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Thapa R, Afzal M, Goyal A, Gupta G, Bhat AA, Almalki WH, Kazmi I, Alzarea SI, Shahwan M, Kukreti N, Ali H, Dureja H, Kumar P, Singh TG, Kuppusamy G, Singh SK, Dua K. Exploring ncRNA-mediated regulation of EGFR signalling in glioblastoma: From mechanisms to therapeutics. Life Sci 2024; 345:122613. [PMID: 38582393 DOI: 10.1016/j.lfs.2024.122613] [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: 02/15/2024] [Revised: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024]
Abstract
Glioblastoma (GBM) is the most prevalent and deadly primary brain tumor type, with a discouragingly low survival rate and few effective treatments. An important function of the EGFR signalling pathway in the development of GBM is to affect tumor proliferation, persistence, and treatment resistance. Advances in molecular biology in the last several years have shown how important ncRNAs are for controlling a wide range of biological activities, including cancer progression and development. NcRNAs have become important post-transcriptional regulators of gene expression, and they may affect the EGFR pathway by either directly targeting EGFR or by modifying important transcription factors and downstream signalling molecules. The EGFR pathway is aberrantly activated in response to the dysregulation of certain ncRNAs, which has been linked to GBM carcinogenesis, treatment resistance, and unfavourable patient outcomes. We review the literature on miRNAs, circRNAs and lncRNAs that are implicated in the regulation of EGFR signalling in GBM, discussing their mechanisms of action, interactions with the signalling pathway, and implications for GBM therapy. Furthermore, we explore the potential of ncRNA-based strategies to overcome resistance to EGFR-targeted therapies, including the use of ncRNA mimics or inhibitors to modulate the activity of key regulators within the pathway.
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Affiliation(s)
- Riya Thapa
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura 302017, Mahal Road, Jaipur, India
| | - Muhammad Afzal
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, P.O. Box 6231, Jeddah 21442, Saudi Arabia
| | - Ahsas Goyal
- Institute of Pharmaceutical Research, GLA University, Mathura, U.P., India
| | - Gaurav Gupta
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura 302017, Mahal Road, Jaipur, India; Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates.
| | - Asif Ahmad Bhat
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura 302017, Mahal Road, Jaipur, India
| | - Waleed Hassan Almalki
- Department of Pharmacology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Sami I Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Aljouf 72341, Saudi Arabia
| | - Moyad Shahwan
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates; Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, 346, 7, United Arab Emirates
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun 248007, India
| | - Haider Ali
- Centre for Global Health Research, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, India; Department of Pharmacology, Kyrgyz State Medical College, Bishkek, Kyrgyzstan
| | - Harish Dureja
- Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak 124001, Haryana, India
| | - Puneet Kumar
- Department of Pharmacology, Central University of Punjab, Ghudda, Punjab, India
| | - Thakur Gurjeet Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab 140401, India
| | - Gowthamarajan Kuppusamy
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, India
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India; Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Kamal Dua
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia; Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, NSW 2007, Australia
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Chen Y, Du F, Tang L, Xu J, Zhao Y, Wu X, Li M, Shen J, Wen Q, Cho CH, Xiao Z. Carboranes as unique pharmacophores in antitumor medicinal chemistry. Mol Ther Oncolytics 2022; 24:400-416. [PMID: 35141397 PMCID: PMC8807988 DOI: 10.1016/j.omto.2022.01.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Carborane is a carbon-boron molecular cluster that can be viewed as a 3D analog of benzene. It features special physical and chemical properties, and thus has the potential to serve as a new type of pharmacophore for drug design and discovery. Based on the relative positions of two cage carbons, icosahedral closo-carboranes can be classified into three isomers, ortho-carborane (o-carborane, 1,2-C2B10H12), meta-carborane (m-carborane, 1,7-C2B10H12), and para-carborane (p-carborane, 1,12-C2B10H12), and all of them can be deboronated to generate their nido- forms. Cage compound carborane and its derivatives have been demonstrated as useful chemical entities in antitumor medicinal chemistry. The applications of carboranes and their derivatives in the field of antitumor research mainly include boron neutron capture therapy (BNCT), as BNCT/photodynamic therapy dual sensitizers, and as anticancer ligands. This review summarizes the research progress on carboranes achieved up to October 2021, with particular emphasis on signaling transduction pathways, chemical structures, and mechanistic considerations of using carboranes.
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Affiliation(s)
- Yu Chen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Fukuan Du
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Liyao Tang
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Jinrun Xu
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Yueshui Zhao
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Xu Wu
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Mingxing Li
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Jing Shen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Qinglian Wen
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
- Luzhou Key Laboratory of Cell Therapy & Cell Drugs, Southwest Medical University, Luzhou 646000, China
| | - Chi Hin Cho
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Luzhou Key Laboratory of Cell Therapy & Cell Drugs, Southwest Medical University, Luzhou 646000, China
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Zhangang Xiao
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
- Luzhou Key Laboratory of Cell Therapy & Cell Drugs, Southwest Medical University, Luzhou 646000, China
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Alamdari-Palangi V, Karami Z, Karami H, Baazm M. MiRNA-7 Replacement Effect on Proliferation and Tarceva-Sensitivity in U373-MG Cell Line. Asian Pac J Cancer Prev 2020; 21:1747-1753. [PMID: 32592373 PMCID: PMC7568905 DOI: 10.31557/apjcp.2020.21.6.1747] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Deregulation of the EGFR signaling pathway activity has been shown to can be effective in resistance to EGFR-TKIs, such as Tarceva (erlotinib), in glioblastoma cells. In addition, reports have shown that the reduction of miRNA-7 expression levels is associated with an increase in the expression of EGFR. Here, we evaluated the effect of miRNA-7 on EGFR expression and sensitivity of the U373-MG glioblastoma to erlotinib. METHODS The effect of miRNA-7 on EGFR expression was examined using RT-qPCR and western blotting. Trypan blue and MTT assays were performed to explore the effect of treatments on cell growth and survival, respectively. The combination index analysis was used to evaluate the interaction between drugs. Apoptosis was measured by ELISA cell death assay. RESULTS We showed that miRNA-7 markedly inhibited the expression of EGFR and decreased the growth of glioblastoma cells, relative to blank control and negative control miRNA (p < 0.05). Introduction of miRNA-7 synergistically increased the sensitivity of the U373-MG cells to erlotinib. Results of apoptosis assay demonstrated that miRNA-7 can trigger apoptosis and enhance the erlotinib-mediated apoptosis. CONCLUSIONS Our results show that miRNA-7 plays a critical role in the growth, survival and sensitivity of the U373-MG cells to erlotinib by targeting EGFR. Thus, miRNA-7 replacement therapy can become an effective therapeutic procedure in glioblastoma.
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Affiliation(s)
- Vahab Alamdari-Palangi
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran.,Department of Molecular Medicine and Biotechnology, Arak University of Medical Sciences, Arak, Iran
| | - Zahra Karami
- Department of Oral Medicine, Dental Research Center, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hadi Karami
- Department of Molecular Medicine and Biotechnology, Arak University of Medical Sciences, Arak, Iran.,Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Maryam Baazm
- Department of Anatomy, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
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Alamdari-Palangi V, Amini R, Karami H. MiRNA-7 enhances erlotinib sensitivity of glioblastoma cells by blocking the IRS-1 and IRS-2 expression. J Pharm Pharmacol 2020; 72:531-538. [DOI: 10.1111/jphp.13226] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 12/06/2019] [Indexed: 11/27/2022]
Abstract
Abstract
Objectives
Down-regulation of miRNA-7 is correlated with over-expression of IRS-1 and IRS-2 proteins, the upstream regulators of IGF-1R/Akt pathway, in glioblastoma cells. In this study, the effect of miRNA-7 on expression of IRS-1 and IRS-2 and sensitivity of the U373-MG glioblastoma cells to erlotinib was explored.
Methods
After miRNA-7 transfection, the expression of IRS-1 and IRS-2 mRNAs was measured by RT-qPCR. Trypan blue assay was used to assess the effect of miRNA-7 on cell proliferation. The effects of miRNA-7 and erlotinib, alone and in combination, on cell survival and apoptosis were measured using MTT assay and ELISA cell death assay, respectively.
Key findings
Our data showed that miRNA-7 markedly inhibited the expression of IRS-1 and IRS-2 in a time-dependent manner, inhibited the proliferation of glioblastoma cells and enhanced apoptosis (P < 0.05, relative to control). Pretreatment with miRNA-7 synergistically inhibited the cell survival rate and decreased the IC50 of erlotinib. Furthermore, miRNA-7 significantly augmented the apoptotic effect of erlotinib.
Conclusions
Our data propose that inhibition of IRS-1 and IRS-2 by miRNA-7 can effectively induce apoptosis and sensitize glioblastoma cell to EGFR-TKIs. Therefore, miRNA-7 may be a potential therapeutic target in patients with glioblastoma.
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Affiliation(s)
- Vahab Alamdari-Palangi
- Department of Molecular Medicine and Biotechnology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Razieh Amini
- Department of Molecular Medicine and Biotechnology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Hadi Karami
- Department of Molecular Medicine and Biotechnology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
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Yaman E, Buyukberber S, Uner A, Coskun U, Yamac D, Ozturk B, Kaya AO, Yildiz R. Carboplatin and oral cyclophosphamide combination after temozolomide failure in malignant gliomas. TUMORI JOURNAL 2018; 94:674-80. [DOI: 10.1177/030089160809400505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Temozolomide is a novel cytotoxic agent for malignant gliomas. However, treatment failure occurs approximately in half of patients, and the optimal regimen in this setting has yet to be defined. In the present study, we assessed retrospectively the efficacy and toxicity of the combination of carboplatin and oral cyclophosphamide in temozolomide-resistant patients. Methods We evaluated the medical records of 30 patients with malignant gliomas. After failure of temozolomide therapy, patients were treated with a combination of carboplatin and oral cyclophosphamide. Treatment consisted of intravenous carboplatin AUC 6 (based on the Calvert Formula) on day 1 and oral cyclophosphamide 75 mg/m2 daily on days 1 to 14, followed by 14 days of rest, with the treatment repeated every 4 weeks. Results All patients were evaluated for response and toxicity. The objective response rate was 30%, including 9 partial responses. Median time to disease progression and median overall survival was 7 months and 8 months, respectively. Clinically responsive patients had statistically significant longer progression-free survival and overall survival than unresponsive patients. Hematological side effects were commonly observed toxicities, with neutropenia the most frequent. Conclusions Our data suggest that carboplatin and oral cyclophosphamide therapy is a convenient regimen after failure of temozolomide therapy in patients with malignant gliomas because of its activity, feasibility and tolerability. Further prospective studies are needed in this setting.
