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New Avenues in Radiotherapy of Glioblastoma: from Bench to Bedside. Curr Treat Options Neurol 2020. [DOI: 10.1007/s11940-020-00654-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rotkopf LT, Wiestler B, Preibisch C, Liesche-Starnecker F, Pyka T, Nörenberg D, Bette S, Gempt J, Thierfelder KM, Zimmer C, Huber T. The wavelet power spectrum of perfusion weighted MRI correlates with tumor vascularity in biopsy-proven glioblastoma samples. PLoS One 2020; 15:e0228030. [PMID: 31971966 PMCID: PMC6977746 DOI: 10.1371/journal.pone.0228030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 01/06/2020] [Indexed: 01/16/2023] Open
Abstract
Background Wavelet transformed reconstructions of dynamic susceptibility contrast (DSC) MR perfusion (wavelet-MRP) are a new and elegant way of visualizing vascularization. Wavelet-MRP maps yield a clear depiction of hypervascular tumor regions, as recently shown. Objective The aim of this study was to elucidate a possible connection of the wavelet-MRP power spectrum in glioblastoma (GBM) with local vascularity and cell proliferation. Methods For this IRB-approved study 12 patients (63.0+/-14.9y; 7m) with histologically confirmed IDH-wildtype GBM were included. Target regions for biopsies were prospectively marked on tumor regions as seen on preoperative 3T MRI. During subsequent neurosurgical tumor resection 43 targeted biopsies were taken from these target regions, of which all 27 matching samples were analyzed. All specimens were immunohistochemically analyzed for endothelial cell marker CD31 and proliferation marker Ki67 and correlated to the wavelet-MRP power spectrum as derived from DSC perfusion weighted imaging. Results There was a strong correlation between wavelet-MRP power spectrum (median = 4.41) and conventional relative cerebral blood volume (median = 5.97 ml/100g) in Spearman's rank-order correlation (κ = .83, p < .05). In a logistic regression model, the wavelet-MRP power spectrum showed a significant correlation to CD31 dichotomized to no or present staining (p = .04), while rCBV did not show a significant correlation to CD31 (p = .30). No significant association between Ki67 and rCBV or wavelet-MRP was found (p = .62 and p = .70, respectively). Conclusion The wavelet-MRP power spectrum derived from existing DSC-MRI data might be a promising new surrogate for tumor vascularity in GBM.
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Affiliation(s)
- Lukas T. Rotkopf
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
- * E-mail:
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Christine Preibisch
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | | | - Thomas Pyka
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Dominik Nörenberg
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stefanie Bette
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Universitaetsklinikum Augsburg, Augsburg, Germany
| | - Jens Gempt
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Kolja M. Thierfelder
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Thomas Huber
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Lopes-Ventura S, Pojo M, Matias AT, Moura MM, Marques IJ, Leite V, Cavaco BM. The efficacy of HRAS and CDK4/6 inhibitors in anaplastic thyroid cancer cell lines. J Endocrinol Invest 2019; 42:527-540. [PMID: 30191474 DOI: 10.1007/s40618-018-0947-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 08/11/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Anaplastic thyroid carcinomas (ATCs) are non-responsive to multimodal therapy, representing one of the major challenges in thyroid cancer. Previously, our group has shown that genes involved in cell cycle are deregulated in ATCs, and the most common mutations in these tumours occurred in cell proliferation and cell cycle related genes, namely TP53, RAS, CDKN2A and CDKN2B, making these genes potential targets for ATCs treatment. Here, we investigated the inhibition of HRAS by tipifarnib (TIP) and cyclin D-cyclin-dependent kinase 4/6 (CDK4/6) by palbociclib (PD), in ATC cells. METHODS ATC cell lines, mutated or wild type for HRAS, CDKN2A and CDKN2B genes, were used and the cytotoxic effects of PD and TIP in each cell line were evaluated. Half maximal inhibitory concentration (IC50) values were determined for these drugs and its effects on cell cycle, cell death and cell proliferation were subsequently analysed. RESULTS Cell culture studies demonstrated that 0.1 µM TIP induced cell cycle arrest in the G2/M phase (50%, p < 0.01), cell death, and inhibition of cell viability (p < 0.001), only in the HRAS mutated cell line. PD lowest concentration (0.1 µM) increased significantly cell cycle arrest in the G0/G1 phase (80%, p < 0.05), but only in ATC cell lines with alterations in CDKN2A/CDKN2B genes; additionally, 0.5 µM PD induced cell death. The inhibition of cell viability by PD was more pronounced in cells with alterations in CDKN2A/CDKN2B genes (p < 0.05) and/or cyclin D1 overexpression. CONCLUSIONS This study suggests that TIP and PD, which are currently in clinical trials for other types of cancer, may play a relevant role in ATC treatment, depending on the specific tumour molecular profile.
