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Mukthavaram R, Jiang P, Pastorino S, Nomura N, Lin F, Kesari S. Evaluation of the EMulate Therapeutics Voyager's ultra-low radiofrequency energy in murine model of glioblastoma. Bioelectron Med 2024; 10:10. [PMID: 38594769 PMCID: PMC11005219 DOI: 10.1186/s42234-024-00143-8] [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: 11/15/2023] [Accepted: 02/20/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Glioblastoma (GBM) presents as an aggressive brain cancer, notorious for its recurrence and resistance to conventional treatments. This study aimed to assess the efficacy of the EMulate Therapeutics Voyager®, a non-invasive, non-thermal, non-ionizing, battery-operated, portable experimental medical device, in treating GBM. Using ultra-low radiofrequency energy (ulRFE) to modulate intracellular activity, previous preliminary results in patients have been encouraging. Now, with a focus on murine models, our investigation seeks to elucidate the device's mechanistic impacts, further optimizing its therapeutic potential and understanding its limitations. METHODS The device employs a silicone over molded coil to deliver oscillating magnetic fields, which are believed to interact with and disrupt cellular targets. These fields are derived from the magnetic fluctuations of solvated molecules. Xenograft and syngeneic murine models were chosen for the study. Mice were injected with U-87 MG or GL261 glioma cells in their flanks and were subsequently treated with one of two ulRFE cognates: A1A, inspired by paclitaxel, or A2, based on murine siRNA targeting CTLA4 + PD1. A separate group of untreated mice was maintained as controls. RESULTS Mice that underwent treatments with either A1A or A2 exhibited significantly reduced tumor sizes when compared to the untreated cohort. CONCLUSION The EMulate Therapeutics Voyager® demonstrates promising potential in inhibiting glioma cells in vivo through its unique ulRFE technology and should be further studied in terms of biological effects in vitro and in vivo.
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Affiliation(s)
- Rajesh Mukthavaram
- Neuro-Oncology Program, Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Pengfei Jiang
- Neuro-Oncology Program, Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Sandra Pastorino
- Neuro-Oncology Program, Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Natsuko Nomura
- Neuro-Oncology Program, Moores Cancer Center, UC San Diego, La Jolla, CA, USA
- Department of Translational Neurosciences, Pacific Neuroscience Institute & Saint John's Cancer Institute at Providence Saint John's Health Center, 2200 Santa Monica Blvd., Santa Monica, CA, 90404, USA
| | - Feng Lin
- Curescience Institute, 5820 Oberlin Drive Ste 202, San Diego, CA, 92121, USA
| | - Santosh Kesari
- Department of Translational Neurosciences, Pacific Neuroscience Institute & Saint John's Cancer Institute at Providence Saint John's Health Center, 2200 Santa Monica Blvd., Santa Monica, CA, 90404, USA.
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Buckland ME, Sarkar C, Santosh V, Al‐Hussaini M, Park SH, Tihan T, Ng HK, Komori T. Announcing the Asian Oceanian Society of Neuropathology guidelines for Adapting Diagnostic Approaches for Practical Taxonomy in Resource-Restrained Regions (AOSNP-ADAPTR). Brain Pathol 2024; 34:e13201. [PMID: 37574221 PMCID: PMC10901611 DOI: 10.1111/bpa.13201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023] Open
Affiliation(s)
- M. E. Buckland
- Department of NeuropathologyRoyal Prince Alfred HospitalSydneyAustralia
| | - C. Sarkar
- Department of PathologyAll India Institute of Medical SciencesNew DelhiIndia
| | - V. Santosh
- Department of NeuropathologyNational Institute of Mental Health and Neuro SciencesBengaluruIndia
| | - M. Al‐Hussaini
- Department of Pathology and Laboratory MedicineKing Hussein Cancer CenterAmmanJordan
| | - S. H. Park
- Department of PathologySeoul National University, College of MedicineSeoulRepublic of Korea
| | - T. Tihan
- Department of PathologyUniversity of California San FranciscoSan FranciscoUSA
| | - H. K. Ng
- Department of Anatomical and Cellular PathologyChinese University of Hong KongHong KongChina
| | - T. Komori
- Department of Laboratory Medicine and PathologyTokyo Metropolitan Neurological Hospital, Tokyo Metropolitan Hospital OrganizationTokyoJapan
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Sollmann N, Hoffmann G, Schramm S, Reichert M, Hernandez Petzsche M, Strobel J, Nigris L, Kloth C, Rosskopf J, Börner C, Bonfert M, Berndt M, Grön G, Müller HP, Kassubek J, Kreiser K, Koerte IK, Liebl H, Beer A, Zimmer C, Beer M, Kaczmarz S. Arterial Spin Labeling (ASL) in Neuroradiological Diagnostics - Methodological Overview and Use Cases. ROFO-FORTSCHR RONTG 2024; 196:36-51. [PMID: 37467779 DOI: 10.1055/a-2119-5574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Arterial spin labeling (ASL) is a magnetic resonance imaging (MRI)-based technique using labeled blood-water of the brain-feeding arteries as an endogenous tracer to derive information about brain perfusion. It enables the assessment of cerebral blood flow (CBF). METHOD This review aims to provide a methodological and technical overview of ASL techniques, and to give examples of clinical use cases for various diseases affecting the central nervous system (CNS). There is a special focus on recent developments including super-selective ASL (ssASL) and time-resolved ASL-based magnetic resonance angiography (MRA) and on diseases commonly not leading to characteristic alterations on conventional structural MRI (e. g., concussion or migraine). RESULTS ASL-derived CBF may represent a clinically relevant parameter in various pathologies such as cerebrovascular diseases, neoplasms, or neurodegenerative diseases. Furthermore, ASL has also been used to investigate CBF in mild traumatic brain injury or migraine, potentially leading to the establishment of imaging-based biomarkers. Recent advances made possible the acquisition of ssASL by selective labeling of single brain-feeding arteries, enabling spatial perfusion territory mapping dependent on blood flow of a specific preselected artery. Furthermore, ASL-based MRA has been introduced, providing time-resolved delineation of single intracranial vessels. CONCLUSION Perfusion imaging by ASL has shown promise in various diseases of the CNS. Given that ASL does not require intravenous administration of a gadolinium-based contrast agent, it may be of particular interest for investigations in pediatric cohorts, patients with impaired kidney function, patients with relevant allergies, or patients that undergo serial MRI for clinical indications such as disease monitoring. KEY POINTS · ASL is an MRI technique that uses labeled blood-water as an endogenous tracer for brain perfusion imaging.. · It allows the assessment of CBF without the need for administration of a gadolinium-based contrast agent.. · CBF quantification by ASL has been used in several pathologies including brain tumors or neurodegenerative diseases.. · Vessel-selective ASL methods can provide brain perfusion territory mapping in cerebrovascular diseases.. · ASL may be of particular interest in patient cohorts with caveats concerning gadolinium administration..
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- cBrain, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Gabriel Hoffmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Severin Schramm
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Miriam Reichert
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Moritz Hernandez Petzsche
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Joachim Strobel
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
| | - Lorenzo Nigris
- cBrain, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christopher Kloth
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Johannes Rosskopf
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Section of Neuroradiology, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Corinna Börner
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
- LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Michaela Bonfert
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
- LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maria Berndt
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Georg Grön
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, Ulm, Germany
| | | | - Jan Kassubek
- Department of Neurology, University Hospital Ulm, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE), Ulm University, Ulm, Germany
| | - Kornelia Kreiser
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Radiology and Neuroradiology, Universitäts- und Rehabilitationskliniken Ulm, Ulm, Germany
| | - Inga K Koerte
- cBrain, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Boston, United States
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, United States
| | - Hans Liebl
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany
| | - Ambros Beer
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
- MoMan - Center for Translational Imaging, University Hospital Ulm, Ulm, Germany
- i2SouI - Innovative Imaging in Surgical Oncology, University Hospital Ulm, Ulm, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- MoMan - Center for Translational Imaging, University Hospital Ulm, Ulm, Germany
- i2SouI - Innovative Imaging in Surgical Oncology, University Hospital Ulm, Ulm, Germany
| | - Stephan Kaczmarz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Market DACH, Philips GmbH, Hamburg, Germany
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Barkhoudarian G, Badruddoja M, Blondin N, Chowdhary S, Cobbs C, Duic JP, Flores JP, Fonkem E, McClay E, Nabors LB, Salacz M, Taylor L, Vaillant B, Gill J, Kesari S. An expanded safety/feasibility study of the EMulate Therapeutics Voyager™ System in patients with recurrent glioblastoma. CNS Oncol 2023; 12:CNS102. [PMID: 37462385 PMCID: PMC10410686 DOI: 10.2217/cns-2022-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Aim: The EMulate Therapeutics Voyager™ is a simple, wearable, home-use device that uses an alternating electromagnetic field to alter biologic signaling within cells. Objective: To assess the safety/feasibility of the Voyager in the treatment of recurrent glioblastoma (rGBM). Methods: In this study, patients with rGBM were treated with Voyager as monotherapy or in combination with standard chemotherapy at the Investigator's discretion. Safety was assessed by incidence of adverse events associated with the Voyager. Patients were followed until death. Results: A total of 75 patients were enrolled and treated for at least one day with the Voyager (safety population). Device-related adverse events were uncommon and generally did not result in interruption or withdrawal from treatment. There were no serious adverse events associated with Voyager. A total of 60 patients were treated for at least one month (clinical utility population). The median progression-free survival (PFS) was 17 weeks (4.3 months) in the Voyager only group (n = 24) and 21 weeks (5.3 months) in the Voyager + concurrent therapy group (n = 36). The median overall survival (OS) was 7 months in the Voyager only group and 9 months in the Voyager + concurrent therapy group. In patients treated with Voyager + concurrent therapy, the median OS for patients enrolled with their 1st or 2nd recurrence (n = 26) was 10 months, while in patients enrolled with their 3rd or 4th recurrence (n = 10) OS was 7 months. Conclusion: The data support the safety and feasibility of the Voyager for the treatment of rGBM. Further prospective study of the device is warranted. Trial Registration Number: NCT02296580 (ClinicalTrials.gov).