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Affiliation(s)
| | - Emel Yaman
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Suleyman Buyukberber
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Aytug Uner
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ugur Coskun
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Deniz Yamac
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Banu Ozturk
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ali Osman Kaya
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ramazan Yildiz
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
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Reardon DA, Lassman AB, van den Bent M, Kumthekar P, Merrell R, Scott AM, Fichtel L, Sulman EP, Gomez E, Fischer J, Lee HJ, Munasinghe W, Xiong H, Mandich H, Roberts-Rapp L, Ansell P, Holen KD, Gan HK. Efficacy and safety results of ABT-414 in combination with radiation and temozolomide in newly diagnosed glioblastoma. Neuro Oncol 2017; 19:965-975. [PMID: 28039367 PMCID: PMC5570193 DOI: 10.1093/neuonc/now257] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The purpose of this study was to determine the maximum tolerated dose (MTD), recommended phase II dose (RPTD), safety, and pharmacokinetics of ABT-414 plus radiation and temozolomide in newly diagnosed glioblastoma. ABT-414 is a first-in-class, tumor-specific antibody-drug conjugate that preferentially targets tumors expressing overactive epidermal growth factor receptor (EGFR). METHODS In this multicenter phase I study, patients received 0.5-3.2 mg/kg ABT-414 every 2 weeks by intravenous infusion. EGFR alterations, O6-methylguanine-DNA methyltransferase (MGMT) promoter hypermethylation, and isocitrate dehydrogenase (IDH1) gene mutations were assessed in patient tumors. Distinct prognostic classes were assigned to patients based on a Molecular Classification Predictor model. RESULTS As of January 7, 2016, forty-five patients were enrolled to receive ABT-414 plus radiation and temozolomide. The most common treatment emergent adverse events were ocular: blurred vision, dry eye, keratitis, photophobia, and eye pain. Ocular toxicity at any grade occurred in 40 patients and at grades 3/4 in 12 patients. RPTD and MTD were set at 2 mg/kg and 2.4 mg/kg, respectively. Among 38 patients with pretreatment tumor tested centrally, 39% harbored EGFR amplification, of which 73% had EGFRvIII mutation. Among patients with available tumor tissue (n = 30), 30% showed MGMT promoter methylation and none had IDH1 mutations. ABT-414 demonstrated an approximately dose proportional pharmacokinetic profile. The median duration of progression-free survival was 6.1 months; median overall survival has not been reached. CONCLUSION ABT-414 plus chemoradiation demonstrated an acceptable safety and pharmacokinetic profile in newly diagnosed glioblastoma. Randomized studies are ongoing to determine efficacy in newly diagnosed (NCT02573324) and recurrent glioblastoma (NCT02343406).
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Affiliation(s)
- David A Reardon
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew B Lassman
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Martin van den Bent
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Priya Kumthekar
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Ryan Merrell
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew M Scott
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Fichtel
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Erik P Sulman
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Erica Gomez
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - JuDee Fischer
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Ho-Jin Lee
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Wijith Munasinghe
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Hao Xiong
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Mandich
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Roberts-Rapp
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Ansell
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Kyle D Holen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Hui K Gan
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Neuro-Oncology Unit, Erasmus MC Cancer Center, Rotterdam, the Netherlands; Department of Neurology, Northwestern University, Chicago, Illinois; Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois; Department of Medical Oncology, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia; South Texas Accelerated Research Therapeutics (START), San Antonio, Texas; Department of Radiation Oncology, The University of Texas M.D.Anderson Cancer Center, Houston, Texas; AbbVie Inc., North Chicago, Illinois; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
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7
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Zhao LL, Xu KL, Wang SW, Hu BL, Chen LR. Pathological significance of epidermal growth factor receptor expression and amplification in human gliomas. Histopathology 2016; 61:726-36. [PMID: 22978472 DOI: 10.1111/j.1365-2559.2012.04354.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To investigate epidermal growth factor receptor (EGFR) expression and amplification in gliomas and to assess their association with survival. METHODS AND RESULTS Immunohistochemistry and fluorescence in-situ hybridization were performed to analyse EGFR status in 158 cases of primary glioma. Kaplan-Meier survival and Cox regression analyses were performed to analyse the prognosis of patients. Overexpression of EGFR and expression of EGFR variant III (EGFRvIII) were found in 102 cases (64.6%) and 47 cases (29.7%), respectively. Overexpression of EGFR was significantly correlated with World Health Organization (WHO) grade and Karnofsky performance score (KPS) (both P < 0.05). Expression of EGFRvIII was significantly correlated with WHO grade, gender, age, and KPS (all P < 0.05). EGFR amplification was found in 46 cases (29.1%), and was significantly correlated with WHO grade, age, KPS and EGFR overexpression (all P < 0.05). Cox multifactor analysis showed that EGFR amplification was an independent unfavourable prognostic factor for human gliomas at all ages, and EGFRvIII was an independent prognostic factor in patients older than 60 years. CONCLUSION EGFR amplification and EGFRvIII expression were associated with an unfavourable prognosis for patients of all ages, and for those older than 60 years, respectively. The differing significance of EGFR status in young and old glioma patients and its impact on prognosis needs further study.
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Affiliation(s)
- Li-li Zhao
- Department of Pathology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang ProvinceDepartment of Pathology, Department of Basic Medicine, Xi'an Medical University, Xi'an, Shanxi Province, China
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8
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Okamura T, Antoun G, Keir ST, Friedman H, Bigner DD, Ali-Osman F. Phosphorylation of Glutathione S-Transferase P1 (GSTP1) by Epidermal Growth Factor Receptor (EGFR) Promotes Formation of the GSTP1-c-Jun N-terminal kinase (JNK) Complex and Suppresses JNK Downstream Signaling and Apoptosis in Brain Tumor Cells. J Biol Chem 2015; 290:30866-78. [PMID: 26429914 DOI: 10.1074/jbc.m115.656140] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Indexed: 11/06/2022] Open
Abstract
Under normal physiologic conditions, the glutathione S-transferase P1 (GSTP1) protein exists intracellularly as a dimer in reversible equilibrium with its monomeric subunits. In the latter form, GSTP1 binds to the mitogen-activated protein kinase, JNK, and inhibits JNK downstream signaling. In tumor cells, which frequently are characterized by constitutively high GSTP1 expression, GSTP1 undergoes phosphorylation by epidermal growth factor receptor (EGFR) at tyrosine residues 3, 7, and 198. Here we report on the effect of this EGFR-dependent GSTP1 tyrosine phosphorylation on the interaction of GSTP1 with JNK, on the regulation of JNK downstream signaling by GSTP1, and on tumor cell survival. Using in vitro and in vivo growing human brain tumors, we show that tyrosine phosphorylation shifts the GSTP1 dimer-monomer equilibrium to the monomeric state and facilitates the formation of the GSTP1-JNK complex, in which JNK is functionally inhibited. Targeted mutagenesis and functional analysis demonstrated that the increased GSTP1 binding to JNK results from phosphorylation of the GSTP1 C-terminal Tyr-198 by EGFR and is associated with a >2.5-fold decrease in JNK downstream signaling and a significant suppression of both spontaneous and drug-induced apoptosis in the tumor cells. The findings define a novel mechanism of regulatory control of JNK signaling that is mediated by the EGFR/GSTP1 cross-talk and provides a survival advantage for tumors with activated EGFR and high GSTP1 expression. The results lay the foundation for a novel strategy of dual EGFR/GSTP1 for treating EGFR+ve, GSTP1 expressing GBMs.
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Affiliation(s)
| | | | - Stephen T Keir
- From the Departments of Neurosurgery and the Preston Robert Tisch Brain Tumor Center
| | - Henry Friedman
- From the Departments of Neurosurgery and the Preston Robert Tisch Brain Tumor Center, Duke Cancer Institute and Duke University School of Medicine, Durham, North Carolina 27710
| | - Darell D Bigner
- From the Departments of Neurosurgery and the Preston Robert Tisch Brain Tumor Center, Duke Cancer Institute and Duke University School of Medicine, Durham, North Carolina 27710 Pathology and
| | - Francis Ali-Osman
- From the Departments of Neurosurgery and the Preston Robert Tisch Brain Tumor Center, Duke Cancer Institute and Duke University School of Medicine, Durham, North Carolina 27710 Pathology and
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9
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Qiao XJ, Ellingson BM, Kim HJ, Wang DJJ, Salamon N, Linetsky M, Sepahdari AR, Jiang B, Tian JJ, Esswein SR, Cloughesy TF, Lai A, Nghiemphu L, Pope WB. Arterial spin-labeling perfusion MRI stratifies progression-free survival and correlates with epidermal growth factor receptor status in glioblastoma. AJNR Am J Neuroradiol 2014; 36:672-7. [PMID: 25542879 DOI: 10.3174/ajnr.a4196] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 09/27/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Glioblastoma is a common primary brain tumor with a poor but variable prognosis. Our aim was to investigate the feasibility of MR perfusion imaging by using arterial spin-labeling for determining the prognosis of patients with glioblastoma. MATERIALS AND METHODS Pseudocontinuous arterial spin-labeling with 3D background-suppressed gradient and spin-echo was acquired before surgery on 53 patients subsequently diagnosed with glioblastoma. The calculated CBF color maps were visually evaluated by 3 independent readers blinded to patient history. Pathologic and survival data were correlated with CBF map findings. Arterial spin-labeling values in tumor tissue were also quantified by using manual fixed-size ROIs. RESULTS Two perfusion patterns were characterized by visual evaluation of CBF maps on the basis of either the presence (pattern 1) or absence (pattern 2) of substantial hyperperfused tumor tissue. Evaluation of the perfusion patterns was highly concordant among the 3 readers (κ = 0.898, P < .001). Pattern 1 (versus pattern 2) was associated with significantly shorter progression-free survival by Kaplan-Meier analysis (median progression-free survival of 182 days versus 485 days, P < .01) and trended with shorter overall survival (P = .079). There was a significant association between pattern 1 and epidermal growth factor receptor variant III expression (P < .01). CONCLUSIONS Qualitative evaluation of arterial spin-labeling CBF maps can be used to stratify survival and predict epidermal growth factor receptor variant III expression in patients with glioblastoma.
