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Gu X, He X, Wang H, Li J, Chen R, Liu H. Dynamic Susceptibility Contrast-Enhanced Perfusion-Weighted Imaging in Differentiation Between Recurrence and Pseudoprogression in High-Grade Glioma: A Meta-analysis. J Comput Assist Tomogr 2024; 48:303-310. [PMID: 37654056 DOI: 10.1097/rct.0000000000001543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
INTRODUCTION In glioma patients that have undergone surgical tumor resection, the ability to reliably distinguish between pseudoprogression (PsP) and a recurrent tumor (RT) is of key clinical importance. Accordingly, this meta-analysis evaluated the utility of dynamic susceptibility contrast-enhanced perfusion-weighted imaging as a means of distinguishing between PsP and RT when analyzing patients with high-grade glioma. MATERIALS AND METHODS The PubMed, Web of Science, and Wanfang databases were searched for relevant studies. Pooled analyses of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) values were conducted, after which the area under the curve (AUC) for summary receiver operating characteristic curves was computed. RESULTS This meta-analysis ultimately included 21 studies enrolling 879 patients with 888 lesions. Cerebral blood volume-associated diagnostic results were reported in 20 of the analyzed studies, and the respective pooled sensitivity, specificity, PLR, and NLR values were 86% (95% confidence interval [CI], 0.81-0.89), 83% (95% CI, 0.77-0.87), 4.94 (95% CI, 3.61-6.75), and 0.18 (95% CI, 0.13-0.23) for these 20 studies. The corresponding AUC value was 0.91 (95% CI, 0.88-0.93), and the publication bias risk was low ( P = 0.976). Cerebral blood flow-related diagnostic results were additionally reported in 6 of the analyzed studies, with respective pooled sensitivity, specificity, PLR, and NLR values of 85% (95% CI, 0.78-0.90), 85% (95% CI, 0.76-0.91), 5.54 (95% CI, 3.40-9.01), and 0.18 (95% CI, 0.12-0.26). The corresponding AUC value was 0.92 (95% CI, 0.89-0.94), and the publication bias risk was low ( P = 0.373). CONCLUSIONS The present meta-analysis results suggest that dynamic susceptibility contrast-enhanced perfusion-weighted imaging represents an effective diagnostic approach to distinguishing between PsP and RT in high-grade glioma patients.
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Affiliation(s)
| | - Xining He
- From the Departments of Neurosurgery
| | - Hualong Wang
- Radiology, Binzhou People's Hospital, Binzhou, China
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Yang S, Baeg E, Kim K, Kim D, Xu D, Ahn JH, Yang S. Neurodiagnostic and neurotherapeutic potential of graphene nanomaterials. Biosens Bioelectron 2024; 247:115906. [PMID: 38101185 DOI: 10.1016/j.bios.2023.115906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/06/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023]
Abstract
Graphene has emerged as a highly promising nanomaterial for a variety of advanced technologies, including batteries, energy, electronics, and biotechnologies. Its recent contribution to neurotechnology is particularly noteworthy because its superior conductivity, chemical resilience, biocompatibility, thermal stability, and scalable nature make it well-suited for measuring brain activity and plasticity in health and disease. Graphene-mediated compounds are microfabricated in two central methods: chemical processes with natural graphite and chemical vapor deposition of graphene in a film form. They are widely used as biosensors and bioelectronics for neurodiagnostic and neurotherapeutic purposes in several brain disorders, such as Parkinson's disease, stroke, glioma, epilepsy, tinnitus, and Alzheimer's disease. This review provides an overview of studies that have demonstrated the technical advances of graphene nanomaterials in neuroscientific and clinical applications. We also discuss current limitations and future demands in relation to the clinical application of graphene, highlighting its potential technological and clinical significance for treating brain disorders. Our review underscores the potential of graphene nanomaterials as powerful tools for advancing the understanding of the brain and developing new therapeutic strategies.
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Affiliation(s)
- Sunggu Yang
- Department of Nano-bioengineering, Incheon National University, Incheon, 22012, Republic of Korea; Center for Brain-Machine Interface, Incheon National University, Incheon, 22012, Republic of Korea; gBrain Inc., Incheon, 21984, Republic of Korea.
| | - Eunha Baeg
- Department of Nano-bioengineering, Incheon National University, Incheon, 22012, Republic of Korea
| | - Kyungtae Kim
- Department of Nano-bioengineering, Incheon National University, Incheon, 22012, Republic of Korea
| | - Donggue Kim
- Department of Nano-bioengineering, Incheon National University, Incheon, 22012, Republic of Korea
| | - Duo Xu
- School of Electrical & Electronic Engineering, Yonsei University, Seoul, 03722, Republic of Korea
| | - Jong-Hyun Ahn
- School of Electrical & Electronic Engineering, Yonsei University, Seoul, 03722, Republic of Korea.
| | - Sungchil Yang
- Department of Neuroscience, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong.
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Ahluwalia MS, Khosla AA, Ozair A, Gouda MA, Subbiah V. Impact of tissue-agnostic approvals on management of primary brain tumors. Trends Cancer 2024; 10:256-274. [PMID: 38245379 DOI: 10.1016/j.trecan.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/11/2023] [Accepted: 11/17/2023] [Indexed: 01/22/2024]
Abstract
Novel tissue-agnostic therapeutics targeting driver mutations in tumor cells have been recently approved by FDA, driven by basket trials that have demonstrated their efficacy and safety across diverse tumor histology. However, the relative rarity of primary brain tumors (PBTs) has limited their representation in early trials of tissue-agnostic medications. Thus, consensus continues to evolve regarding utility of tissue-agnostic medications in routine practice for PBTs, a diverse group of neoplasms characterized by limited treatment options and unfavorable prognoses. We describe current and potential impact of tissue-agnostic approvals on management of PBTs. We discuss data from clinical trials for PBTs regarding tissue-agnostic targets, including BRAFV600E, neurotrophic tyrosine receptor kinase (NTRK) fusions, microsatellite instability-high (MSI-High), mismatch repair deficiency (dMMR), and high tumor mutational burden (TMB-H), in context of challenges in managing PBTs. Described are additional tissue-agnostic targets that hold promise for benefiting patients with PBTs, including RET fusion, fibroblast growth factor receptor (FGFR), ERBB2/HER2, and KRASG12C, and TP53Y220C.
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Affiliation(s)
- Manmeet S Ahluwalia
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA; Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Atulya A Khosla
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA; Department of Internal Medicine, William Beaumont University Hospital, Royal Oak, MI, USA
| | - Ahmad Ozair
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mohamed A Gouda
- Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vivek Subbiah
- Early Phase Drug Development Program, Sarah Cannon Research Institute, Nashville, TN, USA.
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104
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Hiller-Vallina S, Mondejar-Ruescas L, Caamaño-Moreno M, Cómitre-Mariano B, Alcivar-López D, Sepulveda JM, Hernández-Laín A, Pérez-Núñez Á, Segura-Collar B, Gargini R. Sexual-biased necroinflammation is revealed as a predictor of bevacizumab benefit in Glioblastoma. Neuro Oncol 2024:noae033. [PMID: 38411438 DOI: 10.1093/neuonc/noae033] [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: 08/04/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Glioblastoma (GBM) is a highly malignant brain tumor that affects men more often than women. In addition, the former shows a poorer survival prognosis. To date the reason for this sex-specific aggressiveness remains unclear. Therefore, the aim of this study is to investigate tumor processes that explain these sex differences. METHODS This was a retrospective study of GBM patients which was stratified according to sex. Cohort with 73 tumors were analyzed with immunohistochemistry, RNA-seq and RT-qPCR to characterize differences in vascular and immunological profiles. Transcriptomic profiling, GSEA and pathway enrichment analysis were used for discovery molecular pathways predominant in each group. We further investigated the therapeutic effect of Bevacizumab (VEGFA blocking antibody) in retrospective GBM cohort (36 tumors) based on sex differences. RESULTS We found that under hypoxic tumor conditions, two distinct tumor immuno-angiogenic ecosystems develop linked to sex differences and ESR1 expression are generated. One of these subgroups, which includes male patients with low ESR1 expression, is characterized by vascular fragility associated with the appearance of regions of necrosis and high inflammation (called necroinflamed tumors). This male-specific tumor subtype shows high inflammation related to MDSC infiltration. Using this stratification, we identified a possible group of patients who could respond to bevacizumab (BVZ) and revealed a genetic signature that may find clinical applications as a predictor of those who may benefit most from this treatment. CONCLUSIONS This study provides a stratification based on the sexual differences in GBM, which associates the poor prognosis with the presence of immunosuppressive myeloid cells in the necrotic areas. This new stratification could change the current prognosis of GBM and identifies those who respond to BVZ treatment.
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Affiliation(s)
- Sara Hiller-Vallina
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Pathology and Neurooncology Unit, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
| | - Lucia Mondejar-Ruescas
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Pathology and Neurooncology Unit, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
| | - Marta Caamaño-Moreno
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Pathology and Neurooncology Unit, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
| | - Blanca Cómitre-Mariano
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Pathology and Neurooncology Unit, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
| | - Denisse Alcivar-López
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Pathology and Neurooncology Unit, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
| | - Juan M Sepulveda
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Medical Oncology, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
| | - Aurelio Hernández-Laín
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Pathology and Neurooncology Unit, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
| | - Ángel Pérez-Núñez
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Department of Neurosurgery, 12 de Octubre University Hospital (i+12), 28041 Madrid, Spain
| | - Berta Segura-Collar
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Pathology and Neurooncology Unit, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
| | - Ricardo Gargini
- Instituto de Investigación Biomédicas I+12, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Pathology and Neurooncology Unit, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
- Medical Oncology, Hospital Universitario 12 de Octubre, Madrid 28041, Spain
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Staub-Bartelt F, Suresh Babu MP, Szelényi A, Rapp M, Sabel M. Establishment of Different Intraoperative Monitoring and Mapping Techniques and Their Impact on Survival, Extent of Resection, and Clinical Outcome in Patients with High-Grade Gliomas-A Series of 631 Patients in 14 Years. Cancers (Basel) 2024; 16:926. [PMID: 38473288 DOI: 10.3390/cancers16050926] [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: 12/12/2023] [Revised: 02/17/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The resection of brain tumors can be critical concerning localization, but is a key point in treating gliomas. Intraoperative neuromonitoring (IONM), awake craniotomy, and mapping procedures have been incorporated over the years. Using these intraoperative techniques, the resection of eloquent-area tumors without increasing postoperative morbidity became possible. This study aims to analyze short-term and particularly long-term outcomes in patients diagnosed with high-grade glioma, who underwent surgical resection under various technical intraoperative settings over 14 years. METHODS A total of 1010 patients with high-grade glioma that underwent resection between 2004 and 2018 under different monitoring or mapping procedures were screened; 631 were considered eligible for further analyses. We analyzed the type of surgery (resection vs. biopsy) and type of IONM or mapping procedures that were performed. Furthermore, the impact on short-term (The National Institute of Health Stroke Scale, NIHSS; Karnofsky Performance Scale, KPS) and long-term (progression-free survival, PFS; overall survival, OS) outcomes was analyzed. Additionally, the localization, extent of resection (EOR), residual tumor volume (RTV), IDH status, and adjuvant therapy were approached. RESULTS In 481 patients, surgery, and in 150, biopsies were performed. The number of biopsies decreased significantly with the incorporation of awake surgeries with bipolar stimulation, IONM, and/or monopolar mapping (p < 0.001). PFS and OS were not significantly influenced by any intraoperative technical setting. EOR and RTV achieved under different operative techniques showed no statistical significance (p = 0.404 EOR, p = 0.186 RTV). CONCLUSION Based on the present analysis using data from 14 years and more than 600 patients, we observed that through the implementation of various monitoring and mapping techniques, a significant decrease in biopsies and an increase in the resection of eloquent tumors was achieved. With that, the operability of eloquent tumors without a negative influence on neurological outcomes is suggested by our data. However, a statistical effect of monitoring and mapping procedures on long-term outcomes such as PFS and OS could not be shown.
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Affiliation(s)
- Franziska Staub-Bartelt
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | | | - Andrea Szelényi
- Department of Neurosurgery, LMU University Hospital, LMU Munich, 80539 München, Germany
| | - Marion Rapp
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Michael Sabel
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
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Oldak L, Zielinska Z, Milewska P, Chludzinska-Kasperuk S, Latoch E, Konończuk K, Krawczuk-Rybak M, Starosz A, Grubczak K, Reszeć J, Gorodkiewicz E. Changes in the Concentrations of Proangiogenic Cytokines in Human Brain Glioma and Acute Lymphoblastic Leukemia. Int J Mol Sci 2024; 25:2586. [PMID: 38473833 DOI: 10.3390/ijms25052586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Acute lymphoblastic leukemia (ALL) and glioma are some of the most common malignancies, with ALL most often affecting children and glioma affecting adult men. Proangiogenic cytokines and growth factors play an important role in the development of both of these tumors. Glioma is characterized by an extremely extensive network of blood vessels, which continues to expand mainly in the process of neoangiogenesis, the direct inducers of which are cytokines from the family of vascular endothelial growth factors, i.e., vascular endothelial growth factor (VEGF-A) and its receptor vascular endothelial growth factor receptor 2 (VEGF-R2), as well as a cytokine from the fibroblast growth factor family, fibroblast growth factor 2 (FGF-2 or bFGF). Growth factors are known primarily for their involvement in the progression and development of solid tumors, but there is evidence that local bone marrow angiogenesis and increased blood vessel density are also present in hematological malignancies, including leukemias. The aim of this study was to examine changes in the concentrations of VEGF-A, VEGF-R2, and FGF-2 (with a molecular weight of 17 kDa) in a group of patients divided into specific grades of malignancy (glioma) and a control group; changes of VEGF-A and FGF-2 concentrations in childhood acute lymphoblastic leukemia and a control group; and to determine correlations between the individual proteins as well as the influence of the patient's age, diet, and other conditions that may place the patient in the risk group. During the statistical analysis, significant differences in concentrations were found between the patient and control groups in samples from people with diagnosed glioma and from children with acute lymphoblastic leukemia, but in general, there are no significant differences in the concentrations of VEGF-A, VEGF-R2, and FGF-2 between different grades of glioma malignancy. Among individuals treated for glioma, there was no significant impact from the patient's gender and age, consumption of food from plastic packaging, frequency of eating vegetables and fruit, smoking of tobacco products, the intensity of physical exercise, or the general condition of the body (Karnofsky score) on the concentrations of the determined cytokines and receptor. The listed factors do not bring about an actual increase in the risk of developing brain glioma.
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Affiliation(s)
- Lukasz Oldak
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, 15-245 Bialystok, Poland
| | - Zuzanna Zielinska
- Doctoral School of Exact and Natural Science, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, 15-245 Bialystok, Poland
| | - Patrycja Milewska
- Biobank, Medical University of Bialystok, Waszyngtona 13, 15-269 Bialystok, Poland
| | | | - Eryk Latoch
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Katarzyna Konończuk
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Aleksandra Starosz
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Waszyngtona 13, 15-269 Bialystok, Poland
| | - Kamil Grubczak
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Waszyngtona 13, 15-269 Bialystok, Poland
| | - Joanna Reszeć
- Biobank, Medical University of Bialystok, Waszyngtona 13, 15-269 Bialystok, Poland
- Department of Medical Pathology, Medical University of Bialystok, Waszyngtona 13, 15-269 Bialystok, Poland
| | - Ewa Gorodkiewicz
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, 15-245 Bialystok, Poland
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107
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Walke A, Krone C, Stummer W, König S, Suero Molina E. Protoporphyrin IX in serum of high-grade glioma patients: A novel target for disease monitoring via liquid biopsy. Sci Rep 2024; 14:4297. [PMID: 38383693 PMCID: PMC10881484 DOI: 10.1038/s41598-024-54478-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/12/2024] [Indexed: 02/23/2024] Open
Abstract
High-grade gliomas (HGG) carry a dismal prognosis. Diagnosis comprises MRI followed by histopathological evaluation of tissue; no blood biomarker is available. Patients are subjected to serial MRIs and, if unclear, surgery for monitoring of tumor recurrence, which is laborious. MRI provides only limited diagnostic information regarding the differentiation of true tumor progression from therapy-associated side effects. 5-aminolevulinic acid (5-ALA) is routinely used for induction of protoporphyrin IX (PpIX) accumulation in malignant glioma tissue, enabling improved tumor visualization during fluorescence-guided resection (FGR). We investigated whether PpIX can also serve as a serum HGG marker to monitor relapse. Patients (HGG: n = 23 primary, pHGG; n = 5 recurrent, rHGG) undergoing FGR received 5-ALA following standard clinical procedure. The control group of eight healthy volunteers (HCTR) also received 5-ALA. Serum was collected before and repeatedly up to 72 h after drug administration. Significant PpIX accumulation in HGG was observed after 5-ALA administration (ANOVA: p = 0.005, post-hoc: HCTR vs. pHGG p = 0.029, HCTR vs. rHGG p = 0.006). Separation of HCTR from pHGG was possible when maximum serum PpIX levels were reached (CI95% of tMax). ROC analysis of serum PpIX within CI95% of tMax showed successful classification of HCTR and pHGG (AUCROC 0.943, CI95% 0.884-1.000, p < 0.001); the optimal cut-off for diagnosis was 1275 pmol PpIX/ml serum, reaching 87.0% accuracy, 90.5% positive predictive and 84.0% negative predictive value. Baseline PpIX level was similar in patient and control groups. Thus, 5-ALA is required for PpIX induction, which is safe at the standard clinical dosage. PpIX is a new target for liquid biopsy in glioma. More extensive clinical studies are required to characterize its full potential.
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Affiliation(s)
- Anna Walke
- Department of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Germany.
- Core Unit Proteomics, Interdisciplinary Centre for Clinical Research, University of Münster, Münster, Germany.
| | - Christopher Krone
- Department of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Germany
| | - Walter Stummer
- Department of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Germany
| | - Simone König
- Core Unit Proteomics, Interdisciplinary Centre for Clinical Research, University of Münster, Münster, Germany
| | - Eric Suero Molina
- Department of Neurosurgery, University Hospital of Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Germany.