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Affiliation(s)
- Garni Barkhoudarian
- Saint John's Cancer Institute & Pacific Neuroscience Institute at Providence St. John's Health Center, Santa Monica, CA 90404, USA
| | | | - Nicholas Blondin
- Associated Neurologists of Southern Connecticut, Fairfield, CT 06824, USA
| | | | - Charles Cobbs
- Swedish Medical Center, Ben and Catherine Ivy Center For Advanced Brain Tumor Treatment, Seattle, WA 98122, USA
| | | | | | | | - Edward McClay
- cCARE (California Cancer Associates for Research & Excellence), Encinitas, CA 92024, USA
| | - Louis Burt Nabors
- University of Alabama, Division of Neuro-Oncology, Birmingham, AL 35294-3410, USA
| | - Michael Salacz
- University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Lynn Taylor
- University of Washington, Seattle, WA 98195, USA
| | | | - Jaya Gill
- Saint John's Cancer Institute & Pacific Neuroscience Institute at Providence St. John's Health Center, Santa Monica, CA 90404, USA
| | - Santosh Kesari
- Saint John's Cancer Institute & Pacific Neuroscience Institute at Providence St. John's Health Center, Santa Monica, CA 90404, USA
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Jiang YT, Wang TC, Zhang W. Preoperative Systemic Immune-Inflammation Index is a Potential Biomarker in Adult Patients with High-Grade Gliomas Undergoing Radical Resection. J Inflamm Res 2023; 16:3479-3490. [PMID: 37608884 PMCID: PMC10440602 DOI: 10.2147/jir.s423488] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
Background Increasing evidence has highlighted that systemic immune-inflammation index (SII), a recently developed prognostic biomarker that utilizes peripheral platelet, lymphocyte and neutrophil counts, is associated with unfavorable prognosis in various tumors. Nevertheless, the prognostic significance of SII in high-grade gliomas patients undergoing radical resection remains unclear. Therefore, the present study aimed to assess the potential of SII as a prognostic biomarker in this patient population. Methods A total of 111 adult patients with high-grade gliomas who underwent radical resection were consecutively enrolled in this investigation. The study involved the categorization of patients into high and low SII groups using predetermined cut-off values. Subsequently, forward stepwise logistic regression was employed to identify autonomous predictors for early gliomas recurrence. To mitigate the impact of confounding factors, a propensity score matching (PSM) analysis was performed between high and low SII patients. Finally, the Kaplan-Meier approach was utilized to compare the progression-free survival (PFS) and overall survival (OS) of the two groups. Results The study involved the categorization of patients into two groups based on their SII levels, namely high SII (> 604.8) and low SII (≤ 604.8) groups. Forward stepwise logistic regression revealed that high SII (p < 0.001) and tumor size ≥ 50 mm (p < 0.001) were significantly related to early recurrence of gliomas. Furthermore, the results indicate that PFS and OS were significantly shorter in the high SII group compared to the low SII group, both before and after PSM (p < 0.05). Conclusion Preoperative biomarker SII can serve as a prognostic biomarker for early recurrence and prognosis in patients with high-grade gliomas undergoing radical resection. Furthermore, the combination of tumor size and SII demonstrates a robust predictive capacity for early recurrence and prognosis in this patient population.
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Affiliation(s)
- Yu-Ting Jiang
- Department of Radiology, Brain Hospital of Hunan Province, the School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China
| | - Tian-Cheng Wang
- Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
| | - Wei Zhang
- Department of Radiology, Brain Hospital of Hunan Province, the School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China
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Hu D, Xia M, Wu L, Liu H, Chen Z, Xu H, He C, Wen J, Xu X. Challenges and advances for glioma therapy based on inorganic nanoparticles. Mater Today Bio 2023; 20:100673. [PMID: 37441136 PMCID: PMC10333687 DOI: 10.1016/j.mtbio.2023.100673] [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: 03/15/2023] [Revised: 05/10/2023] [Accepted: 05/18/2023] [Indexed: 07/15/2023] Open
Abstract
Glioma is one of the most serious central nervous system diseases, with high mortality and poor prognosis. Despite the continuous development of existing treatment methods, the median survival time of glioma patients is still only 15 months. The main treatment difficulties are the invasive growth of glioma and the obstruction of the blood-brain barrier (BBB) to drugs. With rapid advancements in nanotechnology, inorganic nanoparticles (INPs) have shown favourable application prospects in the diagnosis and treatment of glioma. Due to their extraordinary intrinsic features, INPs can be easily fabricated, while doping with other elements and surface modification by biological ligands can be used to enhance BBB penetration, targeted delivery and biocompatibility. Guided glioma theranostics with INPs can improve and enhance the efficacy of traditional methods such as chemotherapy, radiotherapy and gene therapy. New strategies, such as immunotherapy, photothermal and photodynamic therapy, magnetic hyperthermia therapy, and multifunctional inorganic nanoplatforms, have also been facilitated by INPs. This review emphasizes the current state of research and clinical applications of INPs, including glioma targeting and BBB penetration enhancement methods, in vivo and in vitro biocompatibility, and diagnostic and treatment strategies. As such, it provides insights for the development of novel glioma treatment strategies.
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Affiliation(s)
- Die Hu
- Key Laboratory of Cell Biology, Ministry of Public Health and Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Miao Xia
- Key Laboratory of Cell Biology, Ministry of Public Health and Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Linxuan Wu
- Key Laboratory of Cell Biology, Ministry of Public Health and Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Hanmeng Liu
- Key Laboratory of Cell Biology, Ministry of Public Health and Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Zhigang Chen
- Key Laboratory of Cell Biology, Ministry of Public Health and Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Hefeng Xu
- Key Laboratory of Cell Biology, Ministry of Public Health and Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, 110122, China
| | - Chuan He
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Jian Wen
- Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China
| | - Xiaoqian Xu
- Key Laboratory of Cell Biology, Ministry of Public Health and Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, 110122, China
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Colopi A, Fuda S, Santi S, Onorato A, Cesarini V, Salvati M, Balistreri CR, Dolci S, Guida E. Impact of age and gender on glioblastoma onset, progression, and management. Mech Ageing Dev 2023; 211:111801. [PMID: 36996926 DOI: 10.1016/j.mad.2023.111801] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, while its frequency in pediatric patients is 10-15%. For this reason, age is considered one of the major risk factors for the development of GBM, as it correlates with cellular aging phenomena involving glial cells and favoring the process of tumor transformation. Gender differences have been also identified, as the incidence of GBM is higher in males than in females, coupled with a worse outcome. In this review, we analyze age- and gender- dependent differences in GBM onset, mutational landscape, clinical manifestations, and survival, according to the literature of the last 20 years, focusing on the major risk factors involved in tumor development and on the mutations and gene alterations most frequently found in adults vs young patients and in males vs females. We then highlight the impact of age and gender on clinical manifestations and tumor localization and their involvement in the time of diagnosis and in determining the tumor prognostic value.
