David Brauge
- Pôle Neurosciences, Neurochirurgie, PPR, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,Université Paul-Sabatier, Toulouse, France
| | - Isabelle Catalaa
- Neuroradiologie, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,Université Paul-Sabatier, Toulouse, France
| | - Adam Brenner
- Western University of Health Sciences, Pomona, USA
| | | | - Franck-Emmanuel Roux
- Pôle Neurosciences, Neurochirurgie, PPR, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,Université Paul-Sabatier, Toulouse, France.,CNRS (Centre Recherche et Cognition), Toulouse, France
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15
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Alimohammadi E, Bagheri SR, Sadeghsalehi A, Rizevandi P, Rezaie Z, Abdi A. Prognostic factors in patients with glioblastoma multiforme: focus on the pathologic variants. Acta Neurol Belg 2020; 120:1341-1350. [PMID: 31222512 DOI: 10.1007/s13760-019-01171-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 06/11/2019] [Indexed: 12/16/2022]
Abstract
The aim of this study was to offer predicting factors for survival in adult patients with glioblastoma multiforme. 153 consecutive patients with high-grade glioma (WHO grade IV) were studied in Imam Reza hospital, Kermanshah University of Medical Science, Kermanshah, Iran, between April 2003 and April 2017. All patients treated with surgical resection and standard postoperative radiotherapy (54 Gy). Using the patients' charts and electronic medical records system, the following data were obtained: gender, age, Karnofsky performance status (KPS) score on admission, primary vs. secondary type, extent of surgery, tumor location, tumor size, necrosis size, use of Temozolomide (TMZ), pathology subtype, and immunohistochemistry results. Patients were followed from the time of the surgery until the death occurred. Overall survival (OS) and progression-free survival (PFS) were calculated by the Kaplan-Meier method. Survival time curves for various subgroups were compared by the log-rank test. The impact of the suggested prognostic factors on survival was evaluated by univariate and multivariate analyses. Age, gender, KPS, extent of surgery, tumor location, necrosis size, and reoperation in recurrence had not any statistically significant effect on survival. Univariate analysis revealed a significant impact on outcome for pathology subtype (PFS: P < 0.001, OS: P < 0.001), tumor type (primary vs. secondary) (PFS: P = P < 0.001, OS: P < 0.001), tumor size (PFS: P = 0.044, OS: P = 0.04), TMZ therapy (PFS: P < 0.001, OS: P < 0.001), P53 (PFS: P < 0.001, OS: P < 0.001), and Ki67 (PFS: P < 0.001, OS: P < 0.001). In multivariate analysis, independent favorable prognostic factors for survival were pathology subtype (PFS: P < 0.001, OS: P < 0.001), type (PFS: P < 0.001, OS: 0.012), TMZ (PFS: P < 0.001, OS: P < 0.001), P53 (PFS: P < 0.001, OS: P < 0.001), and Ki67 (PFS: P < 0.001, OS: P < 0.001). The results suggest that pathology subtype, primary vs. secondary type, TMZ therapy, P53, and Ki 63 may play an important role in the survival of patients with glioblastoma multiforme. There is no relationship detected between age, gender, KPS, tumor size and location, necrosis size, extent of surgery, reoperation in recurrence, and patient survival.
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Affiliation(s)
- Ehsan Alimohammadi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Seyed Reza Bagheri
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Parisa Rizevandi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Rezaie
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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16
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Anselmo P, Maranzano E, Selimi A, Lupattelli M, Palumbo I, Bini V, Casale M, Trippa F, Bufi A, Arcidiacono F, Aristei C. Clinical characterization of glioblastoma patients living longer than 2 years: A retrospective analysis of two Italian institutions. Asia Pac J Clin Oncol 2020; 17:273-279. [PMID: 33078909 DOI: 10.1111/ajco.13457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/12/2020] [Indexed: 11/28/2022]
Abstract
AIM Despite the advances in surgery and radio-chemotherapy, the prognosis of glioblastoma (GBM) remains poor with about 13% of patients alive at 24 months. METHODS A total of 75 long-term survivors (LTS), defined as alive at least 24 months from diagnosis, were retrospectively analyzed. Overall survival (OS) and recurrence-free-survival (RFS) were calculated and related to patient characteristics and treatment received. RESULTS Median age and Karnofsky performance status (KPS) were 56 years and 100%, respectively. After surgery (gross tumor resection-GTR in 62, 83% patients), all LTS received concomitant temozolomide (TMZ) with radiotherapy and 70 (93%) adjuvant TMZ. Of these, 10 (13%) discontinued TMZ prior the completion of 6 cycles, 37 (49%) received 6 cycles and 23 (31%) >6 cycles. Sixty-nine (92%) patients experienced a first tumor recurrence at a median time of 21 months. Of these, 32 (46%) were submitted to a second surgery, 34 (49%) to other no-surgical treatments and 3 (5%) only supportive care. At multivariate analysis, OS was significantly improved by second surgery after first recurrence (P = 0.0032) and by cycles of adjuvant TMZ > 6 versus ≤6 (P = 0.05). More than six cycles of TMZ significantly conditioned also first RFS (P = 0.011) and second RFS (P = 0.033). CONCLUSION The large majority of LTS had <65 years, had a high KPS and received GTR. OS and RFS resulted significantly related to an extended administration of adjuvant TMZ (>6 cycles) and a second surgery in case of recurrence.
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Affiliation(s)
- Paola Anselmo
- Radiotherapy Oncology Centre, "Santa Maria" Hospital, Terni, Italy
| | | | - Adelina Selimi
- Department of Surgical and Biomedical Science, Radiotherapy Oncology Centre, University of Perugia and "Santa Maria della Misericordia" Hospital, Perugia, Italy
| | - Marco Lupattelli
- Radiotherapy Oncology Centre, "Santa Maria della Misericordia" Hospital, Perugia, Italy
| | - Isabella Palumbo
- Department of Surgical and Biomedical Science, Radiotherapy Oncology Centre, University of Perugia and "Santa Maria della Misericordia" Hospital, Perugia, Italy
| | - Vittorio Bini
- Internal Medicine, Endocrinology & Metabolism, University of Perugia and "Santa Maria della Misericordia" Hospital, Perugia, Italy
| | - Michelina Casale
- Radiotherapy Oncology Centre, "Santa Maria" Hospital, Terni, Italy
| | - Fabio Trippa
- Radiotherapy Oncology Centre, "Santa Maria" Hospital, Terni, Italy
| | - Alessandro Bufi
- Department of Surgical and Biomedical Science, Radiotherapy Oncology Centre, University of Perugia and "Santa Maria della Misericordia" Hospital, Perugia, Italy
| | | | - Cynthia Aristei
- Department of Surgical and Biomedical Science, Radiotherapy Oncology Centre, University of Perugia and "Santa Maria della Misericordia" Hospital, Perugia, Italy
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17
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Salehani A, Tabibian BE, Self DM, Agee B, Chagoya G, Stetler W, Fisher WS. An Observational Study Investigating the Need for Decompressive Hemicraniectomy after Thrombectomy in Acute Ischemic Stroke of the Middle Cerebral Artery Territory. Cureus 2020; 12:e9665. [PMID: 32944425 PMCID: PMC7488623 DOI: 10.7759/cureus.9665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The frequency incidence of decompressive hemicraniectomy following intra-arterial thrombectomy (IAT) in acute ischemic stroke (AIS) involving the middle cerebral artery (MCA) territory was assessed as a surrogate for morbidity. METHODS A single-institution retrospective chart review was conducted involving 209 consecutive patients between September 2014 and May 2017 with infarctions affecting the MCA territory and who subsequently underwent IAT. The outcomes of interest included the frequency of hemicraniectomy following IAT and the effects of intravenous tissue plasminogen activator (IV tPA) use and primary occlusion site on the Thrombolysis in Cerebral Infarction (TICI) score. RESULTS Thirty-one patients were excluded for infarctions not involving the MCA territory. A total of 178 patients were included in the study. Sixty-eight patients (38.6%) had infarctions of less than one-third of the MCA territory, 50 (28.4%) had infarctions between one-third and two-thirds, and 58 (33%) had infarctions involving greater than two-thirds with 54.3% suffering infarctions of the left side. Only four patients (2.2%) required a hemicraniectomy with no statistically significant association found between TICI score and hemicraniectomy (p=0.41) or between administration of IV tPA and hemicraniectomy (p=0.36). The primary occlusion site was found to influence TICI score (p=0.045). CONCLUSION A very small number of patients required hemicraniectomy after IAT as compared to previously published rates in the literature. However, several factors may prevent the patient from being an appropriate hemicraniectomy candidate in the first place and the small number of these patients in this study limits statistical analysis. The variables that determine a patient's candidacy for decompressive hemicraniectomy remains multi-factorial.
