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Alsajjan R, Mason WP. Bispecific T-Cell Engagers and Chimeric Antigen Receptor T-Cell Therapies in Glioblastoma: An Update. Curr Oncol 2023; 30:8501-8549. [PMID: 37754534 PMCID: PMC10529026 DOI: 10.3390/curroncol30090619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/28/2023] Open
Abstract
Glioblastoma is the most common malignant primary brain tumor in adults. The prognosis is extremely poor even with standard treatment of maximal safe resection, radiotherapy, and chemotherapy. Recurrence is inevitable within months, and treatment options are very limited. Chimeric antigen receptor T-cell therapy (CART) and bispecific T-cell engagers (TCEs) are two emerging immunotherapies that can redirect T-cells for tumor-specific killing and have shown remarkable success in hematological malignancies and been under extensive study for application in glioblastoma. While there have been multiple clinical trials showing preliminary evidence of safety and efficacy for CART, bispecific TCEs are still in the early stages of clinical testing, with preclinical studies showing very promising results. However, there are multiple shared challenges that need to be addressed in the future, including the route of delivery, antigen escape, the immunosuppressive tumor microenvironment, and toxicity resulting from the limited choice of tumor-specific antigens. Efforts are underway to optimize the design of both these treatments and find the ideal combination therapy to overcome these challenges. In this review, we describe the work that has been performed as well as novel approaches in glioblastoma and in other solid tumors that may be applicable in the future.
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Affiliation(s)
- Roa Alsajjan
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2C1, Canada
- Division of Neurology, Department of Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Warren P. Mason
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2C1, Canada
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2
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Clavreul A, Autier L, Lemée JM, Augereau P, Soulard G, Bauchet L, Figarella-Branger D, Menei P, Network FGB. Management of Recurrent Glioblastomas: What Can We Learn from the French Glioblastoma Biobank? Cancers (Basel) 2022; 14:cancers14225510. [PMID: 36428604 PMCID: PMC9688811 DOI: 10.3390/cancers14225510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/12/2022] Open
Abstract
Safe maximal resection followed by radiotherapy plus concomitant and adjuvant temozolomide (TMZ) is universally accepted as the first-line treatment for glioblastoma (GB), but no standard of care has yet been defined for managing recurrent GB (rGB). We used the French GB biobank (FGB) to evaluate the second-line options currently used, with a view to defining the optimal approach and future directions in GB research. We retrospectively analyzed data for 338 patients with de novo isocitrate dehydrogenase (IDH)-wildtype GB recurring after TMZ chemoradiotherapy. Cox proportional hazards models and Kaplan-Meier analyses were used to investigate survival outcomes. Median overall survival after first surgery (OS1) was 19.8 months (95% CI: 18.5-22.0) and median OS after first progression (OS2) was 9.9 months (95% CI: 8.8-10.8). Two second-line options were noted for rGB patients in the FGB: supportive care and treatments, with systemic treatment being the treatment most frequently used. The supportive care option was independently associated with a shorter OS2 (p < 0.001). None of the systemic treatment regimens was unequivocally better than the others for rGB patients. An analysis of survival outcomes based on time to first recurrence (TFR) after chemoradiotherapy indicated that survival was best for patients with a long TFR (≥18 months; median OS1: 44.3 months (95% CI: 41.7-56.4) and median OS2: 13.0 months (95% CI: 11.2-17.7), but that such patients constituted only a small proportion of the total patient population (13.0%). This better survival appeared to be more strongly associated with response to first-line treatment than with response to second-line treatment, indicating that the recurring tumors were more aggressive and/or resistant than the initial tumors in these patients. In the face of high rates of treatment failure for GB, the establishment of well-designed large cohorts of primary and rGB samples, with the help of biobanks, such as the FGB, taking into account the TFR and survival outcomes of GB patients, is urgently required for solid comparative biological analyses to drive the discovery of novel prognostic and/or therapeutic clinical markers for GB.