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Affiliation(s)
- S Lopes-Ventura
- Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal
| | - M Pojo
- Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal
| | - A T Matias
- Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal
| | - M M Moura
- Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal
| | - I J Marques
- Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal
- Centro de Estudos de Doenças Crónicas (CEDOC), Rua Câmara Pestana nº 6, 6-A, Edifício CEDOC II, 1150-082, Lisbon, Portugal
- NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056, Lisbon, Portugal
| | - V Leite
- Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal
- Serviço de Endocrinologia, Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal
- NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056, Lisbon, Portugal
| | - B M Cavaco
- Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023, Lisbon, Portugal.
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Huber T, Rotkopf L, Wiestler B, Kunz WG, Bette S, Gempt J, Preibisch C, Ricke J, Zimmer C, Kirschke JS, Sommer WH, Thierfelder KM. Wavelet-based reconstruction of dynamic susceptibility MR-perfusion: a new method to visualize hypervascular brain tumors. Eur Radiol 2018; 29:2669-2676. [PMID: 30552476 DOI: 10.1007/s00330-018-5892-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 10/16/2018] [Accepted: 11/14/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Parameter maps based on wavelet-transform post-processing of dynamic perfusion data offer an innovative way of visualizing blood vessels in a fully automated, user-independent way. The aims of this study were (i) a proof of concept regarding wavelet-based analysis of dynamic susceptibility contrast (DSC) MRI data and (ii) to demonstrate advantages of wavelet-based measures compared to standard cerebral blood volume (CBV) maps in patients with the initial diagnosis of glioblastoma (GBM). METHODS Consecutive 3-T DSC MRI datasets of 46 subjects with GBM (mean age 63.0 ± 13.1 years, 28 m) were retrospectively included in this feasibility study. Vessel-specific wavelet magnetic resonance perfusion (wavelet-MRP) maps were calculated using the wavelet transform (Paul wavelet, order 1) of each voxel time course. Five different aspects of image quality and tumor delineation were each qualitatively rated on a 5-point Likert scale. Quantitative analysis included image contrast and contrast-to-noise ratio. RESULTS Vessel-specific wavelet-MRP maps could be calculated within a mean time of 2:27 min. Wavelet-MRP achieved higher scores compared to CBV in all qualitative ratings: tumor depiction (4.02 vs. 2.33), contrast enhancement (3.93 vs. 2.23), central necrosis (3.86 vs. 2.40), morphologic correlation (3.87 vs. 2.24), and overall impression (4.00 vs. 2.41); all p < .001. Quantitative image analysis showed a better image contrast and higher contrast-to-noise ratios for wavelet-MRP compared to conventional perfusion maps (all p < .001). CONCLUSIONS wavelet-MRP is a fast and fully automated post-processing technique that yields reproducible perfusion maps with a clearer vascular depiction of GBM compared to standard CBV maps. KEY POINTS • Wavelet-MRP offers high-contrast perfusion maps with a clear delineation of focal perfusion alterations. • Both image contrast and visual image quality were beneficial for wavelet-MRP compared to standard perfusion maps like CBV. • Wavelet-MRP can be automatically calculated from existing dynamic susceptibility contrast (DSC) perfusion data.