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Affiliation(s)
- Arsalaan Salehani
- Neurological Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - Borna E Tabibian
- Neurological Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - D M Self
- Neurological Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - Bonita Agee
- Neurological Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - Gustavo Chagoya
- Neurological Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - William Stetler
- Neurological Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - Winfield S Fisher
- Neurological Surgery, University of Alabama at Birmingham, Birmingham, USA
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18
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Bower A, Hsu FC, Weaver KE, Yelton C, Merrill R, Wicks R, Soike M, Hutchinson A, McTyre E, Laxton A, Tatter S, Cramer C, Chan M, Lesser G, Strowd RE. Community economic factors influence outcomes for patients with primary malignant glioma. Neurooncol Pract 2020; 7:453-460. [PMID: 32765895 DOI: 10.1093/nop/npaa010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Community economics and other social health determinants influence outcomes in oncologic patient populations. We sought to explore their impact on presentation, treatment, and survival in glioma patients. Methods A retrospective cohort of patients with glioma (World Health Organization grades III-IV) diagnosed between 1999 and 2017 was assembled with data abstracted from medical record review. Patient factors included race, primary care provider (PCP) identified, marital status, insurance status, and employment status. Median household income based on zip code was used to classify patients as residing in high-income communities (HICs; ie, above the median state income) or low-income communities (LICs; ie, below the median state income). The Kaplan-Meier method was used to assess overall survival (OS); Cox proportional hazards regression was used to explore associations with OS. Results Included were 312 patients, 73% from LICs. Survivors residing in LICs and HICs did not differ by age, sex, race, tumor grade, having a PCP, employment status, insurance, time to presentation, or baseline performance status. Median OS was 4.1 months shorter for LIC patients (19.7 vs 15.6 mo; hazard ratio [HR], 0.75; 95% CI: 0.56-0.98, P = 0.04); this difference persisted with 1-year survival of 66% for HICs versus 61% for LICs at 1 year, 34% versus 24% at 3 years, and 29% versus 17% at 5 years. Multivariable analysis controlling for age, grade, and chemotherapy treatment showed a 25% lower risk of death for HIC patients (HR, 0.75; 95% CI: 0.57-0.99, P < 0.05). Conclusions The economic status of a glioma patient's community may influence survival. Future efforts should investigate potential mechanisms such as health care access, stress, treatment adherence, and social support.
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Affiliation(s)
- Aaron Bower
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kathryn E Weaver
- Departments of Social Sciences and Health Policy and Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Caleb Yelton
- Wake Forest Baptist Medical Center Department of Neurology, Winston-Salem, North Carolina
| | - Rebecca Merrill
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Robert Wicks
- Wake Forest Baptist Medical Center Department of Neurosurgery, Winston-Salem, North Carolina
| | - Mike Soike
- Wake Forest Baptist Medical Center Department of Radiation Oncology, Winston-Salem, North Carolina
| | - Angelica Hutchinson
- Wake Forest Baptist Medical Center Department of Social Sciences and Health Policy, Winston-Salem, North Carolina
| | - Emory McTyre
- Wake Forest Baptist Medical Center Department of Radiation Oncology, Winston-Salem, North Carolina
| | - Adrian Laxton
- Wake Forest Baptist Medical Center Department of Neurosurgery, Winston-Salem, North Carolina
| | - Stephen Tatter
- Wake Forest Baptist Medical Center Department of Neurosurgery, Winston-Salem, North Carolina
| | - Christina Cramer
- Wake Forest Baptist Medical Center Department of Radiation Oncology, Winston-Salem, North Carolina
| | - Michael Chan
- Wake Forest Baptist Medical Center Department of Radiation Oncology, Winston-Salem, North Carolina
| | - Glenn Lesser
- Wake Forest Baptist Medical Center Department of Neurology, Winston-Salem, North Carolina
| | - Roy E Strowd
- Wake Forest School of Medicine, Winston-Salem, North Carolina
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19
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Flores-Alvarez E, Durand-Muñoz C, Cortes-Hernandez F, Muñoz-Hernandez O, Moreno-Jimenez S, Roldan-Valadez E. Clinical Significance of Fractional Anisotropy Measured in Peritumoral Edema as a Biomarker of Overall Survival in Glioblastoma: Evidence Using Correspondence Analysis. Neurol India 2020; 67:1074-1081. [PMID: 31512638 DOI: 10.4103/0028-3886.266284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction Fractional anisotropy (FA), a diffusion tensor image (DTI) derived biomarker is related to invasion, infiltration, and extension of glioblastoma (GB). We aimed to evaluate FA values and their association with intervals of overall survival (OS). Materials and Methods Retrospective study conducted in 36 patients with GB included 23 (63.9%) males, 46 ± 14 y; and 13 (36.1%) females, 53 ± 13; followed up for 36 months. We measured FA at edema, enhancing rim, and necrosis. We created two categorical variables using levels of FA and intervals of OS to evaluate their relationships. Kaplan-Meier method and correspondence analysis evaluated the association between OS (grouped in 7 six-month intervals) and FA measurements. Results Median FA values were higher in healthy brain regions (0.351), followed by peritumoral edema (0.190), enhancing ring (0.116), and necrosis (0.071). Pair-wise comparisons among tumor regions showed a significant difference, P < 0.001. The median OS for all patients was 19.3 months; variations in the OS curves among subgroups was significant χ2 (3) = 8.48, P = 0.037. Correspondence analysis showed a significant association between FA values in the edema region and the survival intervals χ2 (18) = 30.996, P = 0.029. Conclusions Alternative multivariate assessment using correspondence analysis might supplement the traditional survival analysis in patients with GB. A close follow-up of the variability of FA in the peritumoral edema region is predictive of the OS within specific six-month interval subgroup. Further studies should focus on predictive models combining surgical and DTI biomarkers.
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Affiliation(s)
- Eduardo Flores-Alvarez
- Department of Neurosurgery, Hospital General de Mexico Eduardo Liceaga (HGMEL), Mexico City, Mexico
| | - Coral Durand-Muñoz
- Department of Internal Medicine, Medica Sur Clinic and Foundation, Mexico City, Mexico
| | | | - Onofre Muñoz-Hernandez
- Direction of Research, Hospital Infantil de Mexico Federico Gomez (HIMFG), National Health Institute, Mexico City, Mexico
| | - Sergio Moreno-Jimenez
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Ernesto Roldan-Valadez
- Directorate of Research, Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico; I.M. Sechenov First Moscow State Medical University (Sechenov University), Department of Radiology, Moscow, Russia
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20
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Marenco-Hillembrand L, Wijesekera O, Suarez-Meade P, Mampre D, Jackson C, Peterson J, Trifiletti D, Hammack J, Ortiz K, Lesser E, Spiegel M, Prevatt C, Hawayek M, Quinones-Hinojosa A, Chaichana KL. Trends in glioblastoma: outcomes over time and type of intervention: a systematic evidence based analysis. J Neurooncol 2020; 147:297-307. [PMID: 32157552 DOI: 10.1007/s11060-020-03451-6] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Despite aggressive treatment with chemoradiotherapy and maximum surgical resection, survival in patients with glioblastoma (GBM) remains poor. Ongoing efforts are aiming to prolong the lifespan of these patients; however, disparities exist in reported survival values with lack of clear evidence that objectively examines GBM survival trends. We aim to describe the current status and advances in the survival of patients with GBM, by analyzing median overall survival through time and between treatment modalities. METHODS A systematic review was conducted according to PRISMA guidelines to identify articles of newly diagnosed glioblastoma from 1978 to 2018. Full-text glioblastoma papers with human subjects, ≥ 18 years old, and n ≥ 25, were included for evaluation. RESULTS The central tendency of median overall survival (MOS) was 13.5 months (2.3-29.6) and cumulative 5-year survival was 5.8% (0.01%-29.1%), with a significant difference in survival between studies that predate versus postdate the implementation of temozolomide and radiation, [12.5 (2.3-28) vs 15.6 (3.8-29.6) months, P < 0.001]. In clinical trials, bevacizumab [18.2 (10.6-23.0) months], tumor treating fields (TTF) [20.7 (20.5-20.9) months], and vaccines [19.2 (15.3-26.0) months] reported the highest central measure of median survival. CONCLUSION Coadministration with radiotherapy and temozolomide provided a statistically significant increase in survival for patients suffering from glioblastoma. However, the natural history for GBM remains poor. Therapies including TTF pooled values of MOS and provide means of prolonging the survival of GBM patients.
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Affiliation(s)
- Lina Marenco-Hillembrand
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA
| | - Olindi Wijesekera
- Department of Neurological Surgery, Case Western University, Cleveland, OH, USA
| | - Paola Suarez-Meade
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA
| | - David Mampre
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Christina Jackson
- Department of Neurological Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer Peterson
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Daniel Trifiletti
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Julie Hammack
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Kyle Ortiz
- School of Medicine, University of Puerto Rico, San Juan, PR, USA
| | - Elizabeth Lesser
- Division of Biomedical Statistics and Bioinformatics, Mayo Clinic, Jacksonville, FL, USA
| | - Matthew Spiegel
- Division of Biomedical Statistics and Bioinformatics, Mayo Clinic, Jacksonville, FL, USA
| | - Calder Prevatt
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA
| | - Maria Hawayek
- School of Medicine, University of Puerto Rico, San Juan, PR, USA
| | - Alfredo Quinones-Hinojosa
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA
| | - Kaisorn L Chaichana
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, 32224, USA.
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21
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Ius T, Pignotti F, Della Pepa GM, La Rocca G, Somma T, Isola M, Battistella C, Gaudino S, Polano M, Dal Bo M, Bagatto D, Pegolo E, Chiesa S, Arcicasa M, Olivi A, Skrap M, Sabatino G. A Novel Comprehensive Clinical Stratification Model to Refine Prognosis of Glioblastoma Patients Undergoing Surgical Resection. Cancers (Basel) 2020; 12:cancers12020386. [PMID: 32046132 PMCID: PMC7072471 DOI: 10.3390/cancers12020386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 12/14/2022] Open
Abstract
Despite recent discoveries in genetics and molecular fields, glioblastoma (GBM) prognosis still remains unfavorable with less than 10% of patients alive 5 years after diagnosis. Numerous studies have focused on the research of biological biomarkers to stratify GBM patients. We addressed this issue in our study by using clinical/molecular and image data, which is generally available to Neurosurgical Departments in order to create a prognostic score that can be useful to stratify GBM patients undergoing surgical resection. By using the random forest approach [CART analysis (classification and regression tree)] on Survival time data of 465 cases, we developed a new prediction score resulting in 10 groups based on extent of resection (EOR), age, tumor volumetric features, intraoperative protocols and tumor molecular classes. The resulting tree was trimmed according to similarities in the relative hazard ratios amongst groups, giving rise to a 5-group classification tree. These 5 groups were different in terms of overall survival (OS) (p < 0.000). The score performance in predicting death was defined by a Harrell’s c-index of 0.79 (95% confidence interval [0.76–0.81]). The proposed score could be useful in a clinical setting to refine the prognosis of GBM patients after surgery and prior to postoperative treatment.