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Affiliation(s)
- Anne Clavreul
- Département de Neurochirurgie, CHU, 49933 Angers, France
- Université d’Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCINA, F-49000 Angers, France
- Correspondence: ; Tel.: +33-241-354822; Fax: +33-241-354508
| | - Lila Autier
- Département de Neurologie, CHU, 49933 Angers, France
- Département d’Oncologie Médicale, Institut de Cancérologie de l’Ouest, Site Paul Papin, 49055 Angers, France
| | - Jean-Michel Lemée
- Département de Neurochirurgie, CHU, 49933 Angers, France
- Université d’Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCINA, F-49000 Angers, France
| | - Paule Augereau
- Département d’Oncologie Médicale, Institut de Cancérologie de l’Ouest, Site Paul Papin, 49055 Angers, France
| | | | - Luc Bauchet
- Département de Neurochirurgie, Hôpital Gui de Chauliac, CHU Montpellier, Université de Montpellier, 34295 Montpellier, France
- Institut de Génomique Fonctionnelle, CNRS, INSERM, 34295 Montpellier, France
| | - Dominique Figarella-Branger
- APHM, CHU Timone, Service d’Anatomie Pathologique et de Neuropathologie, 13385 Marseille, France
- Aix-Marseille University, CNRS, INP, Inst. Neurophysiopathol, 13005 Marseille, France
| | - Philippe Menei
- Département de Neurochirurgie, CHU, 49933 Angers, France
- Université d’Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCINA, F-49000 Angers, France
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3
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Gatto L, Di Nunno V, Franceschi E, Tosoni A, Bartolini S, Brandes AA. Pharmacotherapeutic Treatment of Glioblastoma: Where Are We to Date? Drugs 2022; 82:491-510. [PMID: 35397073 DOI: 10.1007/s40265-022-01702-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 12/30/2022]
Abstract
The clinical management of glioblastoma (GBM) is still bereft of treatments able to significantly improve the poor prognosis of the disease. Despite the extreme clinical need for novel therapeutic drugs, only a small percentage of patients with GBM benefit from inclusion in a clinical trial. Moreover, often clinical studies do not lead to final interpretable conclusions. From the mistakes and negative results obtained in the last years, we are now able to plan a novel generation of clinical studies for patients with GBM, allowing the testing of multiple anticancer agents at the same time. This assumes critical importance, considering that, thanks to improved knowledge of altered molecular mechanisms related to the disease, we are now able to propose several potential effective compounds in patients with both newly diagnosed and recurrent GBM. Among the novel compounds assessed, the initially great enthusiasm toward trials employing immune checkpoint inhibitors (ICIs) was disappointing due to the negative results that emerged in three randomized phase III trials. However, novel biological insights into the disease suggest that immunotherapy can be a convincing and effective treatment in GBM even if ICIs failed to prolong the survival of these patients. In this regard, the most promising approach consists of engineered immune cells such as chimeric antigen receptor (CAR) T, CAR M, and CAR NK alone or in combination with other treatments. In this review, we discuss several issues related to systemic treatments in GBM patients. First, we assess critical issues toward the planning of clinical trials and the strategies employed to overcome these obstacles. We then move on to the most relevant interventional studies carried out on patients with previously untreated (newly diagnosed) GBM and those with recurrent and pretreated disease. Finally, we investigate novel immunotherapeutic approaches with special emphasis on preclinical and clinical data related to the administration of engineered immune cells in GBM.
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Affiliation(s)
- Lidia Gatto
- Department of Oncology, AUSL Bologna, Bologna, Italy
| | | | - Enrico Franceschi
- Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, Bologna, Italy.
| | - Alicia Tosoni
- Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, Bologna, Italy
| | - Stefania Bartolini
- Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, Bologna, Italy
| | - Alba Ariela Brandes
- Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, Bologna, Italy
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4
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Di Nunno V, Franceschi E, Tosoni A, Gatto L, Lodi R, Bartolini S, Brandes AA. Glioblastoma: Emerging Treatments and Novel Trial Designs. Cancers (Basel) 2021; 13:cancers13153750. [PMID: 34359651 PMCID: PMC8345198 DOI: 10.3390/cancers13153750] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Nowadays, very few systemic agents have shown clinical activity in patients with glioblastoma, making the research of novel therapeutic approaches a critical issue. Fortunately, the availability of novel compounds is increasing thanks to better biological knowledge of the disease. In this review we want to investigate more promising ongoing clinical trials in both primary and recurrent GBM. Furthermore, a great interest of the present work is focused on novel trial design strategies. Abstract Management of glioblastoma is a clinical challenge since very few systemic treatments have shown clinical efficacy in recurrent disease. Thanks to an increased knowledge of the biological and molecular mechanisms related to disease progression and growth, promising novel treatment strategies are emerging. The expanding availability of innovative compounds requires the design of a new generation of clinical trials, testing experimental compounds in a short time and tailoring the sample cohort based on molecular and clinical behaviors. In this review, we focused our attention on the assessment of promising novel treatment approaches, discussing novel trial design and possible future fields of development in this setting.
