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Marinho MAG, da Silva Marques M, de Oliveira Vian C, de Moraes Vaz Batista Filgueira D, Horn AP. Photodynamic therapy with curcumin and near-infrared radiation as an antitumor strategy to glioblastoma cells. Toxicol In Vitro 2024; 100:105917. [PMID: 39142446 DOI: 10.1016/j.tiv.2024.105917] [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: 05/14/2024] [Revised: 07/18/2024] [Accepted: 08/09/2024] [Indexed: 08/16/2024]
Abstract
Glioblastoma is a malignant neoplasm that develops in the central nervous system and is characterized by high rates of cell proliferation and invasion, presenting resistance to treatments and a poor prognosis. Photodynamic therapy (PDT) is a therapeutic modality that can be applied in oncological cases and stands out for being less invasive. Photosensitizers (PS) of natural origin gained prominence in PDT. Curcumin (CUR) is a natural compound that has been used in PDT, considered a promising PS. In this work, we evaluated the effects of PDT-mediated CUR and near-infrared radiation (NIR) in glioblastoma cells. Through trypan blue exclusion analysis, we chose the concentration of 5 μM of CUR and the dose of 2 J/cm2 of NIR that showed better responses in reducing the viable cell number in the C6 cell line and did not show cytotoxic/cytostatic effects in the HaCat cell line. Our results show that there is a positive interaction between CUR and NIR as a PDT model since there was an increase in ROS levels, a decrease in cell proliferation, increase in cytotoxicity with cell death by autophagy and necrosis, in addition to the presence of oxidative damage to proteins. These results suggest that the use of CUR and NIR is a promising strategy for the antitumor application of PDT.
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Affiliation(s)
- Marcelo Augusto Germani Marinho
- Programa de Pós-Graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil; Laboratório de Cultura Celular, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil.
| | - Magno da Silva Marques
- Programa de Pós-Graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil; Laboratório de Neurociências, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil
| | - Camila de Oliveira Vian
- Programa de Pós-Graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil; Laboratório de Neurociências, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil
| | - Daza de Moraes Vaz Batista Filgueira
- Programa de Pós-Graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil; Laboratório de Cultura Celular, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil
| | - Ana Paula Horn
- Programa de Pós-Graduação em Ciências Fisiológicas, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil; Laboratório de Neurociências, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS 96210-900, Brazil
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Latzer P, Zelba H, Battke F, Reinhardt A, Shao B, Bartsch O, Rabsteyn A, Harter J, Schulze M, Okech T, Golf A, Kyzirakos-Feger C, Kayser S, Pieper N, Feldhahn M, Wünsche J, Seitz C, Hadaschik D, Garbe C, Hauser TK, la Fougère C, Biskup D, Brooke D, Parker D, Martens UM, Illerhaus G, Blumenthal DT, Merrell R, Lorenzo LS, Hidvégi M, de Robles P, Kebir S, Li WW, Li VW, Williams M, Miller AM, Kesari S, Castro M, Desjardins A, Ashley DM, Friedman HS, Wen PY, Neil EC, Iwamoto FM, Sipos B, Geletneky K, Zender L, Glas M, Reardon DA, Biskup S. A real-world observation of patients with glioblastoma treated with a personalized peptide vaccine. Nat Commun 2024; 15:6870. [PMID: 39127809 PMCID: PMC11316744 DOI: 10.1038/s41467-024-51315-8] [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: 02/29/2024] [Accepted: 08/06/2024] [Indexed: 08/12/2024] Open
Abstract
Current treatment outcome of patients with glioblastoma (GBM) remains poor. Following standard therapy, recurrence is universal with limited survival. Tumors from 173 GBM patients are analysed for somatic mutations to generate a personalized peptide vaccine targeting tumor-specific neoantigens. All patients were treated within the scope of an individual healing attempt. Among all vaccinated patients, including 70 treated prior to progression (primary) and 103 treated after progression (recurrent), the median overall survival from first diagnosis is 31.9 months (95% CI: 25.0-36.5). Adverse events are infrequent and are predominantly grade 1 or 2. A vaccine-induced immune response to at least one of the vaccinated peptides is detected in blood samples of 87 of 97 (90%) monitored patients. Vaccine-specific T-cell responses are durable in most patients. Significantly prolonged survival is observed for patients with multiple vaccine-induced T-cell responses (53 months) compared to those with no/low induced responses (27 months; P = 0.03). Altogether, our results highlight that the application of personalized neoantigen-targeting peptide vaccine is feasible and represents a promising potential treatment option for GBM patients.
