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Michelucci A, Catacuzzeno L. Piezo1, the new actor in cell volume regulation. Pflugers Arch 2024; 476:1023-1039. [PMID: 38581527 PMCID: PMC11166825 DOI: 10.1007/s00424-024-02951-y] [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: 01/11/2024] [Revised: 02/29/2024] [Accepted: 03/20/2024] [Indexed: 04/08/2024]
Abstract
All animal cells control their volume through a complex set of mechanisms, both to counteract osmotic perturbations of the environment and to enable numerous vital biological processes, such as proliferation, apoptosis, and migration. The ability of cells to adjust their volume depends on the activity of ion channels and transporters which, by moving K+, Na+, and Cl- ions across the plasma membrane, generate the osmotic gradient that drives water in and out of the cell. In 2010, Patapoutian's group identified a small family of evolutionarily conserved, Ca2+-permeable mechanosensitive channels, Piezo1 and Piezo2, as essential components of the mechanically activated current that mediates mechanotransduction in vertebrates. Piezo1 is expressed in several tissues and its opening is promoted by a wide range of mechanical stimuli, including membrane stretch/deformation and osmotic stress. Piezo1-mediated Ca2+ influx is used by the cell to convert mechanical forces into cytosolic Ca2+ signals that control diverse cellular functions such as migration and cell death, both dependent on changes in cell volume and shape. The crucial role of Piezo1 in the regulation of cell volume was first demonstrated in erythrocytes, which need to reduce their volume to pass through narrow capillaries. In HEK293 cells, increased expression of Piezo1 was found to enhance the regulatory volume decrease (RVD), the process whereby the cell re-establishes its original volume after osmotic shock-induced swelling, and it does so through Ca2+-dependent modulation of the volume-regulated anion channels. More recently we reported that Piezo1 controls the RVD in glioblastoma cells via the modulation of Ca2+-activated K+ channels. To date, however, the mechanisms through which this mechanosensitive channel controls cell volume and maintains its homeostasis have been poorly investigated and are still far from being understood. The present review aims to provide a broad overview of the literature discussing the recent advances on this topic.
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Affiliation(s)
- A Michelucci
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123, Perugia, Italy.
| | - L Catacuzzeno
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123, Perugia, Italy.
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Pal S, Singh RP, Kumar A. Analysis of Hybrid Feature Optimization Techniques Based on the Classification Accuracy of Brain Tumor Regions Using Machine Learning and Further Evaluation Based on the Institute Test Data. J Med Phys 2024; 49:22-32. [PMID: 38828069 PMCID: PMC11141750 DOI: 10.4103/jmp.jmp_77_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 06/05/2024] Open
Abstract
Aim The goal of this study was to get optimal brain tumor features from magnetic resonance imaging (MRI) images and classify them based on the three groups of the tumor region: Peritumoral edema, enhancing-core, and necrotic tumor core, using machine learning classification models. Materials and Methods This study's dataset was obtained from the multimodal brain tumor segmentation challenge. A total of 599 brain MRI studies were employed, all in neuroimaging informatics technology initiative format. The dataset was divided into training, validation, and testing subsets online test dataset (OTD). The dataset includes four types of MRI series, which were combined together and processed for intensity normalization using contrast limited adaptive histogram equalization methodology. To extract radiomics features, a python-based library called pyRadiomics was employed. Particle-swarm optimization (PSO) with varying inertia weights was used for feature optimization. Inertia weight with a linearly decreasing strategy (W1), inertia weight with a nonlinear coefficient decreasing strategy (W2), and inertia weight with a logarithmic strategy (W3) were different strategies used to vary the inertia weight for feature optimization in PSO. These selected features were further optimized using the principal component analysis (PCA) method to further reducing the dimensionality and removing the noise and improve the performance and efficiency of subsequent algorithms. Support vector machine (SVM), light gradient boosting (LGB), and extreme gradient boosting (XGB) machine learning classification algorithms were utilized for the classification of images into different tumor regions using optimized features. The proposed method was also tested on institute test data (ITD) for a total of 30 patient images. Results For OTD test dataset, the classification accuracy of SVM was 0.989, for the LGB model (LGBM) was 0.992, and for the XGB model (XGBM) was 0.994, using the varying inertia weight-PSO optimization method and the classification accuracy of SVM was 0.996 for the LGBM was 0.998, and for the XGBM was 0.994, using PSO and PCA-a hybrid optimization technique. For ITD test dataset, the classification accuracy of SVM was 0.994 for the LGBM was 0.993, and for the XGBM was 0.997, using the hybrid optimization technique. Conclusion The results suggest that the proposed method can be used to classify a brain tumor as used in this study to classify the tumor region into three groups: Peritumoral edema, enhancing-core, and necrotic tumor core. This was done by extracting the different features of the tumor, such as its shape, grey level, gray-level co-occurrence matrix, etc., and then choosing the best features using hybrid optimal feature selection techniques. This was done without much human expertise and in much less time than it would take a person.
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Affiliation(s)
- Soniya Pal
- Department of Physics, GLA University, Mathura, Uttar Pradesh, India
- Batra Hospital and Medical Research Center, New Delhi, India
| | - Raj Pal Singh
- Department of Physics, GLA University, Mathura, Uttar Pradesh, India
| | - Anuj Kumar
- Department of Radiotherapy, S. N. Medical College, Agra, Uttar Pradesh, India
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Mellor NG, Chung SA, Graham ES, Day BW, Unsworth CP. Eliciting calcium transients with UV nanosecond laser stimulation in adult patient-derived glioblastoma brain cancer cells in vitro. J Neural Eng 2023; 20:066026. [PMID: 37988746 DOI: 10.1088/1741-2552/ad0e7d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/21/2023] [Indexed: 11/23/2023]
Abstract
Objective.Glioblastoma (GBM) is the most common and lethal type of high-grade adult brain cancer. The World Health Organization have classed GBM as an incurable disease because standard treatments have yielded little improvement with life-expectancy being 6-15 months after diagnosis. Different approaches are now crucial to discover new knowledge about GBM communication/function in order to establish alternative therapies for such an aggressive adult brain cancer. Calcium (Ca2+) is a fundamental cell molecular messenger employed in GBM being involved in a wide dynamic range of cellular processes. Understanding how the movement of Ca2+behaves and modulates activity in GBM at the single-cell level is relatively unexplored but holds the potential to yield opportunities for new therapeutic strategies and approaches for cancer treatment.Approach.In this article we establish a spatially and temporally precise method for stimulating Ca2+transients in three patient-derived GBM cell-lines (FPW1, RN1, and RKI1) such that Ca2+communication can be studied from single-cell to larger network scales. We demonstrate that this is possible by administering a single optimized ultra-violet (UV) nanosecond laser pulse to trigger GBM Ca2+transients.Main results.We determine that 1.58µJµm-2is the optimal UV nanosecond laser pulse energy density necessary to elicit a single Ca2+transient in the GBM cell-lines whilst maintaining viability, functionality, the ability to be stimulated many times in an experiment, and to trigger further Ca2+communication in a larger network of GBM cells.Significance.Using adult patient-derived mesenchymal GBM brain cancer cell-lines, the most aggressive form of GBM cancer, this work is the first of its kind as it provides a new effective modality of which to stimulate GBM cells at the single-cell level in an accurate, repeatable, and reliable manner; and is a first step toward Ca2+communication in GBM brain cancer cells and their networks being more effectively studied.
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Affiliation(s)
- Nicholas G Mellor
- Department of Engineering Science, The University of Auckland, Auckland, New Zealand
| | - Sylvia A Chung
- Adult Cancer Program, Lowy Cancer Research Centre, The University of New South Wales, Sydney, Australia
| | - E Scott Graham
- Department of Molecular Medicine and Pathology & The Centre for Brain Research, The University of Auckland, Auckland, New Zealand
| | - Bryan W Day
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Charles P Unsworth
- Department of Engineering Science, The University of Auckland, Auckland, New Zealand
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Michelucci A, Sforna L, Franciolini F, Catacuzzeno L. Hypoxia, Ion Channels and Glioblastoma Malignancy. Biomolecules 2023; 13:1742. [PMID: 38136613 PMCID: PMC10742235 DOI: 10.3390/biom13121742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
The malignancy of glioblastoma (GBM), the most aggressive type of human brain tumor, strongly correlates with the presence of hypoxic areas within the tumor mass. Oxygen levels have been shown to control several critical aspects of tumor aggressiveness, such as migration/invasion and cell death resistance, but the underlying mechanisms are still unclear. GBM cells express abundant K+ and Cl- channels, whose activity supports cell volume and membrane potential changes, critical for cell proliferation, migration and death. Volume-regulated anion channels (VRAC), which mediate the swelling-activated Cl- current, and the large-conductance Ca2+-activated K+ channels (BK) are both functionally upregulated in GBM cells, where they control different aspects underlying GBM malignancy/aggressiveness. The functional expression/activity of both VRAC and BK channels are under the control of the oxygen levels, and these regulations are involved in the hypoxia-induced GBM cell aggressiveness. The present review will provide a comprehensive overview of the literature supporting the role of these two channels in the hypoxia-mediated GBM malignancy, suggesting them as potential therapeutic targets in the treatment of GBM.
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Affiliation(s)
- Antonio Michelucci
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123 Perugia, Italy; (L.S.); (F.F.)
| | | | | | - Luigi Catacuzzeno
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123 Perugia, Italy; (L.S.); (F.F.)
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Michelucci A, Sforna L, Di Battista A, Franciolini F, Catacuzzeno L. Ca 2+ -activated K + channels regulate cell volume in human glioblastoma cells. J Cell Physiol 2023; 238:2120-2134. [PMID: 37431808 DOI: 10.1002/jcp.31072] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/10/2023] [Accepted: 06/20/2023] [Indexed: 07/12/2023]
Abstract
Glioblastoma (GBM), the most lethal form of brain tumors, bases its malignancy on the strong ability of its cells to migrate and invade the narrow spaces of healthy brain parenchyma. Cell migration and invasion are both critically dependent on changes in cell volume and shape driven by the transmembrane transport of osmotically important ions such as K+ and Cl- . However, while the Cl- channels participating in cell volume regulation have been clearly identified, the precise nature of the K+ channels involved is still uncertain. Using a combination of electrophysiological and imaging approaches in GBM U87-MG cells, we found that hypotonic-induced cell swelling triggered the opening of Ca2+ -activated K+ (KCa ) channels of large and intermediate conductance (BKCa and IKCa , respectively), both highly expressed in GBM cells. The influx of Ca2+ mediated by the hypotonic-induced activation of mechanosensitive channels was found to be a key step for opening both the BKCa and the IKCa channels. Finally, the activation of both KCa channels mediated by mechanosensitive channels was found to be essential for the development of the regulatory volume decrease following hypotonic shock. Taken together, these data indicate that KCa channels are the main K+ channels responsible for the volume regulation in U87-MG cells.
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Affiliation(s)
- Antonio Michelucci
- Department of Chemistry, Biology, and Biotechnology, University of Perugia, Perugia, Italy
| | - Luigi Sforna
- Department of Chemistry, Biology, and Biotechnology, University of Perugia, Perugia, Italy
| | - Angela Di Battista
- Department of Chemistry, Biology, and Biotechnology, University of Perugia, Perugia, Italy
| | - Fabio Franciolini
- Department of Chemistry, Biology, and Biotechnology, University of Perugia, Perugia, Italy
| | - Luigi Catacuzzeno
- Department of Chemistry, Biology, and Biotechnology, University of Perugia, Perugia, Italy
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Srivastava S, Patil K, Thompson EW, Nakhai SA, Kim YN, Haynes C, Bryant C, Pai SB. Disruption of Glioblastoma Multiforme Cell Circuits with Cinnamaldehyde Highlights Potential Targets with Implications for Novel Therapeutic Strategies. Cells 2023; 12:cells12091277. [PMID: 37174677 PMCID: PMC10177046 DOI: 10.3390/cells12091277] [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: 03/11/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Glioblastoma multiforme (GBM) is a major aggressive primary brain tumor with dismal survival outcome and few therapeutic options. Although Temozolomide (TMZ) is a part of the standard therapy, over time, it can cause DNA damage leading to deleterious effects, necessitating the discovery of drugs with minimal side effects. To this end, we investigated the effect of cinnamaldehyde (CA), a highly purified, single ingredient from cinnamon, on the GBM cell lines U87 and U251 and the neuroglioma cell line H4. On observing similar impact on the viability in all the three cell lines, detailed studies were conducted with CA and its isomer/analog, trans-CA (TCA), and methoxy-CA (MCA) on U87 cells. The compounds exhibited equal potency when assessed at the cellular level in inhibiting U87 cells as well as at the molecular level, resulting in an increase in reactive oxygen species (ROS) and an increase in the apoptotic and multicaspase cell populations. To further characterize the key entities, protein profiling was performed with CA. The studies revealed differential regulation of entities that could be key to glioblastoma cell circuits such as downregulation of pyruvate kinase-PKM2, the key enzyme of the glycolytic pathway that is central to the Warburg effect. This allows for monitoring the levels of PKM2 after therapy using recently developed noninvasive technology employing PET [18F] DASA-23. Additionally, the observation of downregulation of phosphomevalonate kinase is significant as the brain tumor initiating cells (BTIC) are maintained by the metabolism occurring via the mevalonate pathway. Results from the current study, if translated in vivo, could provide additional efficacious treatment options for glioblastoma with minimal side effects.