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Affiliation(s)
- X J Qiao
- From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.)
| | - B M Ellingson
- From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.)
| | - H J Kim
- From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.)
| | - D J J Wang
- Neurology (D.J.J.W., T.F.C., A.L., L.N.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - N Salamon
- From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.)
| | - M Linetsky
- From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.)
| | - A R Sepahdari
- From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.)
| | - B Jiang
- Department of Radiology (B.J.), Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - J J Tian
- From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.)
| | - S R Esswein
- From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.)
| | - T F Cloughesy
- Neurology (D.J.J.W., T.F.C., A.L., L.N.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - A Lai
- Neurology (D.J.J.W., T.F.C., A.L., L.N.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - L Nghiemphu
- Neurology (D.J.J.W., T.F.C., A.L., L.N.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - W B Pope
- From the Departments of Radiological Sciences (X.J.Q., B.M.E., H.J.K., N.S., M.L., A.R.S., J.J.T., S.R.E., W.B.P.)
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10
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The role of targeted therapies in the management of progressive glioblastoma. J Neurooncol 2014; 118:557-99. [DOI: 10.1007/s11060-013-1339-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 12/28/2013] [Indexed: 12/28/2022]
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11
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Qaddoumi I, Kocak M, Pai Panandiker AS, Armstrong GT, Wetmore C, Crawford JR, Lin T, Boyett JM, Kun LE, Boop FA, Merchant TE, Ellison DW, Gajjar A, Broniscer A. Phase II Trial of Erlotinib during and after Radiotherapy in Children with Newly Diagnosed High-Grade Gliomas. Front Oncol 2014; 4:67. [PMID: 24744992 PMCID: PMC3978340 DOI: 10.3389/fonc.2014.00067] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 03/19/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Epidermal growth factor receptor is overexpressed in most pediatric high-grade gliomas (HGG). Since erlotinib had shown activity in adults with HGG, we conducted a phase II trial of erlotinib and local radiotherapy (RT) in children with newly diagnosed HGG. METHODS Following maximum surgical resection, patients between 3 and 21 years with non-metastatic HGG received local RT at 59.4 Gy (54 Gy for spinal tumors and those with ≥70% brain involvement). Erlotinib started on day 1 of RT (120 mg/m(2) per day) and continued for 2 years unless there was tumor progression or intolerable toxicities. The 2-year progression-free survival (PFS) was estimated for patients with intracranial anaplastic astrocytoma (AA) and glioblastoma (GBM). RESULTS Median age at diagnosis for 41 patients with intracranial tumors (21 with GBM and 20 with AA) was 10.9 years (range, 3.3-19 years). The 2-year PFS for patients with AA and GBM was 15 ± 7 and 19 ± 8%, respectively. Only five patients remained alive without tumor progression. Twenty-six patients had at least one grade 3 or 4 toxicity irrespective of association with erlotinib; only four required dose modifications. The main toxicities were gastrointestinal (n = 11), dermatologic (n = 5), and metabolic (n = 4). One patient with gliomatosis cerebri who required prolonged corticosteroids died of septic shock associated with pancreatitis. CONCLUSION Although therapy with erlotinib was mostly well-tolerated, it did not change the poor outcome of our patients. Our results showed that erlotinib is not a promising medication in the treatment of children with intracranial AA and GBM.
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Affiliation(s)
- Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Mehmet Kocak
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Gregory T. Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Cynthia Wetmore
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - John R. Crawford
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - Tong Lin
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - James M. Boyett
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Larry E. Kun
- Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Thomas E. Merchant
- Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - David W. Ellison
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Amar Gajjar
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Alberto Broniscer
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
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12
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Abstract
Malignant gliomas comprise a small percentage of all cancers, but continue to cause disproportionate levels of morbidity and mortality. Despite decades of intensive effort from many disciplines--surgery, radiation oncology and medicine--they remain refractory to cure and, in most cases, even to prolonged treatment response. Comprehensive multidisciplinary treatment is well recognized as the optimal approach. While continued advances and refinement in both surgical and radiotherapy-based techniques are certain, medical therapies are expanding at a much more rapid rate. This is due, in large part, to an understanding of the molecular events that underlie cancer pathogenesis and improved laboratory techniques to manufacture and study molecules that influence this process. This review will focus on medical therapies in the treatment of malignant glioma, never losing sight of their place as one of several therapeutic modalities used to confront brain cancer.
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Affiliation(s)
- M Kelly Nicholas
- Department of Neurology, University of Chicago, 5801 South Ellis Ave., Chicago, IL 60637, USA.
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13
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Wen PY, Kesari S, Drappatz J. Malignant gliomas: strategies to increase the effectiveness of targeted molecular treatment. Expert Rev Anticancer Ther 2014; 6:733-54. [PMID: 16759164 DOI: 10.1586/14737140.6.5.733] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Recently, there has been increasing interest in the use of targeted molecular agents for the treatment of malignant gliomas. These agents are generally well tolerated but have demonstrated only modest activity. In this article, the current status of targeted molecular agents for malignant gliomas will be reviewed and strategies to improve their effectiveness will be discussed.
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Affiliation(s)
- Patrick Y Wen
- Harvard Medical School, Dana-Farber/Brigham and Women's Cancer Center, SW430D, Boston, MA 02115, USA.
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14
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Penas-Prado M, Gilbert MR. Molecularly targeted therapies for malignant gliomas: advances and challenges. Expert Rev Anticancer Ther 2014; 7:641-61. [PMID: 17492929 DOI: 10.1586/14737140.7.5.641] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The identification of molecular markers associated with tumor but not with normal tissue has allowed the development of highly specific, targeted therapies for the treatment of cancer. Over the last several years, tremendous advances in our understanding of the genetic and molecular changes involved in the progression of malignant gliomas have triggered a large effort in the development of targeted therapies to treat these tumors. However, to date only a modest clinical benefit, limited to subsets of patients, has been demonstrated. Furthermore, despite a high degree of target selectivity, the use of targeted therapies often has systemic toxicity. The reasons behind this limited clinical success are complex and include the intricacy of the signaling pathways in gliomas and the heterogeneity of the disease process, compounded by existing limitations in assessing the efficacy of these novel agents when conventional end points and clinical trial designs are utilized. However, despite these difficulties targeted therapies remain a very attractive avenue of treatment for malignant gliomas. Three basic approaches are needed to overcome the hurdles associated with targeted therapies: first, further development of genetic profiling techniques will help to better determine the genetic changes and molecular pathways involved in gliomas and will potentially allow the design of individualized therapies based on the genetic and molecular signature of each tumor. Second, there is a need for the development of better combination strategies (complementary targeted agents or targeted agents with chemotherapy drugs) directed towards disease heterogeneity. Third, we need to optimize the design of preclinical and clinical trials to obtain the maximum amount of information in the shortest period of time.
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Affiliation(s)
- Marta Penas-Prado
- The UT MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, 77030 TX, USA.
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15
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Heme oxygenase-1 expression in human gliomas and its correlation with poor prognosis in patients with astrocytoma. Tumour Biol 2013; 35:2803-15. [DOI: 10.1007/s13277-013-1373-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 10/28/2013] [Indexed: 12/28/2022] Open
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16
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Pinel S, Mriouah J, Vandamme M, Chateau A, Plénat F, Guérin E, Taillandier L, Bernier-Chastagner V, Merlin JL, Chastagner P. Synergistic antitumor effect between gefitinib and fractionated irradiation in anaplastic oligodendrogliomas cannot be predicted by the Egfr signaling activity. PLoS One 2013; 8:e68333. [PMID: 23874590 PMCID: PMC3715478 DOI: 10.1371/journal.pone.0068333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 05/28/2013] [Indexed: 11/18/2022] Open
Abstract
In high-grade gliomas, the identification of patients that could benefit from EGFR inhibitors remains a challenge, hindering the use of these agents. Using xenografts models, we evaluated the antitumor effect of the combined treatment "gefitinib + radiotherapy" and aimed to identify the profile of responsive tumors. Expression of phosphorylated proteins involved in the EGFR-dependent signaling pathways was analyzed in 10 glioma models. We focused on three models of anaplastic oligodendrogliomas (TCG2, TCG3 and TCG4) harboring high levels of phospho-EGFR, phospho-AKT and phospho-MEK1. They were treated with gefitinib (GEF 75 mg/kg/day x 5 days/week, for 2 weeks) and/or fractionated radiotherapy (RT: 5x2Gy/week for 2 weeks). Our results showed that GEF and/or RT induced significant tumor growth delays. However, only the TCG3 xenografts were highly responsive to the combination GEF+RT, with ∼50% of tumor cure. Phosphoproteins analysis five days after treatment onset demonstrated in TCG3 xenografts, but not in TCG2 model, that the EGFR-dependent pathways were inhibited after GEF treatment. Moreover, TCG3-bearing mice receiving GEF monotherapy exhibited a transient beneficial therapeutic response, rapidly followed by tumor regrowth, along with a major vascular remodeling. Taken together, our data evoked an "EGFR-addictive" behavior for TCG3 tumors. This study confirms that combination of gefitinib with fractionated irradiation could be a potent therapeutic strategy for anaplastic oligodendrogliomas harboring EGFR abnormalities but this treatment seems mainly beneficial for "EGFR-addictive" tumors. Unfortunately, neither the usual molecular markers (EGFR amplification, PTEN loss) nor the basal overexpression of phosphoproteins were useful to distinguish this responsive tumor. Evaluating the impact of TKIs on the EGFR-dependent pathways during the treatment might be more relevant, and requires further validation.
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Affiliation(s)
- Sophie Pinel
- Université de Lorraine, CRAN, UMR 7039, Campus Science, Vandoeuvre-les-Nancy, France.