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Affiliation(s)
| | - Henning Zelba
- Zentrum für Humangenetik Tübingen, Tübingen, Germany
| | | | | | - Borong Shao
- Zentrum für Humangenetik Tübingen, Tübingen, Germany
| | | | | | | | | | - Thomas Okech
- MVZ Zentrum für ambulante Onkologie GmbH, Tübingen, Germany
| | - Alexander Golf
- MVZ Zentrum für ambulante Onkologie GmbH, Tübingen, Germany
| | | | - Simone Kayser
- Zentrum für Humangenetik Tübingen, Tübingen, Germany
| | | | | | - Julian Wünsche
- Zentrum für Humangenetik Tübingen, Tübingen, Germany
- MVZ Zentrum für ambulante Onkologie GmbH, Tübingen, Germany
| | - Christian Seitz
- Universitätsklinikum Heidelberg, KiTZ, Hopp Children's Cancer Center, Heidelberg, Germany
| | | | - Claus Garbe
- Department of Dermatology, University Hospital Tübingen, Tübingen, Germany
| | | | - Christian la Fougère
- Nuklearmedizin und Klinische Molekulare Bildgebung, Universitätsklinikum Tübingen, Tübingen, Germany
| | | | - Dawn Brooke
- Provenance Precision Medicine Foundation, Wilmette, IL, USA
| | | | - Uwe M Martens
- Department of Hematology and Oncology, Cancer Center Heilbronn-Franken, SLK Kliniken GmbH, Heilbronn, Germany
| | | | | | - Ryan Merrell
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Máté Hidvégi
- Jewish Theological Seminary-University of Jewish Studies (OR-ZSE), Budapest, Hungary
| | - Paula de Robles
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
- Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Sied Kebir
- Universitätsklinikum Essen, Essen, Germany
| | | | - Vincent W Li
- Angiogenesis Foundation, Cambridge, MA, USA
- Harvard Medical School Dermatology, Boston, MA, USA
| | | | - Alexandra M Miller
- Brain and Spine Tumor Center, NYU Langone Health's Perlmutter Cancer Center, New York, NY, USA
| | - Santosh Kesari
- Pacific Neuroscience Institute, Saint John's Cancer Institute, Providence Saint John's Health Center, Santa Monica, CA, USA
| | - Michael Castro
- Cellworks Group Inc, South San Francisco, CA, USA
- Personalized Cancer Medicine, PLLC, Santa Monica, CA, USA
| | - Annick Desjardins
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - David M Ashley
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
- Preston Robert Tisch Brain Tumor Centre, Duke University, Durham, NC, USA
| | - Henry S Friedman
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Elisabeth C Neil
- Department of Neurology, University of Minnesota Health, Minneapolis, MN, USA
| | | | - Bence Sipos
- BAG für Pathologie und Molekularpathologie Stuttgart, Molekularpathologie Baden-Württemberg GbR, Stuttgart, Germany
| | | | - Lars Zender
- University Hospital Tübingen, Internal Medicine VIII, Tübingen, Germany
| | - Martin Glas
- Division of Clinical Neurooncology, Department of Neurology, Universitätsklinikum Essen Klinik für Neurologie, Essen, Germany
| | - David A Reardon
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Saskia Biskup
- Zentrum für Humangenetik Tübingen, Tübingen, Germany.
- CeGaT GmbH, Tübingen, Germany.