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Affiliation(s)
- Ambra Colopi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Serena Fuda
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Samuele Santi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Angelo Onorato
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Valeriana Cesarini
- Department of Biomedicine, Institute of Translational Pharmacology-CNR, Rome, Italy
| | - Maurizio Salvati
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carmela Rita Balistreri
- Cellular and Molecular Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Corso Tukory 211, 90134 Palermo, Italy
| | - Susanna Dolci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Eugenia Guida
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
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Maszczyk M, Banach K, Rok J, Rzepka Z, Beberok A, Wrześniok D. Evaluation of Possible Neobavaisoflavone Chemosensitizing Properties towards Doxorubicin and Etoposide in SW1783 Anaplastic Astrocytoma Cells. Cells 2023; 12:cells12040593. [PMID: 36831260 PMCID: PMC9953891 DOI: 10.3390/cells12040593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
Flavonoids exert many beneficial properties, such as anticancer activity. They were found to have chemopreventive effects hindering carcinogenesis, and also being able to affect processes important for cancer cell pathophysiology inhibiting its growth or promoting cell death. There are also reports on the chemosensitizing properties of flavonoids, which indicate that they could be used as a support of anticancer therapy. It gives promise for a novel therapeutic approach in tumors characterized by ineffective treatment, such as high-grade gliomas. The research was conducted on the in vitro culture of human SW1783 anaplastic astrocytoma cells incubated with neobavaisoflavone (NEO), doxorubicin, etoposide, and their combinations with NEO. The analyses involved the WST-1 cell viability assay and image cytometry techniques including cell count assay, Annexin V assay, the evaluation of mitochondrial membrane potential, and the cell-cycle phase distribution. We found that NEO affects the activity of doxorubicin and etoposide by reducing the viability of SW1783 cells. The combination of NEO and etoposide caused an increase in the apoptotic and low mitochondrial membrane potential subpopulations of SW1783 cells. Changes in the cell cycle were observed in all combined treatments. These findings indicate a potential chemosensitizing effect exerted by NEO.
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Johansen ML, Vincent J, Rose M, Sloan AE, Brady-Kalnay SM. Comparison of Near-Infrared Imaging Agents Targeting the PTPmu Tumor Biomarker. Mol Imaging Biol 2023:10.1007/s11307-023-01799-5. [PMID: 36695968 DOI: 10.1007/s11307-023-01799-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE Maximal, safe resection of solid tumors is considered a critical first step in successful cancer treatment. The advent of fluorescence image-guided surgery (FIGS) using non-specific agents has improved patient outcomes, particularly in the case of glioblastoma. Molecularly targeted agents that recognize specific tumor biomarkers have the potential to augment these gains. Identification of the optimal combination of targeting moiety and fluorophore is needed prior to initiating clinical trials. PROCEDURES A 20-amino acid peptide (SBK2) recognizing the receptor protein-tyrosine phosphatase mu (PTPmu)-derived tumor-specific biomarker, with or without a linker, was conjugated to three different near-infrared fluorophores: indocyanine green (ICG), IRDye® 800CW, and Tide Fluor™ 8WS. The in vivo specificity, time course, and biodistribution were evaluated for each using mice with heterotopic human glioma tumors that express the PTPmu biomarker to identify component combinations with optimal properties for FIGS. RESULTS SBK2 conjugated to ICG demonstrated excellent specificity for gliomas in heterotopic tumors. SBK2-ICG showed significantly higher in vivo tumor labeling compared to the Scram-ICG control from 10 min to 24 h, p < 0.01 at all timepoints, following injection, as well as a significantly higher ex vivo tumor signal at 24 h, p < 0.001. Inserting a six-amino acid linker between the targeting peptide and ICG increased the clearance rate and resulted in significantly higher in vivo tumor signal relative to its linker-containing Scrambled control from 10 min to 8 h, p < 0.05 at all timepoints, after dosing. Agents made with the more hydrophilic IRDye® 800CW and Tide Fluor™ 8WS showed no specific tumor labeling relative to the controls. The IRDye 800CW-conjugated agents cleared within 1 h, while the non-specific fluorescent tumor signal generated by the Tide Fluor 8WS-conjugated agents persists beyond 24 h. CONCLUSIONS The SBK2 PTPmu-targeting peptide conjugated to ICG specifically labels heterotopic human gliomas grown in mice between 10 min and 24 h following injection. Similar molecules constructed with more hydrophilic dyes demonstrated no specificity. These studies present a promising candidate for use in FIGS of PTPmu biomarker-expressing tumors.
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Affiliation(s)
- Mette L Johansen
- Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Jason Vincent
- Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Marissa Rose
- Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Andrew E Sloan
- Department of Neurological Surgery, Case Western Reserve University and University Hospitals, Cleveland, OH, 44106, USA
- The Case Comprehensive Cancer Center, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Susann M Brady-Kalnay
- Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, 10900 Euclid Ave., Cleveland, OH, 44106, USA.
- The Case Comprehensive Cancer Center, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA.
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Cui J, Wang X, Li J, Zhu A, Du Y, Zeng W, Guo Y, Di L, Wang R. Immune Exosomes Loading Self-Assembled Nanomicelles Traverse the Blood-Brain Barrier for Chemo-immunotherapy against Glioblastoma. ACS NANO 2023; 17:1464-1484. [PMID: 36626296 DOI: 10.1021/acsnano.2c10219] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Effective drug delivery and prevention of postoperative recurrence are significant challenges for current glioblastoma (GBM) treatment. Poor drug delivery is mainly due to the presence of the blood-brain barrier (BBB), and postoperative recurrence is primarily due to the resistance of GBM cells to chemotherapeutic drugs and the presence of an immunosuppressive microenvironment. Herein, a biomimetic nanodrug delivery platform based on endogenous exosomes that could efficiently target the brain without targeting modifications and co-deliver pure drug nanomicelles and immune adjuvants for safe and efficient chemo-immunotherapy against GBM is prepared. Inspired by the self-assembly technology of small molecules, tanshinone IIA (TanIIA) and glycyrrhizic acid (GL), which are the inhibitors of signal transducers and activators of transcription 3 from traditional Chinese medicine (TCM), self-assembled to form TanIIA-GL nanomicelles (TGM). Endogenous serum exosomes are selected to coat the pure drug nanomicelles, and the CpG oligonucleotides, agonists of Toll-like receptor 9, are anchored on the exosome membrane to obtain immune exosomes loaded with TCM self-assembled nanomicelles (CpG-EXO/TGM). Our results demonstrate that CpG-EXO/TGM can bind free transferrin in blood, prolong blood circulation, and maintain intact structures when traversing the BBB and targeting GBM cells. In the GBM microenvironment, the strong anti-GBM effect of CpG-EXO/TGM is mainly attributed to two factors: (i) highly efficient uptake by GBM cells and sufficient intracellular release of drugs to induce apoptosis and (ii) stimulation of dendritic cell maturation and induction of tumor-associated macrophages polarization by CpG oligonucleotides to generate anti-GBM immune responses. Further research found that CpG-EXO/TGM can not only produce better efficacy in combination with temozolomide but also prevent a postoperative recurrence.
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Affiliation(s)
- Jiwei Cui
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing210023, China
- Jiangsu Provincial TCM Engineering Technology Research Center of High Efficient Drug Delivery System (DDS), Nanjing210023, China
| | - Xue Wang
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing210023, China
- Jiangsu Provincial TCM Engineering Technology Research Center of High Efficient Drug Delivery System (DDS), Nanjing210023, China
| | - Jinge Li
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing210023, China
- Jiangsu Provincial TCM Engineering Technology Research Center of High Efficient Drug Delivery System (DDS), Nanjing210023, China
| | - Anran Zhu
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing210023, China
- Jiangsu Provincial TCM Engineering Technology Research Center of High Efficient Drug Delivery System (DDS), Nanjing210023, China
| | - Yingjiang Du
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing210023, China
- Jiangsu Provincial TCM Engineering Technology Research Center of High Efficient Drug Delivery System (DDS), Nanjing210023, China
| | - Wei Zeng
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing210023, China
- Jiangsu Provincial TCM Engineering Technology Research Center of High Efficient Drug Delivery System (DDS), Nanjing210023, China
| | - Yumiao Guo
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing210023, China
- Jiangsu Provincial TCM Engineering Technology Research Center of High Efficient Drug Delivery System (DDS), Nanjing210023, China
| | - Liuqing Di
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing210023, China
- Jiangsu Provincial TCM Engineering Technology Research Center of High Efficient Drug Delivery System (DDS), Nanjing210023, China
| | - Ruoning Wang
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing210023, China
- Jiangsu Provincial TCM Engineering Technology Research Center of High Efficient Drug Delivery System (DDS), Nanjing210023, China
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11
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Wang LM, Englander ZK, Miller ML, Bruce JN. Malignant Glioma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:1-30. [PMID: 37452933 DOI: 10.1007/978-3-031-23705-8_1] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
This chapter provides a comprehensive overview of malignant gliomas, the most common primary brain tumor in adults. These tumors are varied in their cellular origin, genetic profile, and morphology under the microscope, but together they share some of the most dismal prognoses of all neoplasms in the body. Although there is currently no cure for malignant glioma, persistent efforts to improve outcomes in patients with these tumors have led to modest increases in survival, and researchers worldwide continue to strive toward a deeper understanding of the factors that influence glioma development and response to treatment. In addition to well-established epidemiology, clinical manifestations, and common histopathologic and radiologic features of malignant gliomas, this section considers recent advances in molecular biology that have led to a more nuanced understanding of the genetic changes that characterize the different types of malignant glioma, as well as their implications for treatment. Beyond the traditional classification of malignant gliomas based on histopathological features, this chapter incorporates the World Health Organization's 2016 criteria for the classification of brain tumors, with special focus on disease-defining genetic alterations and newly established subcategories of malignant glioma that were previously unidentifiable based on microscopic examination alone. Traditional therapeutic modalities that form the cornerstone of treatment for malignant glioma, such as aggressive surgical resection followed by adjuvant chemotherapy and radiation therapy, and the studies that support their efficacy are reviewed in detail. This provides a foundation for additional discussion of novel therapeutic methods such as immunotherapy and convection-enhanced delivery, as well as new techniques for enhancing extent of resection such as fluorescence-guided surgery.