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17
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Pozo N, Zahonero C, Fernández P, Liñares JM, Ayuso A, Hagiwara M, Pérez A, Ricoy JR, Hernández-Laín A, Sepúlveda JM, Sánchez-Gómez P. Inhibition of DYRK1A destabilizes EGFR and reduces EGFR-dependent glioblastoma growth. J Clin Invest 2013; 123:2475-87. [PMID: 23635774 PMCID: PMC3668845 DOI: 10.1172/jci63623] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 03/01/2013] [Indexed: 01/12/2023] Open
Abstract
Glioblastomas (GBMs) are very aggressive tumors that are resistant to conventional chemo- and radiotherapy. New molecular therapeutic strategies are required to effectively eliminate the subpopulation of GBM tumor-initiating cells that are responsible for relapse. Since EGFR is altered in 50% of GBMs, it represents one of the most promising targets; however, EGFR kinase inhibitors have produced poor results in clinical assays, with no clear explanation for the observed resistance. We uncovered a fundamental role for the dual-specificity tyrosine phosphorylation-regulated kinase, DYRK1A, in regulating EGFR in GBMs. We found that DYRK1A was highly expressed in these tumors and that its expression was correlated with that of EGFR. Moreover, DYRK1A inhibition promoted EGFR degradation in primary GBM cell lines and neural progenitor cells, sharply reducing the self-renewal capacity of normal and tumorigenic cells. Most importantly, our data suggest that a subset of GBMs depends on high surface EGFR levels, as DYRK1A inhibition compromised their survival and produced a profound decrease in tumor burden. We propose that the recovery of EGFR stability is a key oncogenic event in a large proportion of gliomas and that pharmacological inhibition of DYRK1A could represent a promising therapeutic intervention for EGFR-dependent GBMs.
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Affiliation(s)
- Natividad Pozo
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Cristina Zahonero
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Paloma Fernández
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jose M. Liñares
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Angel Ayuso
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Masatoshi Hagiwara
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Angel Pérez
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jose R. Ricoy
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Aurelio Hernández-Laín
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Juan M. Sepúlveda
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pilar Sánchez-Gómez
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain.
Instituto de Medicina Molecular Aplicada (IMMA), Universidad CEU-San
Pablo, Madrid, Spain. Brain Tumor Laboratory, Centro Integral
Oncológico Clara Campal, Hospital de Madrid, Madrid, Spain.
Department of Anatomy and Developmental Biology, Graduate School of
Medicine, Kyoto University, Kyoto, Japan. Unidad Multidisciplinar de
Neurooncología, Hospital Universitario 12 de Octubre, Madrid, Spain
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Sun W, Kajimoto Y, Inoue H, Miyatake SI, Ishikawa T, Kuroiwa T. Gefitinib enhances the efficacy of photodynamic therapy using 5-aminolevulinic acid in malignant brain tumor cells. Photodiagnosis Photodyn Ther 2012; 10:42-50. [PMID: 23465372 DOI: 10.1016/j.pdpdt.2012.06.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Revised: 06/19/2012] [Accepted: 06/19/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Since the ATP-binding cassette transporter ABCG2 plays a physiologically significant role of porphyrin efflux from living cells, the expression of ABCG2 may influences the efficacy of photodynamic therapy (PDT). In this study, we evaluated the effect of gefitinib, a potent ABCG2 inhibitor, on 5-aminolevulinic acid (5-ALA)-PDT in brain tumor cell lines in vitro. MATERIALS AND METHODS Four human glioma cell lines (U87MG, U118MG, A172, and T98G) and a malignant meningioma cell line (IOMM-Lee) were incubated with gefitinib (0.01-1.0μM) before incubation with 5-ALA (1mM). The effects gefitinib on intracellular protoporphyrin IX (PpIX), mRNA and protein expression of ABCG2, and PDT were evaluated, in vitro. RESULTS At concentrations of 0.1μM or higher, gefitinib enhanced intracellular levels of PpIX in a dose-dependent manner in all those cell lines. Gefitinib decreased mRNA and plasma membrane protein expression of ABCG2, and efficiently enhanced the effect of 5-ALA-PDT in malignant brain tumor cells. CONCLUSION Gefitinib can inhibit ABCG2-mediated PpIX efflux from malignant brain tumor cells to increase the intracellular PpIX and thereby enhance the PDT effect.
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Affiliation(s)
- Wei Sun
- Department of Neurosurgery, Osaka Medical College, Takatsuki, Osaka, Japan; Department of Neurosurgery, Pu Nan Hospital, Shanghai, People's Republic of China
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Huang FYJ, Lee TW, Kao CHK, Chang CH, Zhang X, Lee WY, Chen WJ, Wang SC, Lo JM. Imaging, autoradiography, and biodistribution of (188)Re-labeled PEGylated nanoliposome in orthotopic glioma bearing rat model. Cancer Biother Radiopharm 2012; 26:717-25. [PMID: 22145660 DOI: 10.1089/cbr.2011.1052] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The (188)Re-labeled pegylated nanoliposome (abbreviated as (188)Re-Liposome) was prepared and evaluated for its potential as a theragnostic agent for glioma. (188)Re-BMEDA complex was loaded into the pegylated liposome core with pH 5.5 ammonium sulfate gradient to produce (188)Re-Liposome. Orthotopic Fischer344/F98 glioma tumor-bearing rats were prepared and intravenously injected with (188)Re-Liposome. Biodistribution, pharmacokinetic study, autoradiography (ARG), histopathology, and nano-SPECT/CT imaging were conducted for the animal model. The result showed that (188)Re-Liposome accumulated in the brain tumor of the animal model from 0.28%±0.09% injected dose (ID)/g (n=3) at 1 hour to a maximum of 1.95%±0.35% ID/g (n=3) at 24 hours postinjection. The tumor-to-normal brain uptake ratio (T/N ratio) increased from 3.5 at 1 hour to 32.5 at 24 hours. Both ARG and histopathological images clearly showed corresponding tumor regions with high T/N ratios. Nano-SPECT/CT detected a very clear tumor image from 4 hours till 48 hours. This study reveals the potential of (188)Re-Liposome as a theragnostic agent for brain glioma.
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Affiliation(s)
- Feng-Yun J Huang
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
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20
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Enhanced brain accumulation of pazopanib by modulating P-gp and Bcrp1 mediated efflux with canertinib or erlotinib. Int J Pharm 2012; 436:127-34. [PMID: 22688250 DOI: 10.1016/j.ijpharm.2012.05.038] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 05/13/2012] [Accepted: 05/15/2012] [Indexed: 11/23/2022]
Abstract
Primary objective of this investigation was to delineate the differential impact of efflux transporters P-glycoprotein (P-gp/Abcb1) and breast cancer resistance protein (Bcrp1/Abcg2) on brain disposition and plasma pharmacokinetics of pazopanib. In addition, this research investigated whether inhibition of these efflux transporters with clinically relevant efflux modulators canertinib or erlotinib could be a viable strategy for improving pazopanib brain delivery. In vitro assays with MDCKII cell monolayers suggested that pazopanib is a high affinity substrate for Bcrp1 and a moderate substrate for P-gp. Co-incubation with specific transport inhibitors restored cell accumulation and completely abolished the directionality of pazopanib flux. Brain and plasma pharmacokinetic studies were conducted in FVB wild type mice in the absence and presence of specific transport inhibitors. Drug levels in plasma and brain were determined using a validated high performance liquid chromatography method using vandetanib as an internal standard. In vivo studies indicated that specific inhibition of either P-gp (by zosuquidar or LY335979) or Bcrp1 (by Ko143) alone did not significantly alter pazopanib brain accumulation. However, dual P-gp/Bcrp1 inhibition by elacridar (GF120918), significantly enhanced pazopanib brain penetration by ~5-fold without altering its plasma concentrations. Thus, even though Bcrp1 showed higher affinity towards pazopanib in vitro, in vivo at the mouse BBB both P-gp and Bcrp1 act in concert to limit brain accumulation of pazopanib. Furthermore, erlotinib and canertinib as clinically relevant efflux modulators efficiently abrogated directionality in pazopanib efflux in vitro and their co-administration resulted in 2-2.5-fold increase in pazopanib brain accumulation in vivo. Further pre-clinical and clinical investigations are warranted as erlotinib or canertinib may have a synergistic pharmacological effect in addition to their primary role of pazopanib efflux modulation as a combination regimen for the treatment of recurrent brain tumors.
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Long-term survival after gamma knife radiosurgery in a case of recurrent glioblastoma multiforme: a case report and review of the literature. Case Rep Med 2012; 2012:545492. [PMID: 22548078 PMCID: PMC3324895 DOI: 10.1155/2012/545492] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 01/15/2012] [Indexed: 12/23/2022] Open
Abstract
The management of recurrent glioblastoma is highly challenging, and treatment outcomes remain uniformly poor. Glioblastoma is a highly infiltrative tumor, and complete surgical resection of all microscopic extensions cannot be achieved at the time of initial diagnosis, and hence local recurrence is observed in most patients. Gamma Knife radiosurgery has been used to treat these tumor recurrences for select cases and has been successful in prolonging the median survival by 8-12 months on average for select cases. We present the unique case of a 63-year-old male with multiple sequential recurrences of glioblastoma after initial standard treatment with surgery followed by concomitant external beam radiation therapy and chemotherapy (temozolomide). The patient was followed clinically as well as with surveillance MRI scans at every 2-3-month intervals. The patient underwent Gamma Knife radiosurgery three times for 3 separate tumor recurrences, and the patient survived for seven years following the initial diagnosis with this aggressive treatment. The median survival in patients with recurrent glioblastoma is usually 8-12 months after recurrence, and this unique case illustrates that aggressive local therapy can lead to long-term survivors in select situations. We advocate that each patient treatment at the time of recurrence should be tailored to each clinical situation and desire for quality of life and improved longevity.