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Affiliation(s)
- Tamara Ius
- Neurosurgery Unit, Department of Neuroscience, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
- Correspondence: or ; Tel.: 0039-347-0178730/0039-0432
| | - Fabrizio Pignotti
- Department of Neurosurgery, Mater Olbia Hospital, 07026 Olbia, Italy; (F.P.); (G.S.); (G.L.R.)
| | | | - Giuseppe La Rocca
- Department of Neurosurgery, Mater Olbia Hospital, 07026 Olbia, Italy; (F.P.); (G.S.); (G.L.R.)
- Institute of Neurosurgery, Catholic University, 00168 Rome, Italy; (G.M.D.P.); (A.O.)
| | - Teresa Somma
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, 80131 Naples, Italy;
| | - Miriam Isola
- Department of Medicine, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy; (M.I.); (C.B.)
| | - Claudio Battistella
- Department of Medicine, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy; (M.I.); (C.B.)
| | - Simona Gaudino
- Institute of radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Maurizio Polano
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (M.P.); (M.D.B.)
| | - Michele Dal Bo
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (M.P.); (M.D.B.)
| | - Daniele Bagatto
- Neuroradiology Unit, Department of Diagnostic Imaging ASUIUD Udine, 33100 Udine, Italy;
| | - Enrico Pegolo
- Institute of Pathology, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
| | - Silvia Chiesa
- Radiation Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Mauro Arcicasa
- Department of Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy;
| | - Alessandro Olivi
- Institute of Neurosurgery, Catholic University, 00168 Rome, Italy; (G.M.D.P.); (A.O.)
| | - Miran Skrap
- Neurosurgery Unit, Department of Neuroscience, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
| | - Giovanni Sabatino
- Department of Neurosurgery, Mater Olbia Hospital, 07026 Olbia, Italy; (F.P.); (G.S.); (G.L.R.)
- Institute of Neurosurgery, Catholic University, 00168 Rome, Italy; (G.M.D.P.); (A.O.)
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22
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Blomstergren A, Rydelius A, Abul-Kasim K, Lätt J, Sundgren PC, Bengzon J. Evaluation of reproducibility in MRI quantitative volumetric assessment and its role in the prediction of overall survival and progression-free survival in glioblastoma. Acta Radiol 2019; 60:516-525. [PMID: 29966430 DOI: 10.1177/0284185118786060] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Residual tumor volume (RTV) and extent of resection (EOR) have previously been shown to affect survival in glioblastoma (GB) patients. Quantitative radiological assessment (QRA) of these factors could potentially affect clinical decision-making in the postoperative period. PURPOSE The first aim was to evaluate the reproducibility of different volume estimation methods of RTV and EOR by comparing QRA with subjective visual estimation and with objective volume estimations. The second aim was to clarify whether QRA of RTV and EOR would provide accuracy in predicting progression-free survival (PFS) and overall survival (OS) in GB patients. MATERIAL AND METHODS Seventy GB patients were studied retrospectively. Reproducibility of QRA was compared to conventional visual analysis. Intra-rater agreement between two repeated measurements of 25 patients was calculated. QRA for RTV and EOR was made for the entire study population. Survival analysis was performed by multivariate cox-regression analysis. RESULTS QRA of RTV and EOR gave superior intra-rater agreement compared to subjective evaluation. Multivariate survival analysis showed prognostic significance on 18 months PFS (hazard ratio [HR] = 0.44, P = 0.003) and OS (HR = 0.42, P = 0.012) at RTV < 1.6 mL and with EOR > 96% on PFS (HR = 2.152, P = 0.005) but not on OS (HR = 1.92, P = 0.053). CONCLUSION QRA of tumor volumes is more robust compared to standard evaluation methods. Since EOR and RTV are correlated to the prognosis in GB, quantitative analysis of tumor volumes could aid decision-making and patient management postoperatively.
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Affiliation(s)
- Adam Blomstergren
- Department of Clinical Sciences, Division of Neurosurgery, Lund University and Region Skåne, Lund, Sweden
| | - Anna Rydelius
- Department of Clinical Sciences, Division of Neurology, Lund University, Lund, Sweden
| | - Kasim Abul-Kasim
- Centre for Imaging and Function, Section of Neuroradiology, SUS Malmö, Lund University, Malmö, Sweden
| | - Jimmy Lätt
- Centre for Imaging and Function, SUS, Lund University, Lund, Sweden
| | - Pia C Sundgren
- Centre for Imaging and Function, SUS, Lund University, Lund, Sweden
- Department of Clinical Sciences, Division of Radiology, Lund University, Lund, Sweden
| | - Johan Bengzon
- Department of Clinical Sciences, Division of Neurosurgery, Lund University and Region Skåne, Lund, Sweden
- Stem Cell Center, BMC B10, Lund University, Lund, Sweden
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23
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Hou BL, Wen S, Katsevman GA, Liu H, Urhie O, Turner RC, Carpenter J, Bhatia S. Magnetic Resonance Imaging Parameters and Their Impact on Survival of Patients with Glioblastoma: Tumor Perfusion Predicts Survival. World Neurosurg 2018; 124:S1878-8750(18)32908-5. [PMID: 30593971 PMCID: PMC6597330 DOI: 10.1016/j.wneu.2018.12.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Many prognostic factors influence overall survival (OS) of patients with glioblastoma. Despite gross total resection and Stupp protocol adherence, many patients have poor survival. Perfusion magnetic resonance imaging may assist in diagnosis, treatment monitoring, and prognostication. METHODS This retrospective study of 36 patients with glioblastoma assessed influence of preoperative magnetic resonance imaging parameters reflecting tumor cell density and vascularity and patient age on OS. RESULTS The area under curve based on optimal receiver operating characteristic curves for the perfusion parameters normalized relative tumor blood volume (n_rTBV) and normalized relative tumor blood flow (n_rTBF) were 0.92 and 0.89, respectively, and the highest among all imaging parameters and age. OS showed strongly negative correlations with corrected n_rTBV (R = -0.70; P < 0.001) and n_rTBF (R = -0.67; P < 0.001). The Cox model, which included age and imaging parameters, demonstrated that n_rTBV and n_rTBF were most predictive of OS, with hazard ratios of 5.97 (P = 0.0001) and 8.76 (P = 0.0001), respectively, compared with 1.63 (P = 0.19) for age. Eighteen patients with corrected n_rTBV ≤2.5 (best cutoff value) had a median OS of 15.1 months (95% confidence interval (CI), 11.34-21.25) compared with 2.8 months (95% CI, 1.48-4.03; P < 0.001) for 18 patients with corrected n_rTBV >2.5. Twenty-four patients with n_rTBF ≤2.79 had a median OS of 12 months (95% CI, 10.46-17.9) compared with 2.8 months for 12 patients with n_rTBF >2.79 (95% CI, 1.31-4.2; P < 0.001). CONCLUSIONS The dominant predictors of OS are normalized perfusion parameters n_rTBV and n_rTBF. Preoperative perfusion imaging may be used as a surrogate to predict glioblastoma aggressiveness and survival independent of treatment.
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Affiliation(s)
- Bob L Hou
- Department of Radiology, West Virginia University, Morgantown, West Virginia, USA
| | - Sijin Wen
- Department of Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Gennadiy A Katsevman
- Department of Neurosurgery, West Virginia University, Morgantown, West Virginia, USA.
| | - Hui Liu
- Department of Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Ogaga Urhie
- West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Ryan C Turner
- Department of Neurosurgery, West Virginia University, Morgantown, West Virginia, USA
| | - Jeffrey Carpenter
- Department of Radiology, West Virginia University, Morgantown, West Virginia, USA
| | - Sanjay Bhatia
- Department of Neurosurgery, West Virginia University, Morgantown, West Virginia, USA
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24
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Shah AH, Burks JD, Buttrick SS, Debs L, Ivan ME, Komotar RJ. Laser Interstitial Thermal Therapy as a Primary Treatment for Deep Inaccessible Gliomas. Neurosurgery 2018; 84:768-777. [DOI: 10.1093/neuros/nyy238] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 05/11/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ashish H Shah
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Joshua D Burks
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Simon S Buttrick
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Luca Debs
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Michael E Ivan
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Ricardo J Komotar
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida
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25
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Eisemann T, Costa B, Strelau J, Mittelbronn M, Angel P, Peterziel H. An advanced glioma cell invasion assay based on organotypic brain slice cultures. BMC Cancer 2018; 18:103. [PMID: 29378533 PMCID: PMC5789681 DOI: 10.1186/s12885-018-4007-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 01/18/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The poor prognosis for glioblastoma patients is caused by the diffuse infiltrative growth pattern of the tumor. Therefore, the molecular and cellular processes underlying cell migration continue to be a major focus of glioblastoma research. Emerging evidence supports the concept that the tumor microenvironment has a profound influence on the functional properties of tumor cells. Accordingly, substantial effort must be devoted to move from traditional two-dimensional migration assays to three-dimensional systems that more faithfully recapitulate the complex in vivo tumor microenvironment. METHODS In order to mimic the tumor microenvironment of adult gliomas, we used adult organotypic brain slices as an invasion matrix for implanted, fluorescently labeled tumor spheroids. Cell invasion was imaged by confocal or epi-fluorescence microscopy and quantified by determining the average cumulative sprout length per spheroid. The tumor microenvironment was manipulated by treatment of the slice with small molecule inhibitors or using different genetically engineered mouse models as donors. RESULTS Both epi-fluorescence and confocal microscopy were applied to precisely quantify cell invasion in this ex vivo approach. Usage of a red-emitting membrane dye in addition to tissue clearing drastically improved epi-fluorescence imaging. Preparation of brain slices from of a genetically engineered mouse with a loss of a specific cell surface protein resulted in significantly impaired tumor cell invasion. Furthermore, jasplakinolide treatment of either tumor cells or brain slice significantly reduced tumor cell invasion. CONCLUSION We present an optimized invasion assay that closely reflects in vivo invasion by the implantation of glioma cells into organotypic adult brain slice cultures with a preserved cytoarchitecture. The diversity of applications including manipulation of the tumor cells as well as the microenvironment, permits the investigation of rate limiting factors of cell migration in a reliable context. This model will be a valuable tool for the discovery of the molecular mechanisms underlying glioma cell invasion and, ultimately, the development of novel therapeutic strategies.