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Affiliation(s)
- Shraddha Srivastava
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Ketki Patil
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Elizabeth W Thompson
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Shadi A Nakhai
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Yoo Na Kim
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Casey Haynes
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Crystal Bryant
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - S Balakrishna Pai
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
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Teglia F, Boffetta P. Association between trends of mortality and incidence, survival and stage at diagnosis for six digestive and respiratory cancers in United States (2009-2013). Eur J Cancer Prev 2023; 32:195-202. [PMID: 35881938 DOI: 10.1097/cej.0000000000000766] [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: 02/03/2023]
Abstract
BACKGROUND A decrease in cancer mortality has been reported in the USA, possibly due to decreased incidence, downstaging and improved survival. The aim of the present study is to estimate the contribution of these factors on the trend in cancer mortality. METHODS Data on incidence, mortality, stage at diagnosis, and overall and stage-specific survival for six common digestive and respiratory cancers (esophagus, stomach, colorectal, liver, pancreas and lung) during 2009-2013 in the USA from the surveillance, epidemiology and end results (SEER) program, was analyzed using generalized linear models separately among men and women. RESULTS Our study showed a decrease in mortality for esophageal (-0.09/100 000/year and -0.03/100 000/year), stomach (-0.11/100 000/year and -0.05/100 000/year), colorectal (-0.45/100 000/year and -0.29/100 000/year) and lung cancer (-1.89/100 000/year in men and -0.78/100 000/year in women) in men and women, respectively: for all of them, except lung cancer in women, there was a decrease in the incidence of comparable or greater magnitude; stage distribution and survival also contributed to the decrease in mortality for lung and colorectal cancer. Mortality from pancreatic cancer was stable: an increase in incidence was counterbalanced by an improvement in survival. Mortality from liver cancer increased, driven by an increase in mortality that was not offset by favorable trends in stage distribution and survival. CONCLUSIONS Trends in mortality were primarily affected by changes in incidence; an increase in the proportion of local stage at diagnosis and improved survival, although evident for some cancers, played a lesser role in mortality trends.
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Affiliation(s)
- Federica Teglia
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Department of Family, Population & Preventive Medicine, Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
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Innocenti L, Ortenzi V, Scarpitta R, Montemurro N, Pasqualetti F, Asseri R, Lazzi S, Szumera-Cieckiewicz A, De Ieso K, Perrini P, Naccarato AG, Scatena C, Fanelli GN. The Prognostic Impact of Gender, Therapeutic Strategies, Molecular Background, and Tumor-Infiltrating Lymphocytes in Glioblastoma: A Still Unsolved Jigsaw. Genes (Basel) 2023; 14:501. [PMID: 36833428 PMCID: PMC9956148 DOI: 10.3390/genes14020501] [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: 12/08/2022] [Revised: 01/21/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
Despite the adoption of novel therapeutical approaches, the outcomes for glioblastoma (GBM) patients remain poor. In the present study, we investigated the prognostic impact of several clinico-pathological and molecular features as well as the role of the cellular immune response in a series of 59 GBM. CD4+ and CD8+ tumor-infiltrating lymphocytes (TILs) were digitally assessed on tissue microarray cores and their prognostic role was investigated. Moreover, the impact of other clinico-pathological features was evaluated. The number of CD4+ and CD8+ is higher in GBM tissue compared to normal brain tissue (p < 0.0001 and p = 0.0005 respectively). A positive correlation between CD4+ and CD8+ in GBM is present (rs = 0.417-p = 0.001). CD4+ TILs are inversely related to overall survival (OS) (HR = 1.79, 95% CI 1.1-3.1, p = 0.035). The presence of low CD4+ TILs combined with low CD8+ TILs is an independent predictor of longer OS (HR 0.38, 95% CI 0.18-0.79, p = 0.014). Female sex is independently related to longer OS (HR 0.42, 95% CI 0.22-0.77, p = 0.006). Adjuvant treatment, methylguanine methyltransferase (MGMT) promoter methylation, and age remain important prognostic factors but are influenced by other features. Adaptive cell-mediated immunity can affect the outcomes of GBM patients. Further studies are needed to elucidate the commitment of the CD4+ cells and the effects of different TILs subpopulations in GBM.
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Affiliation(s)
- Lorenzo Innocenti
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Valerio Ortenzi
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
| | - Rosa Scarpitta
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Nicola Montemurro
- Department of Neurosurgery, Pisa University Hospital, 56126 Pisa, Italy
| | - Francesco Pasqualetti
- Department of Radiation Oncology, Pisa University Hospital, 56126 Pisa, Italy
- Department of Oncology, Oxford University, Oxford OX1 4BH, UK
| | - Roberta Asseri
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Stefano Lazzi
- Anatomic Pathology Unit, Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy
| | - Anna Szumera-Cieckiewicz
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
| | - Katia De Ieso
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
| | - Paolo Perrini
- Department of Neurosurgery, Pisa University Hospital, 56126 Pisa, Italy
| | - Antonio Giuseppe Naccarato
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
| | - Cristian Scatena
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
| | - Giuseppe Nicolò Fanelli
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
- Department of Laboratory Medicine, Pisa University Hospital, 56126 Pisa, Italy
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10021, USA
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Ciammella P, Cozzi S, Botti A, Giaccherini L, Sghedoni R, Orlandi M, Napoli M, Pascarella R, Pisanello A, Russo M, Cavallieri F, Ruggieri MP, Cavuto S, Savoldi L, Iotti C, Iori M. Safety of Inhomogeneous Dose Distribution IMRT for High-Grade Glioma Reirradiation: A Prospective Phase I/II Trial (GLIORAD TRIAL). Cancers (Basel) 2022; 14:cancers14194604. [PMID: 36230525 PMCID: PMC9562035 DOI: 10.3390/cancers14194604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Glioblastoma multiforme (GBM) is the most frequent primary malignant brain tumor, and despite advances in imaging techniques and treatment options, the outcome remains poor and recurrence is inevitable. Salvage therapy presents a challenge, and re-irradiation can be a therapeutic option in recurrent GBM. The decision-making process for re-irradiation is a challenge for radiation oncologists due to the expected toxicity of a second course of radiotherapy and the limited radiation tolerance of normal tissue; nevertheless, it is being increasingly used, as several studies have demonstrated its feasibility. The current study aimed to investigate the safety of moderate–high-voxel-based dose escalation radiotherapy in recurrent GBM patients after conventional concurrent chemoradiation. Twelve patients were enrolled in this prospective single-center study. Retreatment consisted of re-irradiation with a total dose range of 30–50 Gy over 5 days using the IMRT (arc VMAT) technique using dose painting planning. The treatment was well tolerated. No toxicities greater than 3 were recorded; only one patient had severe G3 acute toxicity, characterized by muscle weakness and fatigue. Median overall survival (OS2) and progression-free survival (PFS2) from the time of re-irradiation were 10.4 months and 5.7 months, respectively. Our phase I study demonstrated an acceptable tolerance profile of this approach, and the future prospective phase II study will analyze the efficacy in terms of PFS and OS. Abstract Glioblastoma multiforme (GBM) is the most aggressive astrocytic primary brain tumor, and concurrent temozolomide (TMZ) and radiotherapy (RT) followed by maintenance of adjuvant TMZ is the current standard of care. Despite advances in imaging techniques and multi-modal treatment options, the median overall survival (OS) remains poor. As an alternative to surgery, re-irradiation (re-RT) can be a therapeutic option in recurrent GBM. Re-irradiation for brain tumors is increasingly used today, and several studies have demonstrated its feasibility. Besides differing techniques, the published data include a wide range of doses, emphasizing that no standard approach exists. The current study aimed to investigate the safety of moderate–high-voxel-based dose escalation in recurrent GBM. From 2016 to 2019, 12 patients met the inclusion criteria and were enrolled in this prospective single-center study. Retreatment consisted of re-irradiation with a total dose of 30 Gy (up to 50 Gy) over 5 days using the IMRT (arc VMAT) technique. A dose painting by numbers (DPBN)/dose escalation plan were performed, and a continuous relation between the voxel intensity of the functional image set and the risk of recurrence in that voxel were used to define target and dose distribution. Re-irradiation was well tolerated in all treated patients. No toxicities greater than G3 were recorded; only one patient had severe G3 acute toxicity, characterized by muscle weakness and fatigue. Median overall survival (OS2) and progression-free survival (PFS2) from the time of re-irradiation were 10.4 months and 5.7 months, respectively; 3-, 6-, and 12-month OS2 were 92%, 75%, and 42%, respectively; and 3-, 6-, and 12-month PFS2 were 83%, 42%, and 8%, respectively. Our work demonstrated a tolerable tolerance profile of this approach, and the future prospective phase II study will analyze the efficacy in terms of PFS and OS.
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Affiliation(s)
- Patrizia Ciammella
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Salvatore Cozzi
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- Correspondence: ; Tel.: +39-3297317608
| | - Andrea Botti
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Lucia Giaccherini
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Roberto Sghedoni
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Matteo Orlandi
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Manuela Napoli
- Neuroradiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Rosario Pascarella
- Neuroradiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Anna Pisanello
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Marco Russo
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Maria Paola Ruggieri
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Silvio Cavuto
- Clinical Trials and Statistics Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Luisa Savoldi
- Clinical Trials and Statistics Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Cinzia Iotti
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Mauro Iori
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
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Jia Z, Li X, Yan Y, Shen X, Wang J, Yang H, Liu S, Han C, Hu Y. Exploring the relationship between age and prognosis in glioma: rethinking current age stratification. BMC Neurol 2022; 22:350. [PMID: 36109699 PMCID: PMC9476578 DOI: 10.1186/s12883-022-02879-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 09/08/2022] [Indexed: 12/04/2022] Open
Abstract
Background The age of glioma plays a unique role in prognosis. We hypothesized that age is not positively correlated with survival prognosis and explored its exact relationship. Methods Glioma was identified from the SEER database (between 2000 and 2018). A multivariate Cox proportional regression model and restricted cubic spline (RCS) plot were used to assess the relationship between age and prognosis. Results A total of 66465 patients with glioma were included. Hazard ratios (HR) for ten-year by age: 0–9 years, HR 1.06 (0.93–1.20); 10–19 years: reference; 20–29 years, HR 0.90 (0.82–1.00); 30–39 years, HR 1.14 (1.04–1.25); 40–49 years, HR 2.09 (1.91–2.28); 50–59 years, HR 3.48 (3.19–3.79); 60–69 years, HR 4.91 (4.51–5.35);70–79 years, HR 7.95 (7.29–8.66); 80–84 years, HR 12.85 (11.74–14.06). After adjusting for covariates, the prognosis was not positively correlated with age. The smooth curve of RCS revealed this non-linear relationship: HR increased to 10 years first, decreased to 23 years, reached its lowest point, and became J-shaped. Conclusion The relationship between age and glioma prognosis is non-linear. These results challenge the applicability of current age groupings for gliomas and advocate the consideration of individualized treatment guided by precise age. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02879-9.
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11
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Substrate viscosity impairs temozolomide-mediated inhibition of glioblastoma cells' growth. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166513. [PMID: 35932892 DOI: 10.1016/j.bbadis.2022.166513] [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: 03/07/2022] [Revised: 07/16/2022] [Accepted: 07/29/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The mechanical state of the extracellular environment of the brain cells considerably affects their phenotype during the development of central nervous system (CNS) pathologies, and when the cells respond to drugs. The reports on the evaluation of the viscoelastic properties of different brain tumors have shown that both tissue stiffness and viscosity can be altered during cancer development. Although a compelling number of reports established the role of substrate stiffness on the proliferation, motility, and drug sensitivity of brain cancer cells, there is a lack of parallel data in terms of alterations in substrate viscosity. METHODS Based on viscoelasticity measurements of rat brain samples using strain rheometry, polyacrylamide (PAA) hydrogels mimicking elastic and viscous parameters of the tissues were prepared. Optical microscopy and flow cytometry were employed to assess the differences in glioblastoma cells morphology, proliferation, and cytotoxicity of anticancer drug temozolomide (TZM) due to increased substrate viscosity. RESULTS Our results indicate that changes in substrate viscosity affect the proliferation of untreated glioma cells to a lesser extent, but have a significant impact on the apoptosis-associated depolarization of mitochondria and level of DNA fragmentation. This suggests that viscosity sensing and stiffness sensing machinery can activate different signaling pathways in glioma cells. CONCLUSION Collected data indicate that viscosity should be considered an important parameter in in vitro polymer-based cell culture systems used for drug screening.