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Affiliation(s)
- Thomas Huber
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
| | - Lukas Rotkopf
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Benedikt Wiestler
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Wolfgang G Kunz
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Stefanie Bette
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Jens Gempt
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Christine Preibisch
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Claus Zimmer
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Jan S Kirschke
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Wieland H Sommer
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Kolja M Thierfelder
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,Institute of Diagnostic and Interventional Radiology, University Medicine Rostock, Schillingallee 35, 18057, Rostock, Germany
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Peyraga G, Robaine N, Khalifa J, Cohen-Jonathan-Moyal E, Payoux P, Laprie A. Molecular PET imaging in adaptive radiotherapy: brain. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2018; 62:337-348. [PMID: 30497232 DOI: 10.23736/s1824-4785.18.03116-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Owing to their heterogeneity and radioresistance, the prognosis of primitive brain tumors, which are mainly glial tumors, remains poor. Dose escalation in radioresistant areas is a potential issue for improving local control and overall survival. This review focuses on advances in biological and metabolic imaging of brain tumors that are proving to be essential for defining tumor target volumes in radiation therapy (RT) and for increasing the use of DPRT (dose painting RT) and ART (adaptative RT), to optimize dose in radio-resistant areas. EVIDENCE ACQUISITION Various biological imaging modalities such as PET (hypoxia, glucidic metabolism, protidic metabolism, cellular proliferation, inflammation, cellular membrane synthesis) and MRI (spectroscopy) may be used to identify these areas of radioresistance. The integration of these biological imaging modalities improves the diagnosis, prognosis and treatment of brain tumors. EVIDENCE SYNTHESIS Technological improvements (PET and MRI), the development of research, and intensive cooperation between different departments are necessary before using daily metabolic imaging (PET and MRI) to treat patients with brain tumors. CONCLUSIONS The adaptation of treatment volumes during RT (ART) seems promising, but its development requires improvements in several areas and an interdisciplinary approach involving radiology, nuclear medicine and radiotherapy. We review the literature on biological imaging to outline the perspectives for using DPRT and ART in brain tumors.
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Affiliation(s)
- Guillaume Peyraga
- Department of Radiation Therapy, Claudius Regaud Institute, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Nesrine Robaine
- Department of Nuclear Medicine, Claudius Regaud Institute, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Jonathan Khalifa
- Department of Radiation Therapy, Claudius Regaud Institute, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.,Paul Sabatier University, Toulouse III, Toulouse, France
| | - Elizabeth Cohen-Jonathan-Moyal
- Department of Radiation Therapy, Claudius Regaud Institute, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.,Paul Sabatier University, Toulouse III, Toulouse, France
| | - Pierre Payoux
- Department of Nuclear Medicine, Purpan University Hospital Center, Toulouse, France
| | - Anne Laprie
- Department of Radiation Therapy, Claudius Regaud Institute, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France - .,Paul Sabatier University, Toulouse III, Toulouse, France
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Li W, Quan YY, Li Y, Lu L, Cui M. Monitoring of tumor vascular normalization: the key points from basic research to clinical application. Cancer Manag Res 2018; 10:4163-4172. [PMID: 30323672 PMCID: PMC6175544 DOI: 10.2147/cmar.s174712] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Tumor vascular normalization alleviates hypoxia in the tumor microenvironment, reduces the degree of malignancy, and increases the efficacy of traditional therapy. However, the time window for vascular normalization is narrow; therefore, how to determine the initial and final points of the time window accurately is a key factor in combination therapy. At present, the gold standard for detecting the normalization of tumor blood vessels is histological staining, including tumor perfusion, microvessel density (MVD), vascular morphology, and permeability. However, this detection method is almost unrepeatable in the same individual and does not dynamically monitor the trend of the time window; therefore, finding a relatively simple and specific monitoring index has important clinical significance. Imaging has long been used to assess changes in tumor blood vessels and tumor changes caused by the oxygen environment in clinical practice; some preclinical and clinical research studies demonstrate the feasibility to assess vascular changes, and some new methods were in preclinical research. In this review, we update the most recent insights of evaluating tumor vascular normalization.