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Affiliation(s)
- Vincenzo Di Nunno
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
- Correspondence: ; Tel.: +39-0516225697
| | - Enrico Franceschi
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
| | - Alicia Tosoni
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
| | - Lidia Gatto
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
| | - Raffaele Lodi
- Istituto delle Scienze Neurologiche di Bologna, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 40139 Bologna, Italy;
| | - Stefania Bartolini
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
| | - Alba Ariela Brandes
- Department of Oncology, AUSL Bologna, Via Altura 3, 40139 Bologna, Italy; (E.F.); (A.T.); (L.G.); (S.B.); (A.A.B.)
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5
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Durgin JS, Henderson F, Nasrallah MP, Mohan S, Wang S, Lacey SF, Melenhorst JJ, Desai AS, Lee JYK, Maus MV, June CH, Brem S, O'Connor RS, Binder Z, O'Rourke DM. Case Report: Prolonged Survival Following EGFRvIII CAR T Cell Treatment for Recurrent Glioblastoma. Front Oncol 2021; 11:669071. [PMID: 34026647 PMCID: PMC8138201 DOI: 10.3389/fonc.2021.669071] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/07/2021] [Indexed: 12/01/2022] Open
Abstract
Autologous chimeric antigen receptor (CAR) T cells targeted to epidermal growth factor receptor variant III (CAR T-EGFRvIII) have been developed and administered experimentally to treat patients with IDH1 wildtype recurrent glioblastoma (rGBM) (NCT02209376). We report the case of a 59-year-old patient who received a single peripheral infusion of CAR T-EGFRvIII cells and survived 36 months after disease recurrence, exceeding expected survival for recurrent glioblastoma. Post-infusion histopathologic analysis of tissue obtained during a second stage surgical resection revealed immunosuppressive adaptive changes in the tumor tissue as well as reduced EGFRvIII expression. Serial brain imaging demonstrated a significant reduction in relative cerebral blood volume (rCBV), a measure strongly associated with tumor proliferative activity, at early time points following CAR T treatment. Notably, CAR T-EGFRvIII cells persisted in her peripheral circulation during 29 months of follow-up, the longest period of CAR T persistence reported in GBM trials to date. These findings in a long-term survivor show that peripherally administered CAR T-EGFRvIII cells can persist for years in the circulation and suggest that this cell therapy approach could be optimized to achieve broader efficacy in recurrent GBM patients.