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Tykocinski ES, Grant RA, Kapoor GS, Krejza J, Bohman LE, Gocke TA, Chawla S, Halpern CH, Lopinto J, Melhem ER, O'Rourke DM. Use of magnetic perfusion-weighted imaging to determine epidermal growth factor receptor variant III expression in glioblastoma. Neuro Oncol 2012; 14:613-23. [PMID: 22492960 DOI: 10.1093/neuonc/nos073] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Identification of the epidermal growth factor receptor variant III (EGFRvIII) mutation in glioblastoma has become increasingly relevant in the optimization of therapy. Traditionally, determination of tumor EGFRvIII-expression has relied on tissue-based diagnostics. Here, we assess the accuracy of magnetic resonance perfusion-weighted imaging (MR-PWI) in discriminating the EGFRvIII-expressing glioblastoma subtype. We analyzed RNA from 132 primary human glioblastoma tissue samples by reverse-transcription polymerase chain reaction (RT-PCR) for the EGFRvIII and EGFR wild-type mutations and by quantitative RT-PCR for expression of vascular endothelial growth factor (VEGF). Concurrently, 3 independent observers reviewed preoperative 1.5-Tesla (T)/SE or 3.0-Tesla (T)/GE MR perfusion images to determine the maximum relative tumor blood volume (rTBV) of each of these tumors. EGFRvIII-expressing glioblastomas showed significantly higher rTBV, compared with those tumors lacking EGFRvIII expression. This association was observed in both the 1.5T/SE (P = .000) and 3.0T/GE (P = .001) cohorts. By logistic regression analysis, combining the 2 MR system cohorts, rTBV was a very strong predictor of EGFRvIII mutation (odds ratio [rTBV] = 2.70; P = .000; McFadden's ρ(2) = 0.23). Furthermore, by receiver-operating characteristic curve analysis, rTBV discriminated EGFRvIII with very high accuracy (A(z) = 0.81). In addition, we found that VEGF upregulation was associated, although without reaching statistical significance, with EGFRvIII expression (P = .16) and with increased rTBV (F-ratio = 2.71; P = .102). These trends suggest that VEGF-mediated angiogenesis may be a potential mediator of angiogenesis to increase perfusion in EGFRvIII-expressing glioblastomas, but there are likely several other contributing factors. This study demonstrates the potential to use rTBV, a MR-PWI-derived parameter, as a noninvasive surrogate of the EGFRvIII mutation.
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Affiliation(s)
- Elana S Tykocinski
- Departments of Neurosurgery, Hospital of The University of Pennsylvania and The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
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Asano K, Ohkuma H. Epithelial growth factor receptor tyrosine kinase inhibitor prevents infiltration and cerebrospinal fluid dissemination in malignant glioma: an experimental study. Neurosurgery 2012; 69:399-410; discussion 410-1. [PMID: 21415790 DOI: 10.1227/neu.0b013e318215a3d0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED BAC1KGROUND: AG1478 is an epithelial growth factor receptor tyrosine kinase inhibitor. Epithelial growth factor receptor regulates the expression of cadherin in cells via its action on β-catenin, and N-cadherin downregulation promotes infiltration and cerebrospinal fluid (CSF) dissemination of glioma cells. OBJECTIVE To confirm whether AG1478 might have indirect effects on N-cadherin upregulation and whether, in addition to exhibiting an antitumor effect, AG1478 might also exert protective effects against infiltration and CSF dissemination. METHODS Green fluorescent protein (GFP) was introduced into C6 cells to obtain C6-GFP, and N-cadherin was introduced into C6-GFP to obtain C6-GFP-NCH. To confirm N-cadherin upregulation and the anti-infiltrative effect of AG1478 in vitro, we conducted Western blotting, aggregation assays, and Matrigel infiltration experiments. To confirm whether AG1478 exerted preventive effects against infiltration and CSF dissemination in vivo, in addition to exerting an antitumor effect, AG1478 was administered via various routes to rat C6-GFP inoculation models. RESULTS In vitro experiments demonstrated that AG1478 could indirectly upregulate N-cadherin in C6-GFP and reduced infiltration to the level of C6-GFP-NCH. In in vivo experiments, intrathecal administration of AG1478 inhibited CSF dissemination but did not prevent infiltration. Direct administration into the tumor mass demonstrated antitumor and anti-infiltration effects and inhibited CSF dissemination in each cistern, except at the convexity. Direct and intrathecal administration was the best treatment, resulting in significantly reduced numbers of disseminated cells in the CSF smear test. CONCLUSION AG1478 was highly effective both when administered intrathecally and when inoculated directly into the tumor mass.
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Affiliation(s)
- Kenichiro Asano
- Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
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24
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Serum antibody coupled with the construction of gentamicin sulfate for the Escherichia coli targeted drug. Res Vet Sci 2011; 91:e136-43. [DOI: 10.1016/j.rvsc.2011.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Revised: 01/10/2011] [Accepted: 01/23/2011] [Indexed: 11/17/2022]
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Reszeć J, Bernaczyk PS, Milewski R, Chyczewski L, Mariak Z. c-erbB-2 protein expression in astrocytic tumors of the brain. Med Sci Monit 2011; 17:BR216-220. [PMID: 21804458 PMCID: PMC3539622 DOI: 10.12659/msm.881900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Astrocytic tumors are the primary brain tumors, which often progress to glioblastoma, a highly malignant neoplasm of the central nervous system. There is much new data regarding to the formation and progression of these tumors; however, glioblastoma remains one of the most fatal neoplasms in humans. The aim of the study was to evaluate the role of c-erbB-2 protein expression in various groups of astrocytic tumors. Material/Methods 65 cases of astrocytic tumors were divided into 3 groups: diffuse astrocytoma (group I; n=17 cases), anaplastic astrocytoma (group II; n=23 cases) and glioblastoma (group III; n=25 cases). C-erbB-2 protein expression was estimated semiquantitatively on immunohistochemically stained tissue sections using antibodies against c-erbB-2 protein. Statistical analysis was performed in all examined groups. Results The c-erbB-2 protein expression was observed in 15 out of 17 cases (88.3%) in group I, 22 out of 25 cases (88%) cases in group II, and in 19 out of 23 cases (82.6%) in group III. There were no statistically significant differences between the examined groups. The strongest c-erbB-2 immunoexpression was observed in low grade astrocytomas (diffuse astrocytomas G2); in the glioblastoma group the c-erbB-2 protein expression was weak and 17.4% of cases were negative. Conclusions C-erbB-2 protooncogene alteration is an early phenomenon in glial tumor development and progression.
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Affiliation(s)
- Joanna Reszeć
- Department of Medical Pathomorphology, Medical University of Bialystok, Bialystok, Poland.
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26
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Mut M, Lule S, Demir O, Kurnaz IA, Vural I. Both mitogen-activated protein kinase (MAPK)/extracellular-signal-regulated kinases (ERK) 1/2 and phosphatidylinositide-3-OH kinase (PI3K)/Akt pathways regulate activation of E-twenty-six (ETS)-like transcription factor 1 (Elk-1) in U138 glioblastoma cells. Int J Biochem Cell Biol 2011; 44:302-10. [PMID: 22085529 DOI: 10.1016/j.biocel.2011.10.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 10/27/2011] [Accepted: 10/28/2011] [Indexed: 02/02/2023]
Abstract
Epidermal growth factor (EGF) and its receptor (EGFR) have been shown to play a significant role in the pathogenesis of glioblastoma. In our study, the EGFR was stimulated with EGF in human U138 glioblastoma cells. We show that the activated mitogen-activated protein kinase (MAPK)/extracellular-signal-regulated kinases (ERK) 1/2 pathway phosphorylated the E twenty-six (ETS)-like transcription factor 1 (Elk-1) mainly at serine 383 residue. Mitogen-activated protein kinase kinase (MEK) 1/2 inhibitor, UO126 and ERK inhibitor II, FR180204 blocked the Elk-1 phosphorylation and activation. The phosphatidylinositide-3-OH kinase (PI3K)/Akt pathway was also involved in the Elk-1 activation. Activation of the Elk-1 led to an increased survival and a proliferative response with the EGF stimulation in the U138 glioblastoma cells. Knocking-down the Elk-1 using an RNA interference technique caused a decrease in survival of the unstimulated U138 glioblastoma cells and also decreased the proliferative response to the EGF stimulation. The Elk-1 transcription factor was important for the survival and proliferation of U138 glioblastoma cells upon the stimulation of EGFR with EGF. The MAPK/ERK1/2 and PI3K/Akt pathways regulated this response via activation of the Elk-1 transcription factor. The Elk-1 may be one of the convergence points for pathways located downstream of EGFR in glioblastoma cells. Utilization of the Elk-1 as a therapeutic target may lead to a novel strategy in treatment of glioblastoma.
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Affiliation(s)
- Melike Mut
- Hacettepe University Department of Neurosurgery, Institute of Neurological Sciences and Psychiatry, 06100 Ankara, Turkey.
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27
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Tyler B, Wadsworth S, Recinos V, Mehta V, Vellimana A, Li K, Rosenblatt J, Do H, Gallia GL, Siu IM, Wicks RT, Rudek MA, Zhao M, Brem H. Local delivery of rapamycin: a toxicity and efficacy study in an experimental malignant glioma model in rats. Neuro Oncol 2011; 13:700-9. [PMID: 21727209 DOI: 10.1093/neuonc/nor050] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rapamycin, an anti-proliferative agent, is effective in the treatment of renal cell carcinoma and recurrent breast cancers. We proposed that this potent mammalian target of rapamycin inhibitor may be useful for the treatment of gliomas as well. We examined the cytotoxicity of rapamycin against a rodent glioma cell line, determined the toxicity of rapamycin when delivered intracranially, and investigated the efficacy of local delivery of rapamycin for the treatment of experimental malignant glioma in vivo. We also examined the dose-dependent efficacy of rapamycin and the effect when locally delivered rapamycin was combined with radiation therapy. Rapamycin was cytotoxic to 9L cells, causing 34% growth inhibition at a concentration of 0.01 µg/mL. No in vivo toxicity was observed when rapamycin was incorporated into biodegradable caprolactone-glycolide (35:65) polymer beads at 0.3%, 3%, and 30% loading doses and implanted intracranially. Three separate efficacy studies were performed to test the reproducibility of the effect of the rapamycin beads as well as the validity of this treatment approach. Animals treated with the highest dose of rapamycin beads tested (30%) consistently demonstrated significantly longer survival durations than the control and placebo groups. All dose-escalating rapamycin bead treatment groups (0.3%, 3% and 30%), treated both concurrently with tumor and in a delayed manner after tumor placement, experienced a significant increase in survival, compared with controls. Radiation therapy in addition to the simultaneous treatment with 30% rapamycin beads led to significantly longer survival duration than either therapy alone. These results suggest that the local delivery of rapamycin for the treatment of gliomas should be further investigated.