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12
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Mechanical Properties of the Extracellular Environment of Human Brain Cells Drive the Effectiveness of Drugs in Fighting Central Nervous System Cancers. Brain Sci 2022; 12:brainsci12070927. [PMID: 35884733 PMCID: PMC9313046 DOI: 10.3390/brainsci12070927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 12/04/2022] Open
Abstract
The evaluation of nanomechanical properties of tissues in health and disease is of increasing interest to scientists. It has been confirmed that these properties, determined in part by the composition of the extracellular matrix, significantly affect tissue physiology and the biological behavior of cells, mainly in terms of their adhesion, mobility, or ability to mutate. Importantly, pathophysiological changes that determine disease development within the tissue usually result in significant changes in tissue mechanics that might potentially affect the drug efficacy, which is important from the perspective of development of new therapeutics, since most of the currently used in vitro experimental models for drug testing do not account for these properties. Here, we provide a summary of the current understanding of how the mechanical properties of brain tissue change in pathological conditions, and how the activity of the therapeutic agents is linked to this mechanical state.
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Xavier MA, Rezende F, Titze-de-Almeida R, Cornelissen B. BRCAness as a Biomarker of Susceptibility to PARP Inhibitors in Glioblastoma Multiforme. Biomolecules 2021; 11:1188. [PMID: 34439854 PMCID: PMC8394995 DOI: 10.3390/biom11081188] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/20/2022] Open
Abstract
Glioblastoma multiforme (GBM) is the most common primary brain cancer. GBMs commonly acquire resistance to standard-of-care therapies. Among the novel means to sensitize GBM to DNA-damaging therapies, a promising strategy is to combine them with inhibitors of the DNA damage repair (DDR) machinery, such as inhibitors for poly(ADP-ribose) polymerase (PARP). PARP inhibitors (PARPis) have already shown efficacy and have received regulatory approval for breast, ovarian, prostate, and pancreatic cancer treatment. In these cancer types, after PARPi administration, patients carrying specific mutations in the breast cancer 1 (BRCA1) and 2 (BRCA2) suppressor genes have shown better response when compared to wild-type carriers. Mutated BRCA genes are infrequent in GBM tumors, but their cells can carry other genetic alterations that lead to the same phenotype collectively referred to as 'BRCAness'. The most promising biomarkers of BRCAness in GBM are related to isocitrate dehydrogenases 1 and 2 (IDH1/2), epidermal growth factor receptor (EGFR), phosphatase and tensin homolog (PTEN), MYC proto-oncogene, and estrogen receptors beta (ERβ). BRCAness status identified by accurate biomarkers can ultimately predict responsiveness to PARPi therapy, thereby allowing patient selection for personalized treatment. This review discusses potential biomarkers of BRCAness for a 'precision medicine' of GBM patients.
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Affiliation(s)
- Mary-Ann Xavier
- Central Institute of Sciences, Technology for Gene Therapy Laboratory, University of Brasília—UnB/FAV, Brasília 70910-900, Brazil; (F.R.); (R.T.-d.-A.)
| | - Fernando Rezende
- Central Institute of Sciences, Technology for Gene Therapy Laboratory, University of Brasília—UnB/FAV, Brasília 70910-900, Brazil; (F.R.); (R.T.-d.-A.)
| | - Ricardo Titze-de-Almeida
- Central Institute of Sciences, Technology for Gene Therapy Laboratory, University of Brasília—UnB/FAV, Brasília 70910-900, Brazil; (F.R.); (R.T.-d.-A.)
| | - Bart Cornelissen
- Department of Oncology, Radiobiology Research Institute, University of Oxford, Oxford OX3 7LJ, UK;
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, 9700 RB Groningen, The Netherlands
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Highly Expressed CYBRD1 Associated with Glioma Recurrence Regulates the Immune Response of Glioma Cells to Interferon. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2793222. [PMID: 34326882 PMCID: PMC8302377 DOI: 10.1155/2021/2793222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/30/2021] [Indexed: 11/18/2022]
Abstract
Invasiveness, resistance to treatment, and recurrence of gliomas are significant hurdles to successful treatment regimens. Data sets from Gene Expression Omnibus (GEO), CGGA-RNAseq, and The Cancer Genome Atlas Glioblastoma Multiforme (TCGA-GBM) were analyzed, and an increased expression of Cytochrome B Reductase 1 (CYBRD1) was identified and could be associated with aggravated clinical outcomes. Gene ontology (GO) enrichment analysis indicated that CYBRD1 co-expressed genes are enriched during an immune response. CYBRD1 overexpression in glioma cell lines is enhanced, whereas CYBRD1 silencing attenuated the aggressiveness of glioma cells. In IFN-α-treated glioma cells, IFN-α suppressed the viability and migratory ability and invasive ability of glioma cells, whereas CYBRD1 overexpression attenuated the antitumor effects of IFN-α. CYBRD1 could potentially serve as a biomarker for glioma recurrence. CYBRD1 overexpression enhances glioma cell aggressiveness and attenuates glioma cell response to IFN-α.
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Liu X, Chen JY, Chien Y, Yang YP, Chen MT, Lin LT. Overview of the molecular mechanisms of migration and invasion in glioblastoma multiforme. J Chin Med Assoc 2021; 84:669-677. [PMID: 34029218 DOI: 10.1097/jcma.0000000000000552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Glioblastoma (GBM) is one of the most devastating cancers, with an approximate median survival of only 16 months. Although some new insights into the fantastic heterogeneity of this kind of brain tumor have been revealed in recent studies, all subclasses of GBM still demonstrate highly aggressive invasion properties to the surrounding parenchyma. This behavior has become the main obstruction to current curative therapies as invasive GBM cells migrate away from these foci after surgical therapies. Therefore, this review aimed to provide a relatively comprehensive study of GBM invasion mechanisms, which contains an intricate network of interactions and signaling pathways with the extracellular matrix (ECM). Among these related molecules, TGF-β, the ECM, Akt, and microRNAs are most significant in terms of cellular procedures related to GBM motility and invasion. Moreover, we also review data indicating that Musashi-1 (MSI1), a neural RNA-binding protein (RBP), regulates GBM motility and invasion, maintains stem cell populations in GBM, and promotes drug-resistant GBM phenotypes by stimulating necessary oncogenic signaling pathways through binding and regulating mRNA stability. Importantly, these necessary oncogenic signaling pathways have a close connection with TGF-β, ECM, and Akt. Thus, it appears promising to find MSI-specific inhibitors or RNA interference-based treatments to prevent the actions of these molecules despite using RBPs, which are known as hard therapeutic targets. In summary, this review aims to provide a better understanding of these signaling pathways to help in developing novel therapeutic approaches with better outcomes in preclinical studies.
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Affiliation(s)
- Xian Liu
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Ju-Yu Chen
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Yueh Chien
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yi-Ping Yang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Teh Chen
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medical Education & Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Liang-Ting Lin
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- Department of Health Technology and Informatics, Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, Guangdong, China
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Attallah O. CoMB-Deep: Composite Deep Learning-Based Pipeline for Classifying Childhood Medulloblastoma and Its Classes. Front Neuroinform 2021; 15:663592. [PMID: 34122031 PMCID: PMC8193683 DOI: 10.3389/fninf.2021.663592] [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: 02/08/2021] [Accepted: 04/26/2021] [Indexed: 12/28/2022] Open
Abstract
Childhood medulloblastoma (MB) is a threatening malignant tumor affecting children all over the globe. It is believed to be the foremost common pediatric brain tumor causing death. Early and accurate classification of childhood MB and its classes are of great importance to help doctors choose the suitable treatment and observation plan, avoid tumor progression, and lower death rates. The current gold standard for diagnosing MB is the histopathology of biopsy samples. However, manual analysis of such images is complicated, costly, time-consuming, and highly dependent on the expertise and skills of pathologists, which might cause inaccurate results. This study aims to introduce a reliable computer-assisted pipeline called CoMB-Deep to automatically classify MB and its classes with high accuracy from histopathological images. This key challenge of the study is the lack of childhood MB datasets, especially its four categories (defined by the WHO) and the inadequate related studies. All relevant works were based on either deep learning (DL) or textural analysis feature extractions. Also, such studies employed distinct features to accomplish the classification procedure. Besides, most of them only extracted spatial features. Nevertheless, CoMB-Deep blends the advantages of textural analysis feature extraction techniques and DL approaches. The CoMB-Deep consists of a composite of DL techniques. Initially, it extracts deep spatial features from 10 convolutional neural networks (CNNs). It then performs a feature fusion step using discrete wavelet transform (DWT), a texture analysis method capable of reducing the dimension of fused features. Next, the CoMB-Deep explores the best combination of fused features, enhancing the performance of the classification process using two search strategies. Afterward, it employs two feature selection techniques on the fused feature sets selected in the previous step. A bi-directional long-short term memory (Bi-LSTM) network; a DL-based approach that is utilized for the classification phase. CoMB-Deep maintains two classification categories: binary category for distinguishing between the abnormal and normal cases and multi-class category to identify the subclasses of MB. The results of the CoMB-Deep for both classification categories prove that it is reliable. The results also indicate that the feature sets selected using both search strategies have enhanced the performance of Bi-LSTM compared to individual spatial deep features. CoMB-Deep is compared to related studies to verify its competitiveness, and this comparison confirmed its robustness and outperformance. Hence, CoMB-Deep can help pathologists perform accurate diagnoses, reduce misdiagnosis risks that could occur with manual diagnosis, accelerate the classification procedure, and decrease diagnosis costs.
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Affiliation(s)
- Omneya Attallah
- Department of Electronics and Communications Engineering, College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Alexandria, Egypt
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17
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Lv F, Du Q, Li L, Xi X, Liu Q, Li W, Liu S. Eriodictyol inhibits glioblastoma migration and invasion by reversing EMT via downregulation of the P38 MAPK/GSK-3β/ZEB1 pathway. Eur J Pharmacol 2021; 900:174069. [PMID: 33811837 DOI: 10.1016/j.ejphar.2021.174069] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/12/2022]
Abstract
Eriodictyol (ERD) is a natural flavonoid that exists in many vegetables and fruits, especially citrus fruits. It has been proven to have many pharmacological effects, such as antioxidative, anti-inflammatory and neuroprotective effects. Our previous study showed that eriodictyol could inhibit the proliferation and induce the apoptosis of glioblastoma cells by downregulating the PI3K/Akt/NF-κB pathway and restraining its migration and invasion. However, the mechanism by which eriodictyol prevents glioblastoma metastasis is still unknown. Epithelial-mesenchymal transition (EMT) is a key process for many cancer metastases; it also confers locomotivity to tumor cells, including glioblastoma. In this study, we found that eriodictyol can suppress the migration and invasion of glioblastoma A172 and U87 MG cell lines by suppressing the EMT markers - N-cadherin and E-cadherin through Wound healing and Transwell assays, Western blot, RT-qPCR, immunofluorescence and immunohistochemistry. Further research revealed that the mechanism could be connected with downregulation of the P38 MAPK/GSK-3β/ZEB1 signaling pathway. These findings can provide a new idea for the treatment of glioblastoma.
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Affiliation(s)
- Feng Lv
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, 401120, PR China
| | - Qian Du
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, 401120, PR China
| | - Lin Li
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, 401120, PR China
| | - Xin Xi
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, 401120, PR China
| | - Qinglong Liu
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, 401120, PR China
| | - Wenjun Li
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, 401120, PR China.
| | - Songqing Liu
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, 401120, PR China.
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18
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Xing J, Li Y, Zhao H. Knockdown of CLN5 inhibits the tumorigenic properties of glioblastoma cells via the Akt/mTOR signaling pathway. Oncol Lett 2021; 21:387. [PMID: 33777210 PMCID: PMC7988714 DOI: 10.3892/ol.2021.12648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 08/18/2020] [Indexed: 12/14/2022] Open
Abstract
Gliomas are highly malignant tumors with a rapid progression and poor prognosis. The present study investigated the cellular effects of CLN5-knockdown in the glioblastoma (GBM) U251 and U87MG cell lines. The Cell Counting Kit-8 and colony formation assays indicated that CLN5-knockdown inhibited the proliferation of GBM cells. Additionally, the results of the Transwell and scratch assays revealed that CLN5-knockdown significantly inhibited migration and invasion, and the flow cytometry analysis confirmed that apoptosis was promoted. Knockdown of CLN5 downregulated the expression levels of MMP-2, Bcl-2, cyclin D1, CDK4 and CDK6, and upregulated the expression levels of Bax and activated caspase-9. Additionally, it blocked GBM cells in the G1-phase and induced early apoptosis. Knockdown of CLN5 inhibited the activation of the Akt and mTOR signaling pathways in GBM by decreasing the levels of phosphorylated (p)-Akt and p-mTOR. The present data suggested that downregulation of CLN5 may be a potential treatment option for GBM. Knockdown of CLN5 inhibited the development of GBM via the inhibition of the Akt and mTOR signaling pathways.