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Affiliation(s)
- Joseph S Durgin
- Glioblastoma Translational Center of Excellence, The Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.,Center for Cellular Immunotherapies, University of Pennsylvania, Philadelphia, PA, United States.,Department of Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Fraser Henderson
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, United States
| | - MacLean P Nasrallah
- Glioblastoma Translational Center of Excellence, The Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.,Department of Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Suyash Mohan
- Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Sumei Wang
- Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Simon F Lacey
- Center for Cellular Immunotherapies, University of Pennsylvania, Philadelphia, PA, United States
| | - Jan Joseph Melenhorst
- Glioblastoma Translational Center of Excellence, The Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.,Center for Cellular Immunotherapies, University of Pennsylvania, Philadelphia, PA, United States.,Department of Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Arati S Desai
- Glioblastoma Translational Center of Excellence, The Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.,Division of Hematology/Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - John Y K Lee
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Marcela V Maus
- Cellular Immunotherapy Program, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA, United States
| | - Carl H June
- Center for Cellular Immunotherapies, University of Pennsylvania, Philadelphia, PA, United States.,Department of Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Steven Brem
- Glioblastoma Translational Center of Excellence, The Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Roddy S O'Connor
- Center for Cellular Immunotherapies, University of Pennsylvania, Philadelphia, PA, United States.,Department of Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Zev Binder
- Glioblastoma Translational Center of Excellence, The Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Donald M O'Rourke
- Glioblastoma Translational Center of Excellence, The Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
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6
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Shuford S, Lipinski L, Abad A, Smith AM, Rayner M, O'Donnell L, Stuart J, Mechtler LL, Fabiano AJ, Edenfield J, Kanos C, Gardner S, Hodge P, Lynn M, Butowski NA, Han SJ, Redjal N, Crosswell HE, Vibat CRT, Holmes L, Gevaert M, Fenstermaker RA, DesRochers TM. Prospective prediction of clinical drug response in high-grade gliomas using an ex vivo 3D cell culture assay. Neurooncol Adv 2021; 3:vdab065. [PMID: 34142085 PMCID: PMC8207705 DOI: 10.1093/noajnl/vdab065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Clinical outcomes in high-grade glioma (HGG) have remained relatively unchanged over the last 3 decades with only modest increases in overall survival. Despite the validation of biomarkers to classify treatment response, most newly diagnosed (ND) patients receive the same treatment regimen. This study aimed to determine whether a prospective functional assay that provides a direct, live tumor cell-based drug response prediction specific for each patient could accurately predict clinical drug response prior to treatment. Methods A modified 3D cell culture assay was validated to establish baseline parameters including drug concentrations, timing, and reproducibility. Live tumor tissue from HGG patients were tested in the assay to establish response parameters. Clinical correlation was determined between prospective ex vivo response and clinical response in ND HGG patients enrolled in 3D-PREDICT (ClinicalTrials.gov Identifier: NCT03561207). Clinical case studies were examined for relapsed HGG patients enrolled on 3D-PREDICT, prospectively assayed for ex vivo drug response, and monitored for follow-up. Results Absent biomarker stratification, the test accurately predicted clinical response/nonresponse to temozolomide in 17/20 (85%, P = .007) ND patients within 7 days of their surgery, prior to treatment initiation. Test-predicted responders had a median overall survival post-surgery of 11.6 months compared to 5.9 months for test-predicted nonresponders (P = .0376). Case studies provided examples of the clinical utility of the assay predictions and their impact upon treatment decisions resulting in positive clinical outcomes. Conclusion This study both validates the developed assay analytically and clinically and provides case studies of its implementation in clinical practice.
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Affiliation(s)
| | - Lindsay Lipinski
- Department of Neuro-oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Ajay Abad
- Department of Neuro-oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | | | | | | | | | - Laszlo L Mechtler
- Department of Neuro-oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Andrew J Fabiano
- Department of Neuro-oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Jeff Edenfield
- Department of Medicine, Prisma Health Cancer Institute, Greenville, South Carolina, USA
| | - Charles Kanos
- Deparment of Surgery, Prisma Health Southeastern Neurosurgical and Spine Institute, Greenville, South Carolina, USA
| | - Stephen Gardner
- Deparment of Surgery, Prisma Health Southeastern Neurosurgical and Spine Institute, Greenville, South Carolina, USA
| | - Philip Hodge
- Deparment of Surgery, Prisma Health Southeastern Neurosurgical and Spine Institute, Greenville, South Carolina, USA
| | - Michael Lynn
- Deparment of Surgery, Prisma Health Southeastern Neurosurgical and Spine Institute, Greenville, South Carolina, USA
| | - Nicholas A Butowski
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Seunggu J Han
- Department of Neurological Surgery, Oregon Health Sciences University, Portland, Oregon, USA
| | - Navid Redjal
- Department of Neurosurgery, Capital Health Institute for Neurosciences, Pennington, New Jersey, USA
| | | | | | | | | | - Robert A Fenstermaker
- Department of Neuro-oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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7
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Di Nunno V, Franceschi E, Tosoni A, Di Battista M, Gatto L, Lamperini C, Minichillo S, Mura A, Bartolini S, Brandes AA. Treatment of recurrent glioblastoma: state-of-the-art and future perspectives. Expert Rev Anticancer Ther 2020; 20:785-795. [PMID: 32799576 DOI: 10.1080/14737140.2020.1807949] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Almost all patients affected by glioblastoma experience recurrence of the disease. AREAS COVERED Management of recurrent glioblastoma is a clinical challenge, and several elements should be taken into consideration when making treatment choice. Loco-regional treatments may be the best treatment approach in selected cases while systemic therapies or supportive care alone are necessary for other patients. Unfortunately, few drugs have shown clinical in this setting. This lack of effective treatments has made recurrent glioblastoma a disease orphan of an effective approach. EXPERT OPINION Results of recent clinical trials offer interesting perspectives and may controvert this axiom.