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Affiliation(s)
- Betty Tyler
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA.
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Wick W, Weller M, Weiler M, Batchelor T, Yung AWK, Platten M. Pathway inhibition: emerging molecular targets for treating glioblastoma. Neuro Oncol 2011; 13:566-79. [PMID: 21636705 PMCID: PMC3107100 DOI: 10.1093/neuonc/nor039] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 02/28/2011] [Indexed: 12/26/2022] Open
Abstract
Insights into the molecular pathogenesis of glioblastoma have not yet resulted in relevant clinical improvement. With standard therapy, which consists of surgical resection with concomitant temozolomide in addition to radiotherapy followed by adjuvant temozolomide, the median duration of survival is 12-14 months. Therefore, the identification of novel molecular targets and inhibitory agents has become a focus of research for glioblastoma treatment. Recent results of bevacizumab may represent a proof of principle that treatment with targeted agents can result in clinical benefits for patients with glioblastoma. This review discusses limitations in the existing therapy for glioblastoma and provides an overview of current efforts to identify molecular targets using large-scale screening of glioblastoma cell lines and tumor samples. We discuss preclinical and clinical data for several novel molecular targets, including growth factor receptors, phosphatidylinositol-3 kinase, SRC-family kinases, integrins, and CD95 ligand and agents that inhibit these targets, including erlotinib, enzastaurin, dasatinib, sorafenib, cilengitide, AMG102, and APG101. By combining advances in tumor screening with novel targeted therapies, it is hoped that new treatment options will emerge for this challenging tumor type.
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Affiliation(s)
- Wolfgang Wick
- Department of Neurooncology, National Center of Tumor Disease, University Clinic Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.
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Arko L, Katsyv I, Park GE, Luan WP, Park JK. Experimental approaches for the treatment of malignant gliomas. Pharmacol Ther 2010; 128:1-36. [PMID: 20546782 PMCID: PMC2939300 DOI: 10.1016/j.pharmthera.2010.04.015] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 04/28/2010] [Indexed: 12/13/2022]
Abstract
Malignant gliomas, which include glioblastomas and anaplastic astrocytomas, are the most common primary tumors of the brain. Over the past 30 years, the standard treatment for these tumors has evolved to include maximal safe surgical resection, radiation therapy and temozolomide chemotherapy. While the median survival of patients with glioblastomas has improved from 6 months to 14.6 months, these tumors continue to be lethal for the vast majority of patients. There has, however, been recent substantial progress in our mechanistic understanding of tumor development and growth. The translation of these genetic, epigenetic and biochemical findings into therapies that have been tested in clinical trials is the subject of this review.
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Affiliation(s)
- Leopold Arko
- Surgical and Molecular Neuro-oncology Unit, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD 20892, USA
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Ye F, Gao Q, Cai MJ. Therapeutic targeting of EGFR in malignant gliomas. Expert Opin Ther Targets 2010; 14:303-16. [DOI: 10.1517/14728221003598948] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Li M, Wang J, Ng SSM, Chan CY, He ML, Yu F, Lai L, Shi C, Chen Y, Yew DT, Kung HF, Lin MCM. Adenosine diphosphate-ribosylation factor 6 is required for epidermal growth factor-induced glioblastoma cell proliferation. Cancer 2009; 115:4959-72. [PMID: 19642173 DOI: 10.1002/cncr.24550] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND : Epidermal growth factor (EGF) signaling plays a pivotal role in gliomagenesis. The authors previously demonstrated that adenosine diphospate-ribosylation factor 6 (ARF6), a member of the Ras-related small guanosine-5'-triphospate-binding protein family, is required for EFA6A-induced glioma cell migration and invasion. However, the role of ARF6 in EGF signaling is unknown. METHODS : The authors analyzed messenger RNA (mRNA) levels of ARF6 and EGF receptor (EGFR) in 16 high-grade glioma samples and in 6 low-grade glioma samples by reverse transcriptase-polymerase chain reaction analysis. To determine whether EGF induces ARF6 expression in human glioblastoma U87 cells through transcriptional regulation and EGFR activation, the levels of ARF6 were assayed in EGF-treated U87 cells that were preincubated with a transcriptional inhibitor (actinomycin D) and an EGFR tyrosine kinase inhibitor (PD153035), respectively. The downstream signaling of EGFR-mediated ARF6 up-regulation also was investigated using specific inhibitors of mitogen-activated protein kinase (MEK), phosphatidylinositol 3' kinase (PI3K), and Janus kinase 2. The involvement of SP1 in the downstream signaling was studied by using an SP1 inhibitor (mithramycin A). Small-interfering RNAs (siRNAs) targeting ARF6 were used to investigate the effects of ARF6 on EGF-mediated glioma cell proliferation. RESULTS : The results demonstrated that ARF6 and EGFR mRNA levels were elevated in glioma tissues. Furthermore, EGF stimulated ARF6 expression in U87 cells in a dose-dependent and time-dependant manner. This stimulation was caused by increased transcription of ARF6 and by activation of the MEK/extracellular signal-regulated kinase 1 and 2 (ERK1/2) and PI3K signaling pathways. It is noteworthy that SP1 was essential for EGF-induced ARF6 up-regulation. Finally, EGF-induced glioblastoma cell proliferation depended on ARF6, because the suppression of ARF6 by siRNA or by a dominant-negative mutant significantly inhibited EGF-induced cell proliferation. CONCLUSIONS : The results of the current study suggested that EGF-induced ARF6 expression plays a significant role in glioma cell proliferation. Cancer 2009. (c) 2009 American Cancer Society.
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Affiliation(s)
- Ming Li
- Department of Chemistry, Open Laboratory of Chemical Biology, the University of Hong Kong, Hong Kong, China
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Gadji M, Crous AMT, Fortin D, Krcek J, Torchia M, Mai S, Drouin R, Klonisch T. EGF receptor inhibitors in the treatment of glioblastoma multiform: Old clinical allies and newly emerging therapeutic concepts. Eur J Pharmacol 2009; 625:23-30. [DOI: 10.1016/j.ejphar.2009.10.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 09/27/2009] [Accepted: 10/08/2009] [Indexed: 12/26/2022]
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Guillamo JS, de Boüard S, Valable S, Marteau L, Leuraud P, Marie Y, Poupon MF, Parienti JJ, Raymond E, Peschanski M. Molecular mechanisms underlying effects of epidermal growth factor receptor inhibition on invasion, proliferation, and angiogenesis in experimental glioma. Clin Cancer Res 2009; 15:3697-704. [PMID: 19435839 DOI: 10.1158/1078-0432.ccr-08-2042] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Epidermal growth factor receptor (EGFR) signal transduction pathways are implicated in malignant glioma aggressiveness and promote tumor cell invasion, proliferation, and angiogenesis. Nevertheless, response to EGFR tyrosine kinase inhibitor gefitinib (Iressa, ZD1839) has been disappointing in clinical trials. One potential explanation may come from the diversity of molecular alterations seen in gliomas. To validate that hypothesis, we have investigated responses to gefitinib on various tumor parameters in human malignant gliomas that exhibited different molecular alterations. EXPERIMENTAL DESIGN We used a panel of six human malignant gliomas from established xenografts characterized for their genetic (EGFR, PTEN, TP53, and CDKN2A) and molecular (EGFR, PTEN, ERK, and Akt) alterations. Tumors were treated with gefitinib (1 or 10 micromol/L) for prolonged periods (8 or 16 days) in an organotypic brain slice model that allowed quantification of invasion, proliferation, and angiogenesis. RESULTS In nontreated tumors, EGFR amplification was associated with profuse tumor cell invasion. After treatment, invasion was inhibited in tumors with EGFR amplification in a dose-dependent manner. Treatment had only antiproliferative effect in two of three tumors with EGFR amplification. Tumors with PTEN loss were resistant to treatment. We did not observe shrinkage of the tumors after treatment. None of the tumors had mutations of the EGFR kinase domain. Gefitinib had similar antiangiogenic effect in all of the tumors. CONCLUSIONS Gefitinib reduces cell invasion in EGFR amplified tumors. PTEN loss of expression seems to be a determinant of resistance. Interestingly, inhibition of angiogenesis by gefitinib seems independent on the EGFR genetic status of the tumors.
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Rivera F, Salcedo M, Vega N, Blanco Y, López C. Current situation of zalutumumab. Expert Opin Biol Ther 2009; 9:667-74. [DOI: 10.1517/14712590902932871] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Fernando Rivera
- Hospital Universitario Marqués de Valdecilla, Department of Medical Oncology, 39008 Santander, Spain ;
| | - Matilde Salcedo
- Hospital Universitario Marqués de Valdecilla, Department of Medical Oncology, 39008 Santander, Spain ;
| | - Noelia Vega
- Hospital Universitario Marqués de Valdecilla, Department of Medical Oncology, 39008 Santander, Spain ;
| | - Yolanda Blanco
- Hospital Universitario Marqués de Valdecilla, Department of Medical Oncology, 39008 Santander, Spain ;
| | - Carlos López
- Hospital Universitario Marqués de Valdecilla, Department of Medical Oncology, 39008 Santander, Spain ;
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Liu Y, Kuan CT, Mi J, Zhang X, Clary BM, Bigner DD, Sullenger BA. Aptamers selected against the unglycosylated EGFRvIII ectodomain and delivered intracellularly reduce membrane-bound EGFRvIII and induce apoptosis. Biol Chem 2009; 390:137-44. [PMID: 19040357 DOI: 10.1515/bc.2009.022] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Epidermal growth factor receptor variant III (EGFRvIII) is a glycoprotein uniquely expressed in glioblastoma, but not in normal brain tissues. To develop targeted therapies for brain tumors, we selected RNA aptamers against the histidine-tagged EGFRvIII ectodomain, using an Escherichia coli system for protein expression and purification. Representative aptamer E21 has a dissociation constant (Kd) of 33x10(-9) m, and exhibits high affinity and specificity for EGFRvIII in ELISA and surface plasmon resonance assays. However, selected aptamers cannot bind the same protein expressed from eukaryotic cells because glycosylation, a post-translational modification present only in eukaryotic systems, significantly alters the structure of the target protein. By transfecting EGFRvIII aptamers into cells, we find that membrane-bound, glycosylated EGFRvIII is reduced and the percentage of cells undergoing apoptosis is increased. We postulate that transfected aptamers can interact with newly synthesized EGFRvIII, disrupt proper glycosylation, and reduce the amount of mature EGFRvIII reaching the cell surface. Our work establishes the feasibility of disrupting protein post-translational modifications in situ with aptamers. This finding is useful for elucidating the function of proteins of interest with various modifications, as well as dissecting signal transduction pathways.