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Affiliation(s)
- Jiexia Xing
- Department of Neurology, Shandong University of Qilu Hospital, Jinan, Shandong 250012, P.R. China
| | - Ying Li
- Department of Critical Medicine, The Third People's Hospital of Heze, Heze, Shandong 274000, P.R. China
| | - Huilan Zhao
- Department of Geriatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250011, P.R. China
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EGFRvIII Promotes Cell Survival during Endoplasmic Reticulum Stress through a Reticulocalbin 1-Dependent Mechanism. Cancers (Basel) 2021; 13:cancers13061198. [PMID: 33801941 PMCID: PMC7999088 DOI: 10.3390/cancers13061198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary A key molecule, EGFRvIII has been shown to provide several growth advantages for brain tumors. However, we have found a new mechanism in which the EGFRvIII provides increased survival to brain cancer cells when under sub-optimal conditions. Specifically, we have found that the EGFRvIII drives the expression of a molecule called Reticulocalbin 1 (RCN1) and that RCN1 blocks cell stress and cell death, thereby allowing cells to survive and proliferate. Importantly, these findings will allow for the generation of drugs that block the function of EGFRvIII and RCN1 with the hope that these drugs will induce brain cancer cell death. Abstract Reticulocalbin 1 (RCN1) is an endoplasmic reticulum (ER)-residing protein, involved in promoting cell survival during pathophysiological conditions that lead to ER stress. However, the key upstream receptor tyrosine kinase that regulates RCN1 expression and its potential role in cell survival in the glioblastoma setting have not been determined. Here, we demonstrate that RCN1 expression significantly correlates with poor glioblastoma patient survival. We also demonstrate that glioblastoma cells with expression of EGFRvIII receptor also have high RCN1 expression. Over-expression of wildtype EGFR also correlated with high RCN1 expression, suggesting that EGFR and EGFRvIII regulate RCN1 expression. Importantly, cells that expressed EGFRvIII and subsequently showed high RCN1 expression displayed greater cell viability under ER stress compared to EGFRvIII negative glioblastoma cells. Consistently, we also demonstrated that RCN1 knockdown reduced cell viability and exogenous introduction of RCN1 enhanced cell viability following induction of ER stress. Mechanistically, we demonstrate that the EGFRvIII-RCN1-driven increase in cell survival is due to the inactivation of the ER stress markers ATF4 and ATF6, maintained expression of the anti-apoptotic protein Bcl-2 and reduced activity of caspase 3/7. Our current findings identify that EGFRvIII regulates RCN1 expression and that this novel association promotes cell survival in glioblastoma cells during ER stress.
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Attallah O. MB-AI-His: Histopathological Diagnosis of Pediatric Medulloblastoma and its Subtypes via AI. Diagnostics (Basel) 2021; 11:359. [PMID: 33672752 PMCID: PMC7924641 DOI: 10.3390/diagnostics11020359] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 12/17/2022] Open
Abstract
Medulloblastoma (MB) is a dangerous malignant pediatric brain tumor that could lead to death. It is considered the most common pediatric cancerous brain tumor. Precise and timely diagnosis of pediatric MB and its four subtypes (defined by the World Health Organization (WHO)) is essential to decide the appropriate follow-up plan and suitable treatments to prevent its progression and reduce mortality rates. Histopathology is the gold standard modality for the diagnosis of MB and its subtypes, but manual diagnosis via a pathologist is very complicated, needs excessive time, and is subjective to the pathologists' expertise and skills, which may lead to variability in the diagnosis or misdiagnosis. The main purpose of the paper is to propose a time-efficient and reliable computer-aided diagnosis (CADx), namely MB-AI-His, for the automatic diagnosis of pediatric MB and its subtypes from histopathological images. The main challenge in this work is the lack of datasets available for the diagnosis of pediatric MB and its four subtypes and the limited related work. Related studies are based on either textural analysis or deep learning (DL) feature extraction methods. These studies used individual features to perform the classification task. However, MB-AI-His combines the benefits of DL techniques and textural analysis feature extraction methods through a cascaded manner. First, it uses three DL convolutional neural networks (CNNs), including DenseNet-201, MobileNet, and ResNet-50 CNNs to extract spatial DL features. Next, it extracts time-frequency features from the spatial DL features based on the discrete wavelet transform (DWT), which is a textural analysis method. Finally, MB-AI-His fuses the three spatial-time-frequency features generated from the three CNNs and DWT using the discrete cosine transform (DCT) and principal component analysis (PCA) to produce a time-efficient CADx system. MB-AI-His merges the privileges of different CNN architectures. MB-AI-His has a binary classification level for classifying among normal and abnormal MB images, and a multi-classification level to classify among the four subtypes of MB. The results of MB-AI-His show that it is accurate and reliable for both the binary and multi-class classification levels. It is also a time-efficient system as both the PCA and DCT methods have efficiently reduced the training execution time. The performance of MB-AI-His is compared with related CADx systems, and the comparison verified the powerfulness of MB-AI-His and its outperforming results. Therefore, it can support pathologists in the accurate and reliable diagnosis of MB and its subtypes from histopathological images. It can also reduce the time and cost of the diagnosis procedure which will correspondingly lead to lower death rates.
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Affiliation(s)
- Omneya Attallah
- Department of Electronics and Communications Engineering, College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Alexandria 1029, Egypt
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21
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Multimodal Rehabilitation Following Gliosarcoma Resection: A Case Report. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Reduced EGFR and increased miR-221 is associated with increased resistance to temozolomide and radiotherapy in glioblastoma. Sci Rep 2020; 10:17768. [PMID: 33082482 PMCID: PMC7576591 DOI: 10.1038/s41598-020-74746-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 10/06/2020] [Indexed: 12/21/2022] Open
Abstract
Despite aggressive treatment with temozolomide and radiotherapy and extensive research into alternative therapies there has been little improvement in Glioblastoma patient survival. Median survival time remains between 12 and 15 months mainly due to treatment resistance and tumor recurrence. In this study, we aimed to explore the underlying mechanisms behind treatment resistance and the lack of success with anti-EGFR therapy in the clinic. After generating a number of treatment resistant Glioblastoma cell lines we observed that resistant cell lines lacked EGFR activation and expression. Furthermore, cell viability assays showed resistant cells were significantly less sensitive to the anti-EGFR agents when compared to parental cell lines. To further characterise the resistance mechanism in our cells microRNA prediction software identified miR-221 as a negative regulator of EGFR expression. miR-221 was up-regulated in our resistant cell lines, and this up-regulation led to a significant reduction in EGFR expression in both our cultured cell lines and a large cohort of glioblastoma patient tumor tissue.
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Frankel BM, Cachia D, Patel SJ, Das A. Targeting Subventricular Zone Progenitor Cells with Intraventricular Liposomal Encapsulated Cytarabine in Patients with Secondary Glioblastoma : A Report of Two Cases. ACTA ACUST UNITED AC 2020; 2:836-843. [PMID: 32704621 DOI: 10.1007/s42399-020-00322-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Current treatments for glioblastoma (GB), the most common and malignant primary brain tumor are inadequate and as such, the median survival for most patients with GB is on the order of months, even after cytoreductive surgery, radiation and chemotherapy. Case Description Current study reports two cases of glioblastoma (GB) with subventricular zone (SVZ) involvement. SVZ biopsies demonstrated the presence of hypercellularity, nestin immunoreactivity, and a Ki-67 labeling index (LI) of 1-2%. Interestingly, tumor morphology and proliferative indices are different in the SVZ specimens than the hemispheric recurrences, which displayed similar nestin immunoreactivity, but a greater LI of 10%. Biopsy specimens demonstrated both intense nestin immunoreactivity and GFAP immunoreactivity in and around the GB recurrence. Nestin positive cells were more abundant closer to the SVZ nearest to the dorsolateral horn of the left lateral ventricle, while GFAP immunoreactivity was more intense closer to the center of the tumor recurrence. Additionally, co-labeling of cells with Ki67 and several different progenitor markers (CD133, CD140, TUJ-1, and nestin) demonstrated that these cells found in and around the GB recurrence were actively dividing. Having failed standard therapy with evidence of bi-hemispheric spread and progression to GB, we report a novel approach of using intraventricular liposomal encapsulated cytarabine (DepoCyt) for the treatment for GB by suppressing glial progenitor cells that surround the ventricular system in patients with GB. Conclusions MRI and immunohistochemistry demonstrated that the SVZ is the incubator for future recurrences of GB and propose targeting SVZ progenitor cells with intraventricular liposomal encapsulated Ara-C. Two patients treated using this novel regimen have demonstrated partial radiographic responses warranting further studies looking at targeting the subventricular zone.
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Affiliation(s)
- Bruce M Frankel
- Department of Neurosurgery, Medical University of South Carolina
| | - David Cachia
- Department of Neurosurgery, Medical University of South Carolina
| | - Sunil J Patel
- Department of Neurosurgery, Medical University of South Carolina
| | - Arabinda Das
- Department of Neurosurgery, Medical University of South Carolina
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Al-Khatib SM, Abdo N, Al-Eitan LN, Al-Mistarehi AHW, Zahran DJ, Al Ajlouni M, Kewan TZ. The Impact of the Genetic Polymorphism in DNA Repair Pathways on Increased Risk of Glioblastoma Multiforme in the Arab Jordanian Population: A Case-Control Study. APPLICATION OF CLINICAL GENETICS 2020; 13:115-126. [PMID: 32606887 PMCID: PMC7295542 DOI: 10.2147/tacg.s248994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 05/22/2020] [Indexed: 01/06/2023]
Abstract
Introduction Among the Jordanian population, brain tumors are the tenth most common type of cancers in both males and females, comprising 2.8% of all newly diagnosed neoplasms. Diffuse gliomas are the most prevalent and the most aggressive primary brain tumors in adults. The incidence of diffuse gliomas varies among different populations; this variation is partially linked to genetic polymorphisms. The purpose of the study is to examine the association between (BRCA1 rs799917G>A, rs1799966T>C, EXO1 rs1047840G>A, EME1 rs12450550T>C, ERCC2 rs13181T>G, rs1799793C>T, and XRCC1 rs1799782G>A) DNA repair gene polymorphisms and glioblastoma multiforme (GBM) susceptibility, and survival in the Jordanian Arab population. Methods Eighty-four patients diagnosed with glioblastoma multiforme at the King Abdullah University Hospital (KAUH) between 2013 and 2018 and 225 healthy cancer-free control subjects with similar geographic and ethnic backgrounds to the patients were included in the study. Genomic DNA was extracted from the formalin-fixed paraffin-embedded tissues of the subjects. The Sequenom MassARRAY® sequencer system (iPLEX GOLD) was used. The analyses included assessments of population variability and survival. Results This study is the first to address the relationship between BRCA1 rs1799966 and rs799917 SNP, and the risk of GBM among the Arab Jordanian population. The findings of the study show that BRCA1 rs799917 is associated with decreased risk of GBM in the recessive model (AA vs G/G-A/G: OR, 0.46, 95% CI, 0.26-0.82, p=0.01) and the same SNP is associated with increased risk of GBM in the overdominant model (AG vs G/G-A/A: OR, 1.72, 95% CI, 1.02-2.89, p=0.04).
