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Nagaraja TN, Elmghirbi R, Brown SL, Rey JA, Schultz L, Mukherjee A, Cabral G, Panda S, Lee IY, Sarntinoranont M, Keenan KA, Knight RA, Ewing JR. Imaging acute effects of bevacizumab on tumor vascular kinetics in a preclinical orthotopic model of U251 glioma. NMR IN BIOMEDICINE 2021; 34:e4516. [PMID: 33817893 PMCID: PMC8978145 DOI: 10.1002/nbm.4516] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 05/05/2023]
Abstract
The effect of a human vascular endothelial growth factor antibody on the vasculature of human tumor grown in rat brain was studied. Using dynamic contrast-enhanced magnetic resonance imaging, the effects of intravenous bevacizumab (Avastin; 10 mg/kg) were examined before and at postadministration times of 1, 2, 4, 8, 12 and 24 h (N = 26; 4-5 per time point) in a rat model of orthotopic, U251 glioblastoma (GBM). The commonly estimated vascular parameters for an MR contrast agent were: (i) plasma distribution volume (vp ), (ii) forward volumetric transfer constant (Ktrans ) and (iii) reverse transfer constant (kep ). In addition, extracellular distribution volume (VD ) was estimated in the tumor (VD-tumor ), tumor edge (VD-edge ) and the mostly normal tumor periphery (VD-peri ), along with tumor blood flow (TBF), peri-tumoral hydraulic conductivity (K) and interstitial flow (Flux) and tumor interstitial fluid pressure (TIFP). Studied as % changes from baseline, the 2-h post-treatment time point began showing significant decreases in vp , VD-tumor, VD-edge and VD-peri , as well as K, with these changes persisting at 4 and 8 h in vp , K, VD-tumor, -edge and -peri (t-tests; p < 0.05-0.01). Decreases in Ktrans were observed at the 2- and 4-h time points (p < 0.05), while interstitial volume fraction (ve ; = Ktrans /kep ) showed a significant decrease only at the 2-h time point (p < 0.05). Sustained decreases in Flux were observed from 2 to 24 h (p < 0.01) while TBF and TIFP showed delayed responses, increases in the former at 12 and 24 h and a decrease in the latter only at 12 h. These imaging biomarkers of tumor vascular kinetics describe the short-term temporal changes in physical spaces and fluid flows in a model of GBM after Avastin administration.
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Affiliation(s)
| | - Rasha Elmghirbi
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA
- Department of Physics, Oakland University, Rochester, Michigan, USA
| | - Stephen L. Brown
- Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Julian A. Rey
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida, USA
| | - Lonni Schultz
- Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Abir Mukherjee
- Department of Pathology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Glauber Cabral
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Swayamprava Panda
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Ian Y. Lee
- Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Malisa Sarntinoranont
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida, USA
| | - Kelly A. Keenan
- Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Robert A. Knight
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA
- Department of Physics, Oakland University, Rochester, Michigan, USA
| | - James R. Ewing
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA
- Department of Physics, Oakland University, Rochester, Michigan, USA
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
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Ghosh D, Funk CC, Caballero J, Shah N, Rouleau K, Earls JC, Soroceanu L, Foltz G, Cobbs CS, Price ND, Hood L. A Cell-Surface Membrane Protein Signature for Glioblastoma. Cell Syst 2017; 4:516-529.e7. [PMID: 28365151 DOI: 10.1016/j.cels.2017.03.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 09/08/2016] [Accepted: 03/03/2017] [Indexed: 02/08/2023]
Abstract
We present a systems strategy that facilitated the development of a molecular signature for glioblastoma (GBM), composed of 33 cell-surface transmembrane proteins. This molecular signature, GBMSig, was developed through the integration of cell-surface proteomics and transcriptomics from patient tumors in the REMBRANDT (n = 228) and TCGA datasets (n = 547) and can separate GBM patients from control individuals with a Matthew's correlation coefficient value of 0.87 in a lock-down test. Functionally, 17/33 GBMSig proteins are associated with transforming growth factor β signaling pathways, including CD47, SLC16A1, HMOX1, and MRC2. Knockdown of these genes impaired GBM invasion, reflecting their role in disease-perturbed changes in GBM. ELISA assays for a subset of GBMSig (CD44, VCAM1, HMOX1, and BIGH3) on 84 plasma specimens from multiple clinical sites revealed a high degree of separation of GBM patients from healthy control individuals (area under the curve is 0.98 in receiver operating characteristic). In addition, a classifier based on these four proteins differentiated the blood of pre- and post-tumor resections, demonstrating potential clinical value as biomarkers.