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Affiliation(s)
- Tanja Eisemann
- Division of Signal Transduction and Growth Control, DKFZ/ZMBH Alliance, Heidelberg, Germany
| | - Barbara Costa
- Division of Signal Transduction and Growth Control, DKFZ/ZMBH Alliance, Heidelberg, Germany
| | - Jens Strelau
- Functional Neuroanatomy, University of Heidelberg, Heidelberg, Germany
| | - Michel Mittelbronn
- Institute of Neurology (Edinger-Institute), University Hospital Frankfurt, Goethe University, Frankfurt, Germany.,Luxembourg Centre of Neuropathology (LCNP), Dudelange, Luxembourg.,Laboratoire National de Santé, Dudelange, Luxembourg.,Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg.,Department of Oncology, NORLUX Neuro-Oncology Laboratory, Luxembourg Institute of Health (L.I.H.), Strassen, Luxembourg
| | - Peter Angel
- Division of Signal Transduction and Growth Control, DKFZ/ZMBH Alliance, Heidelberg, Germany.
| | - Heike Peterziel
- Division of Signal Transduction and Growth Control, DKFZ/ZMBH Alliance, Heidelberg, Germany.,Present address: Translational Program, Hopp Children's Cancer Center at NCT Heidelberg (KiTZ), University Hospital and DKFZ Heidelberg, Heidelberg, Germany.,Present address: Clinical Cooperation Unit Pediatric Oncology, DKFZ, Heidelberg, Germany.,German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
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26
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Mistry AM. Clinical correlates of subventricular zone-contacting glioblastomas: a meta-analysis. J Neurosurg Sci 2017; 63:581-587. [PMID: 29205011 DOI: 10.23736/s0390-5616.17.04274-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION The clinical and molecular correlates of glioblastomas (GBMs) contacting the subventricular zone (SVZ+ GBM) are unknown. This work aimed to reveal any such correlates that may help explain their increased GBM malignancy. EVIDENCE ACQUISITION A meta-analysis was, therefore, conducted to assess whether tumor's MGMT promoter methylation status, isocitrate dehydrogenase (IDH) mutation status, volume, and extent of resection as well as patients' age at diagnosis and preoperative Karnofsky performance status score (KPS) correlate with SVZ contact by GBM. In addition, available imaging of GBM patients in The Cancer Imaging Archive was assessed for SVZ contact and their corresponding clinical and molecular variables were obtained through The Cancer Genome Atlas (TCGA) database. EVIDENCE SYNTHESIS Twenty-one studies were identified through PubMed and EMBASE database search. This review included 257 patients identified from the TCIA/TCGA database. MGMT promoter methylation status (summary odds ratio [OD], 1.18 [0.84-1.66], P=0.34), IDH mutation status (OD: 0.63 [0.20-1.99], P=0.43), and patients' age of diagnosis (summary mean difference, MD, 0.10 years [-1.85, 2.05], P=0.92) did not associated with SVZ contact of the GBM. However, SVZ+ GBMs were significantly larger than SVZ- GBMs (MD: 17.3 cm3 [8.70-25.8], P<0.0001). SVZ+ GBM patients had lower KPS scores (MD: -3.33 [-5.31-(-1.35)], P=0.001) and were half as likely to receive a gross total resection (OD: 0.50 [0.40-0.64], P<0.00001). CONCLUSIONS Additional, large studies that rigorously control for all the known clinical and molecular prognosticators, especially extent of resection and preoperative KPS scores, are needed to evaluate whether SVZ contact by GBM independently influences survival.
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Affiliation(s)
- Akshitkumar M Mistry
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA -
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27
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Zhong X, Zhao H, Liang S, Zhou D, Zhang W, Yuan L. Gene delivery of apoptin-derived peptide using an adeno-associated virus vector inhibits glioma and prolongs animal survival. Biochem Biophys Res Commun 2017; 482:506-513. [PMID: 28212737 DOI: 10.1016/j.bbrc.2016.10.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/13/2016] [Accepted: 10/18/2016] [Indexed: 11/29/2022]
Abstract
Glioblastoma (GBM) is the most common malignant brain tumor in adults. We designed an adeno-associated virus (AAV) vector for intracranial delivery of the secreted HSP70-targeted peptide APOPTIN derived from Apoptin to GBM tumors. We applied this therapy to GBM models using human U87MG glioma cells and GBM xenograft models in mice. In U87MG and U251MG cells, conditioned medium from AAV2-apoptin-derived peptide (ADP)-expressing cells induced 83% and 78% cell death. In mice bearing intracranial U87MG tumors treated with AAV2-ADP, treatment resulted in a significant decrease in tumor growth and longer survival in mice bearing orthotopic invasive GBM brain tumors. These data indicate that ssAAV2-ADP injection in the left hemisphere effectively prevented ipsilateral tumor growth but was insufficient to prevent distal tumor growth in the contralateral hemisphere. However, the systemic route is the most effective approach for treating widely dispersed tumors. In summary, systemic delivery of AAV2-ADP is an attractive approach for invasive GBM treatment.
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Affiliation(s)
- Xiuli Zhong
- Department of Biochemistry and Molecular Biology, Daqing Campus, Harbin Medical University, Daqing, Heilongjiang, 163319, PR China
| | - Hengyu Zhao
- Daqing Oilfield General Hospital, Daqing, PR China
| | - Songhe Liang
- Department of Biochemistry and Molecular Biology, Daqing Campus, Harbin Medical University, Daqing, Heilongjiang, 163319, PR China
| | - DanYang Zhou
- Department of Biochemistry and Molecular Biology, Daqing Campus, Harbin Medical University, Daqing, Heilongjiang, 163319, PR China
| | - Wenjia Zhang
- Daqing Oilfield General Hospital, Daqing, PR China
| | - Lijie Yuan
- Department of Biochemistry and Molecular Biology, Daqing Campus, Harbin Medical University, Daqing, Heilongjiang, 163319, PR China.
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Shah AH, Barbarite E, Scoma C, Kuchakulla M, Parikh S, Bregy A, Komotar RJ. Revisiting the Relationship Between Ethnicity and Outcome in Glioblastoma Patients. Cureus 2017; 9:e954. [PMID: 28168132 PMCID: PMC5291705 DOI: 10.7759/cureus.954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Relationships between various ethnicities and glioma subtype have recently been established. As a tertiary referral center for Latin America and the Caribbean, our institution treats a diverse glioblastoma (GBM) population. We sought to clarify the role of ethnicity on patient prognosis in GBM and also compared these findings to a group consisting of elderly patients. We included ‘elderly’ as a group because the subgroups for ethnicities within them were too small. It allowed us to put in scope the effects of ethnicities on the overall survival. Material and Methods: After Institutional Review Board approval, 235 patients with GBM were retrospectively identified. A total of 140 patients were separated into four groups: White adults (n = 47), Hispanic adults (n = 27), elderly (n = 58), and Black adults (n = 6). Overall survival (OS) was our primary endpoint. Results: Overall survival in the White adult group was 24.3 months, compared to 13.0 months in the Hispanic adult group, 20.2 months in the Black group, and 13.8 months in the elderly group (p = 0.01). In the Hispanic group, hypertension (37.9%, p = 0.01) and diabetes (24.1%, p = 0.009) were significantly more prevalent compared to the White adult cohort. No difference in insurance status or postoperative complications was found between subgroups. Conclusion: Based on our analysis, Hispanic adults may have a decreased survival compared to White adults. However, the incidence of hypertension and diabetes was markedly higher in our Hispanic adult cohort; thus, estimating the risk of ethnicity and comorbidities on patient prognosis may be difficult. A prospective study correlating the genome and subgroup prognosis may help elucidate the role of ethnicity in GBM patients.