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Mendanha D, Casanova MR, Gimondi S, Ferreira H, Neves NM. Microfluidic-Derived Docosahexaenoic Acid Liposomes for Targeting Glioblastoma and Its Inflammatory Microenvironment. ACS APPLIED MATERIALS & INTERFACES 2024; 16:40543-40554. [PMID: 39042828 PMCID: PMC11310905 DOI: 10.1021/acsami.4c01368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/25/2024]
Abstract
Glioblastoma (GBM) is the most common malignant primary brain tumor, characterized by limited treatment options and a poor prognosis. Its aggressiveness is attributed not only to the uncontrolled proliferation and invasion of tumor cells but also to the complex interplay between these cells and the surrounding microenvironment. Within the tumor microenvironment, an intricate network of immune cells, stromal cells, and various signaling molecules creates a pro-inflammatory milieu that supports tumor growth and progression. Docosahexaenoic acid (DHA), an essential ω3 polyunsaturated fatty acid for brain function, is associated with anti-inflammatory and anticarcinogenic properties. Therefore, in this work, DHA liposomes were synthesized using a microfluidic platform to target and reduce the inflammatory environment of GBM. The liposomes were rapidly taken up by macrophages in a time-dependent manner without causing cytotoxicity. Moreover, DHA liposomes successfully downregulated the expression of inflammatory-associated genes (IL-6; IL-1β; TNFα; NF-κB, and STAT-1) and the secretion of key cytokines (IL-6 and TNFα) in stimulated macrophages and GBM cells. Conversely, no significant differences were observed in the expression of IL-10, an anti-inflammatory gene expressed in alternatively activated macrophages. Additionally, DHA liposomes were found to be more efficient in regulating the inflammatory profile of these cells compared with a free formulation of DHA. The nanomedicine platform established in this work opens new opportunities for developing liposomes incorporating DHA to target GBM and its inflammatory milieu.
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Affiliation(s)
- Daniel Mendanha
- 3B’s
Research Group, I3Bs—Research Institute on Biomaterials, Biodegradables
and Biomimetics, University of Minho, Headquarters of the European Institute
of Excellence on Tissue Engineering and Regenerative Medicine, AvePark,
Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal
- ICVS/3B’s-PT
Government Associate Laboratory, 4805-017 Barco, Braga/Guimarães, Portugal
| | - Marta R. Casanova
- 3B’s
Research Group, I3Bs—Research Institute on Biomaterials, Biodegradables
and Biomimetics, University of Minho, Headquarters of the European Institute
of Excellence on Tissue Engineering and Regenerative Medicine, AvePark,
Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal
- ICVS/3B’s-PT
Government Associate Laboratory, 4805-017 Barco, Braga/Guimarães, Portugal
| | - Sara Gimondi
- 3B’s
Research Group, I3Bs—Research Institute on Biomaterials, Biodegradables
and Biomimetics, University of Minho, Headquarters of the European Institute
of Excellence on Tissue Engineering and Regenerative Medicine, AvePark,
Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal
- ICVS/3B’s-PT
Government Associate Laboratory, 4805-017 Barco, Braga/Guimarães, Portugal
| | - Helena Ferreira
- 3B’s
Research Group, I3Bs—Research Institute on Biomaterials, Biodegradables
and Biomimetics, University of Minho, Headquarters of the European Institute
of Excellence on Tissue Engineering and Regenerative Medicine, AvePark,
Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal
- ICVS/3B’s-PT
Government Associate Laboratory, 4805-017 Barco, Braga/Guimarães, Portugal
| | - Nuno M. Neves
- 3B’s
Research Group, I3Bs—Research Institute on Biomaterials, Biodegradables
and Biomimetics, University of Minho, Headquarters of the European Institute
of Excellence on Tissue Engineering and Regenerative Medicine, AvePark,
Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal
- ICVS/3B’s-PT
Government Associate Laboratory, 4805-017 Barco, Braga/Guimarães, Portugal