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Affiliation(s)
| | - Cory C Funk
- Institute for Systems Biology, Seattle, WA 98109, USA
| | | | - Nameeta Shah
- The Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment, Swedish Neuroscience Institute, Seattle, WA 98122, USA
| | | | - John C Earls
- Institute for Systems Biology, Seattle, WA 98109, USA; Department of Computer Science and Engineering, University of Washington, Seattle, WA 98195, USA
| | - Liliana Soroceanu
- California Pacific Medical Center Research Institute, San Francisco, CA 94107, USA
| | - Greg Foltz
- The Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment, Swedish Neuroscience Institute, Seattle, WA 98122, USA
| | - Charles S Cobbs
- The Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment, Swedish Neuroscience Institute, Seattle, WA 98122, USA
| | - Nathan D Price
- Institute for Systems Biology, Seattle, WA 98109, USA; Department of Computer Science and Engineering, University of Washington, Seattle, WA 98195, USA
| | - Leroy Hood
- Institute for Systems Biology, Seattle, WA 98109, USA.
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Burger MC, Zeiner PS, Jahnke K, Wagner M, Mittelbronn M, Steinbach JP. Addition of Anti-Angiogenetic Therapy with Bevacizumab to Chemo- and Radiotherapy for Leptomeningeal Metastases in Primary Brain Tumors. PLoS One 2016; 11:e0155315. [PMID: 27253224 PMCID: PMC4890753 DOI: 10.1371/journal.pone.0155315] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/27/2016] [Indexed: 12/11/2022] Open
Abstract
Leptomeningeal dissemination of a primary brain tumor is a condition which is challenging to treat, as it often occurs in rather late disease stages in highly pretreated patients. Its prognosis is dismal and there is still no accepted standard of care. We report here a good clinical effect with a partial response in three out of nine patients and a stable disease with improvement on symptoms in two more patients following systemic anti-angiogenic treatment with bevacizumab (BEV) alone or in combination with chemo- and/or radiotherapy in a series of patients with leptomeningeal dissemination from primary brain tumors (diffuse astrocytoma WHO°II, anaplastic astrocytoma WHO°III, anaplastic oligodendroglioma WHO°III, primitive neuroectodermal tumor and glioblastoma, both WHO°IV). This translated into effective symptom control in five out of nine patients, but only moderate progression-free and overall survival times were reached. Partial responses as assessed by RANO criteria were observed in three patients (each one with anaplastic oligodendroglioma, primitive neuroectodermal tumor and glioblastoma). In these patients progression-free survival (PFS) intervals of 17, 10 and 20 weeks were achieved. In three patients (each one with diffuse astrocytoma, anaplastic astrocytoma and primitive neuroectodermal tumor) stable disease was observed with PFS of 13, 30 and 8 weeks. Another three patients (all with glioblastoma) were primary non-responders and deteriorated rapidly with PFS of 3 to 4 weeks. No severe adverse events were seen. These experiences suggest that the combination of BEV with more conventional therapy schemes with chemo- and/or radiotherapy may be a palliative treatment option for patients with leptomeningeal dissemination of brain tumors.
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Affiliation(s)
- Michael C. Burger
- Dr. Senckenberg Institute of Neurooncology, Goethe University, Frankfurt, Germany
- * E-mail:
| | - Pia S. Zeiner
- Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany
- Department of Neurology, Goethe University, Frankfurt, Germany
| | - Kolja Jahnke
- Department of Neurology, Goethe University, Frankfurt, Germany
| | - Marlies Wagner
- Institute of Neuroradiology, Goethe University, Frankfurt, Germany
| | - Michel Mittelbronn
- Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany
| | - Joachim P. Steinbach
- Dr. Senckenberg Institute of Neurooncology, Goethe University, Frankfurt, Germany
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Abstract
This article provides an overview of the key considerations for the development and application of molecular imaging agents for brain tumors and the major classes of PET tracers that have been used for imaging brain tumors in humans. The mechanisms of uptake, biological implications, primary applications, and limitations of PET tracers in neuro-oncology are reviewed. The available data indicate that several of these classes of tracers, including radiolabeled amino acids, have imaging properties superior to those of (18)F-fluorodeoxyglucose, and can complement contrast-enhanced magnetic resonance imaging in the evaluation of brain tumors.