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Affiliation(s)
- Ashish H Shah
- Department of Neurological Surgery, University of Miami Miller School of Medicine
| | - Eric Barbarite
- Department of Neurological Surgery, University of Miami Miller School of Medicine
| | - Christopher Scoma
- Department of Neurological Surgery, University of Miami Miller School of Medicine
| | - Manish Kuchakulla
- Department of Neurological Surgery, University of Miami Miller School of Medicine
| | - Sahil Parikh
- Department of Neurological Surgery, University of Miami Miller School of Medicine
| | - Amade Bregy
- Department of Neurological Surgery, University of Miami Miller School of Medicine
| | - Ricardo J Komotar
- Department of Neurological Surgery, University of Miami Miller School of Medicine
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Della Puppa A, Lombardi G, Rossetto M, Rustemi O, Berti F, Cecchin D, Gardiman MP, Rolma G, Persano L, Zagonel V, Scienza R. Outcome of patients affected by newly diagnosed glioblastoma undergoing surgery assisted by 5-aminolevulinic acid guided resection followed by BCNU wafers implantation: a 3-year follow-up. J Neurooncol 2016; 131:331-340. [PMID: 27757721 DOI: 10.1007/s11060-016-2301-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 10/09/2016] [Indexed: 12/17/2022]
Abstract
The purpose of the study was to evaluate the clinical outcome of the association of BCNU wafers implantation and 5-aminolevulinic acid (5-ALA) fluorescence in the treatment of patients with newly diagnosed glioblastoma (ndGBM). Clinical and surgical data from patients who underwent 5-ALA surgery followed by BCNU wafers implantation were retrospectively evaluated (20 patients, Group I) and compared with data of patients undergoing surgery with BCNU wafers alone (42 patients, Group II) and 5-ALA alone (59 patients, Group III). Patients undergoing 5-ALA assisted resection followed by BCNU wafers implantation (Group I) resulted long survivors (>3 years) in 15 % of cases and showed a median PFS and MS of 11 and 22 months, respectively. Patients treated with BCNU wafers presented a significantly higher survival when tumor was removed with the assistance of 5-ALA (22 months with vs 18 months without 5-ALA, p < 0.0001); these data could be partially explained by the significantly higher CRET achieved in patients operated with 5-ALA assistance (80 % with vs 47 %% without 5-ALA). Moreover, patients of Group I showed a significant increased survival compared with Group III (5-ALA without BCNU) (22 months with vs 21 months without BCNU wafers, p = 0.0025) even with a comparable CRET (80 % vs 76 %, respectively). The occurrence of adverse events related to wafers did not significantly increase with 5-ALA (20 % with and 19 % without 5-ALA) and did not impact in survival outcome. In conclusion, our experience shows that on selected ndGBM patients 5-ALA technology and BCNU wafers implantation show a synergic action on patients' outcome without increasing adverse events occurrence.
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Affiliation(s)
- Alessandro Della Puppa
- Department of Neurosurgery, Padova University Hospital, Via Giustiniani 2, Azienda Ospedaliera di Padova, 35128, Padova, Italy.
| | - Giuseppe Lombardi
- Department of Clinical and Experimental Oncology, Medical Oncology I Unit, Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - Marta Rossetto
- Department of Neurosurgery, Padova University Hospital, Via Giustiniani 2, Azienda Ospedaliera di Padova, 35128, Padova, Italy
| | - Oriela Rustemi
- Department of Neurosurgery, Padova University Hospital, Via Giustiniani 2, Azienda Ospedaliera di Padova, 35128, Padova, Italy
| | - Franco Berti
- Department of Radiotherapy, IRCCS, Padova, Italy
| | - Diego Cecchin
- Department of Medicine (DIMED), Nuclear Medicine Unit, University of Padua, Padua, Italy
| | - Marina Paola Gardiman
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, University Hospital of Padua, Padua, Italy
| | - Giuseppe Rolma
- Department of Neuro-Radiology, Padova University Hospital, Padova, Italy
| | - Luca Persano
- Oncohematology Laboratory, IRP-Istituto di Ricerca Pediatrica Città della Speranza, Department of Woman and Child Health, University of Padova, Padua, Italy
| | - Vittorina Zagonel
- Department of Clinical and Experimental Oncology, Medical Oncology I Unit, Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - Renato Scienza
- Department of Neurosurgery, Padova University Hospital, Via Giustiniani 2, Azienda Ospedaliera di Padova, 35128, Padova, Italy
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30
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Millward CP, Brodbelt AR, Haylock B, Zakaria R, Baborie A, Crooks D, Husband D, Shenoy A, Wong H, Jenkinson MD. The impact of MGMT methylation and IDH-1 mutation on long-term outcome for glioblastoma treated with chemoradiotherapy. Acta Neurochir (Wien) 2016; 158:1943-53. [PMID: 27526690 DOI: 10.1007/s00701-016-2928-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/04/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND Increasingly, biomarkers have been identified that correlate with improved overall and progression-free survival (OS and PFS) in glioblastoma, including MGMT methylation status and mutations in the IDH1 gene. In this study, we investigated the clinical and biological factors associated with long-term survival in glioblastoma patients treated with chemoradiotherapy. METHOD Demographic and clinical data were collected for all patients with glioblastoma diagnosed between May 2004 and September 2007, treated with chemoradiotherapy and with associated tissue samples available for biomarker analysis. MGMT methylation was determined by pyrosequencing. IDH1 mutation was identified by R132H immunohistochemistry. Univariate Cox regression analysis of factors associated with survival and Kaplan-Meier survival analysis was performed using the SPSS statistics package. RESULTS One hundred patients were included in the study. Median follow-up was 12.2 months (range 1.6-102.4). Median OS was 12.1 months (95 % CI: 10.8-13.3) and median PFS was 8.2 months (95 % CI: 6.8-9.5). The 2-, 3- and 5-year survival was 18, 9 and 6 % respectively. Three patients are still alive at 7.4, 8.3 and 8.5 years after diagnosis. Cox proportional-hazards regression identified independent prognostic factors for OS, female (p = 0.019), MGMT methylation (p < 0.0001) and IDH1 mutation (p = 0.023), and for PFS, MGMT methylation (p = 0.001) and IDH1 mutation (p = 0.018). Kaplan-Meier survival analysis showed that MGMT(methylated)/IDH1(+ve) was associated with a significantly longer OS 66.8 months (95 % CI: 0.0-167.8) and PFS 16.9 months (95 % CI: 11.1-22.7) when compared with MGMT(methylated)/IDH1(-ve) OS 15.5 months (95 % CI: 11.6-19.4) and PFS 9.4 months (95 % CI: 8-10.8) (log-rank, P = 0.000) and MGMT(unmethylated)/IDH1(-ve) OS 11.1 months (95 % CI: 8.5-13.7) and PFS 6.3 months (95 % CI: 4.4-8.3) (log-rank, p = 0.000). CONCLUSIONS While the importance of MGMT methylation is well established, we demonstrate that the combination of MGMT(methylated)/IDH1(+ve) is associated with considerably longer OS and PFS in this series of chemoradiotherapy-treated glioblastoma tumours. The long-term cognitive function and quality of life in these long-term survivors warrant investigation.
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Affiliation(s)
- Christopher P Millward
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, Merseyside, L9 7LJ, UK.
| | - Andrew R Brodbelt
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, Merseyside, L9 7LJ, UK
| | - Brian Haylock
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | - Rasheed Zakaria
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, Merseyside, L9 7LJ, UK
| | - Atik Baborie
- Department of Neuropathology, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, Merseyside, L9 7LJ, UK
| | - Daniel Crooks
- Department of Neuropathology, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, Merseyside, L9 7LJ, UK
| | - David Husband
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | - Aditya Shenoy
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | - Helen Wong
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | - Michael D Jenkinson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, Merseyside, L9 7LJ, UK
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
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Afatinib, an irreversible ErbB family blocker, with protracted temozolomide in recurrent glioblastoma: a case report. Oncotarget 2016; 6:34030-7. [PMID: 26423602 PMCID: PMC4741824 DOI: 10.18632/oncotarget.5297] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 09/11/2015] [Indexed: 11/25/2022] Open
Abstract
There are few effective treatments for recurrent glioblastoma multiforme (GBM). We present a patient with recurrent GBM who achieved a prolonged response to treatment with afatinib, an irreversible ErbB family blocker, plus temozolomide. A 58-year-old female patient was diagnosed with multifocal primary GBM. After surgical resection, first-line therapy comprised radiotherapy and temozolomide. Following disease progression after 3 temozolomide cycles, the patient entered a phase I/II clinical trial of afatinib (20-40 mg daily for 28 days) plus temozolomide (50 mg/m2 every 21/28 days). Next-generation sequencing analysis of the brain tumor specimen was performed. At the last assessment, 63 treatment cycles had been completed and the patient had survived for ~5 years since recurrence. Significant disease regression was observed after 5 cycles and was maintained during long-term follow-up. Adverse events were consistent with the known tolerability profile of afatinib and were managed by treatment interruption/dose reduction. The patient had several epidermal growth factor receptor (EGFR) aberrations, including gene amplification and EGFRvIII positivity. Three somatic mutations were identified, including an unprecedented extracellular-domain substitution (D247Y). The patient has survived ~6-fold longer than normally expected in patients with recurrent GBM. The complex EGFR genotype may underlie sustained response to afatinib plus temozolomide.
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32
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Mehrian-Shai R, Yalon M, Simon AJ, Eyal E, Pismenyuk T, Moshe I, Constantini S, Toren A. High metallothionein predicts poor survival in glioblastoma multiforme. BMC Med Genomics 2015; 8:68. [PMID: 26493598 PMCID: PMC4618994 DOI: 10.1186/s12920-015-0137-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 09/21/2015] [Indexed: 12/31/2022] Open
Abstract
Background Glioblastoma multiforme (GBM) is the most common and aggressive malignant brain tumor. Even with vigorous surgery, radiation and chemotherapy treatment, survival rates of GBM are very poor and predictive markers for prognosis are currently lacking. Methods We performed whole genome expression studies of 67 fresh frozen untreated GBM tumors and validated results by 210 GBM samples’ expression data from The Cancer Genome Atlas. Results and discussion Here we show that in GBM patients, high metallothionein (MT) expression is associated with poor survival whereas low MT levels correspond to good prognosis. Furthermore we show that in U87 GBM cell line, p53 is found to be in an inactive mutant-like conformation concurrently with more than 4 times higher MT3 expression level than normal astrocytes and U251GBM cell line. We then show that U87- p53 inactivity can be rescued by zinc (Zn). Conclusions Taken together, these data suggest that MT expression may be a potential novel prognostic biomarker for GBM, and that U87 cells may be a good model for patients with non active WT p53 resulting from high levels of MTs.