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Affiliation(s)
- Linda M Wang
- Columbia University Irving Medical Center, New York, NY, 10032, USA
| | | | - Michael L Miller
- Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Jeffrey N Bruce
- Department of Neurosurgery, Columbia University Irving Medical Center, New York, NY, 10032, USA.
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12
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Pitcher JL, Alexander N, Miranda PJ, Johns TG. ErbB4 in the brain: Focus on high grade glioma. Front Oncol 2022; 12:983514. [PMID: 36119496 PMCID: PMC9471956 DOI: 10.3389/fonc.2022.983514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
The epidermal growth factor receptor (EGFR) family of receptor tyrosine kinases (RTKs) consists of EGFR, ErbB2, ErbB3, and ErbB4. These receptors play key roles in cell proliferation, angiogenesis, cell migration, and in some cases, tumor promotion. ErbB4 is a unique member of the EGFR family, implicated not only in pro-tumorigenic mechanisms, such as cell proliferation and migration, but also in anti-tumorigenic activities, including cell differentiation and apoptosis. ErbB4 is differentially expressed in a wide variety of tissues, and interestingly, as different isoforms that result in vastly different signalling outcomes. Most studies have either ignored the presence of these isoforms or used overexpression models that may mask the true function of ErbB4. ErbB4 is widely expressed throughout the body with significant expression in skeletal tissue, mammary glands, heart, and brain. Knockout models have demonstrated embryonic lethality due to disrupted heart and brain development. Despite high expression in the brain and a critical role in brain development, remarkably little is known about the potential signalling activity of ErbB4 in brain cancer.This review focuses on the unique biology of ErbB4 in the brain, and in particular, highlights brain cancer research findings. We end the review with a focus on high grade gliomas, primarily glioblastoma, a disease that has been shown to involve EGFR and its mutant forms. The role of the different ErbB4 isotypes in high grade gliomas is still unclear and future research will hopefully shed some light on this question.
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Affiliation(s)
- Jamie-Lee Pitcher
- Oncogenic Signalling Laboratory, Telethon Kids Institute, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia
- *Correspondence: Jamie-Lee Pitcher,
| | - Naomi Alexander
- Oncogenic Signalling Laboratory, Telethon Kids Institute, Nedlands, WA, Australia
| | - Panimaya Jeffreena Miranda
- Oncogenic Signalling Laboratory, Telethon Kids Institute, Nedlands, WA, Australia
- Division of Paediatrics/Centre for Child Health Research, University of Western Australia, Crawley, WA, Australia
| | - Terrance G. Johns
- Oncogenic Signalling Laboratory, Telethon Kids Institute, Nedlands, WA, Australia
- Division of Paediatrics/Centre for Child Health Research, University of Western Australia, Crawley, WA, Australia
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13
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Effect of Parecoxib Sodium Preemptive Analgesia on the Recovery Period of General Anesthesia in Patients Undergoing Glioma Resection. JOURNAL OF ONCOLOGY 2022; 2022:4934343. [PMID: 35734224 PMCID: PMC9208977 DOI: 10.1155/2022/4934343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/26/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Abstract
Objective To investigate the effect of parecoxib sodium preemptive analgesia on postoperative complications and postoperative recovery of patients undergoing glioma resection. Methods A total of 200 eligible patients with low-grade gliomas in the functional brain area scheduled for an awake craniotomy between January 2017 and December 2020 were reviewed. The subjects were divided into two groups: the study group (n = 100) given dexmedetomidine plus parecoxib sodium for pre-emptive analgesia 30 minutes preoperatively, and the control group (n = 100) receiving dexmedetomidine alone. Venous blood was collected before surgery, at the time of postoperative recovery, and 24 hours after operation, mean artery pressure (MAP) and heart rate (HR) were recorded during surgery. Sedation satisfaction, agitation rate, numerical pain score (NRS), postoperative complications, minimental state examination (MMSE) scores, quality of life (QoL) scores, and incidence of adverse events were also investigated after the surgery. Results There were no significant differences in operation time, awakening time, intraoperative awakening time, and extubation time between the two groups (P > 0.05). Compared with the control group, the ΔMAP (7.26 ± 2.21 versus 5.78 ± 2.36 mmHg) and the ΔHR (11.35 ± 3.66 versus 8.84 ± 2.47 beats/min) were significantly lower in the study group (P < 0.05). Compared with the control group, the satisfaction was higher and agitation rate was lower in the study group (P < 0.05). The incidence of intracranial infection and pulmonary infection decreased after operation (P < 0.05). The NRS of the study group was remarkably lower than the control group at 12 hours postoperatively Preoperative MMSE score and QoL score showed no statistical difference (P > 0.05), while postoperative MMSE and QoL scores showed statistical difference (P < 0.05). Conclusion This study suggests that parecoxib sodium can significantly improve the level of sedation and analgesia in patients undergoing glioma resection, reduce the incidence of intracranial infection and pulmonary infection.