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Chaudhry A, Benson L, Varshaver M, Farber O, Weinberg U, Kirson E, Palti Y. NovoTTF™-100A System (Tumor Treating Fields) transducer array layout planning for glioblastoma: a NovoTAL™ system user study. World J Surg Oncol 2015; 13:316. [PMID: 26558989 PMCID: PMC4642621 DOI: 10.1186/s12957-015-0722-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/26/2015] [Indexed: 11/28/2022] Open
Abstract
Background Optune™, previously known as the NovoTTF-100A System™, generates Tumor Treating Fields (TTFields), an effective anti-mitotic therapy for glioblastoma. The system delivers intermediate frequency, alternating electric fields to the supratentorial brain. Patient therapy is personalized by configuring transducer array layout placement on the scalp to the tumor site using MRI measurements and the NovoTAL System. Transducer array layout mapping optimizes therapy by maximizing electric field intensity to the tumor site. This study evaluated physician performance in conducting transducer array layout mapping using the NovoTAL System compared with mapping performed by the Novocure in-house clinical team. Methods Fourteen physicians (7 neuro-oncologists, 4 medical oncologists, and 3 neurosurgeons) evaluated five blinded cases of recurrent glioblastoma and performed head size and tumor location measurements using a standard Digital Imaging and Communications in Medicine reader. Concordance with Novocure measurement and intra- and inter-rater reliability were assessed using relevant correlation coefficients. The study criterion for success was a concordance correlation coefficient (CCC) >0.80. Results CCC for each physician versus Novocure on 20 MRI measurements was 0.96 (standard deviation, SD ± 0.03, range 0.90–1.00), indicating very high agreement between the two groups. Intra- and inter-rater reliability correlation coefficients were similarly high: 0.83 (SD ±0.15, range 0.54–1.00) and 0.80 (SD ±0.18, range 0.48–1.00), respectively. Conclusions This user study demonstrated an excellent level of concordance between prescribing physicians and Novocure in-house clinical teams in performing transducer array layout planning. Intra-rater reliability was very high, indicating reproducible performance. Physicians prescribing TTFields, when trained on the NovoTAL System, can independently perform transducer array layout mapping required for the initiation and maintenance of patients on TTFields therapy.
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Affiliation(s)
| | - Laura Benson
- Medical Affairs, Novocure Ltd., New York, NY, USA.
| | - Michael Varshaver
- Technical Operations, Novocure Ltd., 195 Commerce Way, Portsmouth, NH, USA.
| | - Ori Farber
- Research and Development, Novocure Ltd., Topaz Building, 4th Floor, MATAM Center, PO Box 15022, Sha'ar HaCarmel, Haifa, Israel.
| | - Uri Weinberg
- Clinical Development, Novocure Ltd., Park 6, CH-6039 Root D4, Lucerne, Switzerland.
| | - Eilon Kirson
- Research and Development, Novocure Ltd., Topaz Building, 4th Floor, MATAM Center, PO Box 15022, Sha'ar HaCarmel, Haifa, Israel.
| | - Yoram Palti
- Research and Development, Novocure Ltd., Topaz Building, 4th Floor, MATAM Center, PO Box 15022, Sha'ar HaCarmel, Haifa, Israel.
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Tang Z, Araysi LM, Fathallah-Shaykh HM. c-Src and neural Wiskott-Aldrich syndrome protein (N-WASP) promote low oxygen-induced accelerated brain invasion by gliomas. PLoS One 2013; 8:e75436. [PMID: 24069415 PMCID: PMC3777891 DOI: 10.1371/journal.pone.0075436] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 08/16/2013] [Indexed: 11/22/2022] Open
Abstract
Malignant gliomas remain associated with poor prognosis and high morbidity because of their ability to invade the brain; furthermore, human gliomas exhibit a phenotype of accelerated brain invasion in response to anti-angiogenic drugs. Here, we study 8 human glioblastoma cell lines; U251, U87, D54 and LN229 show accelerated motility in low ambient oxygen. Src inhibition by Dasatinib abrogates this phenotype. Molecular discovery and validation studies evaluate 46 molecules related to motility or the src pathway in U251 cells. Demanding that the molecular changes induced by low ambient oxygen are reversed by Dasatinib in U251 cells, identifies neural Wiskott-Aldrich syndrome protein (NWASP), Focal adhesion Kinase (FAK), -Catenin, and Cofilin. However, only Src-mediated NWASP phosphorylation distinguishes the four cell lines that exhibit enhanced motility in low ambient oxygen. Downregulating c-Src or NWASP by RNA interference abrogates the low-oxygen-induced enhancement in motility by in vitro assays and in organotypic brain slice cultures. The findings support the idea that c-Src and NWASP play key roles in mediating the molecular pathogenesis of low oxygen-induced accelerated brain invasion by gliomas.