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Affiliation(s)
- Ruty Mehrian-Shai
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Tel Hashomer affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Michal Yalon
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Tel Hashomer affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Amos J Simon
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Tel Hashomer affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Eran Eyal
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Tel Hashomer affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Tatyana Pismenyuk
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Tel Hashomer affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Itai Moshe
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Tel Hashomer affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Shlomi Constantini
- Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv-Sourasky Medical Center, Tel-Aviv, Israel.
| | - Amos Toren
- Pediatric Hemato-Oncology, Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Tel Hashomer affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
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Chang W, Pope WB, Harris RJ, Hardy AJ, Leu K, Mody RR, Nghiemphu PL, Lai A, Cloughesy TF, Ellingson BM. Diffusion MR Characteristics Following Concurrent Radiochemotherapy Predicts Progression-Free and Overall Survival in Newly Diagnosed Glioblastoma. Tomography 2015; 1:37-43. [PMID: 26740971 PMCID: PMC4698970 DOI: 10.18383/j.tom.2015.00115] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The standard of care for newly diagnosed glioblastoma (GBM) is surgery, then radiotherapy (RT) with concurrent temozolomide (TMZ), followed by adjuvant TMZ. We hypothesized patients with low diffusivity measured using apparent diffusion coefficient (ADC) histogram analysis evaluated after RT+TMZ, prior to adjuvant TMZ, would have a significantly shorter progression-free (PFS) and overall survival (OS). To test this hypothesis we evaluated 120 patients with newly diagnosed GBM receiving RT+TMZ followed by adjuvant TMZ. MRI was performed after completion of RT+TMZ, prior to initiation of adjuvant TMZ. A double Gaussian mixed model was used to describe the ADC histograms within the enhancing tumor, where ADCL and ADCH were defined as the mean ADC value of the lower and higher Gaussian distribution, respectively. An ADCL value of 1.0 um2/ms and ADCH value of 1.6 um2/ms were used to stratify patients into high and low risk categories. Results suggest patients with low ADCL had significantly shorter PFS (Cox Hazard Ratio = 0.12, P = 0.0006). OS was significantly shorter with low ADCL tumors, showing a median OS of 407 vs. 644 days (Cox Hazard Ratio = 0.31, P = 0.047). ADCH was not predictive of PFS or OS when accounting for age and ADCL. In summary, newly diagnosed glioblastoma patients with low ADCL after completion of RT+TMZ are likely to progress and die earlier than patients with higher ADCL. Results suggest ADC histogram analysis may be useful for patient risk stratification following completion of RT+TMZ.
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Affiliation(s)
| | | | | | | | - Kevin Leu
- Departments of Radiological Sciences
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science; and
| | - Reema R. Mody
- Neurology, and
- Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, CA
| | - Phioanh L. Nghiemphu
- Neurology, and
- Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, CA
| | - Albert Lai
- Neurology, and
- Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, CA
| | - Timothy F. Cloughesy
- Neurology, and
- Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, CA
| | - Benjamin M. Ellingson
- Departments of Radiological Sciences
- Biomedical Physics
- Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science; and
- Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, CA
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Pyka T, Gempt J, Hiob D, Ringel F, Schlegel J, Bette S, Wester HJ, Meyer B, Förster S. Textural analysis of pre-therapeutic [18F]-FET-PET and its correlation with tumor grade and patient survival in high-grade gliomas. Eur J Nucl Med Mol Imaging 2015. [PMID: 26219871 DOI: 10.1007/s00259-015-3140-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Amino acid positron emission tomography (PET) with [18F]-fluoroethyl-L-tyrosine (FET) is well established in the diagnostic work-up of malignant brain tumors. Analysis of FET-PET data using tumor-to-background ratios (TBR) has been shown to be highly valuable for the detection of viable hypermetabolic brain tumor tissue; however, it has not proven equally useful for tumor grading. Recently, textural features in 18-fluorodeoxyglucose-PET have been proposed as a method to quantify the heterogeneity of glucose metabolism in a variety of tumor entities. Herein we evaluate whether textural FET-PET features are of utility for grading and prognostication in patients with high-grade gliomas. METHODS One hundred thirteen patients (70 men, 43 women) with histologically proven high-grade gliomas were included in this retrospective study. All patients received static FET-PET scans prior to first-line therapy. TBR (max and mean), volumetric parameters and textural parameters based on gray-level neighborhood difference matrices were derived from static FET-PET images. Receiver operating characteristic (ROC) and discriminant function analyses were used to assess the value for tumor grading. Kaplan-Meier curves and univariate and multivariate Cox regression were employed for analysis of progression-free and overall survival. RESULTS All FET-PET textural parameters showed the ability to differentiate between World Health Organization (WHO) grade III and IV tumors (p < 0.001; AUC 0.775). Further improvement in discriminatory power was possible through a combination of texture and metabolic tumor volume, classifying 85 % of tumors correctly (AUC 0.830). TBR and volumetric parameters alone were correlated with tumor grade, but showed lower AUC values (0.644 and 0.710, respectively). Furthermore, a correlation of FET-PET texture but not TBR was shown with patient PFS and OS, proving significant in multivariate analysis as well. Volumetric parameters were predictive for OS, but this correlation did not hold in multivariate analysis. CONCLUSIONS Determination of uptake heterogeneity in pre-therapeutic FET-PET using textural features proved valuable for the (sub-)grading of high-grade glioma as well as prediction of tumor progression and patient survival, and showed improved performance compared to standard parameters such as TBR and tumor volume. Our results underscore the importance of intratumoral heterogeneity in the biology of high-grade glial cell tumors and may contribute to individual therapy planning in the future, although they must be confirmed in prospective studies before incorporation into clinical routine.
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Affiliation(s)
- Thomas Pyka
- Department of Nuclear Medicine, Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany.
| | - Jens Gempt
- Neurosurgic Department, Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany
| | - Daniela Hiob
- Department of Nuclear Medicine, Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany
| | - Florian Ringel
- Neurosurgic Department, Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany
| | - Jürgen Schlegel
- Institute of Pathology and Neuropathology, Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany
| | - Stefanie Bette
- Neuroradiologic department, Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany
| | - Hans-Jürgen Wester
- Department of Nuclear Medicine, Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany
| | - Bernhard Meyer
- Neurosurgic Department, Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany
| | - Stefan Förster
- Department of Nuclear Medicine, Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany.,TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar der TU München, Ismaninger Str., Munich, Germany
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Meng J, Li P, Zhang Q, Yang Z, Fu S. A radiosensitivity gene signature in predicting glioma prognostic via EMT pathway. Oncotarget 2015; 5:4683-93. [PMID: 24970813 PMCID: PMC4148091 DOI: 10.18632/oncotarget.2088] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A 31-gene signature derived by integrating four different microarray experiments, has been found to have a potential for predicting radiosensitivity of cancer cells, but it was seldom validated in clinical cancer samples. We proposed that the gene signature may serve as a predictive biomarker for estimating the overall survival of radiation-treated patients. The significance of gene signature was tested in two previously published datasets from Gene Expression Omnibus (GEO) and The Cancer Genome Altas (TCGA), respectively. In GEO data set, patients predicted to be radiosensitive(RS) had an improved overall survival when compared with radioresistant(RR) patients in either radiotherapy(RT)-treated or non radiotherapy(RT)-treated subgroups(p<0.0001 in the RT-treated group). Multivariate Cox regression analysis showed that the gene signature is the strongest predictor(p=0.0093) in the RT-treated subgroup of patients. However, it does not remain significant (p=0.7668) in non radiotherapy-treated group when adjusting for age and Karnofsky performance score (KPS) as covariates. Similarly, in the TCGA data set, radiotherapy-treated glioblastoma multiforme(GBM) patients assigned to RS group had an improved overall survival compared with RR group(p<0.0001). Geneset enrichment analysis(GSEA) analysis revealed that enrichment of epithelial mesenchymal transition(EMT) pathway was observed with radioresistant phenotype. These results suggest that the signature is a predictive biomarker for radiation-treated glioma patients' prognostic.