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Obrador E, Moreno-Murciano P, Oriol-Caballo M, López-Blanch R, Pineda B, Gutiérrez-Arroyo JL, Loras A, Gonzalez-Bonet LG, Martinez-Cadenas C, Estrela JM, Marqués-Torrejón MÁ. Glioblastoma Therapy: Past, Present and Future. Int J Mol Sci 2024; 25:2529. [PMID: 38473776 DOI: 10.3390/ijms25052529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/10/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Glioblastoma (GB) stands out as the most prevalent and lethal form of brain cancer. Although great efforts have been made by clinicians and researchers, no significant improvement in survival has been achieved since the Stupp protocol became the standard of care (SOC) in 2005. Despite multimodality treatments, recurrence is almost universal with survival rates under 2 years after diagnosis. Here, we discuss the recent progress in our understanding of GB pathophysiology, in particular, the importance of glioma stem cells (GSCs), the tumor microenvironment conditions, and epigenetic mechanisms involved in GB growth, aggressiveness and recurrence. The discussion on therapeutic strategies first covers the SOC treatment and targeted therapies that have been shown to interfere with different signaling pathways (pRB/CDK4/RB1/P16ink4, TP53/MDM2/P14arf, PI3k/Akt-PTEN, RAS/RAF/MEK, PARP) involved in GB tumorigenesis, pathophysiology, and treatment resistance acquisition. Below, we analyze several immunotherapeutic approaches (i.e., checkpoint inhibitors, vaccines, CAR-modified NK or T cells, oncolytic virotherapy) that have been used in an attempt to enhance the immune response against GB, and thereby avoid recidivism or increase survival of GB patients. Finally, we present treatment attempts made using nanotherapies (nanometric structures having active anti-GB agents such as antibodies, chemotherapeutic/anti-angiogenic drugs or sensitizers, radionuclides, and molecules that target GB cellular receptors or open the blood-brain barrier) and non-ionizing energies (laser interstitial thermal therapy, high/low intensity focused ultrasounds, photodynamic/sonodynamic therapies and electroporation). The aim of this review is to discuss the advances and limitations of the current therapies and to present novel approaches that are under development or following clinical trials.
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Affiliation(s)
- Elena Obrador
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | | | - María Oriol-Caballo
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Rafael López-Blanch
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Begoña Pineda
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | | | - Alba Loras
- Department of Medicine, Jaume I University of Castellon, 12071 Castellon, Spain
| | - Luis G Gonzalez-Bonet
- Department of Neurosurgery, Castellon General University Hospital, 12004 Castellon, Spain
| | | | - José M Estrela
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
- Department of Physiology, Faculty of Pharmacy, University of Valencia, 46100 Burjassot, Spain
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Fu Z, Chen Z, Ye J, Ji J, Ni W, Lin W, Lin H, Lu L, Zhu G, Xie Q, Yan F, Chen G, Liu F. Identifying PLAUR as a Pivotal Gene of Tumor Microenvironment and Regulating Mesenchymal Phenotype of Glioblastoma. Cancers (Basel) 2024; 16:840. [PMID: 38398231 PMCID: PMC10887327 DOI: 10.3390/cancers16040840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/04/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
The mesenchymal (MES) phenotype of glioblastoma (GBM) is the most aggressive and therapy-resistant subtype of GBM. The MES phenotype transition during tumor progression results from both tumor-intrinsic genetic alterations and tumor-extrinsic microenvironmental factors. In this study, we sought to identify genes that can modulate the MES phenotype via both mechanisms. By integrating weighted gene co-expression network analysis (WGCNA) and the differential expression analysis of hypoxia-immunosuppression-related genes, we identified the plasminogen activator, urokinase receptor (PLAUR) as the hub gene. Functional enrichment analysis and GSVA analysis demonstrated that PLAUR was associated with the MES phenotype of glioma and the hypoxia-immunosuppression-related microenvironmental components. Single-cell sequencing analysis revealed that PLAUR mediated the ligand-receptor interaction between tumor-associated macrophages (TAMs) and glioma cells. Functional experiments in vitro with cell lines or primary glioma cells and xenograft models using BALB/c nude mice confirmed the role of PLAUR in promoting the MES phenotype of GBM. Our findings indicate that PLAUR regulates both glioma cells and tumor cell-extrinsic factors that favor the MES phenotype and suggest that PLAUR might be a potential target for GBM therapy.
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Affiliation(s)
- Zaixiang Fu
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Zihang Chen
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Jingya Ye
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Jianxiong Ji
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Weifang Ni
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Weibo Lin
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Haopu Lin
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Liquan Lu
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Ganggui Zhu
- Department of Lung Transplantation, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China;
| | - Qin Xie
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Feng Yan
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Gao Chen
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
| | - Fuyi Liu
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China; (Z.F.); (Z.C.); (J.Y.); (J.J.); (W.N.); (W.L.); (H.L.); (L.L.); (Q.X.); (F.Y.)
- Key Laboratory of Precise Treatment and Clinical Translational Research of Neurological Diseases, Hangzhou 310000, China
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Zhou T, Igawa K, Kasai T, Sadahira T, Wang W, Watanabe T, Bekku K, Katayama S, Iwata T, Hanafusa T, Xu A, Araki M, Michiue H, Huang P. The current status and novel advances of boron neutron capture therapy clinical trials. Am J Cancer Res 2024; 14:429-447. [PMID: 38455422 PMCID: PMC10915318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/18/2024] [Indexed: 03/09/2024] Open
Abstract
Boron neutron capture therapy (BNCT) is a treatment method that focuses on improving the cure rate of patients with cancer who are difficult to treat using traditional clinical methods. By utilizing the high neutron absorption cross-section of boron, material rich in boron inside tumor cells can absorb neutrons and release high-energy ions, thereby destroying tumor cells. Owing to the short range of alpha particles, this method can precisely target tumor cells while minimizing the inflicted damage to the surrounding normal tissues, making it a potentially advantageous method for treating tumors. Globally, institutions have progressed in registered clinical trials of BNCT for multiple body parts. This review summarized the current achievements in registered clinical trials, Investigator-initiated clinical trials, aimed to integrate the latest clinical research literature on BNCT and to shed light on future study directions.
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Affiliation(s)
- Tianyun Zhou
- Neutron Therapy Research Center, Okayama UniversityOkayama, Japan
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama, Japan
- Department of Urology, The Second Affiliated Hospital of Dalian Medical UniversityDalian, Liaoning, China
| | - Kazuyo Igawa
- Neutron Therapy Research Center, Okayama UniversityOkayama, Japan
| | - Tomonari Kasai
- Neutron Therapy Research Center, Okayama UniversityOkayama, Japan
| | - Takuya Sadahira
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama, Japan
| | - Wei Wang
- Department of Urology, The Second Affiliated Hospital of Dalian Medical UniversityDalian, Liaoning, China
| | - Tomofumi Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama, Japan
| | - Kensuke Bekku
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama, Japan
| | - Satoshi Katayama
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama, Japan
| | - Takehiro Iwata
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama, Japan
| | - Tadashi Hanafusa
- Neutron Therapy Research Center, Okayama UniversityOkayama, Japan
| | - Abai Xu
- Department of Urology, Zhujiang Hospital, Southern Medical UniversityGuangzhou, Guangdong, China
| | - Motoo Araki
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama, Japan
| | - Hiroyuki Michiue
- Neutron Therapy Research Center, Okayama UniversityOkayama, Japan
| | - Peng Huang
- Neutron Therapy Research Center, Okayama UniversityOkayama, Japan
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama, Japan
- Department of Urology, Zhujiang Hospital, Southern Medical UniversityGuangzhou, Guangdong, China
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111
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Habeeb M, Vengateswaran HT, You HW, Saddhono K, Aher KB, Bhavar GB. Nanomedicine facilitated cell signaling blockade: difficulties and strategies to overcome glioblastoma. J Mater Chem B 2024; 12:1677-1705. [PMID: 38288615 DOI: 10.1039/d3tb02485g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Glioblastoma (GBM) is a highly aggressive and lethal type of brain tumor with complex and diverse molecular signaling pathways involved that are in its development and progression. Despite numerous attempts to develop effective treatments, the survival rate remains low. Therefore, understanding the molecular mechanisms of these pathways can aid in the development of targeted therapies for the treatment of glioblastoma. Nanomedicines have shown potential in targeting and blocking signaling pathways involved in glioblastoma. Nanomedicines can be engineered to specifically target tumor sites, bypass the blood-brain barrier (BBB), and release drugs over an extended period. However, current nanomedicine strategies also face limitations, including poor stability, toxicity, and low therapeutic efficacy. Therefore, novel and advanced nanomedicine-based strategies must be developed for enhanced drug delivery. In this review, we highlight risk factors and chemotherapeutics for the treatment of glioblastoma. Further, we discuss different nanoformulations fabricated using synthetic and natural materials for treatment and diagnosis to selectively target signaling pathways involved in GBM. Furthermore, we discuss current clinical strategies and the role of artificial intelligence in the field of nanomedicine for targeting GBM.
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Affiliation(s)
- Mohammad Habeeb
- Department of Pharmaceutics, Crescent School of Pharmacy, B.S. Abdur Rahman Crescent Institute of Science and Technology, Chennai-600048, India.
| | - Hariharan Thirumalai Vengateswaran
- Department of Pharmaceutics, Crescent School of Pharmacy, B.S. Abdur Rahman Crescent Institute of Science and Technology, Chennai-600048, India.
| | - Huay Woon You
- Pusat PERMATA@Pintar Negara, Universiti Kebangsaan 43600, Bangi, Selangor, Malaysia
| | - Kundharu Saddhono
- Faculty of Teacher Training and Education, Universitas Sebelas Maret, 57126, Indonesia
| | - Kiran Balasaheb Aher
- Department of Pharmaceutical Quality Assurance, Shri Vile Parle Kelavani Mandal's Institute of Pharmacy, Dhule, Maharashtra, 424001, India
| | - Girija Balasaheb Bhavar
- Department of Pharmaceutical Chemistry, Shri Vile Parle Kelavani Mandal's Institute of Pharmacy, Dhule, Maharashtra, 424001, India
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Zeineldin RA, Karar ME, Elshaer Z, Coburger J, Wirtz CR, Burgert O, Mathis-Ullrich F. Explainable hybrid vision transformers and convolutional network for multimodal glioma segmentation in brain MRI. Sci Rep 2024; 14:3713. [PMID: 38355678 PMCID: PMC10866944 DOI: 10.1038/s41598-024-54186-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/09/2024] [Indexed: 02/16/2024] Open
Abstract
Accurate localization of gliomas, the most common malignant primary brain cancer, and its different sub-region from multimodal magnetic resonance imaging (MRI) volumes are highly important for interventional procedures. Recently, deep learning models have been applied widely to assist automatic lesion segmentation tasks for neurosurgical interventions. However, these models are often complex and represented as "black box" models which limit their applicability in clinical practice. This article introduces new hybrid vision Transformers and convolutional neural networks for accurate and robust glioma segmentation in Brain MRI scans. Our proposed method, TransXAI, provides surgeon-understandable heatmaps to make the neural networks transparent. TransXAI employs a post-hoc explanation technique that provides visual interpretation after the brain tumor localization is made without any network architecture modifications or accuracy tradeoffs. Our experimental findings showed that TransXAI achieves competitive performance in extracting both local and global contexts in addition to generating explainable saliency maps to help understand the prediction of the deep network. Further, visualization maps are obtained to realize the flow of information in the internal layers of the encoder-decoder network and understand the contribution of MRI modalities in the final prediction. The explainability process could provide medical professionals with additional information about the tumor segmentation results and therefore aid in understanding how the deep learning model is capable of processing MRI data successfully. Thus, it enables the physicians' trust in such deep learning systems towards applying them clinically. To facilitate TransXAI model development and results reproducibility, we will share the source code and the pre-trained models after acceptance at https://github.com/razeineldin/TransXAI .
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Affiliation(s)
- Ramy A Zeineldin
- Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052, Erlangen, Germany.
- Research Group Computer Assisted Medicine (CaMed), Reutlingen University, 72762, Reutlingen, Germany.
- Faculty of Electronic Engineering (FEE), Menoufia University, Minuf, 32952, Egypt.
| | - Mohamed E Karar
- Faculty of Electronic Engineering (FEE), Menoufia University, Minuf, 32952, Egypt
| | - Ziad Elshaer
- Department of Neurosurgery, University of Ulm, 89312, Günzburg, Germany
| | - Jan Coburger
- Department of Neurosurgery, University of Ulm, 89312, Günzburg, Germany
| | - Christian R Wirtz
- Department of Neurosurgery, University of Ulm, 89312, Günzburg, Germany
| | - Oliver Burgert
- Research Group Computer Assisted Medicine (CaMed), Reutlingen University, 72762, Reutlingen, Germany
| | - Franziska Mathis-Ullrich
- Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91052, Erlangen, Germany
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113
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Gorria T, Crous C, Pineda E, Hernandez A, Domenech M, Sanz C, Jares P, Muñoz-Mármol AM, Arpí-Llucía O, Melendez B, Gut M, Esteve A, Esteve-Codina A, Parra G, Alameda F, Carrato C, Aldecoa I, Mallo M, de la Iglesia N, Balana C. The C250T Mutation of TERTp Might Grant a Better Prognosis to Glioblastoma by Exerting Less Biological Effect on Telomeres and Chromosomes Than the C228T Mutation. Cancers (Basel) 2024; 16:735. [PMID: 38398126 PMCID: PMC10886885 DOI: 10.3390/cancers16040735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The aim of this study was to determine how TERTp mutations impact glioblastoma prognosis. MATERIALS AND METHODS TERTp mutations were assessed in a retrospective cohort of 258 uniformly treated glioblastoma patients. RNA-sequencing and whole exome sequencing results were available in a subset of patients. RESULTS Overall, there were no differences in outcomes between patients with mutated TERTp-wt or TERTp. However, we found significant differences according to the type of TERTp mutation. Progression-free survival (mPFS) was 9.1 months for those with the C250T mutation and 7 months for those with either the C228T mutation or TERTp-wt (p = 0.016). Overall survival (mOS) was 21.9 and 15 months, respectively (p = 0.026). This differential effect was more pronounced in patients with MGMTp methylation (mPFS: p = 0.008; mOS: p = 0.021). Multivariate analysis identified the C250T mutation as an independent prognostic factor for longer mOS (HR 0.69; p = 0.044). We found no differences according to TERTp mutation status in molecular alterations common in glioblastoma, nor in copy number variants in genes related to alternative lengthening of telomeres. Nevertheless, in the gene enrichment analysis adjusted for MGMTp methylation status, some Reactome gene sets were differentially enriched, suggesting that the C250T mutation may exert a lesser effect on telomeres or chromosomes. CONCLUSIONS In our series, patients exhibiting the C250T mutation had a more favorable prognosis compared to those with either TERPp-wt or TERTp C228T mutations. Additionally, our findings suggest a reduced involvement of the C250T mutation in the underlying biological mechanisms related to telomeres.
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Affiliation(s)
- Teresa Gorria
- Medical Oncology, Hospital Clínic, Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (T.G.); (C.C.); (E.P.)
| | - Carme Crous
- Medical Oncology, Hospital Clínic, Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (T.G.); (C.C.); (E.P.)
| | - Estela Pineda
- Medical Oncology, Hospital Clínic, Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (T.G.); (C.C.); (E.P.)
| | - Ainhoa Hernandez
- Medical Oncology, Institut Catala d’Oncologia (ICO) Badalona, Badalona Applied Research Group in Oncology (B-ARGO Group), Institut Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain; (A.H.); (M.D.); (A.E.)
| | - Marta Domenech
- Medical Oncology, Institut Catala d’Oncologia (ICO) Badalona, Badalona Applied Research Group in Oncology (B-ARGO Group), Institut Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain; (A.H.); (M.D.); (A.E.)
| | - Carolina Sanz
- Pathology Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (C.S.); (A.M.M.-M.); (C.C.)
| | - Pedro Jares
- Department of Pathology, Biomedical Diagnostic Centre (CDB) and Neurological Tissue Bank of the Biobank-IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain; (P.J.); (I.A.)
| | - Ana María Muñoz-Mármol
- Pathology Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (C.S.); (A.M.M.-M.); (C.C.)
| | - Oriol Arpí-Llucía
- Cancer Research Program, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;
| | - Bárbara Melendez
- Molecular Pathology Research Unit, Hospital Universitario de Toledo, 45007 Toledo, Spain;
| | - Marta Gut
- Centro Nacional de Análisis Genómico, C/Baldiri Reixac 4, 08028 Barcelona, Spain; (M.G.); (A.E.-C.); (G.P.)
| | - Anna Esteve
- Medical Oncology, Institut Catala d’Oncologia (ICO) Badalona, Badalona Applied Research Group in Oncology (B-ARGO Group), Institut Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain; (A.H.); (M.D.); (A.E.)
- Badalona Applied Research Group in Oncology (B-ARGO Group), Institut Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Anna Esteve-Codina
- Centro Nacional de Análisis Genómico, C/Baldiri Reixac 4, 08028 Barcelona, Spain; (M.G.); (A.E.-C.); (G.P.)
| | - Genis Parra
- Centro Nacional de Análisis Genómico, C/Baldiri Reixac 4, 08028 Barcelona, Spain; (M.G.); (A.E.-C.); (G.P.)
| | - Francesc Alameda
- Pathology Department, Neuropathology Unit, Hospital del Mar, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;
| | - Cristina Carrato
- Pathology Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (C.S.); (A.M.M.-M.); (C.C.)
| | - Iban Aldecoa
- Department of Pathology, Biomedical Diagnostic Centre (CDB) and Neurological Tissue Bank of the Biobank-IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain; (P.J.); (I.A.)
| | - Mar Mallo
- Unidad de Microarrays, Institut de Recerca Contra la Leucèmia Josep Carreras (IJC), ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain;
| | - Nuria de la Iglesia
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain;
| | - Carmen Balana
- Pathology Department, Neuropathology Unit, Hospital del Mar, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;
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He Y, Duan L, Dong G, Chen F, Li W. Computational pathology-based weakly supervised prediction model for MGMT promoter methylation status in glioblastoma. Front Neurol 2024; 15:1345687. [PMID: 38385046 PMCID: PMC10880091 DOI: 10.3389/fneur.2024.1345687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/19/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction The methylation status of oxygen 6-methylguanine-DNA methyltransferase (MGMT) is closely related to the treatment and prognosis of glioblastoma. However, there are currently some challenges in detecting the methylation status of MGMT promoters. The hematoxylin and eosin (H&E)-stained histopathological slides have always been the gold standard for tumor diagnosis. Methods In this study, based on the TCGA database and H&E-stained Whole slide images (WSI) of Beijing Tiantan Hospital, we constructed a weakly supervised prediction model of MGMT promoter methylation status in glioblastoma by using two Transformer structure models. Results The accuracy scores of this model in the TCGA dataset and our independent dataset were 0.79 (AUC = 0.86) and 0.76 (AUC = 0.83), respectively. Conclusion The model demonstrates effective prediction of MGMT promoter methylation status in glioblastoma and exhibits some degree of generalization capability. At the same time, our study also shows that adding Patches automatic screening module to the computational pathology research framework of glioma can significantly improve the model effect.