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14
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Cakmakci D, Kaynar G, Bund C, Piotto M, Proust F, Namer IJ, Cicek AE. Targeted metabolomics analyses for brain tumor margin assessment during surgery. BIOINFORMATICS (OXFORD, ENGLAND) 2022; 38:3238-3244. [PMID: 35512389 DOI: 10.1093/bioinformatics/btac309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 01/17/2023]
Abstract
MOTIVATION Identification and removal of micro-scale residual tumor tissue during brain tumor surgery are key for survival in glioma patients. For this goal, High-Resolution Magic Angle Spinning Nuclear Magnetic Resonance (HRMAS NMR) spectroscopy-based assessment of tumor margins during surgery has been an effective method. However, the time required for metabolite quantification and the need for human experts such as a pathologist to be present during surgery are major bottlenecks of this technique. While machine learning techniques that analyze the NMR spectrum in an untargeted manner (i.e. using the full raw signal) have been shown to effectively automate this feedback mechanism, high dimensional and noisy structure of the NMR signal limits the attained performance. RESULTS In this study, we show that identifying informative regions in the HRMAS NMR spectrum and using them for tumor margin assessment improves the prediction power. We use the spectra normalized with the ERETIC (electronic reference to access in vivo concentrations) method which uses an external reference signal to calibrate the HRMAS NMR spectrum. We train models to predict quantities of metabolites from annotated regions of this spectrum. Using these predictions for tumor margin assessment provides performance improvements up to 4.6% the Area Under the ROC Curve (AUC-ROC) and 2.8% the Area Under the Precision-Recall Curve (AUC-PR). We validate the importance of various tumor biomarkers and identify a novel region between 7.97 ppm and 8.09 ppm as a new candidate for a glioma biomarker. AVAILABILITY AND IMPLEMENTATION The code is released at https://github.com/ciceklab/targeted_brain_tumor_margin_assessment. The data underlying this article are available in Zenodo, at https://doi.org/10.5281/zenodo.5781769. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Doruk Cakmakci
- School of Computer Science, McGill University, Montreal, QC H3A 0E9, Canada
| | - Gun Kaynar
- School of Computer Science, McGill University, Montreal, QC H3A 0E9, Canada
| | - Caroline Bund
- MNMS Platform, University Hospitals of Strasbourg, Strasbourg 67098, France.,ICube, University of Strasbourg/CNRS UMR 7357, Strasbourg 67000, France.,Department of Nuclear Medicine and Molecular Imaging, ICANS, Strasbourg 67000, France
| | | | - Francois Proust
- Department of Neurosurgery, University Hospitals of Strasbourg, Strasbourg 67091, France
| | - Izzie Jacques Namer
- MNMS Platform, University Hospitals of Strasbourg, Strasbourg 67098, France.,ICube, University of Strasbourg/CNRS UMR 7357, Strasbourg 67000, France.,Department of Nuclear Medicine and Molecular Imaging, ICANS, Strasbourg 67000, France
| | - A Ercument Cicek
- Computer Engineering Department, Bilkent University, Ankara 06800, Turkey.,Computational Biology Department, Carnegie Mellon University, Pittsburgh, PA 15213, USA
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15
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Haubold J, Hosch R, Parmar V, Glas M, Guberina N, Catalano OA, Pierscianek D, Wrede K, Deuschl C, Forsting M, Nensa F, Flaschel N, Umutlu L. Fully Automated MR Based Virtual Biopsy of Cerebral Gliomas. Cancers (Basel) 2021; 13:cancers13246186. [PMID: 34944806 PMCID: PMC8699054 DOI: 10.3390/cancers13246186] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/23/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the diagnostic accuracy of a radiomics analysis based on a fully automated segmentation and a simplified and robust MR imaging protocol to provide a comprehensive analysis of the genetic profile and grading of cerebral gliomas for everyday clinical use. METHODS MRI examinations of 217 therapy-naïve patients with cerebral gliomas, each comprising a non-contrast T1-weighted, FLAIR and contrast-enhanced T1-weighted sequence, were included in the study. In addition, clinical and laboratory parameters were incorporated into the analysis. The BraTS 2019 pretrained DeepMedic network was used for automated segmentation. The segmentations generated by DeepMedic were evaluated with 200 manual segmentations with a DICE score of 0.8082 ± 0.1321. Subsequently, the radiomics signatures were utilized to predict the genetic profile of ATRX, IDH1/2, MGMT and 1p19q co-deletion, as well as differentiating low-grade glioma from high-grade glioma. RESULTS The network provided an AUC (validation/test) for the differentiation between low-grade gliomas vs. high-grade gliomas of 0.981 ± 0.015/0.885 ± 0.02. The best results were achieved for the prediction of the ATRX expression loss with AUCs of 0.979 ± 0.028/0.923 ± 0.045, followed by 0.929 ± 0.042/0.861 ± 0.023 for the prediction of IDH1/2. The prediction of 1p19q and MGMT achieved moderate results, with AUCs of 0.999 ± 0.005/0.711 ± 0.128 for 1p19q and 0.854 ± 0.046/0.742 ± 0.050 for MGMT. CONCLUSION This fully automated approach utilizing simplified MR protocols to predict the genetic profile and grading of cerebral gliomas provides an easy and efficient method for non-invasive tumor decoding.
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Affiliation(s)
- Johannes Haubold
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45147 Essen, Germany; (R.H.); (V.P.); (C.D.); (M.F.); (F.N.); (N.F.); (L.U.)
- Correspondence: ; Tel.: +49-201-723-84528; Fax: +49-201-723-1548
| | - René Hosch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45147 Essen, Germany; (R.H.); (V.P.); (C.D.); (M.F.); (F.N.); (N.F.); (L.U.)
| | - Vicky Parmar
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45147 Essen, Germany; (R.H.); (V.P.); (C.D.); (M.F.); (F.N.); (N.F.); (L.U.)
| | - Martin Glas
- Department of Neurology, Division of Clinical Neurooncology, University Hospital Essen, D-45147 Essen, Germany;
| | - Nika Guberina
- Department of Radiotherapy, University Hospital Essen, D-45147 Essen, Germany;
| | - Onofrio Antonio Catalano
- Department of Radiology, Division of Abdominal Imaging, A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard University Medical School, Boston 02114, MA, USA;
| | - Daniela Pierscianek
- Department of Neurosurgery, University Hospital Essen, D-45147 Essen, Germany; (D.P.); (K.W.)
| | - Karsten Wrede
- Department of Neurosurgery, University Hospital Essen, D-45147 Essen, Germany; (D.P.); (K.W.)
| | - Cornelius Deuschl
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45147 Essen, Germany; (R.H.); (V.P.); (C.D.); (M.F.); (F.N.); (N.F.); (L.U.)
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45147 Essen, Germany; (R.H.); (V.P.); (C.D.); (M.F.); (F.N.); (N.F.); (L.U.)
| | - Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45147 Essen, Germany; (R.H.); (V.P.); (C.D.); (M.F.); (F.N.); (N.F.); (L.U.)
| | - Nils Flaschel
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45147 Essen, Germany; (R.H.); (V.P.); (C.D.); (M.F.); (F.N.); (N.F.); (L.U.)
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45147 Essen, Germany; (R.H.); (V.P.); (C.D.); (M.F.); (F.N.); (N.F.); (L.U.)
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16
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Wang J, Ma X, Ma J. Identification of Four Enhancer-Associated Genes as Risk Signature for Diffuse Glioma Patients. J Mol Neurosci 2021; 72:410-419. [PMID: 34462884 DOI: 10.1007/s12031-021-01861-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 05/19/2021] [Indexed: 01/21/2023]
Abstract
The abnormal expressions of enhancer-associated genes have been reported to be correlated with poor prognosis of tumors, including glioblastoma (GBM). The objective of the current study is to predict prognosis by identifying enhancer-associated genes (EAGs). The profiles of genome-wide expressions of low-grade glioma (LGG) and GBM tissues in The Cancer Genome Atlas (TCGA) dataset were obtained to explore the expression patterns of EAGs in diffuse glioma. The capacity of prognosis prediction was validated by Rembrandt and GSE16011. Moreover, qPCR was utilized to confirm the effect of JQ1 and THZ1 on the EAGs. We detected 35 differentially expressed EAGs, which were predictive of overall survival. These candidate EAGs were then subjected to the multivariate cox regression analysis and were further scoped down to four signature genes, including TRAM2, SMAGP, KDELC2, and C7ORF25. A total of 662 patients were then stratified according to the expression levels of these four signature genes. The high-risk group accounted for poorer prognosis based on the Rembrandt and GSE16011 databases. The results of qPCR also demonstrated that the expression of the four EAGs could be abolished by JQ1 (bromodomain inhibitor) and THZ1 (CDK7 inhibitor) treatment. Our study not only highlights the potential role of EAGs, which can be used to improve clinical prognosis prediction in patients with diffuse glioma, but also sheds light on the specific biomarkers and therapeutic targets for diffuse glioma patients.
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Affiliation(s)
- Jiajia Wang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xin Ma
- Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jie Ma
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
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17
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Poon MTC, Brennan PM, Jin K, Sudlow CLM, Figueroa JD. Might changes in diagnostic practice explain increasing incidence of brain and central nervous system tumors? A population-based study in Wales (United Kingdom) and the United States. Neuro Oncol 2021; 23:979-989. [PMID: 33346342 PMCID: PMC8168824 DOI: 10.1093/neuonc/noaa282] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Increasing incidence of central nervous system (CNS) tumors has been noted in some populations. However, the influence of changing surgical and imaging practices has not been consistently accounted for. METHODS We evaluated average annual percentage change (AAPC) in age- and gender-stratified incidence of CNS tumors by tumor subtypes and histological confirmation in Wales, United Kingdom (1997-2015) and the United States (2004-2015) using joinpoint regression. FINDINGS In Wales, the incidence of histologically confirmed CNS tumors increased more than all CNS tumors (AAPC 3.62% vs 1.63%), indicating an increasing proportion undergoing surgery. Grade II and III glioma incidence declined significantly (AAPC -3.09% and -1.85%, respectively) but remained stable for those with histological confirmation. Grade IV glioma incidence increased overall (AAPC 3.99%), more markedly for those with histological confirmation (AAPC 5.36%), suggesting reduced glioma subtype misclassification due to increased surgery. In the United States, the incidence of CNS tumors increased overall but was stable for histologically confirmed tumors (AAPC 1.86% vs 0.09%) indicating an increase in patients diagnosed without surgery. An increase in grade IV gliomas (AAPC 0.28%) and a decline in grade II gliomas (AAPC -3.41%) were accompanied by similar changes in those with histological confirmation, indicating the overall trends in glioma subtypes were unlikely to be caused by changing diagnostic and clinical management. CONCLUSIONS Changes in clinical practice have influenced the incidence of CNS tumors in the United Kingdom and the United States. These should be considered when evaluating trends and in epidemiological studies of putative risk factors for CNS tumors.