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Lakomý R, Lojová M, Souckova L, Hynkova L, Polachova K, Vasina J, Demlová R, Poprach A, Sana J, Prochazka T, Smrcka M, Fadrus P, Jancalek R, Selingerova I, Belanova R, Slampa P, Pospisil P, Kazda T. 11C-methionine in the diagnostics and management of glioblastoma patients with rapid early progression: nonrandomized, open label, prospective clinical trial (GlioMET). BMC Cancer 2024; 24:736. [PMID: 38879476 PMCID: PMC11179343 DOI: 10.1186/s12885-024-12469-2] [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: 12/27/2023] [Accepted: 06/03/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Glioblastoma (GBM) is the most common and aggressive primary brain cancer. The treatment of GBM consists of a combination of surgery and subsequent oncological therapy, i.e., radiotherapy, chemotherapy, or their combination. If postoperative oncological therapy involves irradiation, magnetic resonance imaging (MRI) is used for radiotherapy treatment planning. Unfortunately, in some cases, a very early worsening (progression) or return (recurrence) of the disease is observed several weeks after the surgery and is called rapid early progression (REP). Radiotherapy planning is currently based on MRI for target volumes definitions in many radiotherapy facilities. However, patients with REP may benefit from targeting radiotherapy with other imaging modalities. The purpose of the presented clinical trial is to evaluate the utility of 11C-methionine in optimizing radiotherapy for glioblastoma patients with REP. METHODS This study is a nonrandomized, open-label, parallel-setting, prospective, monocentric clinical trial. The main aim of this study was to refine the diagnosis in patients with GBM with REP and to optimize subsequent radiotherapy planning. Glioblastoma patients who develop REP within approximately 6 weeks after surgery will undergo 11C-methionine positron emission tomography (PET/CT) examinations. Target volumes for radiotherapy are defined using both standard planning T1-weighted contrast-enhanced MRI and PET/CT. The primary outcome is progression-free survival defined using RANO criteria and compared to a historical cohort with REP treated without PET/CT optimization of radiotherapy. DISCUSSION PET is one of the most modern methods of molecular imaging. 11C-Methionine is an example of a radiolabelled (carbon 11) amino acid commonly used in the diagnosis of brain tumors and in the evaluation of response to treatment. Optimized radiotherapy may also have the potential to cover those regions with a high risk of subsequent progression, which would not be identified using standard-of-care MRI for radiotherapy planning. This is one of the first study focused on radiotherapy optimization for subgroup of patinets with REP. TRIAL REGISTRATION NCT05608395, registered on 8.11.2022 in clinicaltrials.gov; EudraCT Number: 2020-000640-64, registered on 26.5.2020 in clinicaltrialsregister.eu. Protocol ID: MOU-2020-01, version 3.2, date 18.09.2020.
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Affiliation(s)
- Radek Lakomý
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
- Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
| | - Martina Lojová
- Department of Clinical Trials, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Lenka Souckova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
- International Clinical Research Centre, St. Anne´S University Hospital Brno, 656 91, Brno, Czech Republic
| | - Ludmila Hynkova
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Katerina Polachova
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Vasina
- Department of Nuclear Medicine, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
| | - Regina Demlová
- Department of Pharmacology, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
- Department of Clinical Trials, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Alexandr Poprach
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
- Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
| | - Jiri Sana
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
- Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
| | - Tomas Prochazka
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martin Smrcka
- Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
- Department of Neurosurgery, University Hospital Brno, 625 00, Brno, Czech Republic
| | - Pavel Fadrus
- Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
- Department of Neurosurgery, University Hospital Brno, 625 00, Brno, Czech Republic
| | - Radim Jancalek
- Department of Neurosurgery, St. Anne's University Hospital Brno, 656 91, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
| | - Iveta Selingerova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
- Research Centre for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
| | - Renata Belanova
- Department of Medical Imaging, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
| | - Pavel Slampa
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Pospisil
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomas Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic.
- Research Centre for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, 656 53, Brno, Czech Republic.