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Affiliation(s)
- Sohaib M Al-Khatib
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nour Abdo
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Laith N Al-Eitan
- Department of Biotechnology and Genetic Engineering, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed W Al-Mistarehi
- Department of Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Deeb Jamil Zahran
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Marwan Al Ajlouni
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Tariq Zuheir Kewan
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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25
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Das D, Mahanta LB, Ahmed S, Baishya BK. Classification of childhood medulloblastoma into WHO-defined multiple subtypes based on textural analysis. J Microsc 2020; 279:26-38. [PMID: 32271463 DOI: 10.1111/jmi.12893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/20/2020] [Accepted: 03/30/2020] [Indexed: 11/28/2022]
Abstract
Childhood medulloblastoma is a case of a childhood brain tumour that requires close attention due to the low survival rate. Effective prognosis depends a lot on accurate detection of its subtype. The present study proposes a texture-based computer-aided categorization of childhood medulloblastoma samples. According to the World Health Organization, it has four subtypes (desmoplastic, classic, nodular and large). Classification is done in two levels: (i) normal and abnormal and (ii) its four subtypes. The system is evaluated on indigenous patient samples collected from the region. The main objective of database generation is to create a data set of childhood medulloblastoma samples since there exists no available benchmark data set. The proposed framework for automated classification is based on the architectural property and the distribution of cells. Five texture features were extracted for the feature set, namely: grey-level co-occurrence matrix, grey-level run length matrix, first-order histogram features, local binary pattern and Tamura features. The performance of each feature set was evaluated, both individually and in combinations, using five different classifiers. Fivefold cross-validation was used for training and testing the data set. Experiments on both individual feature sets and combinations (best-2, best-3, best-4 and all-5) of feature sets were evaluated based on the accuracy of performance. It was revealed that the combined best-4 feature set resulted in the highest accuracy of 91.3%. The precision, recall and specificity were 0.913, 0.913 and 0.97, respectively. Significantly, it implied that the all-5 feature set is not necessary to have a useful classification. Feature reduction by principal component analysis resulted in increased accuracy of 96.7%. LAY DESCRIPTION: Childhood medulloblastoma is a case of childhood brain tumour that requires high attention due to a low survival rate. Effective prognosis depends a lot on accurate detection of its subtype. The present study proposes a texture-based computer-aided categorization of childhood medulloblastoma samples. According to the World Health Organization (W.H.O), it has four subtypes (desmoplastic, classic, nodular, and large). Classification is done in two levels: i) normal and abnormal ii) its four subtypes. The system is evaluated on indigenous patient samples collected from the region. The main objective of database generation is to create a data set of childhood medulloblastoma samples since there exists no available benchmark data set. The proposed framework is a model for the automatic classification of the samples. The tissue samples obtained post-operation by doctors are converted into images, and then necessary algorithms are applied so that certain features describing each group of the image are known and studied for classification. Later these images are classified using the image features into the subtypes of abnormal samples.
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Affiliation(s)
- Daisy Das
- Institute of Advanced Study in Science and Technology, Guwahati, India
| | - Lipi B Mahanta
- Institute of Advanced Study in Science and Technology, Guwahati, India
| | - Shabnam Ahmed
- Guwahati Neurological Research Center, Sixmile, Guwahati, India
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26
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Vollmann-Zwerenz A, Leidgens V, Feliciello G, Klein CA, Hau P. Tumor Cell Invasion in Glioblastoma. Int J Mol Sci 2020; 21:E1932. [PMID: 32178267 PMCID: PMC7139341 DOI: 10.3390/ijms21061932] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022] Open
Abstract
Glioblastoma (GBM) is a particularly devastating tumor with a median survival of about 16 months. Recent research has revealed novel insights into the outstanding heterogeneity of this type of brain cancer. However, all GBM subtypes share the hallmark feature of aggressive invasion into the surrounding tissue. Invasive glioblastoma cells escape surgery and focal therapies and thus represent a major obstacle for curative therapy. This review aims to provide a comprehensive understanding of glioma invasion mechanisms with respect to tumor-cell-intrinsic properties as well as cues provided by the microenvironment. We discuss genetic programs that may influence the dissemination and plasticity of GBM cells as well as their different invasion patterns. We also review how tumor cells shape their microenvironment and how, vice versa, components of the extracellular matrix and factors from non-neoplastic cells influence tumor cell motility. We further discuss different research platforms for modeling invasion. Finally, we highlight the importance of accounting for the complex interplay between tumor cell invasion and treatment resistance in glioblastoma when considering new therapeutic approaches.
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Affiliation(s)
- Arabel Vollmann-Zwerenz
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, University Hospital Regensburg, 93053 Regensburg, Germany; (A.V.-Z.); (V.L.)
| | - Verena Leidgens
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, University Hospital Regensburg, 93053 Regensburg, Germany; (A.V.-Z.); (V.L.)
| | - Giancarlo Feliciello
- Fraunhofer-Institute for Toxicology and Experimental Medicine, Division of Personalized Tumor Therapy, 93053 Regensburg, Germany; (G.F.); (C.A.K.)
| | - Christoph A. Klein
- Fraunhofer-Institute for Toxicology and Experimental Medicine, Division of Personalized Tumor Therapy, 93053 Regensburg, Germany; (G.F.); (C.A.K.)
- Experimental Medicine and Therapy Research, University of Regensburg, 93053 Regensburg, Germany
| | - Peter Hau
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, University Hospital Regensburg, 93053 Regensburg, Germany; (A.V.-Z.); (V.L.)
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27
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All-cause and tumor-specific mortality trends in geriatric oligodendroglioma (OG) patients: A surveillance, epidemiology, and end results (SEER) analysis. J Clin Neurosci 2020; 73:94-100. [DOI: 10.1016/j.jocn.2020.01.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/06/2020] [Indexed: 11/16/2022]
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28
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Ma AK, Freedman I, Lee JH, Miyagishima D, Ahmed O, Yeung J. Tumor Location and Treatment Modality are Associated with Overall Survival in Adult Medulloblastoma. Cureus 2020; 12:e7061. [PMID: 32226663 PMCID: PMC7089624 DOI: 10.7759/cureus.7061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Medulloblastoma (MB) is an aggressive brain tumor most commonly found in children. Although prognostic factors are well studied in children, factors affecting survival in adults with medulloblastoma are unclear. Methods We queried the 1973-2015 United States Surveillance, Epidemiology, and End Results (SEER) registry to identify all adult cases of medulloblastoma, and performed multivariate survival analyses to assess the relationships amongst various clinical variables, including age, sex, race, tumor location, treatment modalities, and overall survival. Results A total of 857 patients, 20 years of age and older, with MB were identified in the SEER registry. Adult cases presented most frequently in the cerebellum (91.6%) compared to other less common regions (brain stem 3.2%, brain 2.2%, ventricle 1.8%). The overall median survival for adult MB is 60 months (SD = 94.3) and survival time is related to tumor location and course of treatment (P < 0.001). Multivariate Cox proportional hazard models showed that lesions found outside the cerebellum corresponded to worse median survival times (37 months) than those in the cerebellum (63 months) (hazard ratio 1.69, 95% CI 1.321-2.158, P = 0.001). Patients who were assigned chemotherapy had shorter survival (54 months) than those who were not (67 months) (HR 1.4515, 95% CI 1.26-1.671, P < 0.001), but receiving radiation therapy was associated with better overall survival (66 months) relative to not receiving radiation (25 months) (HR 0.581, 95% CI 0.48-0.70, P < 0.001). Conclusions Tumor location appears to be a significant prognostic factor for survival in adult MB. Recommended treatment regimes, likely reflective of the underlying aggressiveness of the tumor, also seem to impact survival.
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Affiliation(s)
- Anthony K Ma
- Neurological Surgery, Yale University, New Haven, USA
| | | | - Jun Hui Lee
- Neurological Surgery, Yale University, New Haven, USA
| | | | | | - Jacky Yeung
- Neurological Surgery, Yale University, New Haven, USA
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29
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Liu L, Zhang H, Wu J, Yu Z, Chen X, Rekik I, Wang Q, Lu J, Shen D. Overall survival time prediction for high-grade glioma patients based on large-scale brain functional networks. Brain Imaging Behav 2020; 13:1333-1351. [PMID: 30155788 DOI: 10.1007/s11682-018-9949-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
High-grade glioma (HGG) is a lethal cancer with poor outcome. Accurate preoperative overall survival (OS) time prediction for HGG patients is crucial for treatment planning. Traditional presurgical and noninvasive OS prediction studies have used radiomics features at the local lesion area based on the magnetic resonance images (MRI). However, the highly complex lesion MRI appearance may have large individual variability, which could impede accurate individualized OS prediction. In this paper, we propose a novel concept, namely brain connectomics-based OS prediction. It is based on presurgical resting-state functional MRI (rs-fMRI) and the non-local, large-scale brain functional networks where the global and systemic prognostic features rather than the local lesion appearance are used to predict OS. We propose that the connectomics features could capture tumor-induced network-level alterations that are associated with prognosis. We construct both low-order (by means of sparse representation with regional rs-fMRI signals) and high-order functional connectivity (FC) networks (characterizing more complex multi-regional relationship by synchronized dynamics FC time courses). Then, we conduct a graph-theoretic analysis on both networks for a jointly, machine-learning-based individualized OS prediction. Based on a preliminary dataset (N = 34 with bad OS, mean OS, ~400 days; N = 34 with good OS, mean OS, ~1030 days), we achieve a promising OS prediction accuracy (86.8%) on separating the individuals with bad OS from those with good OS. However, if using only conventionally derived descriptive features (e.g., age and tumor characteristics), the accuracy is low (63.2%). Our study highlights the importance of the rs-fMRI and brain functional connectomics for treatment planning.
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Affiliation(s)
- Luyan Liu
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Han Zhang
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jinsong Wu
- Glioma Surgery Division, Neurosurgery Department of Huashan Hospital, Fudan University, Shanghai, 200040, China.,Shanghai Key Lab of Medical Image Computing and Computer-Assisted Intervention, Shanghai, 200040, China.,Neurosurgery Department of Huashan Hospital, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Zhengda Yu
- Glioma Surgery Division, Neurosurgery Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xiaobo Chen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Islem Rekik
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,BASIRA Lab, CVIP Group, School of Science and Engineering, Computing, University of Dundee, Dundee, UK
| | - Qian Wang
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.
| | - Junfeng Lu
- Glioma Surgery Division, Neurosurgery Department of Huashan Hospital, Fudan University, Shanghai, 200040, China. .,Shanghai Key Lab of Medical Image Computing and Computer-Assisted Intervention, Shanghai, 200040, China. .,Neurosurgery Department of Huashan Hospital, 12 Wulumuqi Zhong Road, Shanghai, 200040, China.
| | - Dinggang Shen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Department of Brain and Cognitive Engineering, Korea University, Seoul, 02841, Republic of Korea.
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30
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Xiong W, Xie C, Qiu Y, Tu Z, Gong Q. Origin recognition complex subunit 1 regulates cell growth and metastasis in glioma by altering activation of ERK and JNK signaling pathway. Mol Cell Probes 2019; 49:101496. [PMID: 31866342 DOI: 10.1016/j.mcp.2019.101496] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/18/2019] [Accepted: 12/18/2019] [Indexed: 11/28/2022]
Abstract
Origin recognition complex subunit 1(ORC1) is reported to be closely associated with the cell cycle. However, studies on the role of ORC1 in glioma remain undefined. The aim of the present study was to determine whether ORC1 affects cell migration, invasion, apoptosis, and proliferation and to explore the possible underlying mechanism. GEO database analysis indicated that ORC1 was significantly upregulated in glioma, while Gene set enrichment analysis (GSEA) analysis indicated that ORC1 primarily regulated the cell cycle and affects apoptotic signaling pathways. Analysis of protein-protein interaction (PPI) and gene ontology (GO) to further study the relevant mechanisms revealed that the function of the interaction between proteins and ORC1 was primarily concentrated in the regulation of cell cycle, and apoptosis played a critical role in the whole PPI network. Western blot assay and RT-PCR assay indicated that ORC1 was significantly upregulated in glioma tissues. Western blot assay and RT-PCR indicated that ORC1 was significantly upregulated in glioma cell lines. Cell migration, invasion, apoptosis, and proliferation were detected using Transwell and wound healing assays, flow cytometry, colony formation, and CCK8, respectively. Furthermore, OCR1 inhibition reduced invasion and migration, promoted cell apoptosis. In addition, OCR1 overexpression promoted cell proliferation and induced G2 phase arrest. Moreover, OCR1 downregulation suppressed activation of the ERK/JNK signaling pathway. The effects of ORC1 on biological processes were reversed by ERK and JNK inhibitors. These results indicate that ORC1 could be a novel prognostic marker of glioma via the activation of the ERK/JNK signaling pathway.
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Affiliation(s)
- Wenmin Xiong
- Department of Radiotherapy of Head and Neck, Tumor Hospital of Jiangxi Province, No. 519, Beijing East Road, Qingshanhu District, Nanchang City, 330000, Jiangxi Province, PR China
| | - Chen Xie
- Department of Radiotherapy of Head and Neck, Tumor Hospital of Jiangxi Province, No. 519, Beijing East Road, Qingshanhu District, Nanchang City, 330000, Jiangxi Province, PR China
| | - Yang Qiu
- Department of Radiotherapy of Head and Neck, Tumor Hospital of Jiangxi Province, No. 519, Beijing East Road, Qingshanhu District, Nanchang City, 330000, Jiangxi Province, PR China
| | - Ziwei Tu
- Department of Radiotherapy of Head and Neck, Tumor Hospital of Jiangxi Province, No. 519, Beijing East Road, Qingshanhu District, Nanchang City, 330000, Jiangxi Province, PR China
| | - Qiaoying Gong
- Department of Radiotherapy of Head and Neck, Tumor Hospital of Jiangxi Province, No. 519, Beijing East Road, Qingshanhu District, Nanchang City, 330000, Jiangxi Province, PR China.