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Affiliation(s)
- Michael Tin Chung Poon
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Brain Tumour Centre of Excellence, Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | - Paul M Brennan
- Brain Tumour Centre of Excellence, Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
- Translational Neurosurgery, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Kai Jin
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Brain Tumour Centre of Excellence, Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | - Cathie L M Sudlow
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Brain Tumour Centre of Excellence, Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | - Jonine D Figueroa
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Brain Tumour Centre of Excellence, Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
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18
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Randomized Controlled Immunotherapy Clinical Trials for GBM Challenged. Cancers (Basel) 2020; 13:cancers13010032. [PMID: 33374196 PMCID: PMC7796083 DOI: 10.3390/cancers13010032] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Although multiple meta-analyses on active specific immunotherapy treatment for glioblastoma multiforme (GBM) have demonstrated a significant prolongation of overall survival, no single research group has succeeded in demonstrating the efficacy of this type of treatment in a prospective, double-blind, placebo-controlled, randomized clinical trial. In this paper, we explain how the complexity of the tumor biology and tumor–host interactions make proper stratification of a control group impossible. The individualized characteristics of advanced therapy medicinal products for immunotherapy contribute to heterogeneity within an experimental group. The dynamics of each tumor and in each patient aggravate comparative stable patient groups. Finally, combinations of immunotherapy strategies should be integrated with first-line treatment. We illustrate the complexity of a combined first-line treatment with individualized multimodal immunotherapy in a group of 70 adults with GBM and demonstrate that the integration of immunogenic cell death treatment within maintenance chemotherapy followed by dendritic cell vaccines and maintenance immunotherapy might provide a step towards improving the overall survival rate of GBM patients. Abstract Immunotherapies represent a promising strategy for glioblastoma multiforme (GBM) treatment. Different immunotherapies include the use of checkpoint inhibitors, adoptive cell therapies such as chimeric antigen receptor (CAR) T cells, and vaccines such as dendritic cell vaccines. Antibodies have also been used as toxin or radioactive particle delivery vehicles to eliminate target cells in the treatment of GBM. Oncolytic viral therapy and other immunogenic cell death-inducing treatments bridge the antitumor strategy with immunization and installation of immune control over the disease. These strategies should be included in the standard treatment protocol for GBM. Some immunotherapies are individualized in terms of the medicinal product, the immune target, and the immune tumor–host contact. Current individualized immunotherapy strategies focus on combinations of approaches. Standardization appears to be impossible in the face of complex controlled trial designs. To define appropriate control groups, stratification according to the Recursive Partitioning Analysis classification, MGMT promotor methylation, epigenetic GBM sub-typing, tumor microenvironment, systemic immune functioning before and after radiochemotherapy, and the need for/type of symptom-relieving drugs is required. Moreover, maintenance of a fixed treatment protocol for a dynamic, deadly cancer disease in a permanently changing tumor–host immune context might be inappropriate. This complexity is illustrated using our own data on individualized multimodal immunotherapies for GBM. Individualized medicines, including multimodal immunotherapies, are a rational and optimal yet also flexible approach to induce long-term tumor control. However, innovative methods are needed to assess the efficacy of complex individualized treatments and implement them more quickly into the general health system.
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19
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Venu A, Archana B, Kanumuri R, Vuttaradhi VK, D'Cruze L, Murugan S, Ganesh K, Prathiba D, Dymova MA, Rayala SK, Venkatraman G. Clinical Evaluation of P21 Activated Kinase 1 (PAK1) Activation in Gliomas and Its Effect on Cell Proliferation. Cancer Invest 2020; 39:98-113. [PMID: 33251876 DOI: 10.1080/07357907.2020.1858097] [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] [Indexed: 02/06/2023]
Abstract
Glioblastomas are the primary malignant tumors of brain tissues with poor prognosis and highly invasive phenotypes. Till now Ki-67 LI has emerged as a well-studied proliferation marker that aids in tumor grading, but labeling index alone cannot predict overall survival in gliomas. P21 activated kinase 1 (PAK1) - a serine/threonine kinase has been shown to function as downstream nodule for various oncogenic signaling pathways that promote neoplastic changes. This study is designed to evaluate the expression of PAK1 across various grades and its correlation with Ki-67 LI and overall survival rates among a total number of 140 clinical brain tumors of glioma patients. We also studied the activation status of phospho PAK1 in glioma tissues and established the role of PAK1 in proliferation of glioblatoma cell lines under γ-irradiation.This study provides molecular evidence signifying the role of PAK1 and its activation status in the progression of Gliomas to more aggressive phenotypes.
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Affiliation(s)
- Akkanapally Venu
- Department of Human Genetics, Sri Ramachandra Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Balasubramanian Archana
- Department of Pathology, Sri Ramachandra Medical College, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Rahul Kanumuri
- Department of Human Genetics, Sri Ramachandra Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | | | - Lawrence D'Cruze
- Department of Pathology, Sri Ramachandra Medical College, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Sowmiya Murugan
- Department of Pathology, Sri Ramachandra Medical College, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Krishnamurthy Ganesh
- Department of Neurosurgery, Sri Ramachandra Medical College, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Duvuru Prathiba
- Department of Biotechnology, Indian Institute of Technology, Chennai, India
| | - Mayya Alexandrovna Dymova
- Institute of Chemical Biology and Fundamental Medicine of Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Suresh Kumar Rayala
- Department of Pathology, Sri Ramachandra Medical College, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Ganesh Venkatraman
- Department of Human Genetics, Sri Ramachandra Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Grzmil M, Qin Y, Schleuniger C, Frank S, Imobersteg S, Blanc A, Spillmann M, Berger P, Schibli R, Behe M. Pharmacological inhibition of mTORC1 increases CCKBR-specific tumor uptake of radiolabeled minigastrin analogue [ 177Lu]Lu-PP-F11N. Am J Cancer Res 2020; 10:10861-10873. [PMID: 33042258 PMCID: PMC7532663 DOI: 10.7150/thno.45440] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/14/2020] [Indexed: 12/13/2022] Open
Abstract
Rationale: A high tumor-to-healthy-tissue uptake ratio of radiolabeled ligands is an essential prerequisite for safe and effective peptide receptor radionuclide therapy (PRRT). In the present study, we searched for novel opportunities to increase tumor-specific uptake of the radiolabeled minigastrin analogue [177Lu]Lu-DOTA-(DGlu)6-Ala-Tyr-Gly-Trp-Nle-Asp-Phe-NH2 ([177Lu]Lu-PP-F11N), that targets the cholecystokinin B receptor (CCKBR) in human cancers. Methods: A kinase inhibitor library screen followed by proliferation and internalization assays were employed to identify compounds which can increase uptake of [177Lu]Lu-PP-F11N in CCKBR-transfected human epidermoid carcinoma A431 cells and natural CCKBR-expressing rat pancreatic acinar AR42J cells. Western blot (WB) analysis verified the inhibition of the signaling pathways and the CCKBR level, whereas the cell-based assay analyzed arrestin recruitment. Biodistribution and SPECT imaging of the A431/CCKBR xenograft mouse model as well as histological analysis of the dissected tumors were used for in vivo validation. Results: Our screen identified the inhibitors of mammalian target of rapamycin complex 1 (mTORC1), which increased cell uptake of [177Lu]Lu-PP-F11N. Pharmacological mTORC1 inhibition by RAD001 and metformin increased internalization of [177Lu]Lu-PP-F11N in A431/CCKBR and in AR42J cells. Analysis of protein lysates from RAD001-treated cells revealed increased levels of CCKBR (2.2-fold) and inhibition of S6 phosphorylation. PP-F11N induced recruitment of β-arrestin1/2 and ERK1/2 phosphorylation. In A431/CCKBR-tumor bearing nude mice, 3 or 5 days of RAD001 pretreatment significantly enhanced tumor-specific uptake of [177Lu]Lu-PP-F11N (ratio [RAD001/Control] of 1.56 or 1.79, respectively), whereas metformin treatment did not show a significant difference. Quantification of SPECT/CT images confirmed higher uptake of [177Lu]Lu-PP-F11N in RAD001-treated tumors with ratios [RAD001/Control] of average and maximum concentration reaching 3.11 and 3.17, respectively. HE staining and IHC of RAD001-treated tumors showed a significant increase in necrosis (1.4% control vs.10.6% of necrotic area) and the reduction of proliferative (80% control vs. 61% of Ki67 positive cells) and mitotically active cells (1.08% control vs. 0.75% of mitotic figures). No significant difference in the tumor vascularization was observed after five-day RAD001 or metformin treatment. Conclusions: Our data demonstrates, that increased CCKBR protein level by RAD001 pretreatment has the potential to improve tumor uptake of [177Lu]Lu-PP-F11N and provides proof-of-concept for the development of molecular strategies aimed at enhancing the level of the targeted receptor, to increase the efficacy of PRRT and nuclear imaging.