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Affiliation(s)
- Yongqi He
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ling Duan
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Gehong Dong
- Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Feng Chen
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenbin Li
- Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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115
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Hai L, Hoffmann DC, Wagener RJ, Azorin DD, Hausmann D, Xie R, Huppertz MC, Hiblot J, Sievers P, Heuer S, Ito J, Cebulla G, Kourtesakis A, Kaulen LD, Ratliff M, Mandelbaum H, Jung E, Jabali A, Horschitz S, Ernst KJ, Reibold D, Warnken U, Venkataramani V, Will R, Suvà ML, Herold-Mende C, Sahm F, Winkler F, Schlesner M, Wick W, Kessler T. A clinically applicable connectivity signature for glioblastoma includes the tumor network driver CHI3L1. Nat Commun 2024; 15:968. [PMID: 38320988 PMCID: PMC10847113 DOI: 10.1038/s41467-024-45067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 01/12/2024] [Indexed: 02/08/2024] Open
Abstract
Tumor microtubes (TMs) connect glioma cells to a network with considerable relevance for tumor progression and therapy resistance. However, the determination of TM-interconnectivity in individual tumors is challenging and the impact on patient survival unresolved. Here, we establish a connectivity signature from single-cell RNA-sequenced (scRNA-Seq) xenografted primary glioblastoma (GB) cells using a dye uptake methodology, and validate it with recording of cellular calcium epochs and clinical correlations. Astrocyte-like and mesenchymal-like GB cells have the highest connectivity signature scores in scRNA-sequenced patient-derived xenografts and patient samples. In large GB cohorts, TM-network connectivity correlates with the mesenchymal subtype and dismal patient survival. CHI3L1 gene expression serves as a robust molecular marker of connectivity and functionally influences TM networks. The connectivity signature allows insights into brain tumor biology, provides a proof-of-principle that tumor cell TM-connectivity is relevant for patients' prognosis, and serves as a robust prognostic biomarker.
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Affiliation(s)
- Ling Hai
- Bioinformatics and Omics Data Analytics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Dirk C Hoffmann
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Robin J Wagener
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Daniel D Azorin
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David Hausmann
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Ruifan Xie
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Magnus-Carsten Huppertz
- Department of Chemical Biology, Max Planck Institute for Medical Research, Heidelberg, Germany
| | - Julien Hiblot
- Department of Chemical Biology, Max Planck Institute for Medical Research, Heidelberg, Germany
| | - Philipp Sievers
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, DKTK, DKFZ, Heidelberg, Germany
| | - Sophie Heuer
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Jakob Ito
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Gina Cebulla
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alexandros Kourtesakis
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Leon D Kaulen
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Miriam Ratliff
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurosurgery Clinic, University Hospital Mannheim, Mannheim, Germany
| | - Henriette Mandelbaum
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Erik Jung
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Ammar Jabali
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
- Hector Institute for Translational Brain Research, Mannheim, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Reconstructive Neurobiology, School of Medicine & University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Sandra Horschitz
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
- Hector Institute for Translational Brain Research, Mannheim, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kati J Ernst
- Pediatric Glioma Research Group, DKTK, DKFZ, Heidelberg, Germany
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany
| | - Denise Reibold
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Uwe Warnken
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Varun Venkataramani
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
- Department of Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
| | - Rainer Will
- Genomics and Proteomics Core Facility, DKTK, DKFZ, Heidelberg, Germany
| | - Mario L Suvà
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Pathology and Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, DKTK, DKFZ, Heidelberg, Germany
| | - Frank Winkler
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Matthias Schlesner
- Bioinformatics and Omics Data Analytics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Biomedical Informatics, Data Mining and Data Analytics, Faculty of Applied Computer Science and Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Wolfgang Wick
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Tobias Kessler
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany.
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Bušić M, Rumboldt Z, Čerina D, Bušić Ž, Dolić K. Prognostic Value of Apparent Diffusion Coefficient (ADC) in Patients with Diffuse Gliomas. Cancers (Basel) 2024; 16:681. [PMID: 38398073 PMCID: PMC10886867 DOI: 10.3390/cancers16040681] [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: 01/14/2024] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to evaluate potential posttreatment changes in ADC values within the tissue surrounding the enhancing lesion, particularly in areas not exhibiting MRI characteristics of involvement. Additionally, the objective was to investigate the correlations among ADC values, treatment response, and survival outcomes in individuals diagnosed with gliomas. This retrospective study included a total of 49 patients that underwent either stereotactic biopsy or maximal surgical resection. Histologically confirmed as Grade III or IV gliomas, all cases adhered to the 2016 and 2021 WHO classifications, with subsequent radio-chemotherapy administered post-surgery. Patients were divided into two groups: short and long survival groups. Baseline and follow-up MRI scans were obtained on a 1.5 T MRI scanner. Two ROI circles were positioned near the enhancing area, one ROI in the NAWM ipsilateral to the neoplasm and another symmetrically in the contralateral hemisphere on ADC maps. At follow-up there was a significant difference in both ipsilateral and contralateral NAWM between the two groups, -0.0857 (p = 0.004) and -0.0607 (p = 0.037), respectively. There was a weak negative correlation between survival and ADC values in ipsilateral and contralateral NAWM at the baseline with the correlation coefficient -0.328 (p = 0.02) and -0.302 (p = 0.04), respectively. The correlation was stronger at the follow-up. The findings indicate that ADC values in normal-appearing white matter (NAWM) may function as a prognostic biomarker in patients with diffuse gliomas.
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Affiliation(s)
- Marija Bušić
- Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia; (M.B.); (Ž.B.)
| | - Zoran Rumboldt
- School of Medicine, University of Rijeka, Ulica Braće Branchetta 20/1, 51000 Rijeka, Croatia;
| | - Dora Čerina
- Department of Oncology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia;
| | - Željko Bušić
- Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia; (M.B.); (Ž.B.)
| | - Krešimir Dolić
- Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia; (M.B.); (Ž.B.)
- School of Medicine, University of Split, Šoltanska 1, 21000 Split, Croatia
- University Department of Health Studies, University of Split, Ulica Ruđera Boškovića 35, 21000 Split, Croatia
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Heilmann AM, Riess JW, McLaughlin-Drubin M, Huang RSP, Hjulstrom M, Creeden J, Alexander BM, Erlich RL. Insights of Clinical Significance From 109 695 Solid Tumor Tissue-Based Comprehensive Genomic Profiles. Oncologist 2024; 29:e224-e236. [PMID: 37682776 PMCID: PMC10836312 DOI: 10.1093/oncolo/oyad251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 08/06/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND FoundationOneCDx is approved in the US and Japan as a companion diagnostic test to identify patients with cancer who may benefit from treatment with 30 drug therapies in the US and 23 in Japan. Tumor profiling with FoundationOneCDx also detects genomic findings with evidence of clinical significance that may inform clinical care decisions beyond companion diagnostic claims. This observational study reports the breadth and impact of clinical decision insights from FoundationOneCDx solid tumor profiles. MATERIALS AND METHODS Consecutive test result reports for patients with solid tumor diagnoses (n = 109 695) were retrospectively analyzed for clinically significant predictive, prognostic, and diagnostic genomic alterations and signatures, determined in accordance with professional guidelines. Interventional clinical trials with targeted therapies or immune checkpoint inhibitors were matched to tumor profiles based on evidence that the genomic finding may be an actionable, investigational, or hypothetical target in the patient's tumor type. RESULTS In 14 predefined cancer types (80.7% of analyzed solid tumors), predictive, prognostic, and diagnostic markers were reported in 47.6%, 13.2%, and 4.5% of samples, respectively, accounting for a total of 51.2% of tumor profiles. Pan-cancer predictive markers of tumor mutational burden (TMB) of 10 or more mutations per megabase, high microsatellite instability (MSI), or NTRK1/2/3 fusions were observed in 15.6%, 2.0%, and 0.1% of solid tumors, respectively. Most solid tumor profiles (89.2%) had genomic results that could theoretically inform decisions on the selection of immunotherapy and targeted therapy clinical trials. CONCLUSION For this real-world population of patients with FoundationOneCDx solid tumor profiles in the routine course of clinical care, clinically significant findings were reported for approximately half of patients with genomic results.
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Affiliation(s)
| | - Jonathan W Riess
- University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
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Le Rhun E, Gorlia T, Felsberg J, Jongen J, Maurage CA, Ducray F, Gramatzki D, Hau P, Chinot OL, Preusser M, Cartalat S, Roth P, van den Bent M, Furtner J, Collienne M, Reifenberger G, Weller M. Zotiraciclib (TG02) for newly diagnosed glioblastoma in the elderly or for recurrent glioblastoma: The EORTC 1608 STEAM trial. Eur J Cancer 2024; 198:113475. [PMID: 38159337 DOI: 10.1016/j.ejca.2023.113475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Zotiraciclib (TG02) is an oral multi-cyclin dependent kinase (CDK) inhibitor thought to inhibit tumor growth via CDK-9-dependent depletion of survival proteins such as c-MYC and MCL-1 which are frequently overexpressed in glioblastoma. METHODS EORTC 1608 (NCT03224104) (STEAM) had a three parallel group (A,B,C) phase Ib, open-label, non-randomized, multicenter design in IDH wild-type newly diagnosed glioblastoma or anaplastic astrocytoma. Groups A and B explored the maximum tolerated dose (MTD) of TG02 in elderly patients, in combination with hypofractionated radiotherapy alone (group A) or temozolomide alone (group B), according to O6-methylguanine DNA methyltransferase promoter methylation status determined centrally. Group C explored single agent activity of TG02 at first relapse after temozolomide chemoradiotherapy with a primary endpoint of progression-free survival at 6 months (PFS-6). Tumor expression of CDK-9, c-MYC and MCL-1 was determined by immunohistochemistry. RESULTS The MTD was 150 mg twice weekly in combination with radiotherapy alone (group A) or temozolomide alone (group B). Two dose-limiting toxicities were observed at 150 mg: one in group A (grade 3 seizure), one in group B (multiple grade 1 events). Main toxicities included neutropenia, gastrointestinal disorders and hepatotoxicity. PFS-6 in group C was 6.7%. CDK-9, c-MYC and MCL-1 were confirmed to be expressed and their expression was moderately cross-correlated. High protein levels of MCL-1 were associated with inferior survival. CONCLUSIONS TG02 exhibits overlapping toxicity with alkylating agents and low single agent clinical activity in recurrent glioblastoma. The role of CDK-9 and its down-stream effectors as prognostic factors and therapeutic targets in glioblastoma warrants further study.
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Affiliation(s)
- Emilie Le Rhun
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland; Neuro-Oncology, General and Stereotaxic Neurosurgery Service, University Hospital of Lille, Lille, France; University of Lille, Inserm, U-1192, Lille, France.
| | - Thierry Gorlia
- European Organization for Research and Treatment of Cancer, Brussels, Belgium
| | - Jörg Felsberg
- Institute of Neuropathology, Medical Faculty, Heinrich Heine University and University Hospital Düsseldorf, and German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany
| | - Joost Jongen
- The Brain Tumour Center at the Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | | | | | - Dorothee Gramatzki
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Peter Hau
- Department of Neurology - NeuroOncology and Wilhelm Sander Neuro-Oncology Unit, University Hospital Regensburg, Regensburg, Germany
| | | | - Matthias Preusser
- Division of Oncology, Department of Medicine 1, Medical University, Vienna, Austria
| | | | - Patrick Roth
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Martin van den Bent
- The Brain Tumour Center at the Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Julia Furtner
- Department of Biomedical imaging and Image-guided Therapy, Medical University of Vienna, Austria; Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Faculty of Medicine and Dentistry, Danube Private University, 3500 Krems, Austria
| | - Maike Collienne
- European Organization for Research and Treatment of Cancer, Brussels, Belgium
| | - Guido Reifenberger
- Institute of Neuropathology, Medical Faculty, Heinrich Heine University and University Hospital Düsseldorf, and German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
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Tolboom N, Verger A, Albert NL, Fraioli F, Guedj E, Traub-Weidinger T, Morbelli S, Herrmann K, Zucchetta P, Plasschaert SLA, Yakushev I, Weller M, Glas M, Preusser M, Cecchin D, Barthel H, Van Weehaeghe D. Theranostics in Neurooncology: Heading Toward New Horizons. J Nucl Med 2024; 65:167-173. [PMID: 38071569 DOI: 10.2967/jnumed.123.266205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/23/2023] [Indexed: 02/03/2024] Open
Abstract
Therapeutic approaches to brain tumors remain a challenge, with considerable limitations regarding delivery of drugs. There has been renewed and increasing interest in translating the popular theranostic approach well known from prostate and neuroendocrine cancer to neurooncology. Although far from perfect, some of these approaches show encouraging preliminary results, such as for meningioma and leptomeningeal spread of certain pediatric brain tumors. In brain metastases and gliomas, clinical results have failed to impress. Perspectives on these theranostic approaches regarding meningiomas, brain metastases, gliomas, and common pediatric brain tumors will be discussed. For each tumor entity, the general context, an overview of the literature, and future perspectives will be provided. Ongoing studies will be discussed in the supplemental materials. As most theranostic agents are unlikely to cross the blood-brain barrier, the delivery of these agents will be dependent on the successful development and clinical implementation of techniques enhancing permeability and retention. Moreover, the international community should strive toward sufficiently large and randomized studies to generate high-level evidence on theranostic approaches with radioligand therapies for central nervous system tumors.
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Affiliation(s)
- Nelleke Tolboom
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Antoine Verger
- IADI, INSERM, UMR 1254, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU-Nancy, Université de Lorraine, Nancy, France
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital of Munich, Munich, Germany
| | - Francesco Fraioli
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Eric Guedj
- Département de Médecine Nucléaire, Hôpital de la Timone, CERIMED, Institut Fresnel, Aix Marseille University, APHM, CNRS, Centrale Marseille, Marseille, France
| | - Tatjana Traub-Weidinger
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa Italy
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium-University Hospital Essen, Essen, Germany
| | - Pietro Zucchetta
- Department of Nuclear Medicine, University Hospital of Padova, Padova, Italy
| | | | - Igor Yakushev
- Department of Nuclear Medicine, School of Medicine, Technical University of Munich and Munich Center for Neurosciences-Brain and Mind, Munich, Germany
| | - Michael Weller
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Martin Glas
- Division of Clinical Neurooncology, Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, University Duisburg-Essen and German Cancer Consortium, Essen, Germany
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Diego Cecchin
- Nuclear Medicine Unit, Department of Medicine-DIMED, University Hospital of Padua, Padua, Italy
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Medical Centre, Leipzig, Germany; and
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Ibáñez-Juliá MJ, Picca A, Leclercq D, Berzero G, Jacob J, Feuvret L, Rosso C, Birzu C, Alentorn A, Sanson M, Tafani C, Bompaire F, Bataller L, Hoang-Xuan K, Delattre JY, Psimaras D, Ricard D. Late-onset vascular complications of radiotherapy for primary brain tumors: a case-control and cross-sectional analysis. J Cancer Surviv 2024; 18:59-67. [PMID: 37142871 PMCID: PMC10867030 DOI: 10.1007/s11764-023-01350-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/13/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE Radiotherapy (RT) is a recognized risk factor for cerebrovascular (CV) disease in children and in adults with head and neck cancer. We aimed to investigate whether cerebral RT increases the risk of CV disease in adults with primary brain tumors (PBT). METHODS We retrospectively identified adults with a supratentorial PBT diagnosed between 1975 and 2006 and with at least 10 years follow-up after treatment. We analyzed demographic, clinical, and radiological features with special attention to CV events. We also described CV events, vascular risk factors, and intracranial artery modifications in a cross-sectional study of irradiated patients alive at the time of the study. RESULTS A total of 116 patients, treated with RT (exposed group), and 85 non-irradiated patients (unexposed group) were enrolled. Stroke was more frequent in irradiated PBT patients than in the unexposed group (42/116 (36%) vs 7/85 (8%); p < 0.001), with higher prevalence of both ischemic (27/116 (23%) vs 6/85 (7%); p = 0.004) and hemorrhagic (12/116 (10%) vs 1/85 (1%); p = 0.02) stroke. In the irradiated group, patients with tumors near the Willis Polygon were more likely to experience stroke (p < 0.016). Fourty-four alive irradiated patients were included in the cross-sectional study. In this subgroup, intracranial arterial stenosis was more prevalent (11/45, 24%) compared to general population (9%). CONCLUSIONS Stroke prevalence is increased in long-surviving PBT patients treated with cranial RT. IMPLICATIONS FOR CANCER SURVIVORS CV events are frequent in long survivors of PBT treated with cerebral RT. We propose a check list to guide management of late CV complications in adults treated with RT for PBT.