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31
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Wu S, Gao F, Zheng S, Zhang C, Martinez-Ledesma E, Ezhilarasan R, Ding J, Li X, Feng N, Multani A, Sulman EP, Verhaak RG, de Groot JF, Heffernan TP, Yung WKA, Koul D. EGFR Amplification Induces Increased DNA Damage Response and Renders Selective Sensitivity to Talazoparib (PARP Inhibitor) in Glioblastoma. Clin Cancer Res 2019; 26:1395-1407. [PMID: 31852834 DOI: 10.1158/1078-0432.ccr-19-2549] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 10/21/2019] [Accepted: 12/13/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Exploration of novel strategies to extend the benefit of PARP inhibitors beyond BRCA-mutant cancers is of great interest in personalized medicine. Here, we identified EGFR amplification as a potential biomarker to predict sensitivity to PARP inhibition, providing selection for the glioblastoma (GBM) patient population who will benefit from PARP inhibition therapy. EXPERIMENTAL DESIGN Selective sensitivity to the PARP inhibitor talazoparib was screened and validated in two sets [test set (n = 14) and validation set (n = 13)] of well-characterized patient-derived glioma sphere-forming cells (GSC). FISH was used to detect EGFR copy number. DNA damage response following talazoparib treatment was evaluated by γH2AX and 53BP1 staining and neutral comet assay. PARP-DNA trapping was analyzed by subcellular fractionation. The selective monotherapy of talazoparib was confirmed using in vivo glioma models. RESULTS EGFR-amplified GSCs showed remarkable sensitivity to talazoparib treatment. EGFR amplification was associated with increased reactive oxygen species (ROS) and subsequent increased basal expression of DNA-repair pathways to counterelevated oxidative stress, and thus rendered vulnerability to PARP inhibition. Following talazoparib treatment, EGFR-amplified GSCs showed enhanced DNA damage and increased PARP-DNA trapping, which augmented the cytotoxicity. EGFR amplification-associated selective sensitivity was further supported by the in vivo experimental results showing that talazoparib significantly suppressed tumor growth in EGFR-amplified subcutaneous models but not in nonamplified models. CONCLUSIONS EGFR-amplified cells are highly sensitive to talazoparib. Our data provide insight into the potential of using EGFR amplification as a selection biomarker for the development of personalized therapy.
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Affiliation(s)
- Shaofang Wu
- Department of Neuro-Oncology, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Feng Gao
- Department of Neuro-Oncology, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Siyuan Zheng
- Department of Genomic Medicine, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chen Zhang
- Department of Neuro-Oncology, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Emmanuel Martinez-Ledesma
- Department of Neuro-Oncology, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, Mexico
| | - Ravesanker Ezhilarasan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jie Ding
- Department of Neuro-Oncology, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xiaolong Li
- Department of Neuro-Oncology, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ningping Feng
- Applied Cancer Science Institute, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Asha Multani
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erik P Sulman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Roel G Verhaak
- Department of Genomic Medicine, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - John F de Groot
- Department of Neuro-Oncology, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tim P Heffernan
- Applied Cancer Science Institute, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - W K Alfred Yung
- Department of Neuro-Oncology, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dimpy Koul
- Department of Neuro-Oncology, Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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DGCR8/ZFAT-AS1 Promotes CDX2 Transcription in a PRC2 Complex-Dependent Manner to Facilitate the Malignant Biological Behavior of Glioma Cells. Mol Ther 2019; 28:613-630. [PMID: 31813799 DOI: 10.1016/j.ymthe.2019.11.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/05/2019] [Accepted: 11/11/2019] [Indexed: 11/24/2022] Open
Abstract
Studies have found that RNA-binding proteins (RBPs) and long non-coding RNAs (lncRNAs) are dysregulated and play an important regulatory role in the development of tumors. Based on The Cancer Genome Atlas (TCGA) database, our findings from experiments, and the evidence of previous studies, we screened DiGeorge syndrome critical region gene 8 (DGCR8), ZFAT antisense RNA 1 (ZFAT-AS1), and caudal type homeobox 2 (CDX2) as research candidates. In the present study, DGCR8 and CDX2 were highly expressed and ZFAT-AS1 was markedly downregulated in glioma tissues and cells. DGCR8 or CDX2 knockdown or ZFAT-AS1 overexpression suppressed glioma cell proliferation, migration, and invasion and facilitated apoptosis. DGCR8 might decrease ZFAT-AS1 expression by attenuating its stability in a manner of inducing its cleavage. Importantly, ZFAT-AS1 could inhibit CDX2 transcription by mediating the methylation of histone H3 on lysine 27 (H3K27me3) modification induced by PRC2 in the CDX2 promoter region. In addition, CDX2 transcriptionally activated DGCR8 expression by binding to its promoter regions, forming a positive feedback loop of DGCR8/ZFAT-AS1/CDX2. In conclusion, DGCR8/ZFAT-AS1 promotes CDX2 transcription in a PRC2 complex-dependent manner to facilitate the malignant biological behavior of glioma cells.
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33
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Olubajo F, Achawal S, Greenman J. Development of a Microfluidic Culture Paradigm for Ex Vivo Maintenance of Human Glioblastoma Tissue: A New Glioblastoma Model? Transl Oncol 2019; 13:1-10. [PMID: 31726354 PMCID: PMC6854064 DOI: 10.1016/j.tranon.2019.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/03/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND: One way to overcome the genetic and molecular variations within glioblastoma is to treat each tumour on an individual basis. To facilitate this, we have developed a microfluidic culture paradigm that maintains human glioblastoma tissue ex vivo. METHODS: The assembled device, fabricated using a photolithographic process, is composed of two layers of glass bonded together to contain a tissue chamber and a network of microchannels that allow continued tissue perfusion. RESULTS: A total of 128 tissue biopsies (from 33 patients) were maintained in microfluidic devices for an average of 72 hours. Tissue viability (measured with Annexin V and propidium iodide) was 61.1% in tissue maintained on chip compared with 68.9% for fresh tissue analysed at commencement of the experiments. Other biomarkers, including lactate dehydrogenase absorbance and trypan blue exclusion, supported the viability of the tissue maintained on chip. Histological appearances remained unchanged during the tissue maintenance period, and immunohistochemical analysis of Ki67 and caspase 3 showed no significant differences when compared with fresh tissues. A trend showed that tumours associated with poorer outcomes (recurrent tumours and Isocitrate Dehydrogenase - IDH wildtype) displayed higher viability on chip than tumours linked with improved outcomes (low-grade gliomas, IDH mutants and primary tumours). conclusions: This work has demonstrated for the first time that human glioblastoma tissue can be successfully maintained within a microfluidic device and has the potential to be developed as a new platform for studying the biology of brain tumours, with the long-term aim of replacing current preclinical GBM models and facilitating personalised treatments.
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Affiliation(s)
- Farouk Olubajo
- Department of Neurosurgery, Hull and East Yorkshire Hospitals, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK.
| | - Shailendra Achawal
- Department of Neurosurgery, Hull and East Yorkshire Hospitals, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK
| | - John Greenman
- Department of Biomedical Sciences, University of Hull, Cottingham Road, Hull, HU6 7RX, UK
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Population-Based Brain Tumor Survival Analysis via Spatial- and Temporal-Smoothing. Cancers (Basel) 2019; 11:cancers11111732. [PMID: 31694302 PMCID: PMC6895900 DOI: 10.3390/cancers11111732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/30/2019] [Accepted: 10/30/2019] [Indexed: 11/30/2022] Open
Abstract
In cancer research, population-based survival analysis has played an important role. In this article, we conduct survival analysis on patients with brain tumors using the SEER (Surveillance, Epidemiology, and End Results) database from the NCI (National Cancer Institute). It has been recognized that cancer survival models have spatial and temporal variations which are caused by multiple factors, but such variations are usually not “abrupt” (that is, they should be smooth). As such, spatially and temporally pooling all data and analyzing each spatial/temporal point separately are either inappropriate or ineffective. In this article, we develop and implement a spatial- and temporal-smoothing technique, which can effectively accommodate spatial/temporal variations and realize information borrowing across spatial/temporal points. Simulation demonstrates effectiveness of the proposed approach in improving estimation. Data on a total of 123,571 patients with brain tumors diagnosed between 1911 and 2010 from 16 SEER sites is analyzed. Findings different from separate estimation and simple pooling are made. Overall, this study may provide a practically useful way for modeling the survival of brain tumor (and other cancers) using population data.
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35
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Muñoz M, Coveñas R. Glioma and Neurokinin-1 Receptor Antagonists: A New Therapeutic Approach. Anticancer Agents Med Chem 2019; 19:92-100. [PMID: 29692265 DOI: 10.2174/1871520618666180420165401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 03/17/2018] [Accepted: 03/20/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND In adults, the most lethal and frequent primary brain tumor is glioblastoma. Despite multimodal aggressive therapies, the median survival time after diagnosis is around 15 months. In part, this is due to the blood-brain barrier that restricts common treatments (e.g., chemotherapy). Unfortunately, glioma recurs in 90% of patients. New therapeutic strategies against glioma are urgently required. Substance P (SP), through the neurokinin (NK)-1 receptor, controls cancer cell proliferation by activating c-myc, mitogenactivated protein kinases, activator protein 1 and extracellular signal-regulated kinases 1 and 2. Glioma cells overexpress NK-1 receptors when compared with normal cells. The NK-1 receptor/SP system regulates the proliferation/migration of glioma cells and stimulates angiogenesis, triggering inflammation which contributes to glioma progression. In glioma cells, SP favors glycogen breakdown, essential for glycolysis. By contrast, in glioma, NK-1 receptor antagonists block the proliferation of tumor cells and the breakdown of glycogen and also promote the death (apoptosis) of these cells. These antagonists also inhibit angiogenesis and exert antimetastatic and anti-inflammatory actions. OBJECTIVE This review updates the involvement of the NK-1 receptor/SP system in the development of glioma and the potential clinical application of NK-1 receptor antagonists as antiglioma agents. CONCLUSION The NK-1 receptor plays a crucial role in glioma and NK-1 receptor antagonists could be used as anti-glioma drugs.
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Affiliation(s)
- Miguel Muñoz
- Virgen del Rocío University Hospital, Research Laboratory on Neuropeptides (IBIS), Seville, Spain
| | - Rafael Coveñas
- Institute of Neurosciences of Castilla y León (INCYL), Laboratory of Neuroanatomy of the Peptidergic, Systems (Lab. 14), University of Salamanca, Salamanca, Spain
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Girardi F, Allemani C, Coleman MP. Worldwide Trends in Survival From Common Childhood Brain Tumors: A Systematic Review. J Glob Oncol 2019; 5:1-25. [PMID: 31682549 PMCID: PMC6882508 DOI: 10.1200/jgo.19.00140] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The histology of brain tumors determines treatment and predicts outcome. Population-based survival reflects the effectiveness of a health care system in managing cancer. No systematic review of worldwide variation and time trends in survival from brain tumors in children is currently available. PATIENTS AND METHODS We considered longitudinal, observational studies comprising children diagnosed with intracranial astrocytic or embryonal tumors. We searched six electronic databases from database inception to September 30, 2018, using complex search strategies. The outcome measure was 5-year survival, estimated through a time-to-event analysis. This study is registered with PROSPERO, number CRD42018111981. RESULTS Among 5,244 studies, we identified 47 eligible articles that provided 228 survival estimates. Only five studies were entirely or partially conducted in low-income or middle-income countries. Five-year survival from embryonal tumors increased from 37% in 1980 to approximately 60% in 2009. Although survival for medulloblastoma improved substantially (from 29% to 73% during 1959-2009), survival for primitive neuroectodermal tumors wavered over time (1973-2009) and between countries. Five-year survival from astrocytoma changed very little over the 27 years between 1982 and 2009 (from 78% to 89%). Interpretation of the literature was made difficult by the heterogeneity of study designs. CONCLUSION Survival has improved for embryonal tumors, but little change has been observed for astrocytic tumors. We found a striking gap in knowledge about survival from childhood brain tumor subtypes in middle-income and low-income countries, where half of these tumors are diagnosed. Larger studies are needed, including in under-represented countries and based on standardized data collection, to provide up-to-date survival estimates.