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Affiliation(s)
- Yingmiao Liu
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
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Okamura T, Singh S, Buolamwini J, Haystead T, Friedman H, Bigner D, Ali-Osman F. Tyrosine phosphorylation of the human glutathione S-transferase P1 by epidermal growth factor receptor. J Biol Chem 2009; 284:16979-16989. [PMID: 19254954 DOI: 10.1074/jbc.m808153200] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Epidermal growth factor receptor (EGFR) gene amplification, mutations, and/or aberrant activation are frequent abnormalities in malignant gliomas and other human cancers and have been associated with an aggressive clinical course and a poor therapeutic outcome. Elevated glutathione S-transferase P1 (GSTP1), a major drug-metabolizing and stress response signaling protein, is also associated with drug resistance and poor clinical outcome in gliomas and other cancers. Here, we provide evidence that GSTP1 is a downstream EGFR target and that EGFR binds to and phosphorylates tyrosine residues in the GSTP1 protein in vitro and in vivo. Mass spectrometry and mutagenesis analyses in a cell-free system and in gliomas cells identified Tyr-7 and Tyr-198 as major EGFR-specific phospho-acceptor residues in the GSTP1 protein. The phosphorylation increased GSTP1 enzymatic activity significantly, and computer-based modeling showed a corresponding increase in electronegativity of the GSTP1 active site. In human glioma and breast cancer cells, epidermal growth factor stimulation rapidly increased GSTP1 tyrosine phosphorylation and decreased cisplatin sensitivity. Lapatinib, a clinically active EGFR inhibitor, significantly reversed the epidermal growth factor-induced cisplatin resistance. These data define phosphorylation and activation of GSTP1 by EGFR as a novel, heretofore unrecognized component of the EGFR signaling network and a novel mechanism of tumor drug resistance, particularly in tumors with elevated GSTP1 and/or activated EGFR.
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Affiliation(s)
| | - Simendra Singh
- From the Departments of Surgery, Durham, North Carolina 27710
| | - John Buolamwini
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Sciences Center, Memphis, Tennessee 38163
| | | | - Henry Friedman
- From the Departments of Surgery, Durham, North Carolina 27710
| | - Darell Bigner
- Pathology, Duke Comprehensive Cancer Center, and the Preston Robert Tisch Brain Tumor Center, Duke University, Durham, North Carolina 27710
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Kotliarov Y, Kotliarova S, Charong N, Li A, Walling J, Aquilanti E, Ahn S, Steed ME, Su Q, Center A, Zenklusen JC, Fine HA. Correlation analysis between single-nucleotide polymorphism and expression arrays in gliomas identifies potentially relevant target genes. Cancer Res 2009; 69:1596-603. [PMID: 19190341 DOI: 10.1158/0008-5472.can-08-2496] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Primary brain tumors are a major cause of cancer mortality in the United States. Therapy for gliomas, the most common type of primary brain tumors, remains suboptimal. The development of improved therapeutics will require greater knowledge of the biology of gliomas at both the genomic and transcriptional levels. We have previously reported whole genome profiling of chromosome copy number alterations (CNA) in gliomas, and now present our findings on how those changes may affect transcription of genes that may be involved in tumor induction and progression. By calculating correlation values of mRNA expression versus DNA copy number average in a moving window around a given RNA probe set, biologically relevant information can be gained that is obscured by the analysis of a single data type. Correlation coefficients ranged from -0.6 to 0.7, highly significant when compared with previous studies. Most correlated genes are located on chromosomes 1, 7, 9, 10, 13, 14, 19, 20, and 22, chromosomes known to have genomic alterations in gliomas. Additionally, we were able to identify CNAs whose gene expression correlation suggests possible epigenetic regulation. This analysis revealed a number of interesting candidates such as CXCL12, PTER, and LRRN6C, among others. The results have been verified using real-time PCR and methylation sequencing assays. These data will further help differentiate genes involved in the induction and/or maintenance of the tumorigenic process from those that are mere passenger mutations, thereby enriching for a population of potentially new therapeutic molecular targets.
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Affiliation(s)
- Yuri Kotliarov
- Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, Maryland, USA
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Growdon WB, Boisvert SL, Akhavanfard S, Oliva E, Dias-Santagata DC, Kojiro S, Horowitz NS, Iafrate AJ, Borger DR, Rueda BR. Decreased survival in EGFR gene amplified vulvar carcinoma. Gynecol Oncol 2008; 111:289-97. [DOI: 10.1016/j.ygyno.2008.07.038] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Revised: 07/15/2008] [Accepted: 07/16/2008] [Indexed: 11/30/2022]
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Antitumor activity of F90, an epidermal growth factor receptor tyrosine kinase inhibitor, on glioblastoma cell line SHG-44. Chin Med J (Engl) 2008. [DOI: 10.1097/00029330-200809010-00022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Rivera F, Eugenia Vega-Villegas M, Lopez-Brea MF, Marquez R. Current situation of Panitumumab, Matuzumab, Nimotuzumab and Zalutumumab. Acta Oncol 2008; 47:9-19. [PMID: 18097777 DOI: 10.1080/02841860701704724] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
EGFR overexpression usually correlates with a more advanced disease stage, a poorer prognosis and a worse chemotherapy response. EGFR expression increase has been observed in many tumours. For all the aforementioned reasons, EGFR inhibition can be considered an attractive approach in cancer treatment. One strategy has been receptor inhibition of extracellular domain using monoclonal antibodies. Cetuximab is the most developed one and there is plenty information on the literature about its current status. In this review we focus on other EGFR monoclonal antibodies under clinical development. The more developed one is Panitumumab. Its clinical development is taking place very quickly and it has mainly been studied in colorectal cancer showing promising results. There are also other interesting drugs such as Matuzumab, Nimotuzumab and Zalutumumab.
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Abstract
Epidermal growth factor receptor (EGFR) mutation is frequently observed in human cancer and contributes to the growth, survival and therapeutic resistance of tumors. EGFRvIII is an oncogenic EGFR mutant resulting from the deletion of exons 2-7 and is the most common EGFR mutant observed in glioblastoma multiforme, an aggressive brain tumor. EGFRvIII is constitutively active but poorly ubiquitinated, leading to inefficient receptor trafficking to lysosomes and unattenuated oncogenic signaling. The mechanism by which EGFRvIII evades downregulation is not fully understood although recent studies suggest that its interaction with the ubiquitin ligase Cbl may be compromised. In this study, we examine the regulation of EGFRvIII by the recently identified negative regulator, LRIG1, which targets EGFR through recognition of its extracellular domain. Here, we determine whether the extracellular domain deletion in EGFRvIII renders it refractory to LRIG1 regulation. We find that EGFRvIII retains interaction with LRIG1 and is in fact more sensitive to LRIG1 action than wild-type receptor. We demonstrate that LRIG1 regulation of EGFRvIII is distinct from the only other known mechanism of EGFR regulation, Cbl-mediated degradation. Ectopic expression of LRIG1 in EGFRvIII(+) glioblastoma cells opposes EGFRvIII-driven tumor cell proliferation, survival, motility and invasion. Finally, RNAi-mediated silencing of LRIG1 alters EGFRvIII intracellular trafficking and leads to enhanced EGFRvIII expression, suggesting that loss of LRIG1 in tumors may contribute to a permissive environment for EGFRvIII overexpression, contributing to EGFRvIII oncogenesis.
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Epithelial Growth Factor Receptor Inhibitors for treatment of recurrent or progressive high grade glioma: an exploratory study. J Neurooncol 2008; 89:211-8. [PMID: 18458820 DOI: 10.1007/s11060-008-9608-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Accepted: 04/22/2008] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Erlotinib and Gefitinib (EGFRi) are small molecules specifically inhibiting epidermal growth factor receptor (EGFR). We present here data of an exploratory study evaluating EGFRi monotherapy in patients with recurrent or progressive malignant glioma. PATIENTS 21 patients with recurrent or progressive malignant glioma were included in this study. EGFRi treatment was started at a median of 1.8 years (range 0.54 to 10.95) after initial surgery. 20/21 patients had undergone radiotherapy and all patients had received at least one (range 1 to 5, median 2) line of systemic antineoplastic therapy. Patients received 100 or 150 mg Erlotinib or 250 mg Gefitinib orally per day. RESULTS Median age at primary diagnosis was 47.9 years (range 31.9 to 76 years). 18 patients received a total of 92.8 months (median 3.03) of Erlotinib treatment and 3 patients received a total of 16.1 months (median 6.06) of Gefitinib treatment. The best responses were partial remission in one patient receiving Erlotinib and in two patients receiving Gefitinib, respectively. Median time to progression was 3.05 months. Six months after start of EGFRi treatment, 4/21 (19%) patients were progression-free and 6/21(29%) patients were alive. Expression of EGFRwt, EGFRvIII, PTEN, phospho-Akt or EGFRvIII/PTEN co-expression in tumor cells did not significantly associate with time to progression or survival time. In one patient EGFRi administration had to be discontinued due to toxicity (grade 3 rash). CONCLUSION EGFRi monotherapy is associated with therapeutic efficacy in only a small fraction of patients with malignant gliomas. Biomarkers reliably predicting tumor response to EGFRi need to be identified.
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Abstract
Increase in the expression of epidermal growth factor receptors (EGFRs) has been observed in many tumours. EGFR overexpression usually correlates with a more advanced stage of the disease, a poorer prognosis and a worse chemotherapy response. For all the aforementioned reasons, EGFR inhibition can be considered an attractive approach in cancer treatment. One strategy has been extracellular domain receptor inhibition, using monoclonal antibodies. In this review, we summarize the current status as well as what is likely to be the future use of monoclonal antibodies directed against EGFR. We have focussed on cetuximab being the most developed one. It has been mainly studied in colorectal cancer, and the major portion of this review will focus on all the research that has been carried out on this tumour. Clinical development of cetuximab is also important in head and neck cancer and in lung cancer. Interesting studies have been carried out in pancreatic, gastric, oesophageal and ovarian tumours, as well as in malignant gliomas.