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Affiliation(s)
- María-José Ibáñez-Juliá
- Department of Neurology Mazarin, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
- Department of Neurology, Ascires Biomedical Group, Valencia, Spain
| | - Alberto Picca
- Department of Neurology Mazarin, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
- OncoNeuroTox Group: Center for Patients With Neurological Complications of Oncologic Treatments, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Hôpital d'Instruction Des Armées Percy, Paris, France
- Sorbonne Universités, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, HP, Paris, France
| | - Delphine Leclercq
- OncoNeuroTox Group: Center for Patients With Neurological Complications of Oncologic Treatments, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Hôpital d'Instruction Des Armées Percy, Paris, France
- Department of Neuroradiology, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux Paris (APHP), Paris, France
| | - Giulia Berzero
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Julian Jacob
- OncoNeuroTox Group: Center for Patients With Neurological Complications of Oncologic Treatments, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Hôpital d'Instruction Des Armées Percy, Paris, France
- Department of Radiotherapy, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Loïc Feuvret
- OncoNeuroTox Group: Center for Patients With Neurological Complications of Oncologic Treatments, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Hôpital d'Instruction Des Armées Percy, Paris, France
- Department of Radiotherapy, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
- Radiation Therapy Department, Hospices Civils de Lyon, Lyon, France
| | - Charlotte Rosso
- Department of Vascular Neurology, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Cristina Birzu
- Department of Neurology Mazarin, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
- Sorbonne Universités, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, HP, Paris, France
| | - Agusti Alentorn
- Department of Neurology Mazarin, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
- Sorbonne Universités, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, HP, Paris, France
| | - Marc Sanson
- Department of Neurology Mazarin, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
- Sorbonne Universités, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, HP, Paris, France
| | - Camille Tafani
- Department of Neurology, Hôpital d'Instruction Des Armées Percy, Service de Santé Des Armées, Clamart, France
| | - Flavie Bompaire
- Department of Neurology, Hôpital d'Instruction Des Armées Percy, Service de Santé Des Armées, Clamart, France
| | - Luis Bataller
- Neurology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Khê Hoang-Xuan
- Department of Neurology Mazarin, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
- Sorbonne Universités, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, HP, Paris, France
| | - Jean-Yves Delattre
- Department of Neurology Mazarin, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France
- Sorbonne Universités, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, HP, Paris, France
| | - Dimitri Psimaras
- Department of Neurology Mazarin, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix. Assistance Publique Hôpitaux de Paris (APHP), Paris, France.
- OncoNeuroTox Group: Center for Patients With Neurological Complications of Oncologic Treatments, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Hôpital d'Instruction Des Armées Percy, Paris, France.
- Sorbonne Universités, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, HP, Paris, France.
| | - Damien Ricard
- OncoNeuroTox Group: Center for Patients With Neurological Complications of Oncologic Treatments, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Hôpital d'Instruction Des Armées Percy, Paris, France
- Department of Neurology, Hôpital d'Instruction Des Armées Percy, Service de Santé Des Armées, Clamart, France
- Centre Borelli, Université Paris-Saclay, ENS Paris-Saclay, CNRS, Service Desanté Des Armées, Université de Paris, Saclay, France
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Kurokawa R, Hagiwara A, Kurokawa M, Ellingson BM, Baba A, Moritani T. Diffusion histogram profiles predict molecular features of grade 4 in histologically lower-grade adult diffuse gliomas following WHO classification 2021. Eur Radiol 2024; 34:1367-1375. [PMID: 37581661 PMCID: PMC10853353 DOI: 10.1007/s00330-023-10071-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVES In the latest World Health Organization classification 2021, grade 4 adult diffuse gliomas can be diagnosed with several molecular features even without histological evidence of necrosis or microvascular proliferation. We aimed to explore whole tumor histogram-derived apparent diffusion coefficient (ADC) histogram profiles for differentiating between the presence (Mol-4) and absence (Mol-2/3) of grade 4 molecular features in histologically lower-grade gliomas. METHODS Between June 2019 and October 2022, 184 adult patients with diffuse gliomas underwent MRI. After excluding 121 patients, 18 (median age, 64.5 [range, 37-84 years]) Mol-4 and 45 (median 40 [range, 18-73] years) Mol-2/3 patients with histologically lower-grade gliomas were enrolled. Whole tumor volume-of-interest-derived ADC histogram profiles were calculated and compared between the two groups. Stepwise logistic regression analysis with Akaike's information criterion using the ADC histogram profiles with p values < 0.01 and age at diagnosis was used to identify independent variables for predicting the Mol-4 group. RESULTS The 90th percentile (p < 0.001), median (p < 0.001), mean (p < 0.001), 10th percentile (p = 0.014), and entropy (p < 0.001) of normalized ADC were lower, and kurtosis (p < 0.001) and skewness (p = 0.046) were higher in the Mol-4 group than in the Mol-2/3 group. Multivariate logistic regression analysis revealed that the entropy of normalized ADC and age at diagnosis were independent predictive parameters for the Mol-4 group with an area under the curve of 0.92. CONCLUSION ADC histogram profiles may be promising preoperative imaging biomarkers to predict molecular grade 4 among histologically lower-grade adult diffuse gliomas. CLINICAL RELEVANCE STATEMENT This study highlighted the diagnostic usefulness of ADC histogram profiles to differentiate histologically lower grade adult diffuse gliomas with the presence of molecular grade 4 features and those without. KEY POINTS • ADC histogram profiles to predict molecular CNS WHO grade 4 status among histologically lower-grade adult diffuse gliomas were evaluated. • Entropy of ADC and age were independent predictive parameters for molecular grade 4 status. • ADC histogram analysis is useful for predicting molecular grade 4 among histologically lower-grade gliomas.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA.
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Akifumi Hagiwara
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Radiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
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Guo F, Ling G, Zhai Z, Lei Y, Mo L, Piao H. Identification and validation of prognostic genes and immune landscape signatures based on a fatty acid oxidation‑related risk score model in glioma. Oncol Lett 2024; 27:88. [PMID: 38249808 PMCID: PMC10797317 DOI: 10.3892/ol.2024.14222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/04/2023] [Indexed: 01/23/2024] Open
Abstract
Fatty acid oxidation (FAO) plays a crucial role in glioma metabolism and its interaction with the immune microenvironment. The aim of the present study was to investigate the relationship between FAO-related genes and glioma by constructing gene clusters using a glioma cohort. A total of 287 differentially expressed genes related to FAO were identified and the top 50 genes were selected based on their P-values. Subsequently, patients were classified into two distinct gene subtypes (A and B) based on these genes. Scores for each patient were calculated using the 50 genes and the patients were divided into the high and low-score groups accordingly. Patients in subtype B exhibited higher tumor grades and poor prognostic factors such as older age and worse survival rates. The high-score subgroup had unfavorable indicators, including isocitrate dehydrogenase 1 wild-type, high tumor grade and 1p19q non-codeleted, while immune checkpoint expression was generally higher in the high-score subgroup. The constructed scoring model was validated using an external dataset, and the tissue inhibitor of metalloproteinase 1 gene was identified through protein interaction analysis, suggesting its potential involvement in glioma malignancy and promotion of glioblastoma proliferation. In conclusion, FAO-related genes may contribute to tumor development through immune mechanisms and the present study may provide novel insights for potential therapeutic strategies in glioma treatment.
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Affiliation(s)
- Fangzhou Guo
- Graduate School, The Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning 116000, P.R. China
- Department of Neurosurgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Guoyuan Ling
- Graduate School, The Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning 116000, P.R. China
- Department of Neurosurgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Zhenzhu Zhai
- Department of Neurosurgery, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning 110801, P.R. China
- The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110801, P.R. China
| | - Yi Lei
- Department of Neurosurgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Ligen Mo
- Department of Neurosurgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region 530021, P.R. China
| | - Haozhe Piao
- Department of Neurosurgery, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning 110801, P.R. China
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Lucas D, Carvalho B, Tuna R, Linhares P. Metabolic Syndrome and Survival in Glioblastoma Patients: Retrospective Cohort Study and Review of the Literature. Cureus 2024; 16:e53641. [PMID: 38449965 PMCID: PMC10917394 DOI: 10.7759/cureus.53641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Background Several studies point to metabolic syndrome as a risk factor for the development and progression of several types of cancer. Its association with glioblastoma has yet to be determined, and only two studies investigate the impact of metabolic syndrome on the survival of glioblastoma patients, indicating a trend toward decreased survival in patients with metabolic syndrome. The aim of this study was to determine whether patients with glioblastoma and metabolic syndrome had a worse clinical outcome. Methods We retrospectively reviewed the clinical records of 180 patients diagnosed with glioblastoma. Metabolic syndrome was defined according to the American Heart Association, as the presence of at least three of the following criteria: diabetes, hypertension, hyperlipidemia, and obesity. We analyzed the overall survival and progression-free survival of patients with and without metabolic syndrome. Results Of 180 patients, 20 (11.1%) met the diagnostic criteria for metabolic syndrome. The overall survival of patients with metabolic syndrome was 19.8 months, and without metabolic syndrome was 17.7 months (p-value=0.085). The progression-free survival of patients with metabolic syndrome was 9.9 months, and without metabolic syndrome was 7.9 months (p-value=0.076). Conclusion Our results showed no prognostic relevance of metabolic syndrome in patients with glioblastoma, although there was a trend towards increased overall survival and progression-free survival in patients with metabolic syndrome.
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Affiliation(s)
- Diana Lucas
- Neurosurgery, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Bruno Carvalho
- Neurosurgery, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Rui Tuna
- Neurosurgery, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Paulo Linhares
- Neurosurgery, Centro Hospitalar Universitário de São João, Porto, PRT
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Wamelink IJHG, Azizova A, Booth TC, Mutsaerts HJMM, Ogunleye A, Mankad K, Petr J, Barkhof F, Keil VC. Brain Tumor Imaging without Gadolinium-based Contrast Agents: Feasible or Fantasy? Radiology 2024; 310:e230793. [PMID: 38319162 PMCID: PMC10902600 DOI: 10.1148/radiol.230793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/07/2023] [Accepted: 08/14/2023] [Indexed: 02/07/2024]
Abstract
Gadolinium-based contrast agents (GBCAs) form the cornerstone of current primary brain tumor MRI protocols at all stages of the patient journey. Though an imperfect measure of tumor grade, GBCAs are repeatedly used for diagnosis and monitoring. In practice, however, radiologists will encounter situations where GBCA injection is not needed or of doubtful benefit. Reducing GBCA administration could improve the patient burden of (repeated) imaging (especially in vulnerable patient groups, such as children), minimize risks of putative side effects, and benefit costs, logistics, and the environmental footprint. On the basis of the current literature, imaging strategies to reduce GBCA exposure for pediatric and adult patients with primary brain tumors will be reviewed. Early postoperative MRI and fixed-interval imaging of gliomas are examples of GBCA exposure with uncertain survival benefits. Half-dose GBCAs for gliomas and T2-weighted imaging alone for meningiomas are among options to reduce GBCA use. While most imaging guidelines recommend using GBCAs at all stages of diagnosis and treatment, non-contrast-enhanced sequences, such as the arterial spin labeling, have shown a great potential. Artificial intelligence methods to generate synthetic postcontrast images from decreased-dose or non-GBCA scans have shown promise to replace GBCA-dependent approaches. This review is focused on pediatric and adult gliomas and meningiomas. Special attention is paid to the quality and real-life applicability of the reviewed literature.
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Affiliation(s)
- Ivar J. H. G. Wamelink
- From the Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the
Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of
Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
(I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and
Imaging Sciences, King’s College London, London, United Kingdom (T.C.B.);
Department of Neuroradiology, King’s College Hospital, NHS Foundation
Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience,
Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology,
Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.);
Department of Radiology, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom (K.M.); Institute of
Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf,
Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for
Medical Image Computing, University College London, London, United Kingdom
(F.B.)
| | - Aynur Azizova
- From the Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the
Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of
Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
(I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and
Imaging Sciences, King’s College London, London, United Kingdom (T.C.B.);
Department of Neuroradiology, King’s College Hospital, NHS Foundation
Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience,
Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology,
Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.);
Department of Radiology, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom (K.M.); Institute of
Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf,
Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for
Medical Image Computing, University College London, London, United Kingdom
(F.B.)
| | - Thomas C. Booth
- From the Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the
Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of
Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
(I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and
Imaging Sciences, King’s College London, London, United Kingdom (T.C.B.);
Department of Neuroradiology, King’s College Hospital, NHS Foundation
Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience,
Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology,
Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.);
Department of Radiology, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom (K.M.); Institute of
Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf,
Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for
Medical Image Computing, University College London, London, United Kingdom
(F.B.)
| | - Henk J. M. M. Mutsaerts
- From the Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the
Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of
Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
(I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and
Imaging Sciences, King’s College London, London, United Kingdom (T.C.B.);
Department of Neuroradiology, King’s College Hospital, NHS Foundation
Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience,
Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology,
Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.);
Department of Radiology, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom (K.M.); Institute of
Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf,
Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for
Medical Image Computing, University College London, London, United Kingdom
(F.B.)
| | - Afolabi Ogunleye
- From the Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the
Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of
Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
(I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and
Imaging Sciences, King’s College London, London, United Kingdom (T.C.B.);
Department of Neuroradiology, King’s College Hospital, NHS Foundation
Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience,
Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology,
Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.);
Department of Radiology, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom (K.M.); Institute of
Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf,
Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for
Medical Image Computing, University College London, London, United Kingdom
(F.B.)
| | - Kshitij Mankad
- From the Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the
Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of
Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
(I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and
Imaging Sciences, King’s College London, London, United Kingdom (T.C.B.);
Department of Neuroradiology, King’s College Hospital, NHS Foundation
Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience,
Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology,
Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.);
Department of Radiology, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom (K.M.); Institute of
Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf,
Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for
Medical Image Computing, University College London, London, United Kingdom
(F.B.)
| | - Jan Petr
- From the Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the
Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of
Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
(I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and
Imaging Sciences, King’s College London, London, United Kingdom (T.C.B.);
Department of Neuroradiology, King’s College Hospital, NHS Foundation
Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience,
Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology,
Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.);
Department of Radiology, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom (K.M.); Institute of
Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf,
Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for
Medical Image Computing, University College London, London, United Kingdom
(F.B.)
| | - Frederik Barkhof
- From the Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the
Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of
Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
(I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and
Imaging Sciences, King’s College London, London, United Kingdom (T.C.B.);
Department of Neuroradiology, King’s College Hospital, NHS Foundation
Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience,
Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology,
Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.);
Department of Radiology, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom (K.M.); Institute of
Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf,
Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for
Medical Image Computing, University College London, London, United Kingdom
(F.B.)
| | - Vera C. Keil
- From the Department of Radiology and Nuclear Medicine, Amsterdam
University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the
Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of
Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
(I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and
Imaging Sciences, King’s College London, London, United Kingdom (T.C.B.);
Department of Neuroradiology, King’s College Hospital, NHS Foundation
Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience,
Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology,
Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.);
Department of Radiology, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom (K.M.); Institute of
Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf,
Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for
Medical Image Computing, University College London, London, United Kingdom
(F.B.)
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Sun M, Xie H, Zhang W, Li X, Jiang Z, Liang Y, Zhao G, Huang N, Mao J, Liu G, Zhang Z. Bioinspired Lipoproteins of Furoxans-Gemcitabine Preferentially Targets Glioblastoma and Overcomes Radiotherapy Resistance. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306190. [PMID: 38049204 PMCID: PMC10853724 DOI: 10.1002/advs.202306190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/31/2023] [Indexed: 12/06/2023]
Abstract
Radiotherapy (RT) resistance is an enormous challenge in glioblastoma multiforme (GBM) treatment, which is largely associated with DNA repair, poor distribution of reactive radicals in tumors, and limited delivery of radiosensitizers to the tumor sites. Inspired by the aberrant upregulation of RAD51 (a critical protein of DNA repair), scavenger receptor B type 1 (SR-B1), and C-C motif chemokine ligand 5 (CCL5) in GBM patients, a reduction-sensitive nitric oxide (NO) donor conjugate of gemcitabine (RAD51 inhibitor) (NG) is synthesized as radio-sensitizer and a CCL5 peptide-modified bioinspired lipoprotein system of NG (C-LNG) is rationally designed, aiming to preferentially target the tumor sites and overcome the RT resistance. C-LNG can preferentially accumulate at the orthotopic GBM tumor sites with considerable intratumor permeation, responsively release the gemcitabine and NO, and then generate abundant peroxynitrite (ONOO- ) upon X-ray radiation, thereby producing a 99.64% inhibition of tumor growth and a 71.44% survival rate at 120 days in GL261-induced orthotopic GBM tumor model. Therefore, the rationally designed bioinspired lipoprotein of NG provides an essential strategy to target GBM and overcome RT resistance.
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Affiliation(s)
- Maoyuan Sun
- Department of NeurosurgeryThe Second Affiliated Hospital of Chongqing Medical UniversityChongqing400016China
| | - Honglei Xie
- Institute of PharmacologySchool of Pharmaceutical SciencesShandong First Medical University & Shandong Academy of Medical Sciences619 Changcheng RoadTaian271016China
| | - Wenli Zhang
- Department of RadiologyThe Second Affiliated Hospital of Chongqing Medical UniversityChongqing400016China
| | - Xianlu Li
- School of Pharmacy & Key Laboratory of Smart Drug Delivery (Ministry of Education)Fudan UniversityShanghai201203China
| | - Zhan Jiang
- Department of OncologyThe Chongqing General HospitalChongqing400016China
| | - Yiyu Liang
- School of Pharmacy & Key Laboratory of Smart Drug Delivery (Ministry of Education)Fudan UniversityShanghai201203China
| | - Guanjian Zhao
- Department of NeurosurgeryThe Second Affiliated Hospital of Chongqing Medical UniversityChongqing400016China
| | - Ning Huang
- Department of NeurosurgeryThe Second Affiliated Hospital of Chongqing Medical UniversityChongqing400016China
| | - Jinning Mao
- Health Management CenterThe Second Affiliated HospitalChongqing Medical UniversityChongqing400016China
| | - Guodong Liu
- Department of NeurosurgeryThe Second Affiliated Hospital of Chongqing Medical UniversityChongqing400016China
| | - Zhiwen Zhang
- School of Pharmacy & Key Laboratory of Smart Drug Delivery (Ministry of Education)Fudan UniversityShanghai201203China
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Sevenich L, Heiland DH. [Tumor-host cell interaction in the microenvironment: new target points for treatment?]. DER NERVENARZT 2024; 95:104-110. [PMID: 38180512 DOI: 10.1007/s00115-023-01604-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Primary brain tumors and metastases in the central nervous system (CNS) are characterized by their unique microenvironment, which interacts with neuronal structures and influences structural and adaptive immunity. OBJECTIVE How significant are various tumor-host interactions from a prognostic and therapeutic perspective? MATERIAL AND METHOD A literature search was carried out for relevant articles on the topic: microenvironment glioblastoma or metastasis through PubMed and Medline. RESULTS Modern high-throughput methods, such as spatial and single-cell resolution molecular characterization of tumors and their microenvironment enable a detailed mapping of changes and adaptation of individual cells within the microenvironment of tumors; however, treatment approaches based on altered tumor-host cell interactions, such as immune modeling, cell-based treatment methods or checkpoint inhibition have so far not shown any significant advantages for survival. CONCLUSION A deeper understanding of the complex immune landscape and the microenvironment of metastases of the CNS and intracerebral tumors is essential to optimize future treatment strategies.