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Affiliation(s)
- Fabio Girardi
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Claudia Allemani
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michel P. Coleman
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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37
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Abstract
Background::Human tumor cells lines and tumor samples overexpress the neurokinin-1 receptor (NK-1R). Substance P (SP), after binding to NK-1Rs, induces tumor cell proliferation, an antiapoptotic effect and promotes angiogenesis and the migration of cancer cells for invasion and metastasis.Methods: :In contrast, NK-1R antagonists block the previous pathophysiological actions mediated by SP. These antagonists promote the death of tumor cells by apoptosis. Peptide and non-peptide NK-1R antagonists have been reported.Results: :Peptide NK-1R antagonists show chemical modifications of the SP molecule (L-amino acids being replaced by D-amino acids), whereas non-peptide NK-1R antagonists include numerous compounds with different chemical compositions while showing similar stereochemical features (affinity for the NK- 1R). Currently, there are more than 300 NK-1R antagonists.Conclusion::In combination therapy with classic cytostatics, NK-1R antagonists have additive or synergic effects and minimize the side-effects of cytostatics. The effect of NK-1R antagonists as broad-spectrum anticancer drugs is reviewed and the use of these antagonists for the treatment of cancer is suggested.
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Affiliation(s)
- Miguel Muñoz
- Research Laboratory on Neuropeptides, Virgen del Rocío University Hospital (IBIS), Sevilla, Spain
| | - Rafael Coveñas
- Laboratory of Neuroanatomy of the Peptidergic Systems, Institute of Neurosciences of Castilla y León (INCYL) University of Salamanca, Salamanca, Spain
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Zhang H, Wang R, Yu Y, Liu J, Luo T, Fan F. Glioblastoma Treatment Modalities besides Surgery. J Cancer 2019; 10:4793-4806. [PMID: 31598150 PMCID: PMC6775524 DOI: 10.7150/jca.32475] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 07/04/2019] [Indexed: 01/04/2023] Open
Abstract
Glioblastoma multiforme (GBM) is commonly known as the most aggressive primary CNS tumor in adults. The mean survival of it is 14 to 15 months, following the standard therapy from surgery, chemotherapy, to radiotherapy. Efforts in recent decades have brought many novel therapies to light, however, with limitations. In this paper, authors reviewed current treatments for GBM besides surgery. In the past decades, only radiotherapy, temozolomide (TMZ), and tumor treating field (TTF) were approved by FDA. Though promising in preclinical experiments, therapeutic effects of other novel treatments including BNCT, anti-angiogenic therapy, immunotherapy, epigenetic therapy, oncolytic virus therapy, and gene therapy are still either uncertain or discouraging in clinical results. In this review, we went through current clinical trials, underlying causes, and future therapy designs to present neurosurgeons and researchers a sketch of this field.
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Affiliation(s)
- Hao Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Ruizhe Wang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yuanqiang Yu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jinfang Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Tianmeng Luo
- Department of Medical Affairs, Xiangya Hospital, Central South University, Chang Sha, Hunan Province, China
| | - Fan Fan
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Center for Medical Genetics & Hunan Provincial Key Laboratory of Medical Genetics, School of Life Sciences, Central South University Changsha, China
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68Ga-labeled dimeric and trimeric cyclic RGD peptides as potential PET radiotracers for imaging gliomas. Appl Radiat Isot 2019; 148:168-177. [DOI: 10.1016/j.apradiso.2019.03.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/08/2019] [Accepted: 03/25/2019] [Indexed: 01/04/2023]
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40
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Sheppard JP, Lagman C, Romiyo P, Nguyen T, Azzam D, Alkhalid Y, Duong C, Yang I. Racial Differences in Hospital Stays among Patients Undergoing Craniotomy for Tumour Resection at a Single Academic Hospital. Brain Tumor Res Treat 2019; 7:122-131. [PMID: 31686443 PMCID: PMC6829091 DOI: 10.14791/btrt.2019.7.e29] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/22/2019] [Accepted: 06/04/2019] [Indexed: 01/17/2023] Open
Abstract
Background Racial differences in American patients undergoing brain tumour surgery remain poorly characterized within urban medical centres. Our objective was to assess racial differences in operative brain tumour patients at a single academic hospital in Los Angeles, California. Methods We reviewed medical records of adult patients undergoing craniotomy for tumour resection from March 2013 to January 2017 at UCLA Medical Centre. Patients were categorized as Asian, Hispanic, Black, or White. Racial cohorts were matched on demographic variables for comparisons. Our primary outcome was post-operative length of stay (LOS). Secondary outcomes included hospital mortality and discharge disposition. Results In this study, 462 patients identified as Asian (15.1%), Hispanic (8.7%), Black (3.9%), or White (72.3%). After cohort matching, non-White patients had elevated risk of prolonged LOS [odds ratio (OR)=2.62 (1.44, 4.76)]. No differences were observed in hospital mortality or non-routine discharge. Longer LOS was positively correlated with non-routine discharge [rpb (458)=0.41, p<0.001]. Black patients with government insurance had average LOS 2.84 days shorter than Black patients with private insurance (p=0.04). Among Hispanics, government insurance was associated with non-routine discharge [OR=4.93 (1.03, 24.00)]. Conclusion Racial differences manifested as extended LOS for non-White patients, with comparable rates of hospital mortality and non-routine discharge across races. Prolonged LOS loosely reflected complicated clinical course with greater risk of adverse discharge disposition. Private insurance coverage predicted markedly lower risk of non-routine discharge for Hispanic patients, and LOS of three additional days among Black patients. Further research is needed to elucidate the basis of these differences.
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Affiliation(s)
- John P Sheppard
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Carlito Lagman
- Department of Radiation Oncology, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Prasanth Romiyo
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Thien Nguyen
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Daniel Azzam
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Yasmine Alkhalid
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Courtney Duong
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Isaac Yang
- Department of Neurosurgery, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA.,Department of Radiation Oncology, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA.,Department of Head and Neck Surgery, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA.,Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA.,Los Angeles Biomedical Research Institute (LA BioMed), Harbor-UCLA Medical Center, Torrance, CA, USA.
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Molecular features and clinical outcomes in surgically treated low-grade diffuse gliomas in patients over the age of 60. J Neurooncol 2018; 141:383-391. [DOI: 10.1007/s11060-018-03044-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 11/01/2018] [Indexed: 12/20/2022]
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42
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Fiedler L, Kellner M, Gosewisch A, Oos R, Böning G, Lindner S, Albert N, Bartenstein P, Reulen HJ, Zeidler R, Gildehaus F. Evaluation of 177Lu[Lu]-CHX-A″-DTPA-6A10 Fab as a radioimmunotherapy agent targeting carbonic anhydrase XII. Nucl Med Biol 2018; 60:55-62. [DOI: 10.1016/j.nucmedbio.2018.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 02/05/2018] [Accepted: 02/18/2018] [Indexed: 01/15/2023]
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Ganguly D, Fan M, Yang CH, Zbytek B, Finkelstein D, Roussel MF, Pfeffer LM. The critical role that STAT3 plays in glioma-initiating cells: STAT3 addiction in glioma. Oncotarget 2018; 9:22095-22112. [PMID: 29774125 PMCID: PMC5955139 DOI: 10.18632/oncotarget.25188] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 04/02/2018] [Indexed: 11/26/2022] Open
Abstract
Glioma-Initiating Cells (GICs) are thought to be responsible for tumor initiation, progression and recurrence in glioblastoma (GBM). In previous studies, we reported the constitutive phosphorylation of the STAT3 transcription factor in GICs derived from GBM patient-derived xenografts, and that STAT3 played a critical role in GBM tumorigenesis. In this study, we show that CRISPR/Cas9-mediated deletion of STAT3 in an established GBM cell line markedly inhibited tumorigenesis by intracranial injection but had little effect on cell proliferation in vitro. Tumorigenesis was rescued by the enforced expression of wild-type STAT3 in cells lacking STAT3. In contrast, GICs were highly addicted to STAT3 and upon STAT3 deletion GICs were non-viable. Moreover, we found that STAT3 was constitutively activated in GICs by phosphorylation on both tyrosine (Y705) and serine (S727) residues. Therefore, to study STAT3 function in GICs we established an inducible system to knockdown STAT3 expression (iSTAT3-KD). Using this approach, we demonstrated that Y705-STAT3 phosphorylation was critical and indispensable for GIC-induced tumor formation. Both phosphorylation sites in STAT3 promoted GIC proliferation in vitro. We further showed that S727-STAT3 phosphorylation was Y705-dependent. Targeted microarray and RNA sequencing revealed that STAT3 activated cell-cycle regulator genes, and downregulated genes involved in the interferon response, the hypoxia response, the TGFβ pathway, and remodeling of the extracellular matrix. Since STAT3 is an important oncogenic driver of GBM, the identification of these STAT3 regulated pathways in GICs will inform the development of better targeted therapies against STAT3 in GBM and other cancers.
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Affiliation(s)
- Debolina Ganguly
- Department of Pathology and Laboratory Medicine, and Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Meiyun Fan
- Department of Pathology and Laboratory Medicine, and Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Chuan He Yang
- Department of Pathology and Laboratory Medicine, and Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Blazej Zbytek
- Pathology Group of the Midsouth, Germantown, TN, USA
| | - David Finkelstein
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Martine F Roussel
- Department of Tumor Cell Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lawrence M Pfeffer
- Department of Pathology and Laboratory Medicine, and Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN, USA
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44
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Ulutin C, Fayda M, Aksu G, Cetinayak O, Kuzhan O, Ors F, Beyzadeoglu M. Primary Glioblastoma Multiforme in Younger Patients: A Single-institution Experience. TUMORI JOURNAL 2018; 92:407-11. [PMID: 17168433 DOI: 10.1177/030089160609200507] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background To report our experience of patients with primary glioblastoma multiforme of young age by evaluating the characteristics, prognostic factors, and treatment outcomes. Patients and Methods Seventy patients with primary glioblastoma multiforme (GBM) treated at our department between 1996 and 2004 were studied. The male-female ratio was 2.6:1. The median age was 53 (16-74). Sixty-eight patients (97%) were operated on before radiotherapy and 2 patients (3%) underwent only stereotactic biopsy. All patients received radiotherapy. Postoperative chemotherapy as an adjuvant to radiotherapy was given to 9 patients (12%). The patients were divided into 2 groups according to their age (group A ≤35 years, n = 21 vs group B >35 years, n = 49). Survival was determined with the Kaplan-Meier method and differences were compared using the log-rank test. Cox regression analysis was performed to identify the independent prognostic factors. Karnofsky performance status (≥70 vs <70), age (≤35 vs >35 years), gender, tumor size (≤4 vs >4 cm), number of involved brain lobes (1 vs more than 1), type of surgery (total vs subtotal), preoperative seizure history (present vs absent), radiotherapy field (total cranium vs partial), total radiotherapy dose (60 vs 66 Gy), and adjuvant chemotherapy (present vs absent) were evaluated in univariate analysis. Results The median survival was 10.3 months in the whole group, 19.5 months in the younger age group and 5.7 months in the older age group. During follow-up re-craniotomy was performed in 2 patients (3%), and 1 patient (1%) developed spinal seeding metastases and was given spinal radiotherapy. In univariate analysis younger age vs older age: median 19.5 months vs 5.27 months (P = 0.0012); Karnofsky performance status ≥70 vs <70: median 15.3 months vs 2.67 months (P <0.0001), and external radiotherapy dose 60 Gy vs 66 Gy: median 11.6 months vs 3 months (P = 0.02) were found as significant prognostic factors for survival. In regression analysis a worse performance status (KPS <70) was found to be the only independent factor for survival (P = 0.014, 95% CI HR = 0.0043 [0.0001-0.15]). Conclusions Younger patients with primary glioblastoma multiforme had a relatively long survival (median, 19.5 months, with a 2-year survival rate of 30%) compared to older patients. This was due particularly to their better performance status.
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Affiliation(s)
- Cüneyt Ulutin
- Department of Radiation Oncology, GATA Hospital, Ankara, Turkey.
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Wang G, Xu S, Cao C, Dong J, Chu Y, He G, Xu Z. Evidence from a large-scale meta-analysis indicates eczema reduces the incidence of glioma. Oncotarget 2018; 7:62598-62606. [PMID: 27566584 PMCID: PMC5308749 DOI: 10.18632/oncotarget.11545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 08/09/2016] [Indexed: 12/21/2022] Open
Abstract
We investigated the relationship between eczema and the risk of primary glioma. Relevant studies were selected through electronic searches of PubMed and EMBASE. A meta-analysis of 12 case-control studies and one cohort study was performed. A fixed effect model was applied to analyze 13 studies consisting of 10,897 glioma cases and 56,081 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the strength of the associations. The data demonstrate that eczema significantly reduces the risk of glioma (OR = 0.69, 95% CI = 0.61-0.78, P < 0.001). Additional studies with larger patient cohorts are required to validate our findings.