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Affiliation(s)
- Wei Li
- Department of General Surgery, Zhuhai People's Hospital, Jinan University, Zhuhai, Guangdong, People's Republic of China,
| | - Ying-Yao Quan
- Department of Precision Medical Center, Zhuhai People's Hospital, Jinan University, Zhuhai, Guangdong, People's Republic of China
| | - Yong Li
- Department of Intervention, Zhuhai People's Hospital, Jinan University, Zhuhai, Guangdong, People's Republic of China,
| | - Ligong Lu
- Department of Intervention, Zhuhai People's Hospital, Jinan University, Zhuhai, Guangdong, People's Republic of China,
| | - Min Cui
- Department of General Surgery, Zhuhai People's Hospital, Jinan University, Zhuhai, Guangdong, People's Republic of China,
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Coquery N, Serduc R, Rémy C, Barbier EL, Lemasson B. Cluster versus ROI analysis to assess combined antiangiogenic therapy and radiotherapy in the F98 rat-glioma model. NMR IN BIOMEDICINE 2018; 31:e3933. [PMID: 29863805 DOI: 10.1002/nbm.3933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/20/2018] [Accepted: 03/22/2018] [Indexed: 06/08/2023]
Abstract
For glioblastoma (GBM), current therapeutic approaches focus on the combination of several therapies, each of them individually approved for GBM or other tumor types. Many efforts are made to decipher the best sequence of treatments that would ultimately promote the most efficient tumor response. There is therefore a strong interest in developing new clinical in vivo imaging procedures that can rapidly detect treatment efficacy and allow individual modulation of the treatment. In this preclinical study, we propose to evaluate tumor tissue changes under combined therapies, tumor vascular normalization under antiangiogenic treatment followed by radiotherapy, using a voxel-based clustering approach. This approach was applied to a rat model of glioma (F98). Six MRI parameters were mapped: apparent diffusion coefficient, vessel wall permeability, cerebral blood volume fraction, cerebral blood flow, tissue oxygen saturation and vessel size index. We compared the classical region of interest (ROI)-based analysis with a cluster-based analysis. Five clusters, defined by their MRI features, were sufficient to characterize tumor progression and tumor changes during treatments. These results suggest that the cluster-based analysis was as efficient as the ROI-based analysis to assess tumor physiological changes during treatment, but also gave additional information regarding the voxels impacted by treatments and their localization within the tumor. Overall, cluster-based analysis appears to be a powerful tool for subtle monitoring of tumor changes during combined therapies.
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Affiliation(s)
- Nicolas Coquery
- Université Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
- Inserm, U1216, Grenoble, France
- INRA, INSERM, Université Rennes, Nutrition Metabolisms and Cancer (NuMeCan), Rennes, France
| | - Raphael Serduc
- Rayonnement synchrotron et Recherche médicale, Université Grenoble Alpes, EA, Grenoble, France
| | - Chantal Rémy
- Université Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
- Inserm, U1216, Grenoble, France
| | - Emmanuel Luc Barbier
- Université Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
- Inserm, U1216, Grenoble, France
| | - Benjamin Lemasson
- Université Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
- Inserm, U1216, Grenoble, France
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Comparison between perfusion computed tomography and dynamic contrast-enhanced magnetic resonance imaging in assessing glioblastoma microvasculature. Eur J Radiol 2016; 87:120-124. [PMID: 28034567 DOI: 10.1016/j.ejrad.2016.12.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 12/15/2016] [Accepted: 12/17/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE Perfusion computed tomography (PCT) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) provide independent measurements of biomarkers related to tumor perfusion. The aim of this study was to compare the two techniques in assessing glioblastoma microvasculature. MATERIALS AND METHODS Twenty-five patients diagnosed with glioblastoma (14 males and 11 females; 51±11years old, ranging from 33 to 70 years) were includede in this prospective study. All patients underwent both PCT and DCE-MRI. Imaging was performed on a 256-slice CT scanner and a 3-T MRI system. PCT yielded permeability surface-area product (PS) using deconvolution physiological models; meanwhile, DCE-MRI determined volume transfer constant (Ktrans) using the Tofts-Kermode compartment model. All cases were submitted to surgical intervention, and CD105-microvascular density (CD105-MVD) was measured in each glioblastoma specimen. Then, Spearman's correlation coefficients and Bland-Altman plots were obtained for PS, Ktrans and CD105-MVD. P<0.05 was considered statistically significant. RESULTS Tumor PS and Ktrans values were correlated with CD105-MVD (r=0.644, P<0.001; r=0.683, P<0.001). In addition, PS was correlated with Ktrans in glioblastoma (r=0.931, P<0.001). Finally, Bland-Altman plots showed no significant differences between PS and Ktrans (P=0.063). CONCLUSION PCT and DCE-MRI measurements of glioblastoma perfusion biomarkers have similar results, suggesting that both techniques may have comparable utility. Therefore, PCT may serve as an alternative modality to DCE-MRI for the in vivo evaluation of glioblastoma microvasculature.
