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Andronesi OC, Arrillaga-Romany IC, Ly KI, Bogner W, Ratai EM, Reitz K, Iafrate AJ, Dietrich J, Gerstner ER, Chi AS, Rosen BR, Wen PY, Cahill DP, Batchelor TT. Pharmacodynamics of mutant-IDH1 inhibitors in glioma patients probed by in vivo 3D MRS imaging of 2-hydroxyglutarate. Nat Commun 2018; 9:1474. [PMID: 29662077 PMCID: PMC5902553 DOI: 10.1038/s41467-018-03905-6] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 03/21/2018] [Indexed: 12/27/2022] Open
Abstract
Inhibitors of the mutant isocitrate dehydrogenase 1 (IDH1) entered recently in clinical trials for glioma treatment. Mutant IDH1 produces high levels of 2-hydroxyglurate (2HG), thought to initiate oncogenesis through epigenetic modifications of gene expression. In this study, we show the initial evidence of the pharmacodynamics of a new mutant IDH1 inhibitor in glioma patients, using non-invasive 3D MR spectroscopic imaging of 2HG. Our results from a Phase 1 clinical trial indicate a rapid decrease of 2HG levels by 70% (CI 13%, P = 0.019) after 1 week of treatment. Importantly, inhibition of mutant IDH1 may lead to the reprogramming of tumor metabolism, suggested by simultaneous changes in glutathione, glutamine, glutamate, and lactate. An inverse correlation between metabolic changes and diffusion MRI indicates an effect on the tumor-cell density. We demonstrate a feasible radiopharmacodynamics approach to support the rapid clinical translation of rationally designed drugs targeting IDH1/2 mutations for personalized and precision medicine of glioma patients.
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Affiliation(s)
- Ovidiu C Andronesi
- Department of Radiology, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, 02129, USA.
| | - Isabel C Arrillaga-Romany
- Department of Neurology, Massachusetts General Hospital, Stephen E. and Catherine Pappas Center for Neuro-Oncology, Division of Hematology/Oncology, Harvard Medical School, Boston, MA, 02114, USA
| | - K Ina Ly
- Department of Neurology, Massachusetts General Hospital, Stephen E. and Catherine Pappas Center for Neuro-Oncology, Division of Hematology/Oncology, Harvard Medical School, Boston, MA, 02114, USA
| | - Wolfgang Bogner
- Department of Biomedical Imaging and Image-guided Therapy, High Field MR Centre, Medical University of Vienna, Vienna, 1090, Austria
| | - Eva M Ratai
- Department of Radiology, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, 02129, USA
| | - Kara Reitz
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - A John Iafrate
- Department of Pathology, Massachusetts General Hospital, Center for Integrated Diagnostics, Harvard Medical School, Boston, MA, 02114, USA
| | - Jorg Dietrich
- Department of Neurology, Massachusetts General Hospital, Stephen E. and Catherine Pappas Center for Neuro-Oncology, Division of Hematology/Oncology, Harvard Medical School, Boston, MA, 02114, USA
| | - Elizabeth R Gerstner
- Department of Neurology, Massachusetts General Hospital, Stephen E. and Catherine Pappas Center for Neuro-Oncology, Division of Hematology/Oncology, Harvard Medical School, Boston, MA, 02114, USA
| | - Andrew S Chi
- Brain Tumor Center, Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center and School of Medicine, New York, NY, 10016, USA
| | - Bruce R Rosen
- Department of Radiology, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, 02129, USA
| | - Patrick Y Wen
- Dana-Farber Cancer Institute, Boston, MA, 02284, USA
| | - Daniel P Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Tracy T Batchelor
- Department of Neurology, Massachusetts General Hospital, Stephen E. and Catherine Pappas Center for Neuro-Oncology, Division of Hematology/Oncology, Harvard Medical School, Boston, MA, 02114, USA
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Bogner W, Hangel G, Esmaeili M, Andronesi OC. 1D-spectral editing and 2D multispectral in vivo 1H-MRS and 1H-MRSI - Methods and applications. Anal Biochem 2017; 529:48-64. [PMID: 28034791 DOI: 10.1016/j.ab.2016.12.020] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 12/16/2016] [Accepted: 12/23/2016] [Indexed: 12/27/2022]
Abstract
This article reviews the methodological aspects of detecting low-abundant J-coupled metabolites via 1D spectral editing techniques and 2D nuclear magnetic resonance (NMR) methods applied in vivo, in humans, with a focus on the brain. A brief explanation of the basics of J-evolution will be followed by an introduction to 1D spectral editing techniques (e.g., J-difference editing, multiple quantum coherence filtering) and 2D-NMR methods (e.g., correlation spectroscopy, J-resolved spectroscopy). Established and recently developed methods will be discussed and the most commonly edited J-coupled metabolites (e.g., neurotransmitters, antioxidants, onco-markers, and markers for metabolic processes) will be briefly summarized along with their most important applications in neuroscience and clinical diagnosis.
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Affiliation(s)
- Wolfgang Bogner
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria.
| | - Gilbert Hangel
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria.
| | - Morteza Esmaeili
- Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
| | - Ovidiu C Andronesi
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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