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
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Smith S, Drummond K, Dowling A, Bennett I, Campbell D, Freilich R, Phillips C, Ahern E, Reeves S, Campbell R, Collins IM, Johns J, Dumas M, Hong W, Gibbs P, Gately L. Improving Clinical Registry Data Quality via Linkage With Survival Data From State-Based Population Registries. JCO Clin Cancer Inform 2024; 8:e2400025. [PMID: 38924710 DOI: 10.1200/cci.24.00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/26/2024] [Accepted: 05/03/2024] [Indexed: 06/28/2024] Open
Abstract
PURPOSE Real-world data (RWD) collected on patients treated as part of routine clinical care form the basis of cancer clinical registries. Capturing accurate death data can be challenging, with inaccurate survival data potentially compromising the integrity of registry-based research. Here, we explore the utility of data linkage (DL) to state-based registries to enhance the capture of survival outcomes. METHODS We identified consecutive adult patients with brain tumors treated in the state of Victoria from the Brain Tumour Registry Australia: Innovation and Translation (BRAIN) database, who had no recorded date of death and no follow-up within the last 6 months. Full name and date of birth were used to match patients in the BRAIN registry with those in the Victorian Births, Deaths and Marriages (BDM) registry. Overall survival (OS) outcomes were compared pre- and post-DL. RESULTS Of the 7,346 clinical registry patients, 5,462 (74%) had no date of death and no follow-up recorded within the last 6 months. Of the 5,462 patients, 1,588 (29%) were matched with a date of death in BDM. Factors associated with an increased number of matches were poor prognosis tumors, older age, and social disadvantage. OS was significantly overestimated pre-DL compared with post-DL for the entire cohort (pre- v post-DL: hazard ratio, 1.43; P < .001; median, 29.9 months v 16.7 months) and for most individual tumor types. This finding was present independent of the tumor prognosis. CONCLUSION As revealed by linkage with BDM, a high proportion of patients in a brain cancer clinical registry had missing death data, contributed to by informative censoring, inflating OS calculations. DL to pertinent registries on an ongoing basis should be considered to ensure accurate reporting of survival data and interpretation of RWD outcomes.
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Affiliation(s)
- Samuel Smith
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Oncology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Kate Drummond
- University of Melbourne, Parkville, VIC, Australia
- Department of Neurosurgery, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Anthony Dowling
- Department of Medical Oncology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- University of Melbourne, Parkville, VIC, Australia
| | - Iwan Bennett
- Department of Neurosurgery, Alfred Health, Prahran, VIC, Australia
| | - David Campbell
- Department of Medical Oncology, Barwon Health, Geelong, VIC, Australia
| | - Ronnie Freilich
- Department of Neurology, Cabrini Hospital, Malvern, VIC, Australia
| | - Claire Phillips
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
| | - Elizabeth Ahern
- Department of Medical Oncology, Monash Health, Clayton, VIC, Australia
| | - Simone Reeves
- Department of Radiation Oncology, Ballarat Austin Radiation Oncology Centre, Ballarat, VIC, Australia
| | - Robert Campbell
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC, Australia
| | - Ian M Collins
- Department of Medical Oncology, South West Oncology, Warnambool, VIC, Australia
| | - Julie Johns
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Megan Dumas
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Wei Hong
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Peter Gibbs
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Lucy Gately
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Neurosurgery, Alfred Health, Prahran, VIC, Australia
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Zhu P, Pichardo-Rojas PS, Dono A, Tandon N, Hadjipanayis CG, Berger MS, Esquenazi Y. The detrimental effect of biopsy preceding resection in surgically accessible glioblastoma: results from the national cancer database. J Neurooncol 2024; 168:77-89. [PMID: 38492191 DOI: 10.1007/s11060-024-04644-z] [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: 01/23/2024] [Accepted: 03/12/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Aggressive resection in surgically-accessible glioblastoma (GBM) correlates with improved survival over less extensive resections. However, the clinical impact of performing a biopsy before definitive resection have not been previously evaluated. METHODS We analyzed 17,334 GBM patients from the NCDB from 2010-2014. We categorized them into: "upfront resection" and "biopsy followed by resection". The outcomes of interes included OS, 30-day readmission/mortality, 90-day mortality, and length of hospital stay (LOS). The Kaplan-Meier methods and accelerated failure time (AFT) models were applied for survival analysis. Multivariable binary logistic regression were performed to compare differences among groups. Multiple imputation and propensity score matching (PSM) were conducted for validation. RESULTS "Upfront resection" had superior OS over "biopsy followed by resection" (median OS:12.4 versus 11.1 months, log-rank p = 0.001). Similarly, multivariable AFT models favored "upfront resection" (time ratio[TR]:0.83, 95%CI: 0.75-0.93, p = 0.001). Patients undergoing "upfront gross-total resection (GTR)" had higher OS over "upfront subtotal resection (STR)", "GTR following STR", and "GTR or STR following initial biopsy" (14.4 vs. 10.3, 13.5, 13.3, and 9.1 months;TR: 1.00 [Ref.], 0.75, 0.82, 0.88, and 0.67). Recent years of diagnosis, higher income, facilities located in Southern regions, and treatment at academic facilities were significantly associated with the higher likelihood of undergoing upfront resection. Multivariable regression showed a decreased 30 and 90-day mortality for patients undergoing "upfront resection", 73% and 44%, respectively (p < 0.001). CONCLUSIONS Pre-operative biopsies for surgically accessible GBM are associated with worse survival despite subsequent resection compared to patients undergoing upfront resection.