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21
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Sprenger T, Schirrmacher V, Stücker W, van Gool SW. Position paper: new insights into the immunobiology and dynamics of tumor-host interactions require adaptations of clinical studies. Expert Rev Anticancer Ther 2020; 20:639-646. [PMID: 32600076 DOI: 10.1080/14737140.2020.1785874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Prospective double-blind placebo-controlled randomized clinical trials (RCTs) are considered standard for the proof of the efficacy of oncologic therapies. Molecular methods have provided new insights into tumor biology and led to the development of targeted therapies. Due to the increasing complexity of molecular tumor characteristics and of the individuality of specific anti-tumor immune reactivity, RCTs are unfortunately only of limited use. AREAS COVERED The historical methods of drug research and approval and the related practices of reimbursement by statutory and private health insurance companies are being questioned. New, innovative methods for the documentation of evidence in personalized medicine will be addressed. Possible perspectives and new approaches are discussed, in particular with regard to glioblastoma. EXPERT OPINION Highly specialized translational oncology groups like the IOZK can contribute to medical progress and quick transfer 'from bench to bedside.' Their contribution should be acknowledged and taken into account more strongly in the development of guidelines and the reimbursement of therapy costs. Methodological plurality should be encouraged.
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22
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Wang H, Wu J, Guo W. SP1-Mediated Upregulation of lncRNA LINC01614 Functions a ceRNA for miR-383 to Facilitate Glioma Progression Through Regulation of ADAM12. Onco Targets Ther 2020; 13:4305-4318. [PMID: 32547064 PMCID: PMC7244248 DOI: 10.2147/ott.s242854] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background Long non-coding RNAs (lncRNAs) play an imperative role in tumorigenesis, but few lncRNAs have been functionally characterized in glioma. The aim of the present study was to identify the role of long non-coding RNA LINC01614 (LINC01614) in glioma development and explore the underlying mechanisms of LINC01614/miR-383/ADAM12 axis. Patients and Methods LncRNA expression in glioma specimens was measured by lncRNA microarray and qRT-PCR. The prognostic value of LINC01614 expression was statistically analyzed in 112 glioma patients. Loss-of-function experiments were conducted to investigate the biological functions of LINC01614 in vitro. Luciferase analyses, ChIP assays, and RNA pull-down were performed to determine the underlying LINC01614 mechanisms. Results We identified a novel glioma-related lncRNA LINC01614 by analyzing TCGA datasets. The distinct upregulation of LINC01614 was observed in both glioma specimens and cell lines using RT-PCR. We also observed that LINC01614 upregulation was induced by nuclear transcription factor SP1. Clinical assays revealed that high levels of LINC01614 were associated with KPS, WHO grade and shorter overall survival of glioma patients. Multivariate analysis further confirmed that LINC01614 was an independent prognostic marker for glioma patients. Besides, functional assays displayed that silence of LINC01614 knockdown distinctly inhibited cell growth, migration and invasion and promoted cell apoptosis in glioma cells. LINC01614 expression was enriched in the cytoplasm of glioma cells. Mechanistic investigation revealed that LINC01614 functioned as a competing endogenous RNA to upregulate a disintegrin and metalloproteinase 12 (ADAM12) by sponging miR-383. Conclusion Overall, these findings showed that SP1-induced upregulation of LINC01614 promoted glioma malignant progression via modulating the miR-383/ADAM12 axis, which may provide a promising therapy for glioma.
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Affiliation(s)
- Hao Wang
- Department of Neurosurgery, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China
| | - Jiang Wu
- Department of Neurosurgery, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China
| | - Wei Guo
- Department of Neurosurgery, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China
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23
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Kamath AA, Friedman DD, Akbari SHA, Kim AH, Tao Y, Luo J, Leuthardt EC. Glioblastoma Treated With Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy: Safety, Efficacy, and Outcomes. Neurosurgery 2020; 84:836-843. [PMID: 30137606 PMCID: PMC6425465 DOI: 10.1093/neuros/nyy375] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 07/19/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the multitude of available treatments, glioblastoma (GBM) remains an aggressive and uniformly fatal tumor. Laser interstitial thermal therapy (LITT) is a novel, minimally invasive treatment that holds promise for treating patients with GBM who are not candidates for traditional open craniotomy. However, due to the recent introduction of LITT into clinical practice, large series that evaluate safety and long-term outcomes after LITT are lacking. OBJECTIVE To present our institution's series of over 50 GBM patients treated with LITT, with regard to safety, efficacy, and outcomes. METHODS We performed a retrospective descriptive study of patients with histologically proven GBM who underwent LITT. Data collected included demographics, tumor location and volume, tumor genetic markers, treatment volume, perioperative complications, and long-term follow-up data. RESULTS We performed 58 LITT treatments for GBM in 54 patients over 5.5 yr. Forty-one were recurrent tumors while 17 were frontline treatments. Forty GBMs were lobar in location, while 18 were in deep structures (thalamus, insula, corpus callosum). Average tumor volume was 12.5 ± 13.4 cm3. Average percentage of tumor treated with the yellow thermal damage threshold (TDT) line (dose equivalent of 43°C for 2 min) was 93.3% ± 10.6%, and with the blue TDT line (dose equivalent of 43°C for 10 min) was 88.0% ± 14.2%. There were 7 perioperative complications (12%) and 2 mortalities (3.4%). Median overall survival after LITT for the total cohort was 11.5 mo, and median progression-free survival 6.6 mo. CONCLUSION LITT appears to be a safe and effective treatment for GBM in properly selected patients.
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Affiliation(s)
- Ashwin A Kamath
- Departments of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Daniel D Friedman
- Departments of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - S Hassan A Akbari
- Departments of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Albert H Kim
- Departments of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri.,Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.,Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri.,Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri
| | - Yu Tao
- Department of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Jinqin Luo
- Department of Biostatistics, Washington University School of Medicine, St. Louis, Missouri.,Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Eric C Leuthardt
- Departments of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri.,Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri.,Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, Missouri.,Department of Mechanical Engineering and Materials Science, Washington University School of Medicine, St. Louis, Missouri.,Department of Neuroscience, Washington University School of Medicine, St. Louis, Missouri.,Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, St. Louis, Missouri.,Brain Laser Center, Washington University School of Medicine, St. Louis, Missouri
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24
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Tomita Y, Kurozumi K, Yoo JY, Fujii K, Ichikawa T, Matsumoto Y, Uneda A, Hattori Y, Shimizu T, Otani Y, Oka T, Kaur B, Date I. Oncolytic Herpes Virus Armed with Vasculostatin in Combination with Bevacizumab Abrogates Glioma Invasion via the CCN1 and AKT Signaling Pathways. Mol Cancer Ther 2019; 18:1418-1429. [PMID: 31092561 DOI: 10.1158/1535-7163.mct-18-0799] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/30/2019] [Accepted: 05/10/2019] [Indexed: 11/16/2022]
Abstract
Anti-VEGF treatments such as bevacizumab have demonstrated convincing therapeutic advantage in patients with glioblastoma. However, bevacizumab has also been reported to induce invasiveness of glioma. In this study, we examined the effects of rapid antiangiogenesis mediated by oncolytic virus (RAMBO), an oncolytic herpes simplex virus-1 expressing vasculostatin, on bevacizumab-induced glioma invasion. The effect of the combination of RAMBO and bevacizumab in vitro was assessed by cytotoxicity, migration, and invasion assays. For in vivo experiments, glioma cells were stereotactically inoculated into the brain of mice. RAMBO was intratumorally injected 7 days after tumor inoculation, and bevacizumab was administered intraperitoneally twice a week. RAMBO significantly decreased both the migration and invasion of glioma cells treated with bevacizumab. In mice treated with bevacizumab and RAMBO combination, the survival time was significantly longer and the depth of tumor invasion was significantly smaller than those treated with bevacizumab monotherapy. Interestingly, RAMBO decreased the expression of cysteine-rich protein 61 and phosphorylation of AKT, which were increased by bevacizumab. These results suggest that RAMBO suppresses bevacizumab-induced glioma invasion, which could be a promising approach to glioma therapy.