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Affiliation(s)
- Jin Meng
- Department of Radiation Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China
| | - Ping Li
- Department of Radiation Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China
| | - Qing Zhang
- Radiation Oncology Center, Fudan University Shanghai Cancer Center (FUSCC), Shanghai, China. Radiation Oncology Dept, Shanghai Proton and Heavy Ion Center (SPHIC), Shanghai, China
| | - Zhangru Yang
- Department of Radiation Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China
| | - Shen Fu
- Radiation Oncology Center, Fudan University Shanghai Cancer Center (FUSCC), Shanghai, China. Radiation Oncology Dept, Shanghai Proton and Heavy Ion Center (SPHIC), Shanghai, China
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Veytsman B, Wang L, Cui T, Bruskin S, Baranova A. Distance-based classifiers as potential diagnostic and prediction tools for human diseases. BMC Genomics 2015; 15 Suppl 12:S10. [PMID: 25563076 PMCID: PMC4303935 DOI: 10.1186/1471-2164-15-s12-s10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Typically, gene expression biomarkers are being discovered in course of high-throughput experiments, for example, RNAseq or microarray profiling. Analytic pipelines that extract so-called signatures suffer from the "Dimensionality curse": the number of genes expressed exceeds the number of patients we can enroll in the study and use to train the discriminator algorithm. Hence, problems with the reproducibility of gene signatures are more common than not; when the algorithm is executed using a different training set, the resulting diagnostic signature may turn out to be completely different. In this paper we propose an alternative novel approach which takes into account quantifiable expression levels of all genes assayed. In our analysis, the cumulative gene expression pattern of an individual patient is represented as a point in the multidimensional space formed by all gene expression profiles assayed in given system, where the clusters of "normal samples" and "affected samples" and defined. The degree of separation of the given sample from the space occupied by "normal samples" reflects the drift of the sample away from homeostasis in the course of development of the pathophysiological process that underly the disease. The outlined approach was validated using the publicly available glioma dataset deposited in Rembrandt and associated with survival data. Additionally, the applicability of the distance analysis to the classification of non-malignant sampled was tested using psoriatic lesions and non-lesional matched controls as a model. Keywords: biomarkers; clustering; human diseases; RNA
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Genetic modification of neurons to express bevacizumab for local anti-angiogenesis treatment of glioblastoma. Cancer Gene Ther 2014; 22:1-8. [PMID: 25501993 PMCID: PMC4293257 DOI: 10.1038/cgt.2014.58] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 10/03/2014] [Accepted: 10/07/2014] [Indexed: 01/12/2023]
Abstract
The median survival of glioblastoma multiforme (GBM) approximately 1 yr. Following surgical removal, systemic therapies are limited by the blood-brain barrier. To circumvent this, we developed a method to modify neurons with the genetic sequence for therapeutic monoclonal antibodies using adeno-associated virus (AAV) gene transfer vectors, directing persistent, local expression in the tumor milieu. The human U87MG GBM cell line or patient-derived early passage GBM cells were administered to the striatum of NOD/SCID immunodeficient mice. AAVrh.10BevMab, an AAVrh.10-based vector coding for bevacizumab (Avastin®), an anti-human vascular endothelial growth factor (VEGF) monoclonal antibody, was delivered to the area of the GBM xenograft. Localized expression of bevacizumab was demonstrated by quantitative PCR, ELISA and Western. Immunohistochemistry showed the bevacizumab was expressed in neurons. Concurrent administration of AAVrh.10BevMab with the U87MG tumor reduced tumor blood vessel density, and tumor volume and increased survival. Administration of AAVrh.10BevMab 1 wk after U87MG xenograft reduced growth and increased survival. Studies with patient-derived early passage GBM primary cells showed a reduction in primary tumor burden with an increased survival. This data supports the strategy of AAV-mediated CNS gene therapy to treat GBM, overcoming the blood-brain barrier through local, persistent delivery of an anti-angiogenesis monoclonal antibody.
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Henriksen M, Johnsen KB, Andersen HH, Pilgaard L, Duroux M. MicroRNA expression signatures determine prognosis and survival in glioblastoma multiforme--a systematic overview. Mol Neurobiol 2014; 50:896-913. [PMID: 24619503 PMCID: PMC4225053 DOI: 10.1007/s12035-014-8668-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 02/25/2014] [Indexed: 12/21/2022]
Abstract
Despite advances in our knowledge about glioblastoma multiforme (GBM) pathology, clinical challenges still lie ahead with respect to treatment in GBM due to high prevalence, poor prognosis, and frequent tumor relapse. The implication of microRNAs (miRNAs) in GBM is a rapidly expanding field of research with the aim to develop more targeted molecular therapies. This review aims to present a comprehensive overview of all the available literature, evaluating miRNA signatures as a function of prognosis and survival in GBM. The results are presented with a focus on studies derived from clinical data in databases and independent tissue cohorts where smaller samples sizes were investigated. Here, miRNA associated to longer survival (protective) and miRNA with shorter survival (risk-associated) have been identified and their signatures based on different prognostic attributes are described. Finally, miRNAs associated with disease progression or survival in several studies are identified and functionally described. These miRNAs may be valuable for future determination of patient prognosis and could possibly serve as targets for miRNA-based therapies, which hold a great potential in the treatment of this severe malignant disease.
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Affiliation(s)
- Michael Henriksen
- Laboratory for Cancer Biology, Institute of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 3B, 9220 Aalborg Ø, Denmark
| | - Kasper Bendix Johnsen
- Laboratory for Cancer Biology, Institute of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 3B, 9220 Aalborg Ø, Denmark
| | - Hjalte Holm Andersen
- Laboratory for Cancer Biology, Institute of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 3B, 9220 Aalborg Ø, Denmark
| | - Linda Pilgaard
- Laboratory for Cancer Biology, Institute of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 3B, 9220 Aalborg Ø, Denmark
| | - Meg Duroux
- Laboratory for Cancer Biology, Institute of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 3B, 9220 Aalborg Ø, Denmark
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Badiyan SN, Markovina S, Simpson JR, Robinson CG, DeWees T, Tran DD, Linette G, Jalalizadeh R, Dacey R, Rich KM, Chicoine MR, Dowling JL, Leuthardt EC, Zipfel GJ, Kim AH, Huang J. Radiation Therapy Dose Escalation for Glioblastoma Multiforme in the Era of Temozolomide. Int J Radiat Oncol Biol Phys 2014; 90:877-85. [DOI: 10.1016/j.ijrobp.2014.07.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 06/24/2014] [Accepted: 07/11/2014] [Indexed: 11/29/2022]
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Pyka T, Gempt J, Ringel F, Hüttinger S, van Marwick S, Nekolla S, Wester HJ, Schwaiger M, Förster S. Prediction of glioma recurrence using dynamic ¹⁸F-fluoroethyltyrosine PET. AJNR Am J Neuroradiol 2014; 35:1924-9. [PMID: 24924547 DOI: 10.3174/ajnr.a3980] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND PURPOSE Inter- and intratumor heterogeneity and the variable course of disease in patients with glioma motivate the investigation of new prognostic factors to optimize individual treatment. Here we explore the usefulness of standard static and more sophisticated dynamic (18)F-fluoroethyltyrosine-PET imaging for the assessment of patient prognosis. MATERIALS AND METHODS Thirty-four consecutive patients with untreated, first-diagnosed, histologically proved glioma were included in this retrospective study. All patients underwent dynamic PET scans before surgery (± standard treatment) and were followed up clinically and by MR imaging. Static and dynamic tumor-to-background ratio, TTP, and slope-to-peak were obtained and correlated with progression-free survival. RESULTS Twenty of 34 patients experienced progression, with a median progression-free survival of 28.0 ± 11.1 months. Dynamic TTP was highly prognostic for recurrent disease, showing a strong correlation with progression-free survival (hazard ratio, 6.050; 95% CI, 2.11-17.37; P < .001). Most interesting, this correlation also proved significant in the subgroup of low-grade glioma (hazard ratio, 5.347; 95% CI, 1.05-27.20; P = .044), but not when using established static imaging parameters, such as maximum tumor-to-background ratio and mean tumor-to-background ratio. In the high-grade glioma subgroup, both dynamic and static parameters correlated with progression-free survival. The best results were achieved by defining ROIs around "hot spots" in earlier timeframes, underlining the concept of intratumor heterogeneity. CONCLUSIONS (18)F-fluoroethyltyrosine-PET can predict recurrence in patients with glioma, with dynamic analysis showing advantages over static imaging, especially in the low-grade subgroup.
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Affiliation(s)
- T Pyka
- From the Departments of Nuclear Medicine (T.P., S.v.M., S.N., M.S., S.F)
| | | | | | | | - S van Marwick
- From the Departments of Nuclear Medicine (T.P., S.v.M., S.N., M.S., S.F)
| | - S Nekolla
- From the Departments of Nuclear Medicine (T.P., S.v.M., S.N., M.S., S.F)
| | - H-J Wester
- Pharmaceutical Radiochemistry (H.-J.W.), Technical University Munich, Munich, Germany
| | - M Schwaiger
- From the Departments of Nuclear Medicine (T.P., S.v.M., S.N., M.S., S.F)
| | - S Förster
- From the Departments of Nuclear Medicine (T.P., S.v.M., S.N., M.S., S.F)
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Molenaar RJ, Verbaan D, Lamba S, Zanon C, Jeuken JWM, Boots-Sprenger SHE, Wesseling P, Hulsebos TJM, Troost D, van Tilborg AA, Leenstra S, Vandertop WP, Bardelli A, van Noorden CJF, Bleeker FE. The combination of IDH1 mutations and MGMT methylation status predicts survival in glioblastoma better than either IDH1 or MGMT alone. Neuro Oncol 2014; 16:1263-73. [PMID: 24510240 PMCID: PMC4136888 DOI: 10.1093/neuonc/nou005] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 01/10/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Genetic and epigenetic profiling of glioblastomas has provided a comprehensive list of altered cancer genes of which only O(6)-methylguanine-methyltransferase (MGMT) methylation is used thus far as a predictive marker in a clinical setting. We investigated the prognostic significance of genetic and epigenetic alterations in glioblastoma patients. METHODS We screened 98 human glioblastoma samples for genetic and epigenetic alterations in 10 genes and chromosomal loci by PCR and multiplex ligation-dependent probe amplification (MLPA). We tested the association between these genetic and epigenetic alterations and glioblastoma patient survival. Subsequently, we developed a 2-gene survival predictor. RESULTS Multivariate analyses revealed that mutations in isocitrate dehydrogenase 1 (IDH1), promoter methylation of MGMT, irradiation dosage, and Karnofsky Performance Status (KFS) were independent prognostic factors. A 2-gene predictor for glioblastoma survival was generated. Based on the genetic and epigenetic status of IDH1 and MGMT, glioblastoma patients were stratified into 3 clinically different genotypes: glioblastoma patients with IDH1mt/MGMTmet had the longest survival, followed by patients with IDH1mt/MGMTunmet or IDH1wt/MGMTmet, and patients with IDH1wt/MGMTunmet had the shortest survival. This 2-gene predictor was an independent prognostic factor and performed significantly better in predicting survival than either IDH1 mutations or MGMT methylation alone. The predictor was validated in 3 external datasets. DISCUSSION The combination of IDH1 mutations and MGMT methylation outperforms either IDH1 mutations or MGMT methylation alone in predicting survival of glioblastoma patients. This information will help to increase our understanding of glioblastoma biology, and it may be helpful for baseline comparisons in future clinical trials.