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Affiliation(s)
- Ping Zhu
- The Vivian L. Smith Department of Neurosurgery and Center for Precision Health, The University of Texas Health Science Center at Houston McGovern Medical School, 6400 Fannin Street, Suite # 2800, Houston, TX, 77030, USA
| | - Pavel S Pichardo-Rojas
- The Vivian L. Smith Department of Neurosurgery and Center for Precision Health, The University of Texas Health Science Center at Houston McGovern Medical School, 6400 Fannin Street, Suite # 2800, Houston, TX, 77030, USA
| | - Antonio Dono
- The Vivian L. Smith Department of Neurosurgery and Center for Precision Health, The University of Texas Health Science Center at Houston McGovern Medical School, 6400 Fannin Street, Suite # 2800, Houston, TX, 77030, USA
| | - Nitin Tandon
- The Vivian L. Smith Department of Neurosurgery and Center for Precision Health, The University of Texas Health Science Center at Houston McGovern Medical School, 6400 Fannin Street, Suite # 2800, Houston, TX, 77030, USA
| | | | - Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Yoshua Esquenazi
- The Vivian L. Smith Department of Neurosurgery and Center for Precision Health, The University of Texas Health Science Center at Houston McGovern Medical School, 6400 Fannin Street, Suite # 2800, Houston, TX, 77030, USA.
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Miele E, Anghileri E, Calatozzolo C, Lazzarini E, Patrizi S, Ciolfi A, Pedace L, Patanè M, Abballe L, Paterra R, Maddaloni L, Barresi S, Mastronuzzi A, Petruzzi A, Tramacere I, Farinotti M, Gurrieri L, Pirola E, Scarpelli M, Lombardi G, Villani V, Simonelli M, Merli R, Salmaggi A, Tartaglia M, Silvani A, DiMeco F, Calistri D, Lamperti E, Locatelli F, Indraccolo S, Pollo B. Clinicopathological and molecular landscape of 5-year IDH-wild-type glioblastoma survivors: A multicentric retrospective study. Cancer Lett 2024; 588:216711. [PMID: 38423245 DOI: 10.1016/j.canlet.2024.216711] [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: 10/24/2023] [Revised: 01/19/2024] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
Five-year glioblastoma (GBM) survivors (LTS) are the minority of the isocitrate dehydrogenase (IDH)-wild-type GBM patients, and their molecular fingerprint is still largely unexplored. This multicenter retrospective study analyzed a large LTS-GBM cohort from nine Italian institutions and molecularly characterized a subgroup of patients by mutation, DNA methylation (DNAm) and copy number variation (CNV) profiling, comparing it to standard survival GBM. Mutation scan allowed the identification of pathogenic variants in most cases, showing a similar mutational spectrum in both groups, and highlighted TP53 as the most commonly mutated gene in the LTS group. We confirmed DNAm as a valuable tool for GBM classification with a diagnostic refinement by using brain tumor classifier v12.5. LTS were more heterogeneous with more cases classified as diffuse pediatric high-grade glioma subtypes and having peculiar CNVs. We observed a global higher methylation in CpG islands and in gene promoters of LTS with methylation levels of distinct gene promoters correlating with prognosis.