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Affiliation(s)
- Lisa Sevenich
- Institut für Tumorbiologie und experimentelle Therapie, Georg-Speyer-Haus, Frankfurt am Main, Deutschland
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Deutschland
- Partner Site Frankfurt/Mainz, Deutsches Konsortium für Translationale Krebsforschung, Frankfurt am Main, Deutschland
| | - Dieter Henrik Heiland
- Klinik für Neurochirurgie, Medical Center, Universität Freiburg, Freiburg, Deutschland.
- Microenvironment and Immunology Research Laboratory, Department of Neurosurgery, Medical Center Universität Freiburg, Breisacher Str. 64, 79106, Freiburg, Deutschland.
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA.
- Partner Site Freiburg, Deutsches Konsortium für Translationale Krebsforschung, Freiburg, Deutschland.
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Watanabe G, Wong JM, Estes B, Khan MF, Ogasawara C, Umana GE, Martin AR, Bloch O, Palmisciano P. Diffuse Midline H3K27-Altered Gliomas in the Spinal Cord: A Systematic Review. J Neurooncol 2024; 166:379-394. [PMID: 38342826 DOI: 10.1007/s11060-024-04584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/23/2024] [Indexed: 02/13/2024]
Abstract
PURPOSE To systematically review the clinical features, management, and outcomes of diffuse midline H3K27-altered gliomas of the spinal cord (DMG-SCs). METHODS PubMed, Ovid EMBASE, Scopus, and Web of Science were searched from database inception to 23 September 2023 for histologically confirmed cases of DMG-SC. Patient demographics, tumor characteristics, management information, and survival outcomes were extracted and analyzed. RESULTS A total of 279 patients from 39 studies were collected. Patients were mostly male (61%), with an average age of 32 years. Patients were treated with surgery, radiotherapy, and chemotherapy combined (31%) or surgery only (24%), and extent of resection was most often subtotal (38%). Temozolomide was the most common chemotherapeutic agent (81%). Radiation therapy was delivered with mean dose of 47 Gy in 23 fractions. At mean follow-up time of 21 months, 13% of patients were alive. Average median overall survival was 24 months (range of 13 to 40 months) with a median progression-free survival of 14 months. Historical WHO grades of 2 or 3 appeared to exhibit a longer average median overall survival time than that of grade 4 DMG-SCs (32 vs. 23 months, p = 0.009). CONCLUSIONS Outcomes for DMG-SCs are poor overall but appear to be favorable compared to intracranial DMGs. Despite the recent WHO 2021 grade 4 classification for all DMGs, given the differences in overall survival reported based on historical grading systems, future studies on DMG-SCs are needed to further define if DMG-SCs may represent a heterogeneous group of tumors with different prognoses.
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Affiliation(s)
- Gina Watanabe
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA
| | | | - Bradley Estes
- University of Kansas School of Medicine, Kansas City, KS, USA
| | | | - Christian Ogasawara
- Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Giuseppe E Umana
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Allan R Martin
- Department of Neurological Surgery, University of California, Davis, Sacramento, CA, USA
| | - Orin Bloch
- Department of Neurological Surgery, University of California, Davis, Sacramento, CA, USA
| | - Paolo Palmisciano
- Department of Neurological Surgery, University of California, Davis, Sacramento, CA, USA.
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128
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Santinha J, Katsaros V, Stranjalis G, Liouta E, Boskos C, Matos C, Viegas C, Papanikolaou N. Development of End-to-End AI-Based MRI Image Analysis System for Predicting IDH Mutation Status of Patients with Gliomas: Multicentric Validation. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:31-44. [PMID: 38343254 DOI: 10.1007/s10278-023-00918-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 03/02/2024]
Abstract
Radiogenomics has shown potential to predict genomic phenotypes from medical images. The development of models using standard-of-care pre-operative MRI images, as opposed to advanced MRI images, enables a broader reach of such models. In this work, a radiogenomics model for IDH mutation status prediction from standard-of-care MRIs in patients with glioma was developed and validated using multicentric data. A cohort of 142 (wild-type: 32.4%) patients with glioma retrieved from the TCIA/TCGA was used to train a logistic regression model to predict the IDH mutation status. The model was evaluated using retrospective data collected in two distinct hospitals, comprising 36 (wild-type: 63.9%) and 53 (wild-type: 75.5%) patients. Model development utilized ROC analysis. Model discrimination and calibration were used for validation. The model yielded an AUC of 0.741 vs. 0.716 vs. 0.938, a sensitivity of 0.784 vs. 0.739 vs. 0.875, and a specificity of 0.657 vs. 0.692 vs. 1.000 on the training, test cohort 1, and test cohort 2, respectively. The assessment of model fairness suggested an unbiased model for age and sex, and calibration tests showed a p < 0.05. These results indicate that the developed model allows the prediction of the IDH mutation status in gliomas using standard-of-care MRI images and does not appear to hold sex and age biases.
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Affiliation(s)
- João Santinha
- Computational Clinical Imaging Group, Champalimaud Research , Champalimaud Foundation, Av. Brasília, 1400-038, Lisbon, Portugal.
- Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001, Lisbon, Portugal.
| | - Vasileios Katsaros
- Department of Radiology, General Anti-Cancer and Oncological Hospital of Athens, St. Savvas, Athens, Greece
| | - George Stranjalis
- Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece
- Hellenic Center for Neurosurgical Research "Prof. Petros Kokkalis", Athens, Greece
- Athens Microneurosurgery Laboratory, Athens, Greece
| | - Evangelia Liouta
- Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece
- Hellenic Center for Neurosurgical Research "Prof. Petros Kokkalis", Athens, Greece
| | - Christos Boskos
- Athens Microneurosurgery Laboratory, Athens, Greece
- IATROPOLIS CyberKnife Center, Hellenic Neuro-Oncology Society, Chalandri, Greece
| | - Celso Matos
- Radiology Department, Champalimaud Clinical Centre, Champalimaud Foundation, Av. Brasília, 1400-038, Lisbon, Portugal
| | - Catarina Viegas
- Department of Neurosurgery, Hospital Garcia de Orta, Almada, Portugal
| | - Nickolas Papanikolaou
- Computational Clinical Imaging Group, Champalimaud Research , Champalimaud Foundation, Av. Brasília, 1400-038, Lisbon, Portugal
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Piscopo L, Zampella E, Klain M. [ 18F]FET PET/MR and machine learning in the evaluation of glioma. Eur J Nucl Med Mol Imaging 2024; 51:797-799. [PMID: 37953393 DOI: 10.1007/s00259-023-06505-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Affiliation(s)
- Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Li X, Cheng Y, Han X, Cui B, Li J, Yang H, Xu G, Lin Q, Xiao X, Tang J, Lu J. Exploring the association of glioma tumor residuals from incongruent [ 18F]FET PET/MR imaging with tumor proliferation using a multiparametric MRI radiomics nomogram. Eur J Nucl Med Mol Imaging 2024; 51:779-796. [PMID: 37864593 DOI: 10.1007/s00259-023-06468-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/28/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE The study aimed to using multiparametric MRI radiomics to predict glioma tumor residuals (TRFET over MR) derived from incongruent [18F]fluoroethyl-L-tyrosine ([18F]FET) PET/MR imaging. METHODS One hundred ten patients with gliomas who underwent [18F]FET PET/MR scanning were retrospectively analyzed. The TRFET over MR was identified by the discrepancy-PET that the extent of resection (EOR) based on MRI subtracted the biological tumor volume on PET images. The MRI parameters and radiomics features were extracted based on EOR and selected by the least absolute shrinkage and selection operator to construct radiomics score (Rad-score). The correlation network analysis of all features was analyzed by Spearman's correlation tests. The methods for evaluating the clinical usefulness consisted of the receiver operating characteristic curve, the calibration curve, and decision curve analysis. RESULTS The Rad-score of the patients with the TRFET over MR was significantly higher than those with the non TRFET over MR (p < 0.001). The Rad-score was significantly correlated with the discrepancy-PET (r = 0.72, p < 0.001), Ki-67 level (r = 0.76, p < 0.001), and epidermal growth factor receptor (EGFR) of gliomas (r = 0.75, p < 0.001), respectively. Moreover, there was a difference of the correlation network analysis between the TRPET over MR group and non TRFET over MR group. The nomogram combing Rad-score and clinical features had the greatest performance in predicting TRFET over MR (AUC = 0.90/0.87, training/testing). There was a significant difference in prognosis (median OS, 17 m vs. 43 m) between patients with TRFET over MR and non TRFET over MR based on nomogram prediction (p < 0.001). CONCLUSION The nomogram based on MRI radiomics would predict gliomas tumor residuals caused by the absence of 18F-PET PET examination and adjust EOR to improve prognosis.
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Affiliation(s)
- Xiaoran Li
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Ye Cheng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xin Han
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Bixiao Cui
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Hongwei Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Geng Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qingtang Lin
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xinru Xiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jie Tang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China.
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131
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Park YW, Kim S, Han K, Ahn SS, Moon JH, Kim EH, Kim J, Kang SG, Kim SH, Lee SK, Chang JH. Rethinking extent of resection of contrast-enhancing and non-enhancing tumor: different survival impacts on adult-type diffuse gliomas in 2021 World Health Organization classification. Eur Radiol 2024; 34:1376-1387. [PMID: 37608093 DOI: 10.1007/s00330-023-10125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/22/2023] [Accepted: 07/01/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES Extent of resection (EOR) of contrast-enhancing (CE) and non-enhancing (NE) tumors may have different impacts on survival according to types of adult-type diffuse gliomas in the molecular era. This study aimed to evaluate the impact of EOR of CE and NE tumors in glioma according to the 2021 World Health Organization classification. METHODS This retrospective study included 1193 adult-type diffuse glioma patients diagnosed between 2001 and 2021 (183 oligodendroglioma, 211 isocitrate dehydrogenase [IDH]-mutant astrocytoma, and 799 IDH-wildtype glioblastoma patients) from a single institution. Patients had complete information on IDH mutation, 1p/19q codeletion, and O6-methylguanine-methyltransferase (MGMT) status. Cox survival analyses were performed within each glioma type to assess predictors of overall survival, including clinical, imaging data, histological grade, MGMT status, adjuvant treatment, and EOR of CE and NE tumors. Subgroup analyses were performed in patients with CE tumor. RESULTS Among 1193 patients, 935 (78.4%) patients had CE tumors. In entire oligodendrogliomas, gross total resection (GTR) of NE tumor was not associated with survival (HR = 0.56, p = 0.223). In 86 (47.0%) oligodendroglioma patients with CE tumor, GTR of CE tumor was the only independent predictor of survival (HR = 0.16, p = 0.004) in multivariable analysis. GTR of CE and NE tumors was independently associated with better survival in IDH-mutant astrocytoma and IDH-wildtype glioblastoma (all ps < 0.05). CONCLUSIONS GTR of both CE and NE tumors may significantly improve survival within IDH-mutant astrocytomas and IDH-wildtype glioblastomas. In oligodendrogliomas, the EOR of CE tumor may be crucial in survival; aggressive GTR of NE tumor may be unnecessary, whereas GTR of the CE tumor is recommended. CLINICAL RELEVANCE STATEMENT Surgical strategies on contrast-enhancing (CE) and non-enhancing (NE) tumors should be reassessed considering the different survival outcomes after gross total resection depending on CE and NE tumors in the 2021 World Health Organization classification of adult-type diffuse gliomas. KEY POINTS The survival impact of extent of resection of contrast-enhancing (CE) and non-enhancing (NE) tumors was evaluated in adult-type diffuse gliomas. Gross total resection of both CE and NE tumors may improve survival in isocitrate dehydrogenase (IDH)-mutant astrocytomas and IDH-wildtype glioblastomas, while only gross total resection of the CE tumor improves survival in oligodendrogliomas. Surgical strategies should be reconsidered according to types in adult-type diffuse gliomas.
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Affiliation(s)
- Yae Won Park
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
| | - Sooyon Kim
- Department of Statistics and Data Science, Yonsei University, Seoul, Korea
| | - Kyunghwa Han
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
| | - Ju Hyung Moon
- Department of Neurosurgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
| | - Eui Hyun Kim
- Department of Neurosurgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
| | - Jinna Kim
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
| | - Seok-Gu Kang
- Department of Neurosurgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
| | - Se Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
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van Opijnen MP, Broekman MLD, Cuppen E, Dubbink HJ, Ter Elst A, van Eijk R, Mühlebner A, Jansen C, van der Geize R, Speel EJM, Groenen PJTA, de Vos FYF, Wesseling P, de Leng WWJ, Maas SLN. Next generation sequencing of high-grade adult-type diffuse glioma in the Netherlands: interlaboratory variation in the primary diagnostic and recurrent setting. J Neurooncol 2024; 166:485-492. [PMID: 38285243 PMCID: PMC10876806 DOI: 10.1007/s11060-024-04568-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE Next generation sequencing (NGS) is an important tool used in clinical practice to obtain the required molecular information for accurate diagnostics of high-grade adult-type diffuse glioma (HGG). Since individual centers use either in-house produced or standardized panels, interlaboratory variation could play a role in the practice of HGG diagnosis and treatment. This study aimed to investigate the current practice in NGS application for both primary and recurrent HGG. METHODS This nationwide Dutch survey used the expertise of (neuro)pathologists and clinical scientists in molecular pathology (CSMPs) by sending online questionnaires on clinical and technical aspects. Primary outcome was an overview of panel composition in the different centers for diagnostic practice of HGG. Secondary outcomes included practice for recurrent HGG and future perspectives. RESULTS Out of twelve neuro-oncology centers, the survey was filled out by eleven (neuro)pathologists and seven CSMPs. The composition of the diagnostic NGS panels differed in each center with numbers of genes ranging from 12 to 523. Differences are more pronounced when tests are performed to find therapeutic targets in the case of recurrent disease: about half of the centers test for gene fusions (60%) and tumor mutational burden (40%). CONCLUSION Current notable interlaboratory variations as illustrated in this study should be reduced in order to refine diagnostics and improve precision oncology. In-house developed tests, standardized panels and routine application of broad gene panels all have their own advantages and disadvantages. Future research would be of interest to study the clinical impact of variation in diagnostic approaches.
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Affiliation(s)
- Mark P van Opijnen
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands.
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands.
| | - Marike L D Broekman
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Edwin Cuppen
- Hartwig Medical Foundation, Amsterdam, The Netherlands
- Center for Molecular Medicine and Oncode Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hendrikus J Dubbink
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Arja Ter Elst
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - Ronald van Eijk
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Angelika Mühlebner
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Casper Jansen
- Laboratorium Pathologie Oost-Nederland, Hengelo, The Netherlands
| | | | - Ernst-Jan M Speel
- Department of Pathology, GROW-School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Filip Y F de Vos
- Department of Medical Oncology, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Pieter Wesseling
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Wendy W J de Leng
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sybren L N Maas
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
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Isa AI. Exploring signaling pathway crosstalk in glioma by mapping miRNA and WNT pathways: A review. Int J Biol Macromol 2024; 257:128722. [PMID: 38092099 DOI: 10.1016/j.ijbiomac.2023.128722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/26/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
Glioma is a significant healthcare burden; nevertheless, the particular genetic regulatory mechanism underpinning its onset and progression is still unknown. Recent research has focused in large part on trying to determine the underlying molecular pathways that contribute to the malignancy of this disease because of the difficulties in treating it. Many tumors have been linked to changes in the expression of microRNAs (miRNAs). miRNAs play a critical role in cancer development by controlling a wide variety of targets and signaling cascades. A rising body of evidence emphasizes WNT pathway dysregulation in glioma, despite the fact that it is dysregulated in many malignancies. Here, we give a detailed analysis of the roles played by miRNAs in the WNT pathway by glioma. We also demonstrate how the WNT pathway cooperates with miRNAs to control a variety of functions, including cell proliferation, invasion, migration, and epithelial-mesenchymal transition.
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Affiliation(s)
- Adamu Imam Isa
- Department of Physiology, College of Medicine, University of Bisha, Bisha 61922, Saudi Arabia.
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Losurdo A, Di Muzio A, Cianciotti BC, Dipasquale A, Persico P, Barigazzi C, Bono B, Feno S, Pessina F, Santoro A, Simonelli M. T Cell Features in Glioblastoma May Guide Therapeutic Strategies to Overcome Microenvironment Immunosuppression. Cancers (Basel) 2024; 16:603. [PMID: 38339353 PMCID: PMC10854506 DOI: 10.3390/cancers16030603] [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: 12/28/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Glioblastoma (GBM) is the most aggressive and lethal primary brain tumor, bearing a survival estimate below 10% at five years, despite standard chemoradiation treatment. At recurrence, systemic treatment options are limited and the standard of care is not well defined, with inclusion in clinical trials being highly encouraged. So far, the use of immunotherapeutic strategies in GBM has not proved to significantly improve patients' prognosis in the treatment of newly diagnosed GBM, nor in the recurrent setting. Probably this has to do with the unique immune environment of the central nervous system, which harbors several immunosuppressive/pro-tumorigenic factors, both soluble (e.g., TGF-β, IL-10, STAT3, prostaglandin E2, and VEGF) and cellular (e.g., Tregs, M2 phenotype TAMs, and MDSC). Here we review the immune composition of the GBMs microenvironment, specifically focusing on the phenotype and function of the T cell compartment. Moreover, we give hints on the therapeutic strategies, such as immune checkpoint blockade, vaccinations, and adoptive cell therapy, that, interacting with tumor-infiltrating lymphocytes, might both target in different ways the tumor microenvironment and potentiate the activity of standard therapies. The path to be followed in advancing clinical research on immunotherapy for GBM treatment relies on a twofold strategy: testing combinatorial treatments, aiming to restore active immune anti-tumor responses, tackling immunosuppression, and additionally, designing more phase 0 and window opportunity trials with solid translational analyses to gain deeper insight into the on-treatment shaping of the GBM microenvironment.