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Affiliation(s)
- Guannan Wang
- Academy of Nursing, Zhejiang Chinese Medical University, Hangzhou 310053, China.,Blood Purification Center, Ningbo Medical Center, Lihuili Hospital, Ningbo University, Ningbo 315041, China
| | - Suling Xu
- Department of Dermatology, Affiliated Hospital of Medical College, Ningbo University, Ningbo 315020, China.,Department of Dermatology, Ningbo First Hospital, Ningbo University, Ningbo 315010, China
| | - Chao Cao
- Department of Respiratory Medicine, Ningbo First Hospital, Ningbo University, Ningbo 315010, China
| | - Jing Dong
- Blood Purification Center, Ningbo Medical Center, Lihuili Hospital, Ningbo University, Ningbo 315041, China
| | - Yudong Chu
- Department of Nephrology, Ningbo Medical Center, Lihuili Eastern Hospital, Ningbo 315040, China
| | - Guijuan He
- Academy of Nursing, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Zhiwei Xu
- Department of Critical Care Medicine, Ningbo Medical Center, Lihuili Eastern Hospital, Ningbo 315040, China
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Vysotski S, Madura C, Swan B, Holdsworth R, Lin Y, Rio AMD, Wood J, Kundu B, Penwarden A, Voss J, Gallagher T, Nair VA, Field A, Garcia-Ramos C, Meyerand EM, Baskaya M, Prabhakaran V, Kuo JS. Preoperative FMRI Associated with Decreased Mortality and Morbidity in Brain Tumor Patients. INTERDISCIPLINARY NEUROSURGERY-ADVANCED TECHNIQUES AND CASE MANAGEMENT 2018; 13:40-45. [PMID: 31341789 DOI: 10.1016/j.inat.2018.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Functional Magnetic Resonance Imaging (fMRI) is a presurgical planning technique used to localize functional cortex so as to maximize resection of diseased tissue and avoid viable tissue. In this retrospective study, we examined differences in morbidity and mortality of brain tumor patients who received preoperative fMRI in comparison to those who did not. Methods Brain tumor patients (n=206) were selected from a retrospective review of neurosurgical case logs from 2001-2009 at the University of Wisconsin-Madison. Results Univariate analysis showed improved mortality in the fMRI group and the fMRI+Electrical Cortical Stimulation Mapping (ECM) group compared to the No-fMRI group. Multivariate analyses showed improved mortality of the fMRI group and the fMRI+ECM group compared to the No-fMRI group, with age and tumor grade being the most significant influencers. Overall, the fMRI group showed survival benefits at 3 years; twice that of the No-fMRI group. Furthermore, patients with high-grade tumors showed significant survival benefits in the fMRI group, while patients with low-grade tumors did not (controlling for age and ECM). There was also a significant difference in the two groups with respect to morbidity, with patients receiving fMRI showing improved outcomes in the motor and language domains. Conclusions This study analyzing a large retrospective series of brain tumor patients with and without the use of fMRI in the preoperative planning has resulted in improved mortality and morbidity outcomes with the use of fMRI. These results point to the importance of incorporating fMRI in presurgical planning in the clinical management of patients with brain tumors.
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Affiliation(s)
- Siarhei Vysotski
- Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252
| | - Casey Madura
- Neurological Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252
| | - Benjamin Swan
- Department of Radiology, Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02138
| | - Ryan Holdsworth
- Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252
| | - Yunzhi Lin
- Department of Statistics, University of Wisconsin Madison, 1300 University Avenue, Madison, WI 53705
| | - Alejandro Munoz Del Rio
- Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252.,Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research (WIMR), 1111 Highland Avenue Rm 1005, Madison, WI 53705
| | - Joel Wood
- Department of General Surgery, UW Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792-3252
| | - Bornali Kundu
- Medical Scientist Training Program, University of Wisconsin Madison, 6001 Research Park Blvd. Rm 1056, Madison, WI 51719
| | - Amy Penwarden
- Department of Anesthesiology, University of North Carolina -Chapel Hill, 106 Bel Arbor Ln Carrboro, NC 27510
| | - Jed Voss
- Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252
| | - Thomas Gallagher
- Department of Radiology, Northwestern University Feinberg School of Medicine, NMH/Arkes Family Pavilion Suite 800, 676 N Saint Clair, Chicago IL 60611
| | - Veena A Nair
- Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252
| | - Aaron Field
- Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252.,Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Dr, Madison, WI 53706, USA
| | - Camille Garcia-Ramos
- Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research (WIMR), 1111 Highland Avenue Rm 1005, Madison, WI 53705
| | - Elizabeth M Meyerand
- Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Dr, Madison, WI 53706, USA.,Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research (WIMR), 1111 Highland Avenue Rm 1005, Madison, WI 53705
| | - Mustafa Baskaya
- Neurological Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252
| | - Vivek Prabhakaran
- Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252
| | - John S Kuo
- UW Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA.,UW Center for Stem Cell and Regenerative Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, K3/803 Clinical Science Center, Mail Code 8660, 600 Highland Avenue, Madison, WI 53792-3252
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Wang KY, Vankov ER, Lin DDM. Predictors of clinical outcome in pediatric oligodendroglioma: meta-analysis of individual patient data and multiple imputation. J Neurosurg Pediatr 2018; 21:153-163. [PMID: 29192869 DOI: 10.3171/2017.7.peds17133] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Oligodendroglioma is a rare primary CNS neoplasm in the pediatric population, and only a limited number of studies in the literature have characterized this entity. Existing studies are limited by small sample sizes and discrepant interstudy findings in identified prognostic factors. In the present study, the authors aimed to increase the statistical power in evaluating for potential prognostic factors of pediatric oligodendrogliomas and sought to reconcile the discrepant findings present among existing studies by performing an individual-patient-data (IPD) meta-analysis and using multiple imputation to address data not directly available from existing studies. METHODS A systematic search was performed, and all studies found to be related to pediatric oligodendrogliomas and associated outcomes were screened for inclusion. Each study was searched for specific demographic and clinical characteristics of each patient and the duration of event-free survival (EFS) and overall survival (OS). Given that certain demographic and clinical information of each patient was not available within all studies, a multivariable imputation via chained equations model was used to impute missing data after the mechanism of missing data was determined. The primary end points of interest were hazard ratios for EFS and OS, as calculated by the Cox proportional-hazards model. Both univariate and multivariate analyses were performed. The multivariate model was adjusted for age, sex, tumor grade, mixed pathologies, extent of resection, chemotherapy, radiation therapy, tumor location, and initial presentation. A p value of less than 0.05 was considered statistically significant. RESULTS A systematic search identified 24 studies with both time-to-event and IPD characteristics available, and a total of 237 individual cases were available for analysis. A median of 19.4% of the values among clinical, demographic, and outcome variables in the compiled 237 cases were missing. Multivariate Cox regression analysis revealed subtotal resection (p = 0.007 [EFS] and 0.043 [OS]), initial presentation of headache (p = 0.006 [EFS] and 0.004 [OS]), mixed pathologies (p = 0.005 [EFS] and 0.049 [OS]), and location of the tumor in the parietal lobe (p = 0.044 [EFS] and 0.030 [OS]) to be significant predictors of tumor progression or recurrence and death. CONCLUSIONS The use of IPD meta-analysis provides a valuable means for increasing statistical power in investigations of disease entities with a very low incidence. Missing data are common in research, and multiple imputation is a flexible and valid approach for addressing this issue, when it is used conscientiously. Undergoing subtotal resection, having a parietal tumor, having tumors with mixed pathologies, and suffering headaches at the time of diagnosis portended a poorer prognosis in pediatric patients with oligodendroglioma.
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Affiliation(s)
- Kevin Yuqi Wang
- 1Department of Radiology, Baylor College of Medicine, Houston, Texas
| | - Emilian R Vankov
- 2Center for Energy Studies, Baker Institute for Public Policy, Rice University, Houston, Texas; and
| | - Doris Da May Lin
- 3Division of Neuroradiology, Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Lanzetta G, Minniti G. Treatment of Glioblastoma in Elderly Patients: An Overview of Current Treatments and Future Perspective. TUMORI JOURNAL 2018; 96:650-8. [DOI: 10.1177/030089161009600502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Current treatment of glioblastoma in the elderly includes surgery, radiotherapy and chemotherapy, but the prognosis remains extremely poor, and its optimal management is still debated. Longer survival after extensive resection compared with biopsy only has been reported, although the survival advantage remains modest. Radiation in the form of standard (60 Gy in 30 fractions over 6 weeks) and abbreviated courses of radiotherapy (30–50 Gy in 6–20 fractions over 2–4 weeks) has been employed in elderly patients with glioblastoma, showing survival benefits compared with supportive care alone. Temozolomide is an alkylating agent recently employed in older patients with newly diagnosed glioblastoma. The addition of concomitant and/or adjuvant chemotherapy with temozolomide to radiotherapy, which is currently the standard treatment in adults with glioblastoma, is emerging as an effective therapeutic option for older patients with favorable prognostic factors. The potential benefits on survival, improvement in quality of life and toxicity of different schedules of radiotherapy plus temozolomide need to be addressed in future randomized studies. Free full text available at www.tumorionline.it
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Affiliation(s)
| | - Giuseppe Minniti
- Department of Neuroscience, Neuromed Institute, Pozzilli (IS)
- Radiotherapy Oncology, Sant'Andrea Hospital, University “Sapienza”, Rome, Italy
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Donato V, Papaleo A, Castrichino A, Banelli E, Giangaspero F, Salvati M, Delfini R. Prognostic Implication of Clinical and Pathologic Features in Patients with Glioblastoma Multiforme Treated with Concomitant Radiation plus Temozolomide. TUMORI JOURNAL 2018; 93:248-56. [PMID: 17679459 DOI: 10.1177/030089160709300304] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background Glioblastoma multiforme is the most common and most malignant primary brain tumor in adults. The current standard of care for glioblastoma is surgical resection to the extent feasible, followed by adjuvant radiotherapy plus temozolomide, given concomitantly with and after radiotherapy. This report is a prospective observational study of 43 cases treated in the Department of Radiotherapy, University of Rome La Sapienza, Italy. We examine the relationship between pathologic features and objective response rate in adult patients treated with concomitant radiation plus temozolomide to identify clinical, neuroradiologic, pathologic, and molecular factors with prognostic significance. Methods Forty-three consecutive patients (24 males and 19 females), ages 15-77 years (median, 57) with newly diagnosed glioblastoma multiforme, were included in this trial between 2002 and 2004 at our department. All patients were treated with surgery (complete resection in 81%, incomplete in 19%) followed by concurrent temozolomide (75 mg/m2/day) and radiotherapy (median tumor dose, 60 Gy), followed by temozolomide, 200 mg/m2/day for 5 consecutive days every 28 days. Neurologic evaluations were performed monthly and cranial magnetic resonance bimonthly. We analyzed age, clinical manifestations at diagnosis, seizures, Karnofsky performance score, tumor location, extent of resection, proliferation index (Ki-67 expression), p53, platelet-derived growth factor and epidermal growth factor receptor immunohistochemical expression as prognostic factors in the patients. The Kaplan-Meier statistical method and logrank test were used to assess correlation with survival. Results Fourteen patients (32%) manifested clinical and neuroradiographic evidence of tumor progression within 6 months of surgery. In contrast, 5 patients (12%) showed no disease progression for 18 months from the beginning of treatment. Median overall survival was 19 months. Multivariate analysis revealed that an age of 60 years or older (P <0.03), a postoperative performance score ≤70 (P = 0.04), the nontotal tumor resection (P = 0.03), tumor size >4 cm (P = 0.01) and proliferation index overexpression (P = 0.001) were associated with the worst prognosis. p53, PDGF and EGFR overexpression were not significant prognostic factors associated with survival. Conclusions The results suggest that analysis of prognostic markers in glioblastoma multiforme is complex. In addition to previously recognized prognostic variables such as age and Karnofsky performance score, tumor size, total resection and proliferation index overexpression were identified as predictors of survival in a series of patients with glioblastoma multiforme.
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Affiliation(s)
- Vittorio Donato
- Department of Radiotherapy, University of Rome La Sapienza, Rome, Italy.
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Karhade AV, Larsen AMG, Cote DJ, Dubois HM, Smith TR. National Databases for Neurosurgical Outcomes Research: Options, Strengths, and Limitations. Neurosurgery 2017; 83:333-344. [DOI: 10.1093/neuros/nyx408] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 06/21/2017] [Indexed: 01/12/2023] Open
Affiliation(s)
- Aditya V Karhade
- Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexandra M G Larsen
- Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - David J Cote
- Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Heloise M Dubois
- Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Timothy R Smith
- Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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