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Affiliation(s)
- Evelina Miele
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elena Anghileri
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy.
| | - Chiara Calatozzolo
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elisabetta Lazzarini
- Basic and Translational Oncology Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | - Sara Patrizi
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Ciolfi
- Molecular Genetics and Functional Genomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lucia Pedace
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Monica Patanè
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Luana Abballe
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rosina Paterra
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Luisa Maddaloni
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Sabina Barresi
- Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Angela Mastronuzzi
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandra Petruzzi
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Irene Tramacere
- Department of Research and Clinical Development, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mariangela Farinotti
- Neuroepidemiology-Brain Cancer Registry, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lorena Gurrieri
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) Dino Amadori, Meldola, Italy
| | - Elena Pirola
- Department of Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mauro Scarpelli
- Neurology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | - Giuseppe Lombardi
- Medical Oncology Unit 1, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - Veronica Villani
- Neuro-Oncology Unit, IRCCS Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - Matteo Simonelli
- Department of Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Rossella Merli
- Neurosurgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Marco Tartaglia
- Molecular Genetics and Functional Genomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonio Silvani
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Francesco DiMeco
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Department of Neurological Surgery, John Hopkins Medical School, Baltimore, MD, USA
| | - Daniele Calistri
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Elena Lamperti
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta (FINCB), Milan, Italy
| | - Franco Locatelli
- Department of Onco-Hematology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Stefano Indraccolo
- Basic and Translational Oncology Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy; Department of Surgery Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Bianca Pollo
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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8
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Zanotto A, Glover RN, Zanotto T, Boele FW. Rehabilitation in People Living with Glioblastoma: A Narrative Review of the Literature. Cancers (Basel) 2024; 16:1699. [PMID: 38730651 PMCID: PMC11083409 DOI: 10.3390/cancers16091699] [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: 02/16/2024] [Revised: 03/21/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Glioblastoma is the most common primary malignant brain tumor. While preliminary data point to the positive effects of rehabilitation for patients with glioblastoma, there are unique challenges for clinicians working with this population, including limited life expectancy and/or rapid neurological deterioration. The aim of this article is to review the literature on rehabilitation of adults with glioblastoma, including the feasibility of interventions, their effectiveness, as well as the current clinical practice. The reviewed literature suggests that rehabilitation has been found beneficial for improving the functional prognosis and quality of life of adults with glioblastoma and is desired by patients. We summarize the qualitative evidence regarding healthcare professionals' and patients' perspectives on the use of supportive care services. We conclude there is a need for the design of effective rehabilitation programs for patients with glioblastoma, as well as for the development of glioblastoma-specific clinical guidelines for rehabilitation practitioners.
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Affiliation(s)
- Anna Zanotto
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA; (R.N.G.); (T.Z.)
| | - Rebecca N. Glover
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA; (R.N.G.); (T.Z.)
| | - Tobia Zanotto
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA; (R.N.G.); (T.Z.)
| | - Florien W. Boele
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds LS2 9JT, UK
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9JT, UK
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9
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Liu P, Xing N, Xiahou Z, Yan J, Lin Z, Zhang J. Unraveling the intricacies of glioblastoma progression and recurrence: insights into the role of NFYB and oxidative phosphorylation at the single-cell level. Front Immunol 2024; 15:1368685. [PMID: 38510250 PMCID: PMC10950940 DOI: 10.3389/fimmu.2024.1368685] [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: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
Background Glioblastoma (GBM), with its high recurrence and mortality rates, makes it the deadliest neurological malignancy. Oxidative phosphorylation is a highly active cellular pathway in GBM, and NFYB is a tumor-associated transcription factor. Both are related to mitochondrial function, but studies on their relationship with GBM at the single-cell level are still scarce. Methods We re-analyzed the single-cell profiles of GBM from patients with different subtypes by single-cell transcriptomic analysis and further subdivided the large population of Glioma cells into different subpopulations, explored the interrelationships and active pathways among cell stages and clinical subtypes of the populations, and investigated the relationship between the transcription factor NFYB of the key subpopulations and GBM, searching for the prognostic genes of GBM related to NFYB, and verified by experiments. Results Glioma cells and their C5 subpopulation had the highest percentage of G2M staging and rGBM, which we hypothesized might be related to the higher dividing and proliferating ability of both Glioma and C5 subpopulations. Oxidative phosphorylation pathway activity is elevated in both the Glioma and C5 subgroup, and NFYB is a key transcription factor for the C5 subgroup, suggesting its possible involvement in GBM proliferation and recurrence, and its close association with mitochondrial function. We also identified 13 prognostic genes associated with NFYB, of which MEM60 may cause GBM patients to have a poor prognosis by promoting GBM proliferation and drug resistance. Knockdown of the NFYB was found to contribute to the inhibition of proliferation, invasion, and migration of GBM cells. Conclusion These findings help to elucidate the key mechanisms of mitochondrial function in GBM progression and recurrence, and to establish a new prognostic model and therapeutic target based on NFYB.