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Affiliation(s)
- Remco J Molenaar
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Dagmar Verbaan
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Simona Lamba
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Carlo Zanon
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Judith W M Jeuken
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Sandra H E Boots-Sprenger
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Pieter Wesseling
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Theo J M Hulsebos
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Dirk Troost
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Angela A van Tilborg
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Sieger Leenstra
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - W Peter Vandertop
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Alberto Bardelli
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Cornelis J F van Noorden
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
| | - Fonnet E Bleeker
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (R.J.M., C.J.F.v.N.); Neurosurgical Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands (F.E.B., D.V., W.P.V.); Laboratory of Molecular Genetics, The Oncogenomics Center, Institute for Cancer Research and Treatment, University of Torino Medical School, Candiolo, Italy (S.La., C.Z., A.B., F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands (J.W.M.J., S.H.E.B.-S., P.W.); Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands (P.W.); Department of Neurogenetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (T.J.M.H.); Department of Neuropathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.T., A.A.v.T.); Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands (W.P.V.); Department of Neurosurgery, St. Elisabeth Hospital Tilburg, The Netherlands (S.Le.); Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands (S.Le.); FIRC Institute of Molecular Oncology, Milan, Italy (A.B.)Present affiliation: Department of Clinical Genetics, Academic Medical Center and University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands (F.E.B.); Department of Pathology, Radboud University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (A.A.v.T.); Department of Neurology, Radboud University Medical Centre Nijmegen, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands (S.H.E.B.-S.); Department of Pathology, Stichting PAMM, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands (J.W.M.J.)
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Wang F, Sun JY, Zhu YH, Liu NT, Wu YF, Yu F. MicroRNA-181 inhibits glioma cell proliferation by targeting cyclin B1. Mol Med Rep 2014; 10:2160-4. [PMID: 25070000 DOI: 10.3892/mmr.2014.2423] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 05/02/2014] [Indexed: 11/06/2022] Open
Abstract
Small non‑coding RNAs from the microRNA family (miRs) are important elements in the posttranscriptional control of gene expression. miRs are known to regulate numerous cellular processes and are of crucial importance during development and in pathological conditions, including tumor initiation and progression. In the present study, the expression level of miR‑181 was reduced in glioma tissues compared with the adjacent normal tissues. The enforced expression of miR‑181 was able to inhibit cell proliferation in U251 and SHG‑44 cells, while antisense miR‑181 oligonucleotides (antisense miR‑181) enhanced cell proliferation. At the molecular level, these results further revealed that the expression of cyclin B1, a positive cell‑cycle regulator, was negatively regulated by miR‑181. Therefore, the data reported in the present study demonstrates that miR‑181 is an important regulator in glioma. These results may contribute to improving the understanding of the key misregulated miRNAs in glioma.
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Affiliation(s)
- Fei Wang
- Department of Neurosurgery, Tongji Hospital, Tongji University, Shanghai 200065, P.R. China
| | - Ji-Yong Sun
- Department of Neurosurgery, Wuxi Second Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214002, P.R. China
| | - You-Hou Zhu
- Department of Neurosurgery, Tongji Hospital, Tongji University, Shanghai 200065, P.R. China
| | - Ning-Tao Liu
- Department of Neurosurgery, Tongji Hospital, Tongji University, Shanghai 200065, P.R. China
| | - Yi-Fang Wu
- Department of Neurosurgery, Tongji Hospital, Tongji University, Shanghai 200065, P.R. China
| | - Fei Yu
- Department of Neurosurgery, Tongji Hospital, Tongji University, Shanghai 200065, P.R. China
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Henriksen M, Johnsen KB, Olesen P, Pilgaard L, Duroux M. MicroRNA expression signatures and their correlation with clinicopathological features in glioblastoma multiforme. Neuromolecular Med 2014; 16:565-77. [PMID: 24817689 DOI: 10.1007/s12017-014-8309-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 04/26/2014] [Indexed: 12/11/2022]
Abstract
The increasing interest in identifying molecular biomarkers to determine patient prognosis in glioblastoma multiforme (GBM) has resulted in several microRNA (miRNA)-based signatures able to predict progression-free and overall survival. However, the coherency between these signatures is small, and correlations to clinicopathological features other than survival are seldom seen. The aim of this study was to identify any significant relationship between miRNA signatures and clinicopathological data by combining pathological features with miRNA and mRNA analysis in fourteen GBM patients. In total, 161 miRNAs were shown to cluster the GBM tumor samples into long- and short-term-surviving patients. Many of these miRNAs were associated with differential expression in GBM, including a number of miRNAs shown to confer risk or protection with respect to clinical outcome and to modulate the mesenchymal mode of migration and invasion. An inverse relationship between miR-125b and nestin expression was identified and correlated with overall survival in GBM patients, eloquently illustrating how clinicopathological findings and molecular profiling may be a relevant combination to predict patient outcome. The intriguing finding that many of the differentially expressed miRNAs contained exosome-packaging motifs in their mature sequences suggests that we must expand our view to encompass the complex intercellular communication in order to identify molecular prognostic biomarkers and to increase our knowledge in the field of GBM pathogenesis.
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Affiliation(s)
- Michael Henriksen
- Laboratory for Cancer Biology, Institute of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 3B, 9220, Aalborg Ø, Denmark
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Global diffusion tensor imaging derived metrics differentiate glioblastoma multiforme vs. normal brains by using discriminant analysis: introduction of a novel whole-brain approach. Radiol Oncol 2014; 48:127-36. [PMID: 24991202 PMCID: PMC4078031 DOI: 10.2478/raon-2014-0004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 12/21/2013] [Indexed: 02/08/2023] Open
Abstract
Background Histological behavior of glioblastoma multiforme suggests it would benefit more from a global rather than regional evaluation. A global (whole-brain) calculation of diffusion tensor imaging (DTI) derived tensor metrics offers a valid method to detect the integrity of white matter structures without missing infiltrated brain areas not seen in conventional sequences. In this study we calculated a predictive model of brain infiltration in patients with glioblastoma using global tensor metrics. Methods Retrospective, case and control study; 11 global DTI-derived tensor metrics were calculated in 27 patients with glioblastoma multiforme and 34 controls: mean diffusivity, fractional anisotropy, pure isotropic diffusion, pure anisotropic diffusion, the total magnitude of the diffusion tensor, linear tensor, planar tensor, spherical tensor, relative anisotropy, axial diffusivity and radial diffusivity. The multivariate discriminant analysis of these variables (including age) with a diagnostic test evaluation was performed. Results The simultaneous analysis of 732 measures from 12 continuous variables in 61 subjects revealed one discriminant model that significantly differentiated normal brains and brains with glioblastoma: Wilks’ λ = 0.324, χ2 (3) = 38.907, p < .001. The overall predictive accuracy was 92.7%. Conclusions We present a phase II study introducing a novel global approach using DTI-derived biomarkers of brain impairment. The final predictive model selected only three metrics: axial diffusivity, spherical tensor and linear tensor. These metrics might be clinically applied for diagnosis, follow-up, and the study of other neurological diseases.
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AR-A 014418 Used against GSK3beta Downregulates Expression of hnRNPA1 and SF2/ASF Splicing Factors. JOURNAL OF ONCOLOGY 2014; 2014:695325. [PMID: 24550987 PMCID: PMC3914408 DOI: 10.1155/2014/695325] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 10/23/2013] [Accepted: 11/02/2013] [Indexed: 11/21/2022]
Abstract
Glioblastoma is one of the most aggressive forms of primary brain tumors of glial cells, including aberrant regulation of glycogen synthase kinase 3β (GSK3β) and splicing factors deregulation. Here, we investigate the role of small molecule AR-A014418 and Manzamine A against GSK3 kinase with factual control on splicing regulators. AR-A 014418, 48 hrs posttreatment, caused dose (25–100 μM) dependent inhibition in U373 and U87 cell viability with also inhibition in activating tyrosine phosphorylation of GSK3alpha (Tyr 279) and beta (Tyr 216). Furthermore, inhibition of GSK3 kinase resulted in significant downregulation of splicing factors (SRSF1, SRSF5, PTPB1, and hnRNP) in U87 cells with downregulation of antiapoptotic genes such as BCL2, BCL-xL, Survivin, MCL1, and BMI1. Similarly, downregulation of splicing factors was also observed in U373 glioma cell after using SiRNA against AKT and GSK3beta kinase. In addition, potential roles of AR-A014418 in downregulation of splicing factors were reflected with decrease in Anxa7 (VA) variant and increase in Anxa7 WT tumor suppressor transcript and protein. The above results suggest that inhibition of GSK3beta kinase activation could be the beneficial strategy to inhibit the occurrence of alternative cancer escape pathway via downregulating the expression of splicing regulators as well as apoptosis.
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EMARA MARWAN, TURNER AROBERT, ALLALUNIS-TURNER JOAN. Hypoxia differentially upregulates the expression of embryonic, fetal and adult hemoglobin in human glioblastoma cells. Int J Oncol 2013; 44:950-8. [DOI: 10.3892/ijo.2013.2239] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 11/25/2013] [Indexed: 11/06/2022] Open
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