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Affiliation(s)
- Zhuo Tang
- Department of Neurology, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Lita M. Araysi
- Department of Neurology, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Hassan M Fathallah-Shaykh
- Department of Neurology, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Department of Mathematics, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Department of Mechanical Engineering, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- The UAB Comprehensive Neuroscience Center, Birmingham, Alabama, United States of America
- The UAB Comprehensive Cancer Center, Birmingham, Alabama, United States of America
- * E-mail:
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Kieran MW, Kalluri R, Cho YJ. The VEGF pathway in cancer and disease: responses, resistance, and the path forward. Cold Spring Harb Perspect Med 2012; 2:a006593. [PMID: 23209176 DOI: 10.1101/cshperspect.a006593] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Antiangiogenesis was proposed as a novel target for the treatment of cancer 40 years ago. Since the original hypothesis put forward by Judah Folkman in 1971, factors that mediate angiogenesis, their cellular targets, many of the pathways they signal, and inhibitors of the cytokines and receptors have been identified. Vascular endothelial growth factor (VEGF) is the most prominent among the angiogenic cytokines and is believed to play a central role in the process of neovascularization, both in cancer as well as other inflammatory diseases. This article reviews the biology of VEGF and its receptors, the use of anti-VEGF approaches in clinical disease, the toxicity of these therapies, and the resistance mechanisms that have limited the activity of these agents when used as monotherapy.
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Affiliation(s)
- Mark W Kieran
- Department of Pediatric Medical Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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Sweet JA, Feinberg ML, Sherman JH. The role of avastin in the management of recurrent glioblastoma. Neurosurg Clin N Am 2012; 23:331-41, x. [PMID: 22440876 DOI: 10.1016/j.nec.2012.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Glioblastoma multiforme is a malignant primary brain tumor for which no cure has been developed. However, with aggressive surgical resection, radiation, and the advent of temozolomide, the overall survival of patients with glioblastomas has improved significantly. Despite this multimodal treatment, glioblastoma invariably recurs. Although treatment options for glioblastoma recurrence are limited, one promising therapy is bevacizumab (Avastin). The role of Avastin in the management of recurrent glioblastomas is reviewed.
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Affiliation(s)
- Jennifer A Sweet
- Department of Neurological Surgery, George Washington University Medical Center, 2150 Pennsylvania Avenue, Northwest Suite 7420, Washington, DC 20037, USA
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Grabner G, Nöbauer I, Elandt K, Kronnerwetter C, Woehrer A, Marosi C, Prayer D, Trattnig S, Preusser M. Longitudinal brain imaging of five malignant glioma patients treated with bevacizumab using susceptibility-weighted magnetic resonance imaging at 7 T. Magn Reson Imaging 2011; 30:139-47. [PMID: 21982163 DOI: 10.1016/j.mri.2011.08.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 08/04/2011] [Indexed: 11/26/2022]
Abstract
Malignant glioma is a rare tumor type characterized by prominent vascular proliferation. Antiangiogenic therapy with the monoclonal antibody bevacizumab is considered as a promising therapeutic strategy, although the effect on tumor vascularization is unclear. High-field susceptibility-weighted imaging (SWI) visualizes the microvasculature and may contribute to the investigation of antiangiogenic therapy responses in gliomas. We prospectively studied five adult malignant glioma patients treated with bevacizumab-containing regimens. In each patient, we performed three 7-T SWI and T1-weighted imaging investigations (baseline and 2 and 4 weeks after the start of bevacizumab treatment). In addition, we imaged a postmortem brain of a patient with glioblastoma using 7-T SWI and performed detailed histopathological analysis. We observed almost total resolution of brain edema in three of five patients after initiation of bevacizumab therapy. In one case with rapid increase of the lesion size despite bevacizumab therapy, SWI showed progressive increase of irregular hypointense structures, most likely corresponding to increasing amounts of pathological microvasculature. In one case with progressive neurological decline, 7-T images showed multiple intratumoral microhemorrhages after the first bevacizumab application. Correlation of postmortem neuroimaging with histopathology confirmed that SWI-positive structures correspond to tumor vasculature. The experience from our case series indicates that longitudinal 7-T SWI seems to be an appropriate method for investigation of changes in brain tumor vascularization over time under antiangiogenic therapy.
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Affiliation(s)
- Günther Grabner
- Department of Radiology, Medical University of Vienna, A-1090 Vienna, Austria
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