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Affiliation(s)
- Vincenzo Di Nunno
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
| | - Enrico Franceschi
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
| | - Alicia Tosoni
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
| | - Monica Di Battista
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
| | - Lidia Gatto
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
| | - Cinzia Lamperini
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
| | - Santino Minichillo
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
| | - Antonella Mura
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
| | - Stefania Bartolini
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
| | - Alba A Brandes
- Department of Medical Oncology - Azienda USL di Bologna , Bologna, Italy
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8
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Zhang J, Fan J. Prazosin inhibits the proliferation, migration and invasion, but promotes the apoptosis of U251 and U87 cells via the PI3K/AKT/mTOR signaling pathway. Exp Ther Med 2020; 20:1145-1152. [PMID: 32765662 DOI: 10.3892/etm.2020.8772] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 01/24/2020] [Indexed: 11/06/2022] Open
Abstract
Prazosin, an α-adrenergic receptor antagonist, is used to treat mild to moderate hypertension. It has recently been discovered that α-adrenergic receptors may have potential antitumor properties. Therefore, in the present study, the effect of prazosin on human glioblastoma and the underlying mechanism were investigated. Human glioblastoma U251 and U87 cells were treated with different concentrations of prazosin, and a Cell Counting Kit-8 assay was performed to investigate the effects of prazosin on cell proliferation. Transwell migration and invasion assays were used to assess the effects of prazosin on cell migration and invasion. Prazosin-induced apoptosis in U251 and U87 cells was detected by flow cytometry, and the protein expression levels of anti-apoptotic proteins and proteins related to the PI3K/AKT/mTOR signaling pathway were detected by western blotting. The results suggested that following treatment with prazosin, the proliferation, migration and invasion of U251 and U81 cells were decreased. By contrast, U251 and U81 cell apoptosis, as well as the protein expression levels of Bax and active Caspase-3 were increased after prazosin treatment (P<0.05). Bcl-2 levels were also decreased after prazosin treatment (P<0.05). Additionally, the expression of phosphorylated (p)-AKT and p-mTOR, P70 and cyclin D1 were decreased in U251 and U81 cells following prazosin treatment (P<0.05). The present study suggested that prazosin may suppress glioblastoma progression by downregulating the activity of the PI3K/AKT/mTOR signaling pathway.