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Kotliarov Y, Steed ME, Christopher N, Walling J, Su Q, Center A, Heiss J, Rosenblum M, Mikkelsen T, Zenklusen JC, Fine HA. High-resolution global genomic survey of 178 gliomas reveals novel regions of copy number alteration and allelic imbalances. Cancer Res 2007; 66:9428-36. [PMID: 17018597 PMCID: PMC4316202 DOI: 10.1158/0008-5472.can-06-1691] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Primary brain tumors are the fourth leading cause of cancer mortality in adults under the age of 54 years and the leading cause of cancer mortality in children in the United States. Therapy for the most common type of primary brain tumors, gliomas, remains suboptimal. The development of new and more effective treatments will likely require a better understanding of the biology of these tumors. Here, we show that use of the high-density 100K single-nucleotide polymorphism arrays in a large number of primary tumor samples allows for a much higher resolution survey of the glioma genome than has been previously reported in any tumor type. We not only confirmed alterations in genomic areas previously reported to be affected in gliomas, but we also refined the location of those sites and uncovered multiple, previously unknown regions that are affected by copy number alterations (amplifications, homozygous and heterozygous deletions) as well as allelic imbalances (loss of heterozygosity/gene conversions). The wealth of genomic data produced may allow for the development of a more rational molecular classification of gliomas and serve as an important starting point in the search for new molecular therapeutic targets.
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Affiliation(s)
- Yuri Kotliarov
- Neuro-Oncology Branch, National Cancer Institute, Henry Ford Hospital, Detroit, Michigan
| | - Mary Ellen Steed
- Neuro-Oncology Branch, National Cancer Institute, Henry Ford Hospital, Detroit, Michigan
| | - Neil Christopher
- Neuro-Oncology Branch, National Cancer Institute, Henry Ford Hospital, Detroit, Michigan
| | - Jennifer Walling
- Neuro-Oncology Branch, National Cancer Institute, Henry Ford Hospital, Detroit, Michigan
| | - Qin Su
- Neuro-Oncology Branch, National Cancer Institute, Henry Ford Hospital, Detroit, Michigan
| | - Angela Center
- Neuro-Oncology Branch, National Cancer Institute, Henry Ford Hospital, Detroit, Michigan
| | - John Heiss
- National Institutes of Neurological Disorder and Stroke, NIH, Bethesda, Maryland, Henry Ford Hospital, Detroit, Michigan
| | - Mark Rosenblum
- Departments of Neurology and Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Hospital, Detroit, Michigan
| | - Tom Mikkelsen
- Departments of Neurology and Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Hospital, Detroit, Michigan
| | - Jean C. Zenklusen
- Neuro-Oncology Branch, National Cancer Institute, Henry Ford Hospital, Detroit, Michigan
| | - Howard A. Fine
- Neuro-Oncology Branch, National Cancer Institute, Henry Ford Hospital, Detroit, Michigan
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Zhou H, Miki R, Eeva M, Fike FM, Seligson D, Yang L, Yoshimura A, Teitell MA, Jamieson CAM, Cacalano NA. Reciprocal regulation of SOCS 1 and SOCS3 enhances resistance to ionizing radiation in glioblastoma multiforme. Clin Cancer Res 2007; 13:2344-53. [PMID: 17438093 DOI: 10.1158/1078-0432.ccr-06-2303] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The expression of suppressors of cytokine signaling 1 (SOCS1) and SOCS3 genes is dysregulated in several solid tumors, causing aberrant activation of cell growth and survival signaling pathways. In this study, we analyzed SOCS1 and SOCS3 gene expression in glioblastoma multiforme (GBM) and studied the role of each protein in GBM cell signaling and radiation resistance. EXPERIMENTAL DESIGN SOCS1 and SOCS3 gene expression was analyzed in 10 GBM cell lines by reverse transcription-PCR and Western blotting. SOCS3 expression was also studied in 12 primary GBM tissues by immunohistochemistry. The methylation status of the SOCS1 and SOCS3 loci was determined by methylation-specific PCR. Extracellular signal-regulated kinase (ERK)-mitogen-activated protein kinase (MAPK) activation in GBM cell lines overexpressing SOCS1 or lacking SOCS3 was determined by phosphorylated-specific Western blotting. Radiation responses in SOCS1-positive and SOCS3-deficient GBM cell lines and fibroblasts from wild-type and SOCS1 or SOCS3 knockout mice were studied in a clonogenic survival assay. RESULTS All GBM cell lines tested lacked SOCS1 expression, whereas GBM cell lines and primary GBM tumor samples constitutively expressed SOCS3. SOCS1 gene repression was linked to hypermethylation of the SOCS1 genetic locus in GBM cells. Reintroduction of SOCS1 or blocking SOCS3 expression sensitized cells to radiation and decreased the levels of activated ERK MAPKs in GBM cells. CONCLUSIONS SOCS1 and SOCS3 are aberrantly expressed in GBM cell lines and primary tissues. Altered SOCS gene expression leads to increased cell signaling through the ERK-MAPK pathway and may play a role in disease pathogenesis by enhancing GBM radioresistance.
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Affiliation(s)
- Hong Zhou
- Department of Radiation Oncology, University of California at Los Angeles School of Medicine, Los Angeles, California 90095, USA
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Combs SE, Schulz-Ertner D, Roth W, Herold-Mende C, Debus J, Weber KJ. In vitro responsiveness of glioma cell lines to multimodality treatment with radiotherapy, temozolomide, and epidermal growth factor receptor inhibition with cetuximab. Int J Radiat Oncol Biol Phys 2007; 68:873-82. [PMID: 17544000 DOI: 10.1016/j.ijrobp.2007.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Revised: 03/06/2007] [Accepted: 03/07/2007] [Indexed: 11/22/2022]
Abstract
BACKGROUND The majority of glioblastoma multiforme (GBM) cells express the epidermal growth factor receptor (EGFR). The present study evaluates the combination of temozolomide (TMZ), EGFR inhibition, and radiotherapy (RT) in GBM cell lines. METHODS AND MATERIALS Human GBM cell lines U87, LN229, LN18, NCH 82, and NCH 89 were treated with various combinations of TMZ, RT, and the monoclonal EGFR antibody cetuximab. Responsiveness of glioma cells to the combination treatment was measured by clonogenic survival. RESULTS Overall, double and triple combinations of RT, TMZ, and cetuximab lead to additive cytotoxic effects (independent toxicity). A notable exception was observed for U87 and LN 18 cell lines, where the combination of TMZ and cetuximab showed substantial antagonism. Interestingly, in these two cell lines, the combination of RT with cetuximab resulted in a substantial increase in cell killing over that expected for independent toxicity. The triple combination with RT, cetuximab, and TMZ was nearly able to overcome the antagonism for the TMZ/cetuximab combination in U87, however only marginally in LN18, GBM cell lines. CONCLUSION It appears that EGFR expression is not correlated with cytotoxic effects exerted by cetuximab. Combination treatment with TMZ, cetuximab and radiation resulted in independent toxicity in three out of five cell lines evaluated, the antagonistic effect of the TMZ/cetuximab combination in two cell lines could indicate that TMZ preferentially kills cetuximab-resistant cells, suggesting for some cross-talk between toxicity mechanisms. Expression of EGFR was no surrogate marker for responsiveness to cetuximab, alone or in combination with RT and TMZ.
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Affiliation(s)
- Stephanie E Combs
- Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany.
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Sarkaria JN, Yang L, Grogan PT, Kitange GJ, Carlson BL, Schroeder MA, Galanis E, Giannini C, Wu W, Dinca EB, James CD. Identification of molecular characteristics correlated with glioblastoma sensitivity to EGFR kinase inhibition through use of an intracranial xenograft test panel. Mol Cancer Ther 2007; 6:1167-74. [PMID: 17363510 DOI: 10.1158/1535-7163.mct-06-0691] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the current study, we examined a panel of serially passaged glioblastoma xenografts, in the context of an intracranial tumor therapy response model, to identify associations between glioblastoma molecular characteristics and tumor sensitivity to the epidermal growth factor receptor (EGFR) kinase inhibitor erlotinib. From an initial evaluation of 11 distinct glioblastoma xenografts, two erlotinib-sensitive tumors were identified, each having amplified EGFR and expressing wild-type PTEN. One of these tumors expressed truncated EGFRvIII, whereas the other expressed full-length EGFR. Subsequent cDNA sequence analysis revealed the latter tumor as expressing an EGFR sequence variant with arginine, rather than leucine, at amino acid position 62; this was the only EGFR sequence variant identified among the 11 xenografts, other than the aforementioned vIII sequence variant. EGFR cDNAs were then examined from 12 more xenografts to determine whether additional missense sequence alterations were evident, and this analysis revealed one such case, expressing threonine, rather than alanine, at amino acid position 289 of the extracellular domain. This glioblastoma was also amplified for EGFR, but did not display significant erlotinib sensitivity, presumably due to its lacking PTEN expression. In total, our study identified two erlotinib-sensitive glioblastoma xenografts, with the common molecular characteristics shared by each being the expression of wild-type PTEN in combination with the expression of amplified and aberrant EGFR.
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Affiliation(s)
- Jann N Sarkaria
- Department of Neurological Surgery, University of California, San Francisco, Room HSW 792, 513 Parnassus Avenue, San Francisco, CA 94143, USA
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Abstract
Advances in the understanding of glioma pathogenesis have led to increasing interest in the development of targeted molecular agents, and especially kinase inhibitors, for treatment of malignant gliomas. Protein kinases are a large family of enzymes that function as key regulators of cellular signaling pathways governing diverse functions, such as cell proliferation, growth, differentiation, invasion, angiogenesis and apoptosis in malignant gliomas. Preliminary clinical results with kinase inhibitors suggest that they are generally well-tolerated but have shown only modest activity. However, valuable information was obtained from these early clinical trials that will help the future development of these agents. This article reviews the important protein kinases in malignant gliomas, summarizes the existing clinical development of kinase inhibitors and discusses strategies to improve their effectiveness.
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Affiliation(s)
- Andrew S Chi
- Center For Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Shields-Warren 430D, 44 Binney Street, Boston, MA 02115, USA
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