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Affiliation(s)
- Yusuke Tomita
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiko Kurozumi
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Ji Young Yoo
- Department of Neurosurgery, University of Texas Health Science Center at Houston, Houston, Texas
| | - Kentaro Fujii
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomotsugu Ichikawa
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuji Matsumoto
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Atsuhito Uneda
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuhiko Hattori
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshihiko Shimizu
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshihiro Otani
- Department of Neurosurgery, University of Texas Health Science Center at Houston, Houston, Texas
| | - Tetsuo Oka
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Balveen Kaur
- Department of Neurosurgery, University of Texas Health Science Center at Houston, Houston, Texas
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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25
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Murphy M, Dowling A, Thien C, Priest E, Morgan Murray D, Kesari S. A feasibility study of the Nativis Voyager ® device in patients with recurrent glioblastoma in Australia. CNS Oncol 2019; 8:CNS31. [PMID: 30727742 PMCID: PMC6499017 DOI: 10.2217/cns-2018-0017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: Evaluation of the Nativis Voyager®, an investigational medical device, as monotherapy for recurrent glioblastoma (rGBM). Materials & methods: A total of 15 patients with rGBM were treated with one of two Voyager ultra-low radio frequency energy cognates: A1A or A2HU. Safety and clinical utility were assessed every 2–4 months. Results: Median overall survival was 8.04 months in the A1A arm and 6.89 months in the A2HU arm. No serious adverse events associated with Voyager were reported. No clinically relevant trends were noted in clinical laboratory parameters or physical exams. Conclusion: The data suggest that the Voyager is safe and feasible for the treatment of rGBM.
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Affiliation(s)
- Michael Murphy
- Department of Neurosurgery, St Vincent's Hospital, Fitzroy, Australia.,Department of Surgery, The University of Melbourne, Parkville, Australia
| | - Anthony Dowling
- Department of Oncology, St Vincent's Hospital, Fitzroy, Australia.,Department of Medicine, The University of Melbourne, Parkville, Australia
| | - Christopher Thien
- Department of Neurosurgery, St Vincent's Hospital, Fitzroy, Australia
| | - Emma Priest
- Department of Neurosurgery, St Vincent's Hospital, Fitzroy, Australia
| | - Donna Morgan Murray
- Nativis, Inc., Department of Clinical and Regulatory Affairs, Seattle, WA 98109, USA
| | - Santosh Kesari
- John Wayne Cancer Institute & Pacific Neuroscience Institute, Department of Translational Neurooncology and Neurotherapeutics, Santa Monica, CA, 90404, USA
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26
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Mistry AM, Greenplate AR, Ihrie RA, Irish JM. Beyond the message: advantages of snapshot proteomics with single-cell mass cytometry in solid tumors. FEBS J 2019; 286:1523-1539. [PMID: 30549207 DOI: 10.1111/febs.14730] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/17/2018] [Accepted: 12/12/2018] [Indexed: 12/19/2022]
Abstract
Single-cell technologies that can quantify features of individual cells within a tumor are critical for treatment strategies aiming to target cancer cells while sparing or activating beneficial cells. Given that key players in protein networks are often the primary targets of precision oncology strategies, it is imperative to transcend the nucleic acid message and read cellular actions in human solid tumors. Here, we review the advantages of multiplex, single-cell mass cytometry in tissue and solid tumor investigations. Mass cytometry can quantitatively probe nearly any cellular feature or target. In discussing the ability of mass cytometry to reveal and characterize a broad spectrum of cell types, identify rare cells, and study functional behavior through protein signaling networks in millions of individual cells from a tumor, this review surveys publications of scientific advances in solid tumor biology made with the aid of mass cytometry. Advances discussed include functional identification of rare tumor and tumor-infiltrating immune cells and dissection of cellular mechanisms of immunotherapy in solid tumors and the periphery. The review concludes by highlighting ways to incorporate single-cell mass cytometry in solid tumor precision oncology efforts and rapidly developing cytometry techniques for quantifying cell location and sequenced nucleic acids.
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Affiliation(s)
- Akshitkumar M Mistry
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Allison R Greenplate
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rebecca A Ihrie
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jonathan M Irish
- Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
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27
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Cobbs C, McClay E, Duic JP, Nabors LB, Morgan Murray D, Kesari S. An early feasibility study of the Nativis Voyager ® device in patients with recurrent glioblastoma: first cohort in US. CNS Oncol 2018; 8:CNS30. [PMID: 30547676 PMCID: PMC6499016 DOI: 10.2217/cns-2018-0013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Aim: Evaluation of the Nativis Voyager® device in patients with recurrent glioblastoma (rGBM). Materials & methods: Voyager is a noninvasive, nonthermal, nonionizing and portable investigational device which delivers ultra-low radio frequency energy (ulRFE®) that uses a magnetic field to penetrate tissues to alter specific biologic functions within cells. Patients with rGBM were treated with Voyager alone (V) or Voyager in combination with standard of care (V + SoC). Safety and clinical utility were assessed every 2–4 months. Results: Data from the first 11 patients treated are reported here. Median progression-free survival was 10 weeks in the V arm and 16 weeks in the V + SoC arm. Median overall survival was 16 months in V arm and 11 months in the V + SoC arm. No serious adverse events associated with the device were reported. Conclusion: These data suggest that the Voyager is safe and feasible for the treatment of rGBM.
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Affiliation(s)
- Charles Cobbs
- Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment, Swedish Medical Center, Seattle, WA 98122, USA
| | - Edward McClay
- Melanoma Research Center, California Cancer Associates for Research & Excellence (cCARE), San Marcos, CA 92024, USA
| | - J Paul Duic
- Department of Neuro-oncology, New York University, Winthrop, Mineola, NY 11501, USA
| | - L Burt Nabors
- Division of Neuro-oncology, University of Alabama, Birmingham, AL 35294, USA
| | | | - Santosh Kesari
- Department of Translational Neuro-Oncology and Neurotherapeutics, John Wayne Cancer Institute & Pacific Neuroscience Institute, Santa Monica, CA 90404, USA
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28
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Stepanenko AA, Chekhonin VP. Recent Advances in Oncolytic Virotherapy and Immunotherapy for Glioblastoma: A Glimmer of Hope in the Search for an Effective Therapy? Cancers (Basel) 2018; 10:E492. [PMID: 30563098 PMCID: PMC6316815 DOI: 10.3390/cancers10120492] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 11/19/2018] [Accepted: 11/29/2018] [Indexed: 02/06/2023] Open
Abstract
To date, no targeted drugs, antibodies or combinations of chemotherapeutics have been demonstrated to be more efficient than temozolomide, or to increase efficacy of standard therapy (surgery, radiotherapy, temozolomide, steroid dexamethasone). According to recent phase III trials, standard therapy may ensure a median overall survival of up to 18⁻20 months for adult patients with newly diagnosed glioblastoma. These data explain a failure of positive non-controlled phase II trials to predict positive phase III trials and should result in revision of the landmark Stupp trial as a historical control for median overall survival in non-controlled trials. A high rate of failures in clinical trials and a lack of effective chemotherapy on the horizon fostered the development of conceptually distinct therapeutic approaches: dendritic cell/peptide immunotherapy, chimeric antigen receptor (CAR) T-cell therapy and oncolytic virotherapy. Recent early phase trials with the recombinant adenovirus DNX-2401 (Ad5-delta24-RGD), polio-rhinovirus chimera (PVSRIPO), parvovirus H-1 (ParvOryx), Toca 511 retroviral vector with 5-fluorocytosine, heat shock protein-peptide complex-96 (HSPPC-96) and dendritic cell vaccines, including DCVax-L vaccine, demonstrated that subsets of patients with glioblastoma/glioma may benefit from oncolytic virotherapy/immunotherapy (>3 years of survival after treatment). However, large controlled trials are required to prove efficacy of next-generation immunotherapeutics and oncolytic vectors.
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Affiliation(s)
- Aleksei A Stepanenko
- Department of Fundamental and Applied Neurobiology, V. P. Serbsky National Medical Research Center for Psychiatry and Narcology, the Ministry of Health of the Russian Federation, Kropotkinsky lane 23, 119034 Moscow, Russia.
| | - Vladimir P Chekhonin
- Department of Fundamental and Applied Neurobiology, V. P. Serbsky National Medical Research Center for Psychiatry and Narcology, the Ministry of Health of the Russian Federation, Kropotkinsky lane 23, 119034 Moscow, Russia.
- Department of Medical Nanobiotechnologies, Medico-Biological Faculty, N. I. Pirogov Russian National Research Medical University, the Ministry of Health of the Russian Federation, Ostrovitianov str. 1, 117997 Moscow, Russia.
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