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Affiliation(s)
- Agnese Losurdo
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.L.); (A.D.M.); (A.D.); (P.P.); (C.B.); (A.S.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy;
| | - Antonio Di Muzio
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.L.); (A.D.M.); (A.D.); (P.P.); (C.B.); (A.S.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy;
| | - Beatrice Claudia Cianciotti
- Laboratory of Translational Immunology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (B.C.C.); (S.F.)
| | - Angelo Dipasquale
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.L.); (A.D.M.); (A.D.); (P.P.); (C.B.); (A.S.)
| | - Pasquale Persico
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.L.); (A.D.M.); (A.D.); (P.P.); (C.B.); (A.S.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy;
| | - Chiara Barigazzi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.L.); (A.D.M.); (A.D.); (P.P.); (C.B.); (A.S.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy;
| | - Beatrice Bono
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Simona Feno
- Laboratory of Translational Immunology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (B.C.C.); (S.F.)
| | - Federico Pessina
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy;
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | - Armando Santoro
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.L.); (A.D.M.); (A.D.); (P.P.); (C.B.); (A.S.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy;
| | - Matteo Simonelli
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (A.L.); (A.D.M.); (A.D.); (P.P.); (C.B.); (A.S.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy;
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Saleh Alanazi SH, Farooq Khan M, Alazami AM, Baabbad A, Ahmed Wadaan M. Calotropis procera: A double edged sword against glioblastoma, inhibiting glioblastoma cell line growth by targeting histone deacetylases (HDAC) and angiogenesis. Heliyon 2024; 10:e24406. [PMID: 38304784 PMCID: PMC10831610 DOI: 10.1016/j.heliyon.2024.e24406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/16/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
Despite substantial investments in anti-glioblastoma (GBM) drug discovery over the last decade, progress is limited to preclinical stages, with clinical studies frequently encountering obstacles. Angiogenic and histone deacetylase inhibitors (HDACi) have shown profound results in pre-clinical studies. Investigating a multicomponent anti-cancer remedy that disrupts the tumor angiogenic blood vessels and simultaneously disrupts HDACs, while inducing minimal side effects, is critically needed. The crude extracts derived from medicinal plants serve as a renewable reservoir of anti-tumor drugs, exhibiting reduced toxicity compared to chemically synthesized formulations. Calotropis procera is a traditional medicinal plant, and its anticancer potential against many cancer cell lines has been reported, however its antiangiogenic and HDAC inhibitory action is largely unknown. The anticancer activity of methanol leaf extract of C. procera was tested in three types of human glioblastoma cell lines. Wild-type and transgenic zebrafish embryos were used to evaluate developmental toxicity and angiogenic activity. A human angiogenic antibody array was used to profile angiogenic proteins in the U251 GM cell line. A real-time reverse transcriptase polymerase chain reaction (RT PCR) assay was used to detect the differential expression of eleven HDAC genes in U251 cells treated with C. procera extract. The extract significantly reduced the proliferation of all three types of GBM cell lines and the cytotoxicity was found to be more pronounced in U251 GM cells, with an IC50 value of 2.63 ± 0.23 μg/ml, possibly by arresting the cell cycle at the G2/M transition. The extract did not exhibit toxic effects in zebrafish embryos, even at concentrations as high as 1000 μg/ml. The extract also inhibited angiogenic blood vessel formation in the transgenic zebrafish model in a dose-dependent manner. The results from the angiogenic antibody array have suggested novel angiogenesis targets that can be utilized to treat GBM. Real-time RT PCR analysis has shown that C. procrea extract caused an upregulation of HDAC5, 7, and 10, while the mRNA of HDAC1, 2, 3 and 8 (Class I HDACs), and HDAC4, 6, and 9 (Class II) were downregulated in U251 GM cells. The cytotoxicity of the C. procera extract on GBM cell lines could be due to its dual action by regulation of both tumor angiogenesis and histone deacetylases enzymes. Through this study, the C. procera leaf extract has been suggested as an effective remedy to treat GBM with minimal toxicity. In addition, various novel angiogenic and HDAC targets has been identified which could be helpful in designing better therapeutic strategies to manage glioblastoma multiforme in human patients.
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Affiliation(s)
- Shamsa Hilal Saleh Alanazi
- Bioproducts Research Chair, Department of Zoology, College of Science, King Saud University, P.O Box 2455 Riyadh 11451, Kingdom of Saudi Arabia
| | - Muhammad Farooq Khan
- Bioproducts Research Chair, Department of Zoology, College of Science, King Saud University, P.O Box 2455 Riyadh 11451, Kingdom of Saudi Arabia
| | - Anas M. Alazami
- Translational Genomics Department, Centre for Genomic Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Almohannad Baabbad
- Bioproducts Research Chair, Department of Zoology, College of Science, King Saud University, P.O Box 2455 Riyadh 11451, Kingdom of Saudi Arabia
| | - Mohammad Ahmed Wadaan
- Bioproducts Research Chair, Department of Zoology, College of Science, King Saud University, P.O Box 2455 Riyadh 11451, Kingdom of Saudi Arabia
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Heuer S, Burghaus I, Gose M, Kessler T, Sahm F, Vollmuth P, Venkataramani V, Hoffmann D, Schlesner M, Ratliff M, Hopf C, Herrlinger U, Ricklefs F, Bendszus M, Krieg SM, Wick A, Wick W, Winkler F. PerSurge (NOA-30) phase II trial of perampanel treatment around surgery in patients with progressive glioblastoma. BMC Cancer 2024; 24:135. [PMID: 38279087 PMCID: PMC10811925 DOI: 10.1186/s12885-024-11846-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Glioblastoma is the most frequent and a particularly malignant primary brain tumor with no efficacy-proven standard therapy for recurrence. It has recently been discovered that excitatory synapses of the AMPA-receptor subtype form between non-malignant brain neurons and tumor cells. This neuron-tumor network connectivity contributed to glioma progression and could be efficiently targeted with the EMA/FDA approved antiepileptic AMPA receptor inhibitor perampanel in preclinical studies. The PerSurge trial was designed to test the clinical potential of perampanel to reduce tumor cell network connectivity and tumor growth with an extended window-of-opportunity concept. METHODS PerSurge is a phase IIa clinical and translational treatment study around surgical resection of progressive or recurrent glioblastoma. In this multicenter, 2-arm parallel-group, double-blind superiority trial, patients are 1:1 randomized to either receive placebo or perampanel (n = 66 in total). It consists of a treatment and observation period of 60 days per patient, starting 30 days before a planned surgical resection, which itself is not part of the study interventions. Only patients with an expected safe waiting interval are included, and a safety MRI is performed. Tumor cell network connectivity from resected tumor tissue on single cell transcriptome level as well as AI-based assessment of tumor growth dynamics in T2/FLAIR MRI scans before resection will be analyzed as the co-primary endpoints. Secondary endpoints will include further imaging parameters such as pre- and postsurgical contrast enhanced MRI scans, postsurgical T2/FLAIR MRI scans, quality of life, cognitive testing, overall and progression-free survival as well as frequency of epileptic seizures. Further translational research will focus on additional biological aspects of neuron-tumor connectivity. DISCUSSION This trial is set up to assess first indications of clinical efficacy and tolerability of perampanel in recurrent glioblastoma, a repurposed drug which inhibits neuron-glioma synapses and thereby glioblastoma growth in preclinical models. If perampanel proved to be successful in the clinical setting, it would provide the first evidence that interference with neuron-cancer interactions may indeed lead to a benefit for patients, which would lay the foundation for a larger confirmatory trial in the future. TRIAL REGISTRATION EU-CT number: 2023-503938-52-00 30.11.2023.
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Affiliation(s)
- Sophie Heuer
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Ina Burghaus
- Coordination Centre for Clinical Trials (KKS) Heidelberg, 69120, Heidelberg, Germany
| | - Maria Gose
- Coordination Centre for Clinical Trials (KKS) Heidelberg, 69120, Heidelberg, Germany
| | - Tobias Kessler
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, University Hospital Heidelberg, INF 224, 69120, Heidelberg, Germany
- CCU Neuropathology, German Consortium for Translational Cancer Research (DKTK), Geman Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Philipp Vollmuth
- Department of Neuroradiology, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - Varun Venkataramani
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
| | - Dirk Hoffmann
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Matthias Schlesner
- German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Biomedical Informatics, Data Mining and Data Analytics, University of Augsburg, Augsburg, Germany
| | - Miriam Ratliff
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
- Neurosurgery Clinic, University Hospital Mannheim, 68167, Mannheim, Germany
| | - Carsten Hopf
- Center for Mass Spectrometry and Optical Spectroscopy (CeMOS), Mannheim University of Applied Sciences, Paul-Wittsack Str. 10, 68163, Mannheim, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
- Mannheim Center for Translational Neuroscience (MCTN), Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Ulrich Herrlinger
- Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology, University Hospital Bonn, Bonn, Germany
| | - Franz Ricklefs
- Department of Neurosurgery, University Hospital Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Antje Wick
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - Wolfgang Wick
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Frank Winkler
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany.
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.
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137
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Hariharan S, Whitfield BT, Pirozzi CJ, Waitkus MS, Brown MC, Bowie ML, Irvin DM, Roso K, Fuller R, Hostettler J, Dharmaiah S, Gibson EA, Briley A, Mangoli A, Fraley C, Shobande M, Stevenson K, Zhang G, Malgulwar PB, Roberts H, Roskoski M, Spasojevic I, Keir ST, He Y, Castro MG, Huse JT, Ashley DM. Interplay between ATRX and IDH1 mutations governs innate immune responses in diffuse gliomas. Nat Commun 2024; 15:730. [PMID: 38272925 PMCID: PMC10810843 DOI: 10.1038/s41467-024-44932-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/10/2024] [Indexed: 01/27/2024] Open
Abstract
Stimulating the innate immune system has been explored as a therapeutic option for the treatment of gliomas. Inactivating mutations in ATRX, defining molecular alterations in IDH-mutant astrocytomas, have been implicated in dysfunctional immune signaling. However, little is known about the interplay between ATRX loss and IDH mutation on innate immunity. To explore this, we generated ATRX-deficient glioma models in the presence and absence of the IDH1R132H mutation. ATRX-deficient glioma cells are sensitive to dsRNA-based innate immune agonism and exhibit impaired lethality and increased T-cell infiltration in vivo. However, the presence of IDH1R132H dampens baseline expression of key innate immune genes and cytokines in a manner restored by genetic and pharmacological IDH1R132H inhibition. IDH1R132H co-expression does not interfere with the ATRX deficiency-mediated sensitivity to dsRNA. Thus, ATRX loss primes cells for recognition of dsRNA, while IDH1R132H reversibly masks this priming. This work reveals innate immunity as a therapeutic vulnerability of astrocytomas.
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Affiliation(s)
- Seethalakshmi Hariharan
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Benjamin T Whitfield
- Departments of Pathology and Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christopher J Pirozzi
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Matthew S Waitkus
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Michael C Brown
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Michelle L Bowie
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - David M Irvin
- Departments of Pathology and Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kristen Roso
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Rebecca Fuller
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Janell Hostettler
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Sharvari Dharmaiah
- Departments of Pathology and Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Emiley A Gibson
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Aaron Briley
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Avani Mangoli
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Casey Fraley
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Mariah Shobande
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Kevin Stevenson
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Gao Zhang
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Prit Benny Malgulwar
- Departments of Pathology and Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hannah Roberts
- Departments of Pathology and Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Martin Roskoski
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Ivan Spasojevic
- PK/PD Core Laboratory, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- Department of Medicine - Oncology, Duke University Medical Center, Durham, NC, USA
| | - Stephen T Keir
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Yiping He
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Maria G Castro
- Department of Neurosurgery, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Jason T Huse
- Departments of Pathology and Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - David M Ashley
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA.
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
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138
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Morales-Gallel R, Ulloa-Navas MJ, García-Tárraga P, Prat-Acín R, Reynés G, Pérez-Borredá P, Rubio L, Capilla-González V, Ferrer-Lozano J, García-Verdugo JM. BCAS1 defines a heterogeneous cell population in diffuse gliomas. Oncotarget 2024; 15:49-64. [PMID: 38275289 PMCID: PMC10812236 DOI: 10.18632/oncotarget.28553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Oligodendrocyte precursor markers have become of great interest to identify new diagnostic and therapeutic targets for diffuse gliomas, since state-of-the-art studies point towards immature oligodendrocytes as a possible source of gliomagenesis. Brain enriched myelin associated protein 1 (BCAS1) is a novel marker of immature oligodendrocytes and was proposed to contribute to tumorigenesis in non-central nervous system tumors. However, BCAS1 role in diffuse glioma is still underexplored. This study analyzes the expression of BCAS1 in different tumor samples from patients with diffuse gliomas (17 oligodendrogliomas; 8 astrocytomas; 60 glioblastomas) and uncovers the molecular and ultrastructural features of BCAS1+ cells by immunostaining and electron microscopy. Our results show that BCAS1+ cells exhibit stellate or spherical morphology with similar ultrastructural features. Stellate and spherical cells were detected as isolated cells in all studied gliomas. Nevertheless, only stellate cells were found to be proliferative and formed tightly packed nodules with a highly proliferative rate in oligodendrogliomas. Our findings provide a comprehensive characterization of the BCAS1+ cell population within diffuse gliomas. The observed proliferative capacity and distribution of BCAS1+ stellate cells, particularly in oligodendrogliomas, highlight BCAS1 as an interesting marker, warranting further investigation into its role in tumor malignancy.
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Affiliation(s)
- Raquel Morales-Gallel
- Laboratory of Comparative Neurobiology, Institute Cavanilles of Biodiversity and Evolutionary Biology, University of Valencia-CIBERNED, Valencia, Spain
- These authors contributed equally to this work
| | - María José Ulloa-Navas
- Department of Neurosurgery, Mayo Clinic, Jacksonville, FL 32224, USA
- These authors contributed equally to this work
| | - Patricia García-Tárraga
- Laboratory of Comparative Neurobiology, Institute Cavanilles of Biodiversity and Evolutionary Biology, University of Valencia-CIBERNED, Valencia, Spain
| | - Ricardo Prat-Acín
- Department of Neurosurgery, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Gaspar Reynés
- Group of Clinical and Translational Research in Cancer, Health Research Institute Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Pedro Pérez-Borredá
- Department of Neurosurgery, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Luis Rubio
- Department of Pathology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Vivian Capilla-González
- Department of Integrative Pathophysiology and Therapies, Andalusian Center for Molecular Biology and Regenerative Medicine-CABIMER, Junta de Andalucía-University of Pablo de Olavide-University of Seville-CSIC, Seville, Spain
| | - Jaime Ferrer-Lozano
- Department of Pathology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - José Manuel García-Verdugo
- Laboratory of Comparative Neurobiology, Institute Cavanilles of Biodiversity and Evolutionary Biology, University of Valencia-CIBERNED, Valencia, Spain
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139
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Yang X, Jiang S, Liu F, Li Z, Liu W, Zhang X, Nan F, Li J, Yu M, Wang Y, Wang B. HCMV IE1/IE1mut Therapeutic Vaccine Induces Tumor Regression via Intratumoral Tertiary Lymphoid Structure Formation and Peripheral Immunity Activation in Glioblastoma Multiforme. Mol Neurobiol 2024:10.1007/s12035-024-03937-8. [PMID: 38261253 DOI: 10.1007/s12035-024-03937-8] [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: 10/01/2023] [Accepted: 01/07/2024] [Indexed: 01/24/2024]
Abstract
Glioblastoma multiforme (GBM), a highly malignant invasive brain tumor, is associated with poor prognosis and survival and lacks an effective cure. High expression of the human cytomegalovirus (HCMV) immediate early protein 1 (IE1) in GBM tissues is strongly associated with their malignant progression, presenting a novel target for therapeutic strategies. Here, the bioluminescence imaging technology revealed remarkable tumor shrinkage and improved survival rates in a mouse glioma model treated with HCMV IE1/IE1mut vaccine. In addition, immunofluorescence data demonstrated that the treated group exhibited significantly more and larger tertiary lymphoid structures (TLSs) than the untreated group. The presence of TLS was associated with enhanced T cell infiltration, and a large number of proliferating T cells were found in the treated group. Furthermore, the flow cytometry results showed that in the treatment group, cytotoxic T lymphocytes exhibited partial polarization toward effector memory T cells and were activated to play a lethal role in the peripheral immunological organs. Furthermore, a substantial proportion of B cells in the draining lymph nodes expressed CD40 and CD86. Surprisingly, quantitative polymerase chain reaction indicated that a high expression of cytokines, including chemokines in brain tumors and immune tissues, induced the differentiation, development, and chemokine migration of immune cells in the treated group. Our study data demonstrate that IE1 or IE1mut vaccination has a favorable effect in glioma mice models. This study holds substantial implications for identifying new and effective therapeutic targets within GBM.
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Affiliation(s)
- Xiaoli Yang
- Department of Pathogenic Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Shasha Jiang
- Department of Pathogenic Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Fengjun Liu
- Department of Pathogenic Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Zonghui Li
- Department of Pathogenic Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Wenxuan Liu
- Department of Pathogenic Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Xianjuan Zhang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Fulong Nan
- Department of Pathogenic Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Jun Li
- Department of Pathogenic Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Meng Yu
- Department of Pathogenic Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Yunyang Wang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Bin Wang
- Department of Pathogenic Biology, School of Basic Medicine, Qingdao University, Qingdao, China.
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140
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何 慧, 郭 二, 蒙 文, 王 彧, 王 雯, 何 文, 吴 元, 阳 维. [Predicting cerebral glioma enhancement pattern using a machine learning-based magnetic resonance imaging radiomics model]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2024; 44:194-200. [PMID: 38293992 PMCID: PMC10878898 DOI: 10.12122/j.issn.1673-4254.2024.01.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE To establish a machine learning radiomics model that can accurately predict MRI enhancement patterns of glioma based on T2 fluid attenuated inversion recovery (T2-FLAIR) images for optimizing the workflow of magnetic resonance imaging (MRI) examinations of glioma patients. METHODS We retrospectively collected preoperative MR T2-FLAIR images from 385 patients with pathologically confirmed glioma, who were divided into enhancing and non-enhancing groups according to the enhancement pattern. Predictive radiomics models were established using Gaussian Process, Linear Regression, Linear Regression-Least absolute shrinkage and selection operator, Support Vector Machine, Linear Discriminant Analysis or Naive Bayes as the classifiers in the training cohort (n=201)and tested both in the internal (n=85) and external validation cohorts (n=99). The receiver-operating characteristic curve was used to assess the predictive performance of the models. RESULTS The predictive model constructed based on 15 radiomics features using Gaussian Process as the classifier had the best predictive performance in both the training cohort and the internal validation cohort, with areas under the curve (AUC) of 0.88 (95% CI: 0.81-0.94) and 0.80 (95% CI: 0.71-0.88), respectively. In the external validation cohort, the model showed an AUC of 0.81 (95% CI: 0.71-0.90) with sensitivity, specificity, positive predictive value and negative predictive value of 0.98, 0.61, 0.76 and 0.96, respectively. CONCLUSION The T2-FLAIR-based machine learning radiomics model can accurately predict the enhancement pattern of gliomas on MRI.