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Affiliation(s)
- Jing Zhang
- Department of Pharmacy, Hebei Chemical and Pharmaceutical College, Shijiazhuang, Hebei 050026, P.R. China
| | - Jiye Fan
- Department of Pharmacy, Hebei Chemical and Pharmaceutical College, Shijiazhuang, Hebei 050026, P.R. China.,College of Life Sciences, Hebei Normal University, Shijiazhuang, Hebei 050024, P.R. China
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9
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Ahmed N, Brawley V, Hegde M, Bielamowicz K, Kalra M, Landi D, Robertson C, Gray TL, Diouf O, Wakefield A, Ghazi A, Gerken C, Yi Z, Ashoori A, Wu MF, Liu H, Rooney C, Dotti G, Gee A, Su J, Kew Y, Baskin D, Zhang YJ, New P, Grilley B, Stojakovic M, Hicks J, Powell SZ, Brenner MK, Heslop HE, Grossman R, Wels WS, Gottschalk S. HER2-Specific Chimeric Antigen Receptor-Modified Virus-Specific T Cells for Progressive Glioblastoma: A Phase 1 Dose-Escalation Trial. JAMA Oncol 2017; 3:1094-1101. [PMID: 28426845 DOI: 10.1001/jamaoncol.2017.0184] [Citation(s) in RCA: 563] [Impact Index Per Article: 80.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Glioblastoma is an incurable tumor, and the therapeutic options for patients are limited. Objective To determine whether the systemic administration of HER2-specific chimeric antigen receptor (CAR)-modified virus-specific T cells (VSTs) is safe and whether these cells have antiglioblastoma activity. Design, Setting, and Participants In this open-label phase 1 dose-escalation study conducted at Baylor College of Medicine, Houston Methodist Hospital, and Texas Children's Hospital, patients with progressive HER2-positive glioblastoma were enrolled between July 25, 2011, and April 21, 2014. The duration of follow-up was 10 weeks to 29 months (median, 8 months). Interventions Monotherapy with autologous VSTs specific for cytomegalovirus, Epstein-Barr virus, or adenovirus and genetically modified to express HER2-CARs with a CD28.ζ-signaling endodomain (HER2-CAR VSTs). Main Outcomes and Measures Primary end points were feasibility and safety. The key secondary end points were T-cell persistence and their antiglioblastoma activity. Results A total of 17 patients (8 females and 9 males; 10 patients ≥18 years [median age, 60 years; range, 30-69 years] and 7 patients <18 years [median age, 14 years; range, 10-17 years]) with progressive HER2-positive glioblastoma received 1 or more infusions of autologous HER2-CAR VSTs (1 × 106/m2 to 1 × 108/m2) without prior lymphodepletion. Infusions were well tolerated, with no dose-limiting toxic effects. HER2-CAR VSTs were detected in the peripheral blood for up to 12 months after the infusion by quantitative real-time polymerase chain reaction. Of 16 evaluable patients (9 adults and 7 children), 1 had a partial response for more than 9 months, 7 had stable disease for 8 weeks to 29 months, and 8 progressed after T-cell infusion. Three patients with stable disease are alive without any evidence of progression during 24 to 29 months of follow-up. For the entire study cohort, median overall survival was 11.1 months (95% CI, 4.1-27.2 months) from the first T-cell infusion and 24.5 months (95% CI, 17.2-34.6 months) from diagnosis. Conclusions and Relevance Infusion of autologous HER2-CAR VSTs is safe and can be associated with clinical benefit for patients with progressive glioblastoma. Further evaluation of HER2-CAR VSTs in a phase 2b study is warranted as a single agent or in combination with other immunomodulatory approaches for glioblastoma.
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Affiliation(s)
- Nabil Ahmed
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Vita Brawley
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Meenakshi Hegde
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Kevin Bielamowicz
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,now with Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Mamta Kalra
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,now with Immatics, Houston, Texas
| | - Daniel Landi
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Catherine Robertson
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston
| | - Tara L Gray
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston
| | - Oumar Diouf
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,now with Cell Medica, Houston, Texas
| | - Amanda Wakefield
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Alexia Ghazi
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,now with Baylor University Medical Center, Dallas, Texas
| | - Claudia Gerken
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Zhongzhen Yi
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Aidin Ashoori
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,now with Columbia University Medical Center, New York, New York
| | - Meng-Fen Wu
- Biostatistics Shared Resource Dan L Duncan Center, Baylor College of Medicine, Houston, Texas
| | - Hao Liu
- Biostatistics Shared Resource Dan L Duncan Center, Baylor College of Medicine, Houston, Texas
| | - Cliona Rooney
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Gianpietro Dotti
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas.,now with Department of Microbiology and Immunology, University of North Carolina, Chapel Hill
| | - Adrian Gee
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jack Su
- Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Yvonne Kew
- Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas
| | - David Baskin
- Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas
| | - Yi Jonathan Zhang
- Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas
| | - Pamela New
- Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas
| | - Bambi Grilley
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Milica Stojakovic
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - John Hicks
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Suzanne Z Powell
- Department of Pathology, Houston Methodist Hospital, Houston, Texas.,Department of Medicine, Houston Methodist Hospital, Houston, Texas
| | - Malcolm K Brenner
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Helen E Heslop
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Robert Grossman
- Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas
| | - Winfried S Wels
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt, Germany
| | - Stephen Gottschalk
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
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