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Verreault M, Wehbe M, Strutt D, Masin D, Anantha M, Walker D, Chu F, Backstrom I, Kalra J, Waterhouse D, Yapp DT, Bally MB. Determination of an optimal dosing schedule for combining Irinophore C™ and temozolomide in an orthotopic model of glioblastoma. J Control Release 2015; 220:348-357. [PMID: 26528901 DOI: 10.1016/j.jconrel.2015.10.053] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 10/22/2015] [Accepted: 10/28/2015] [Indexed: 12/30/2022]
Abstract
Our laboratory reported that Irinophore C™ (IrC™; a lipid-based nanoparticulate formulation of irinotecan) is effective against an orthotopic model of glioblastoma (GBM) and that treatment with IrC™ was associated with vascular normalization within the tumor. Here, the therapeutic effects of IrC™ when used in combination with temozolomide (TMZ) in concurrent and sequential treatment schedules were tested. It was anticipated that IrC™ engendered vascular normalization would increase the delivery of TMZ to the tumor and that this would be reflected by improved treatment outcomes. The approach compared equally efficacious doses of irinotecan (IRN; 50 mg/kg) and IrC™ (25 mg/kg) in order to determine if there was a unique advantage achieved when combining TMZ with IrC™. The TMZ sensitive U251MG(O) cell line (null expression of O-6-methylguanine-DNA methyltransferase (MGMT)) modified to express the fluorescent protein mKate2 was inoculated orthotopically into NOD.CB17-SCID mice and treatment was initiated 14 days later. Our results demonstrated that IrC™ and TMZ administered concurrently resulted in optimal treatment outcomes, with 50% long term survivors (>180 days) in comparison to 17% long term survivors in animals treated with IRN and TMZ or TMZ alone. Indeed, the different treatments resulted in a 353%, 222% and 280% increase in median survival time (MST) compared to untreated animals for, respectively, IrC™ combined with TMZ, IRN combined with TMZ, and TMZ alone. When TMZ was administered after completion of IRN or IrC™ dosing, an increase in median survival time of 167-174% was observed compared to untreated animals and of 67% and 74%, respectively, when IRN (50 mg/kg) and IrC™ (25mg/kg) were given as single agents. We confirmed in these studies that after completion of the Q7D×3 dosing of IrC™, but not IRN, the tumor-associated vascular was normalized as compared to untreated tumors. Specifically, reductions in the fraction of collagen IV-free CD31 staining (p<0.05) and reductions in tumor vessel diameter were observed in tumors from IrC™-treated animals when compared to tumors from untreated or IRN treated animals. Analysis by transmission electron microscopy of the ultra-structure of tumors from IrC™-treated and untreated animals revealed that tumor-associated vessels from treated animals were smaller, more organized and exhibited a morphology comparable to normal blood vessels. In conclusion, optimal treatment outcomes were achieved when IrC™ and TMZ were administered concurrently, whereas IrC™ followed by TMZ treatment given sequentially did not confer any therapeutic advantage.
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Affiliation(s)
- M Verreault
- Brain and Spine Institute Research Center, 47 Bd de l'Hopital, Paris, 75013, France.
| | - M Wehbe
- Experimental Therapeutics, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, V5Z 1L3, BC, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, 2146 East Mall, Vancouver V6T 1Z3, BC, Canada
| | - D Strutt
- Experimental Therapeutics, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, V5Z 1L3, BC, Canada
| | - D Masin
- Experimental Therapeutics, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, V5Z 1L3, BC, Canada
| | - M Anantha
- Experimental Therapeutics, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, V5Z 1L3, BC, Canada
| | - D Walker
- Ultrastructural Imaging, UBC James Hogg Research Laboratories (iCAPTURE), Providence Heart and Lung Institute, St. Paul's Hospital, Rm 166, 1081 Burrard St, Vancouver, BC, Canada
| | - F Chu
- Ultrastructural Imaging, UBC James Hogg Research Laboratories (iCAPTURE), Providence Heart and Lung Institute, St. Paul's Hospital, Rm 166, 1081 Burrard St, Vancouver, BC, Canada
| | - I Backstrom
- Experimental Therapeutics, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, V5Z 1L3, BC, Canada
| | - J Kalra
- Experimental Therapeutics, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, V5Z 1L3, BC, Canada
| | - D Waterhouse
- Experimental Therapeutics, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, V5Z 1L3, BC, Canada
| | - D T Yapp
- Experimental Therapeutics, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, V5Z 1L3, BC, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, 2146 East Mall, Vancouver V6T 1Z3, BC, Canada
| | - M B Bally
- Experimental Therapeutics, British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, V5Z 1L3, BC, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, 2146 East Mall, Vancouver V6T 1Z3, BC, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver V6T 2B5, BC, Canada; Center for Drug Research and Development, Vancouver V6T 1Z4, BC, Canada.
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