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Affiliation(s)
- 慧珊 何
- 南方医科大学南方医院(第一临床医学院),广东 广州 510515Nanfang Hospital/First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - 二嘉 郭
- 南方医科大学南方医院(第一临床医学院),广东 广州 510515Nanfang Hospital/First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - 文仪 蒙
- 南方医科大学南方医院(第一临床医学院),广东 广州 510515Nanfang Hospital/First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - 彧 王
- 南方医科大学南方医院(第一临床医学院),广东 广州 510515Nanfang Hospital/First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - 雯 王
- 南方医科大学南方医院(第一临床医学院),广东 广州 510515Nanfang Hospital/First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - 文乐 何
- 广东三九脑科医院影像中心,广东 广州 510515Medical Imaging Center, Guangdong 999 Brain Hospital, Guangzhou 510515, China
| | - 元魁 吴
- 南方医科大学南方医院(第一临床医学院),广东 广州 510515Nanfang Hospital/First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - 维 阳
- 南方医科大学生物医学工程学院,广东 广州 510515School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
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141
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Hönikl LS, Lange S, Butenschoen VM, Delbridge C, Meyer B, Combs SE, Illert AL, Schmidt-Graf F. The role of molecular tumor boards in neuro-oncology: a nationwide survey. BMC Cancer 2024; 24:108. [PMID: 38243190 PMCID: PMC10797778 DOI: 10.1186/s12885-024-11858-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND In neuro-oncology, the inclusion of tumor patients in the molecular tumor board has only become increasingly widespread in recent years, but so far there are no standards for indication, procedure, evaluation, therapy recommendations and therapy implementation of neuro-oncological patients. The present work examines the current handling of neuro-oncological patients included in molecular tumor boards in Germany. METHODS We created an online based survey with questions covering the handling of neuro-oncologic patient inclusion, annotation of genetic analyses, management of target therapies and the general role of molecular tumor boards in neuro-oncology in Germany. We contacted all members of the Neuro-Oncology working group (NOA) of the German Cancer Society (DKG) by e-mail. RESULTS 38 responses were collected. The majority of those who responded were specialists in neurosurgery or neurology with more than 10 years of professional experience working at a university hospital. Molecular tumor boards (MTB) regularly take place once a week and all treatment disciplines of neuro-oncology patients take part. The inclusions to the MTB are according to distinct tumors and predominantly in case of tumor recurrence. An independently MTB member mostly create the recommendations, which are regularly implemented in the tumor treatment. Recommendations are given for alteration classes 4 and 5. Problems exist mostly within the cost takeover of experimental therapies. The experimental therapies are mostly given in the department of medical oncology. CONCLUSIONS Molecular tumor boards for neuro-oncological patients, by now, are not standardized in Germany. Similarities exists for patient inclusion and interpretation of molecular alterations; the time point of inclusion and implementation during the patient treatment differ between the various hospitals. Further studies for standardization and harmonisation are needed. In summary, most of the interviewees envision great opportunities and possibilities for molecular-based neuro-oncological therapy in the future.
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Affiliation(s)
- Lisa S Hönikl
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany.
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany.
| | - Sebastian Lange
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany
- Department of Medicine II, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Vicki M Butenschoen
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Claire Delbridge
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany
- Department of Neuropathology, Institute of Pathology, Technical University of Munich (TUM), Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Anna Lena Illert
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany
- Department of Medicine III, Faculty of Medicine, Klinikum Rechts der Isar, Technical University Munich (TUM), Munich, Germany
| | - Friederike Schmidt-Graf
- Center for Personalized Medicine (ZPM), Klinikum rechts der Isar, Technical Universitiy of Munich (TUM), Munich, Germany
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
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142
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Ullrich V, Ertmer S, Baginska A, Dorsch M, Gull HH, Cima I, Berger P, Dobersalske C, Langer S, Meyer L, Dujardin P, Kebir S, Glas M, Blau T, Keyvani K, Rauschenbach L, Sure U, Roesch A, Grüner BM, Scheffler B. KDM5B predicts temozolomide-resistant subclones in glioblastoma. iScience 2024; 27:108596. [PMID: 38174322 PMCID: PMC10762356 DOI: 10.1016/j.isci.2023.108596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/06/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
Adaptive plasticity to the standard chemotherapeutic temozolomide (TMZ) leads to glioblastoma progression. Here, we examine early stages of this process in patient-derived cellular models, exposing the human lysine-specific demethylase 5B (KDM5B) as a prospective indicator for subclonal expansion. By integration of a reporter, we show its preferential activity in rare, stem-like ALDH1A1+ cells, immediately increasing expression upon TMZ exposure. Naive, genetically unmodified KDM5Bhigh cells phosphorylate AKT (pAKT) and act as slow-cycling persisters under TMZ. Knockdown of KDM5B reverses pAKT levels, simultaneously increasing PTEN expression and TMZ sensitivity. Pharmacological inhibition of PTEN rescues the effect. Interference with KDM5B subsequent to TMZ decreases cellular vitality, and clonal tracing with DNA barcoding demonstrates high individual levels of KDM5B to predict subclonal expansion already before TMZ exposure. Thus, KDM5Bhigh treatment-naive cells preferentially contribute to the dynamics of drug resistance under TMZ. These findings may serve as a cornerstone for future biomarker-assisted clinical trials.
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Affiliation(s)
- Vivien Ullrich
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Sarah Ertmer
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Anna Baginska
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Madeleine Dorsch
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Hanah H. Gull
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
| | - Igor Cima
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Pia Berger
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Celia Dobersalske
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Sarah Langer
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Loona Meyer
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Philip Dujardin
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Sied Kebir
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, 45147 Essen, Germany
| | - Martin Glas
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, 45147 Essen, Germany
| | - Tobias Blau
- Department of Neuropathology, University Hospital Essen, 45147 Essen, Germany
| | - Kathy Keyvani
- Department of Neuropathology, University Hospital Essen, 45147 Essen, Germany
| | - Laurèl Rauschenbach
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
| | - Ulrich Sure
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
| | - Alexander Roesch
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Department of Dermatology, University Hospital Essen, 45147 Essen, Germany
- Center of Medical Biotechnology (ZMB), University Duisburg-Essen, 45141 Essen, Germany
| | - Barbara M. Grüner
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
- Center of Medical Biotechnology (ZMB), University Duisburg-Essen, 45141 Essen, Germany
| | - Björn Scheffler
- DKFZ-Division Translational Neurooncology at the WTZ, DKTK partner site, University Hospital Essen, 45147 Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, a partnership between DKFZ and University Hospital Essen, Germany
- West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Center of Medical Biotechnology (ZMB), University Duisburg-Essen, 45141 Essen, Germany
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Mastall M, Roth P, Bink A, Fischer Maranta A, Läubli H, Hottinger AF, Hundsberger T, Migliorini D, Ochsenbein A, Seystahl K, Imbach L, Hortobagyi T, Held L, Weller M, Wirsching HG. A phase Ib/II randomized, open-label drug repurposing trial of glutamate signaling inhibitors in combination with chemoradiotherapy in patients with newly diagnosed glioblastoma: the GLUGLIO trial protocol. BMC Cancer 2024; 24:82. [PMID: 38225589 PMCID: PMC10789019 DOI: 10.1186/s12885-023-11797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 12/26/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Glioblastoma is the most common and most aggressive malignant primary brain tumor in adults. Glioblastoma cells synthesize and secrete large quantities of the excitatory neurotransmitter glutamate, driving epilepsy, neuronal death, tumor growth and invasion. Moreover, neuronal networks interconnect with glioblastoma cell networks through glutamatergic neuroglial synapses, activation of which induces oncogenic calcium oscillations that are propagated via gap junctions between tumor cells. The primary objective of this study is to explore the efficacy of brain-penetrating anti-glutamatergic drugs to standard chemoradiotherapy in patients with glioblastoma. METHODS/DESIGN GLUGLIO is a 1:1 randomized phase Ib/II, parallel-group, open-label, multicenter trial of gabapentin, sulfasalazine, memantine and chemoradiotherapy (Arm A) versus chemoradiotherapy alone (Arm B) in patients with newly diagnosed glioblastoma. Planned accrual is 120 patients. The primary endpoint is progression-free survival at 6 months. Secondary endpoints include overall and seizure-free survival, quality of life of patients and caregivers, symptom burden and cognitive functioning. Glutamate levels will be assessed longitudinally by magnetic resonance spectroscopy. Other outcomes of interest include imaging response rate, neuronal hyperexcitability determined by longitudinal electroencephalography, Karnofsky performance status as a global measure of overall performance, anticonvulsant drug use and steroid use. Tumor tissue and blood will be collected for translational research. Subgroup survival analyses by baseline parameters include segregation by age, extent of resection, Karnofsky performance status, O6-methylguanine DNA methyltransferase (MGMT) promotor methylation status, steroid intake, presence or absence of seizures, tumor volume and glutamate levels determined by MR spectroscopy. The trial is currently recruiting in seven centers in Switzerland. TRIAL REGISTRATION NCT05664464. Registered 23 December 2022.
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Affiliation(s)
- Maximilian Mastall
- Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University Hospital Zurich, Frauenklinikstrasse 26, Zurich, CH-8091, Switzerland
| | - Patrick Roth
- Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University Hospital Zurich, Frauenklinikstrasse 26, Zurich, CH-8091, Switzerland
- Department of Neurology, University of Zurich, Zurich, Switzerland
| | - Andrea Bink
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
| | | | - Heinz Läubli
- Division of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | | | - Thomas Hundsberger
- Department of Neurology and Medical Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Denis Migliorini
- Department of Oncology, Hopitaux Universitaires de Genève, Geneva, Switzerland
| | - Adrian Ochsenbein
- Department of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Katharina Seystahl
- Department of Neurology and Neurorehabilitation, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Lukas Imbach
- Swiss Epilepsy Center - Klinik Lengg, Zurich, Switzerland
| | - Tibor Hortobagyi
- Department of Neuropathology, University Hospital Zurich, Zurich, Switzerland
| | - Leonhard Held
- Department of Biostatistics, Epidemiology Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University Hospital Zurich, Frauenklinikstrasse 26, Zurich, CH-8091, Switzerland
- Department of Neurology, University of Zurich, Zurich, Switzerland
| | - Hans-Georg Wirsching
- Department of Neurology, Clinical Neuroscience Center and Brain Tumor Center, University Hospital Zurich, Frauenklinikstrasse 26, Zurich, CH-8091, Switzerland.
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144
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Gold L, Barci E, Brendel M, Orth M, Cheng J, Kirchleitner SV, Bartos LM, Pötter D, Kirchner MA, Unterrainer LM, Kaiser L, Ziegler S, Weidner L, Riemenschneider MJ, Unterrainer M, Belka C, Tonn JC, Bartenstein P, Niyazi M, von Baumgarten L, Kälin RE, Glass R, Lauber K, Albert NL, Holzgreve A. The Traumatic Inoculation Process Affects TSPO Radioligand Uptake in Experimental Orthotopic Glioblastoma. Biomedicines 2024; 12:188. [PMID: 38255293 PMCID: PMC10813339 DOI: 10.3390/biomedicines12010188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The translocator protein (TSPO) has been proven to have great potential as a target for the positron emission tomography (PET) imaging of glioblastoma. However, there is an ongoing debate about the potential various sources of the TSPO PET signal. This work investigates the impact of the inoculation-driven immune response on the PET signal in experimental orthotopic glioblastoma. METHODS Serial [18F]GE-180 and O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET) PET scans were performed at day 7/8 and day 14/15 after the inoculation of GL261 mouse glioblastoma cells (n = 24) or saline (sham, n = 6) into the right striatum of immunocompetent C57BL/6 mice. An additional n = 25 sham mice underwent [18F]GE-180 PET and/or autoradiography (ARG) at days 7, 14, 21, 28, 35, 50 and 90 in order to monitor potential reactive processes that were solely related to the inoculation procedure. In vivo imaging results were directly compared to tissue-based analyses including ARG and immunohistochemistry. RESULTS We found that the inoculation process represents an immunogenic event, which significantly contributes to TSPO radioligand uptake. [18F]GE-180 uptake in GL261-bearing mice surpassed [18F]FET uptake both in the extent and the intensity, e.g., mean target-to-background ratio (TBRmean) in PET at day 7/8: 1.22 for [18F]GE-180 vs. 1.04 for [18F]FET, p < 0.001. Sham mice showed increased [18F]GE-180 uptake at the inoculation channel, which, however, continuously decreased over time (e.g., TBRmean in PET: 1.20 at day 7 vs. 1.09 at day 35, p = 0.04). At the inoculation channel, the percentage of TSPO/IBA1 co-staining decreased, whereas TSPO/GFAP (glial fibrillary acidic protein) co-staining increased over time (p < 0.001). CONCLUSION We identify the inoculation-driven immune response to be a relevant contributor to the PET signal and add a new aspect to consider for planning PET imaging studies in orthotopic glioblastoma models.
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Affiliation(s)
- Lukas Gold
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
| | - Enio Barci
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
- Neurosurgical Research, Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
- Munich Cluster for Systems Neurology (SyNergy), LMU Munich, 81377 Munich, Germany
| | - Michael Orth
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
- Department of Radiation Oncology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Jiying Cheng
- Neurosurgical Research, Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Sabrina V. Kirchleitner
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistr 15, 81377 Munich, Germany
| | - Laura M. Bartos
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
| | - Dennis Pötter
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
| | - Maximilian A. Kirchner
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
| | - Lena M. Unterrainer
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
| | - Lena Kaiser
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
| | - Sibylle Ziegler
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
| | - Lorraine Weidner
- Department of Neuropathology, Regensburg University Hospital, 93053 Regensburg, Germany
| | | | - Marcus Unterrainer
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
- DIE RADIOLOGIE, 80331 Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 81377 Munich, Germany
- Bavarian Cancer Research Center (BZKF), 81377 Munich, Germany
| | - Joerg-Christian Tonn
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistr 15, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 81377 Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
- Munich Cluster for Systems Neurology (SyNergy), LMU Munich, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 81377 Munich, Germany
| | - Maximilian Niyazi
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
- Department of Radiation Oncology, University Hospital Tübingen, 72076 Tübingen, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 81377 Munich, Germany
- Bavarian Cancer Research Center (BZKF), 81377 Munich, Germany
| | - Louisa von Baumgarten
- Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistr 15, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 81377 Munich, Germany
- Bavarian Cancer Research Center (BZKF), 81377 Munich, Germany
| | - Roland E. Kälin
- Neurosurgical Research, Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Rainer Glass
- Neurosurgical Research, Department of Neurosurgery, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Kirsten Lauber
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 81377 Munich, Germany
| | - Nathalie L. Albert
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
- German Cancer Consortium (DKTK), Partner Site Munich, 81377 Munich, Germany
- Bavarian Cancer Research Center (BZKF), 81377 Munich, Germany
| | - Adrien Holzgreve
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (L.G.)
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Mishchenko TA, Turubanova VD, Gorshkova EN, Krysko O, Vedunova MV, Krysko DV. Glioma: bridging the tumor microenvironment, patient immune profiles and novel personalized immunotherapy. Front Immunol 2024; 14:1299064. [PMID: 38274827 PMCID: PMC10809268 DOI: 10.3389/fimmu.2023.1299064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
Glioma is the most common primary brain tumor, characterized by a consistently high patient mortality rate and a dismal prognosis affecting both survival and quality of life. Substantial evidence underscores the vital role of the immune system in eradicating tumors effectively and preventing metastasis, underscoring the importance of cancer immunotherapy which could potentially address the challenges in glioma therapy. Although glioma immunotherapies have shown promise in preclinical and early-phase clinical trials, they face specific limitations and challenges that have hindered their success in further phase III trials. Resistance to therapy has been a major challenge across many experimental approaches, and as of now, no immunotherapies have been approved. In addition, there are several other limitations facing glioma immunotherapy in clinical trials, such as high intra- and inter-tumoral heterogeneity, an inherently immunosuppressive microenvironment, the unique tissue-specific interactions between the central nervous system and the peripheral immune system, the existence of the blood-brain barrier, which is a physical barrier to drug delivery, and the immunosuppressive effects of standard therapy. Therefore, in this review, we delve into several challenges that need to be addressed to achieve boosted immunotherapy against gliomas. First, we discuss the hurdles posed by the glioma microenvironment, particularly its primary cellular inhabitants, in particular tumor-associated microglia and macrophages (TAMs), and myeloid cells, which represent a significant barrier to effective immunotherapy. Here we emphasize the impact of inducing immunogenic cell death (ICD) on the migration of Th17 cells into the tumor microenvironment, converting it into an immunologically "hot" environment and enhancing the effectiveness of ongoing immunotherapy. Next, we address the challenge associated with the accurate identification and characterization of the primary immune profiles of gliomas, and their implications for patient prognosis, which can facilitate the selection of personalized treatment regimens and predict the patient's response to immunotherapy. Finally, we explore a prospective approach to developing highly personalized vaccination strategies against gliomas, based on the search for patient-specific neoantigens. All the pertinent challenges discussed in this review will serve as a compass for future developments in immunotherapeutic strategies against gliomas, paving the way for upcoming preclinical and clinical research endeavors.
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Affiliation(s)
- Tatiana A. Mishchenko
- Institute of Biology and Biomedicine, National Research Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
| | - Victoria D. Turubanova
- Institute of Biology and Biomedicine, National Research Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
- Neuroscience Research Institute, National Research Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
| | - Ekaterina N. Gorshkova
- Institute of Biology and Biomedicine, National Research Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
| | - Olga Krysko
- Cell Death Investigation and Therapy Laboratory, Anatomy and Embryology Unit, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maria V. Vedunova
- Institute of Biology and Biomedicine, National Research Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
- Faculty of Biology and Biotechnologies, National Research University Higher School of Economics, Moscow, Russia
| | - Dmitri V. Krysko
- Institute of Biology and Biomedicine, National Research Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
- Cell Death Investigation and Therapy Laboratory, Anatomy and Embryology Unit, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Pathophysiology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Cancer Research Institute Ghent, Ghent, Belgium
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146
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Weller M, Felsberg J, Hentschel B, Gramatzki D, Kubon N, Wolter M, Reusche M, Roth P, Krex D, Herrlinger U, Westphal M, Tonn JC, Regli L, Maurage CA, von Deimling A, Pietsch T, Le Rhun E, Reifenberger G. Improved prognostic stratification of patients with isocitrate dehydrogenase-mutant astrocytoma. Acta Neuropathol 2024; 147:11. [PMID: 38183430 PMCID: PMC10771615 DOI: 10.1007/s00401-023-02662-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 01/08/2024]
Abstract
Prognostic factors and standards of care for astrocytoma, isocitrate dehydrogenase (IDH)-mutant, CNS WHO grade 4, remain poorly defined. Here we sought to explore disease characteristics, prognostic markers, and outcome in patients with this newly defined tumor type. We determined molecular biomarkers and assembled clinical and outcome data in patients with IDH-mutant astrocytomas confirmed by central pathology review. Patients were identified in the German Glioma Network cohort study; additional cohorts of patients with CNS WHO grade 4 tumors were identified retrospectively at two sites. In total, 258 patients with IDH-mutant astrocytomas (114 CNS WHO grade 2, 73 CNS WHO grade 3, 71 CNS WHO grade 4) were studied. The median age at diagnosis was similar for all grades. Karnofsky performance status at diagnosis inversely correlated with CNS WHO grade (p < 0.001). Despite more intensive treatment upfront with higher grade, CNS WHO grade was strongly prognostic: median overall survival was not reached for grade 2 (median follow-up 10.4 years), 8.1 years (95% CI 5.4-10.8) for grade 3, and 4.7 years (95% CI 3.4-6.0) for grade 4. Among patients with CNS WHO grade 4 astrocytoma, median overall survival was 5.5 years (95% CI 4.3-6.7) without (n = 58) versus 1.8 years (95% CI 0-4.1) with (n = 12) homozygous CDKN2A deletion. Lower levels of global DNA methylation as detected by LINE-1 methylation analysis were strongly associated with CNS WHO grade 4 (p < 0.001) and poor outcome. MGMT promoter methylation status was not prognostic for overall survival. Histomolecular stratification based on CNS WHO grade, LINE-1 methylation level, and CDKN2A status revealed four subgroups of patients with significantly different outcomes. In conclusion, CNS WHO grade, global DNA methylation status, and CDKN2A homozygous deletion are prognostic in patients with IDH-mutant astrocytoma. Combination of these parameters allows for improved prediction of outcome. These data aid in designing upcoming trials using IDH inhibitors.
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Affiliation(s)
- Michael Weller
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland.
- Department of Neurology, University of Zurich, Zurich, Switzerland.
| | - Jörg Felsberg
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Bettina Hentschel
- Institute for Medical Informatics, Statistics and Epidemiology, University Leipzig, Leipzig, Germany
| | - Dorothee Gramatzki
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
| | - Nadezhda Kubon
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Marietta Wolter
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, and University Hospital Düsseldorf, Düsseldorf, Germany
| | - Matthias Reusche
- Institute for Medical Informatics, Statistics and Epidemiology, University Leipzig, Leipzig, Germany
| | - Patrick Roth
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
- Department of Neurology, University of Zurich, Zurich, Switzerland
| | - Dietmar Krex
- Faculty of Medicine, Department of Neurosurgery, Technische Universität Dresden, University Hospital Carl Gustav Carus, Dresden, Germany
| | | | - Manfred Westphal
- Department of Neurosurgery, University of Hamburg, Hamburg, Germany
| | - Joerg C Tonn
- Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Luca Regli
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
- Department of Neurosurgery, University of Zurich, Zurich, Switzerland
| | - Claude-Alain Maurage
- Department of Pathology, Centre Biologie Pathologie, Lille University Hospital, Hopital Nord, Lille, France
| | - Andreas von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Center (DKFZ), and German Cancer Consortium (DKTK), Partner Site Heidelberg, Heidelberg, Germany
| | - Torsten Pietsch
- Department of Neuropathology, University of Bonn Medical Center, DGNN Brain Tumor Reference Center, Bonn, Germany
| | - Emilie Le Rhun
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
- Department of Neurology, University of Zurich, Zurich, Switzerland
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
- Department of Neurosurgery, University of Zurich, Zurich, Switzerland
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Guido Reifenberger
- Institute of Neuropathology, Heinrich Heine University, Medical Faculty, and University Hospital Düsseldorf, Düsseldorf, Germany
- German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Düsseldorf, Germany
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147
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Hong B, Yang E, Su D, Ju J, Cui X, Wang Q, Tong F, Zhao J, Yang S, Cheng C, Xin L, Xiao M, Yi K, Zhan Q, Ding Y, Xu H, Cui L, Kang C. EPIC-1042 as a potent PTRF/Cavin1-caveolin-1 interaction inhibitor to induce PARP1 autophagic degradation and suppress temozolomide efflux for glioblastoma. Neuro Oncol 2024; 26:100-114. [PMID: 37651725 PMCID: PMC10768988 DOI: 10.1093/neuonc/noad159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Temozolomide (TMZ) treatment efficacy in glioblastoma is determined by various mechanisms such as TMZ efflux, autophagy, base excision repair (BER) pathway, and the level of O6-methylguanine-DNA methyltransferase (MGMT). Here, we reported a novel small-molecular inhibitor (SMI) EPIC-1042 (C20H28N6) with the potential to decrease TMZ efflux and promote PARP1 degradation via autolysosomes in the early stage. METHODS EPIC-1042 was obtained from receptor-based virtual screening. Co-immunoprecipitation and pull-down assays were applied to verify the blocking effect of EPIC-1042. Western blotting, co-immunoprecipitation, and immunofluorescence were used to elucidate the underlying mechanisms of EPIC-1042. In vivo experiments were performed to verify the efficacy of EPIC-1042 in sensitizing glioblastoma cells to TMZ. RESULTS EPIC-1042 physically interrupted the interaction of PTRF/Cavin1 and caveolin-1, leading to reduced secretion of small extracellular vesicles (sEVs) to decrease TMZ efflux. It also induced PARP1 autophagic degradation via increased p62 expression that more p62 bound to PARP1 and specially promoted PARP1 translocation into autolysosomes for degradation in the early stage. Moreover, EPIC-1042 inhibited autophagy flux at last. The application of EPIC-1042 enhanced TMZ efficacy in glioblastoma in vivo. CONCLUSION EPIC-1042 reinforced the effect of TMZ by preventing TMZ efflux, inducing PARP1 degradation via autolysosomes to perturb the BER pathway and recruitment of MGMT, and inhibiting autophagy flux in the later stage. Therefore, this study provided a novel therapeutic strategy using the combination of TMZ with EPIC-1042 for glioblastoma treatment.
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Affiliation(s)
- Biao Hong
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Eryan Yang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Dongyuan Su
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jiasheng Ju
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Xiaoteng Cui
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Qixue Wang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Fei Tong
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jixing Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Shixue Yang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Chunchao Cheng
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Lei Xin
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Baoding, China
| | - Menglin Xiao
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Baoding, China
| | - Kaikai Yi
- Department of Neuro-Oncology and Neurosurgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Qi Zhan
- Tianjin Key Laboratory of Composite and Functional Materials, School of Materials Science and Engineering, Tianjin University, Tianjin, China
| | - Yaqing Ding
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Hanyi Xu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Longtao Cui
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Chunsheng Kang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Laboratory of Neuro-oncology, Tianjin Neurological Institute, Key Laboratory of Post-Neuro Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
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148
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Pinson H, Silversmit G, Vanhauwaert D, Vanschoenbeek K, Okito JPK, De Vleeschouwer S, Boterberg T, De Gendt C. Epidemiology and survival of adult-type diffuse glioma in Belgium during the molecular era. Neuro Oncol 2024; 26:191-202. [PMID: 37651614 PMCID: PMC10768998 DOI: 10.1093/neuonc/noad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Survival data of diffuse adult-type glioma is mostly based on prospective clinical trials or small retrospective cohort studies. Real-world data with large patient cohorts is currently lacking. METHODS Using the nationwide, population-based Belgian Cancer Registry, all known histological reports of patients diagnosed with an adult-type diffuse glioma in Belgium between 2017 and 2019 were reviewed. The ICD-O-3 morphology codes were matched with the histological diagnosis. The gathered data were transformed into the 2021 World Health Organization classification of CNS tumors using the IDH- and 1p/19q-mutation status. RESULTS Between 2017 and 2019, 2233 diffuse adult-type gliomas were diagnosed in Belgium. Full molecular status was available in 67.1% of identified cases. The age-standardized incidence rate of diffuse adult-type glioma in Belgium was estimated at 8.55 per 100 000 person-years and 6.72 per 100 000 person-years for grade 4 lesions. Median overall survival time in IDH-wild-type glioblastoma was 9.3 months, significantly shorter compared to grade 4 IDH-mutant astrocytoma (median survival time: 25.9 months). The 3-year survival probability was 86.0% and 75.7% for grades 2 and 3 IDH-mutated astrocytoma. IDH-wild-type astrocytoma has a worse prognosis with a 3-year survival probability of 31.6% for grade 2 and 5.7% for grade 3 lesions. CONCLUSIONS This registry-based study presents a large cohort of adult-type diffuse glioma with known molecular status and uses real-world survival data. It adds to the current literature which is mainly based on historical landmark trials and smaller retrospective cohort studies.
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Affiliation(s)
- Harry Pinson
- Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium
| | | | | | | | | | - Steven De Vleeschouwer
- Department of Neurosurgery, UZ Leuven, Leuven, Belgium
- Laboratory for experimental neurosurgery and neuroanatomy, Department of Neurosciences, Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
| | - Tom Boterberg
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
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149
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Karschnia P, Dietrich J, Bruno F, Dono A, Juenger ST, Teske N, Young JS, Sciortino T, Häni L, van den Bent M, Weller M, Vogelbaum MA, Morshed RA, Haddad AF, Molinaro AM, Tandon N, Beck J, Schnell O, Bello L, Hervey-Jumper S, Thon N, Grau SJ, Esquenazi Y, Rudà R, Chang SM, Berger MS, Cahill DP, Tonn JC. Surgical management and outcome of newly diagnosed glioblastoma without contrast enhancement (low-grade appearance): a report of the RANO resect group. Neuro Oncol 2024; 26:166-177. [PMID: 37665776 PMCID: PMC10768992 DOI: 10.1093/neuonc/noad160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Resection of the contrast-enhancing (CE) tumor represents the standard of care in newly diagnosed glioblastoma. However, some tumors ultimately diagnosed as glioblastoma lack contrast enhancement and have a 'low-grade appearance' on imaging (non-CE glioblastoma). We aimed to (a) volumetrically define the value of non-CE tumor resection in the absence of contrast enhancement, and to (b) delineate outcome differences between glioblastoma patients with and without contrast enhancement. METHODS The RANO resect group retrospectively compiled a global, eight-center cohort of patients with newly diagnosed glioblastoma per WHO 2021 classification. The associations between postoperative tumor volumes and outcome were analyzed. Propensity score-matched analyses were constructed to compare glioblastomas with and without contrast enhancement. RESULTS Among 1323 newly diagnosed IDH-wildtype glioblastomas, we identified 98 patients (7.4%) without contrast enhancement. In such patients, smaller postoperative tumor volumes were associated with more favorable outcome. There was an exponential increase in risk for death with larger residual non-CE tumor. Accordingly, extensive resection was associated with improved survival compared to lesion biopsy. These findings were retained on a multivariable analysis adjusting for demographic and clinical markers. Compared to CE glioblastoma, patients with non-CE glioblastoma had a more favorable clinical profile and superior outcome as confirmed in propensity score analyses by matching the patients with non-CE glioblastoma to patients with CE glioblastoma using a large set of clinical variables. CONCLUSIONS The absence of contrast enhancement characterizes a less aggressive clinical phenotype of IDH-wildtype glioblastomas. Maximal resection of non-CE tumors has prognostic implications and translates into favorable outcome.
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Affiliation(s)
- Philipp Karschnia
- Department of Neurosurgery, LMU University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Jorg Dietrich
- Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Francesco Bruno
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Italy
| | - Antonio Dono
- Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, TX, USA
| | | | - Nico Teske
- Department of Neurosurgery, LMU University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Jacob S Young
- Department of Neurosurgery and Division of Neuro-Oncology, University of San Francisco, San Francisco, CA, USA
| | - Tommaso Sciortino
- Division of Neuro-Oncology, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Levin Häni
- Department of Neurosurgery, Medical Center – University of Freiburg, Freiburg, Germany
| | - Martin van den Bent
- Department of Neurology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Michael Weller
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | | | - Ramin A Morshed
- Department of Neurosurgery and Division of Neuro-Oncology, University of San Francisco, San Francisco, CA, USA
| | - Alexander F Haddad
- Department of Neurosurgery and Division of Neuro-Oncology, University of San Francisco, San Francisco, CA, USA
| | - Annette M Molinaro
- Department of Neurosurgery and Division of Neuro-Oncology, University of San Francisco, San Francisco, CA, USA
| | - Nitin Tandon
- Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, TX, USA
| | - Juergen Beck
- Department of Neurosurgery, Medical Center – University of Freiburg, Freiburg, Germany
| | - Oliver Schnell
- Department of Neurosurgery, Medical Center – University of Freiburg, Freiburg, Germany
| | - Lorenzo Bello
- Division of Neuro-Oncology, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Shawn Hervey-Jumper
- Department of Neurosurgery and Division of Neuro-Oncology, University of San Francisco, San Francisco, CA, USA
| | - Niklas Thon
- Department of Neurosurgery, LMU University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
| | - Stefan J Grau
- Department of Neurosurgery, University of Cologne, Cologne, Germany
| | - Yoshua Esquenazi
- Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, TX, USA
| | - Roberta Rudà
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Italy
| | - Susan M Chang
- Department of Neurosurgery and Division of Neuro-Oncology, University of San Francisco, San Francisco, CA, USA
| | - Mitchel S Berger
- Department of Neurosurgery and Division of Neuro-Oncology, University of San Francisco, San Francisco, CA, USA
| | - Daniel P Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joerg-Christian Tonn
- Department of Neurosurgery, LMU University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Germany
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150
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Hayashi T, Tateishi K, Matsuyama S, Iwashita H, Miyake Y, Oshima A, Honma H, Sasame J, Takabayashi K, Sugino K, Hirata E, Udaka N, Matsushita Y, Kato I, Hayashi H, Nakamura T, Ikegaya N, Takayama Y, Sonoda M, Oka C, Sato M, Isoda M, Kato M, Uchiyama K, Tanaka T, Muramatsu T, Miyake S, Suzuki R, Takadera M, Tatezuki J, Ayabe J, Suenaga J, Matsunaga S, Miyahara K, Manaka H, Murata H, Yokoyama T, Tanaka Y, Shuto T, Ichimura K, Kato S, Yamanaka S, Cahill DP, Fujii S, Shankar GM, Yamamoto T. Intraoperative Integrated Diagnostic System for Malignant Central Nervous System Tumors. Clin Cancer Res 2024; 30:116-126. [PMID: 37851071 DOI: 10.1158/1078-0432.ccr-23-1660] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/19/2023] [Accepted: 10/16/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE The 2021 World Health Organization (WHO) classification of central nervous system (CNS) tumors uses an integrated approach involving histopathology and molecular profiling. Because majority of adult malignant brain tumors are gliomas and primary CNS lymphomas (PCNSL), rapid differentiation of these diseases is required for therapeutic decisions. In addition, diffuse gliomas require molecular information on single-nucleotide variants (SNV), such as IDH1/2. Here, we report an intraoperative integrated diagnostic (i-ID) system to classify CNS malignant tumors, which updates legacy frozen-section (FS) diagnosis through incorporation of a qPCR-based genotyping assay. EXPERIMENTAL DESIGN FS evaluation, including GFAP and CD20 rapid IHC, was performed on adult malignant CNS tumors. PCNSL was diagnosed through positive CD20 and negative GFAP immunostaining. For suspected glioma, genotyping for IDH1/2, TERT SNV, and CDKN2A copy-number alteration was routinely performed, whereas H3F3A and BRAF SNV were assessed for selected cases. i-ID was determined on the basis of the 2021 WHO classification and compared with the permanent integrated diagnosis (p-ID) to assess its reliability. RESULTS After retrospectively analyzing 153 cases, 101 cases were prospectively examined using the i-ID system. Assessment of IDH1/2, TERT, H3F3AK27M, BRAFV600E, and CDKN2A alterations with i-ID and permanent genomic analysis was concordant in 100%, 100%, 100%, 100%, and 96.4%, respectively. Combination with FS and intraoperative genotyping assay improved diagnostic accuracy in gliomas. Overall, i-ID matched with p-ID in 80/82 (97.6%) patients with glioma and 18/19 (94.7%) with PCNSL. CONCLUSIONS The i-ID system provides reliable integrated diagnosis of adult malignant CNS tumors.
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Affiliation(s)
- Takahiro Hayashi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
| | - Shinichiro Matsuyama
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Hiromichi Iwashita
- Department of Pathology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yohei Miyake
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Akito Oshima
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Hirokuni Honma
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Jo Sasame
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Katsuhiro Takabayashi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Kyoka Sugino
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
| | - Emi Hirata
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Naoko Udaka
- Department of Diagnostic Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Yuko Matsushita
- Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ikuma Kato
- Department of Molecular Pathology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Hiroaki Hayashi
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Taishi Nakamura
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yutaro Takayama
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Masaki Sonoda
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Chihiro Oka
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Mitsuru Sato
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Masataka Isoda
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Miyui Kato
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
| | - Kaho Uchiyama
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
| | - Tamon Tanaka
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Toshiki Muramatsu
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Shigeta Miyake
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Ryosuke Suzuki
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Department of Neurosurgery, Odawara Municipal Hospital, Odawara, Japan
| | - Mutsumi Takadera
- Department of Neurosurgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
- Department of Neurosurgery, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Junya Tatezuki
- Department of Neurosurgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Junichi Ayabe
- Department of Neurosurgery, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Jun Suenaga
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Shigeo Matsunaga
- Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Japan
| | - Kosuke Miyahara
- Department of Neurosurgery, National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Hiroshi Manaka
- Department of Neurosurgery, Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - Hidetoshi Murata
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | | | - Yoshihide Tanaka
- Department of Neurosurgery, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Takashi Shuto
- Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Japan
| | - Koichi Ichimura
- Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shingo Kato
- Department of Clinical Cancer Genomics, Yokohama City University, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Diagnostic Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Daniel P Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Satoshi Fujii
- Department of Diagnostic Pathology, Yokohama City University Hospital, Yokohama, Japan
- Department of Molecular Pathology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Ganesh M Shankar
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
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