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Affiliation(s)
- Pulin Liu
- Shandong University of Traditional Chinese Medicine, Jinan, China
- Shanxi Key Laboratory of Chinese Medicine Encephalopathy, Shanxi University of Chinese Medicine, Jinzhong, China
- National International Joint Research Center of Molecular Traditional Chinese Medicine, Shanxi University of Chinese Medicine, Jinzhong, China
| | - Naifei Xing
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Zhikai Xiahou
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Jingwei Yan
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Zhiheng Lin
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Junlong Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, China
- Shanxi Key Laboratory of Chinese Medicine Encephalopathy, Shanxi University of Chinese Medicine, Jinzhong, China
- National International Joint Research Center of Molecular Traditional Chinese Medicine, Shanxi University of Chinese Medicine, Jinzhong, China
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10
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Obrador E, Moreno-Murciano P, Oriol-Caballo M, López-Blanch R, Pineda B, Gutiérrez-Arroyo JL, Loras A, Gonzalez-Bonet LG, Martinez-Cadenas C, Estrela JM, Marqués-Torrejón MÁ. Glioblastoma Therapy: Past, Present and Future. Int J Mol Sci 2024; 25:2529. [PMID: 38473776 DOI: 10.3390/ijms25052529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/10/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Glioblastoma (GB) stands out as the most prevalent and lethal form of brain cancer. Although great efforts have been made by clinicians and researchers, no significant improvement in survival has been achieved since the Stupp protocol became the standard of care (SOC) in 2005. Despite multimodality treatments, recurrence is almost universal with survival rates under 2 years after diagnosis. Here, we discuss the recent progress in our understanding of GB pathophysiology, in particular, the importance of glioma stem cells (GSCs), the tumor microenvironment conditions, and epigenetic mechanisms involved in GB growth, aggressiveness and recurrence. The discussion on therapeutic strategies first covers the SOC treatment and targeted therapies that have been shown to interfere with different signaling pathways (pRB/CDK4/RB1/P16ink4, TP53/MDM2/P14arf, PI3k/Akt-PTEN, RAS/RAF/MEK, PARP) involved in GB tumorigenesis, pathophysiology, and treatment resistance acquisition. Below, we analyze several immunotherapeutic approaches (i.e., checkpoint inhibitors, vaccines, CAR-modified NK or T cells, oncolytic virotherapy) that have been used in an attempt to enhance the immune response against GB, and thereby avoid recidivism or increase survival of GB patients. Finally, we present treatment attempts made using nanotherapies (nanometric structures having active anti-GB agents such as antibodies, chemotherapeutic/anti-angiogenic drugs or sensitizers, radionuclides, and molecules that target GB cellular receptors or open the blood-brain barrier) and non-ionizing energies (laser interstitial thermal therapy, high/low intensity focused ultrasounds, photodynamic/sonodynamic therapies and electroporation). The aim of this review is to discuss the advances and limitations of the current therapies and to present novel approaches that are under development or following clinical trials.
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Affiliation(s)
- Elena Obrador
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | | | - María Oriol-Caballo
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Rafael López-Blanch
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Begoña Pineda
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | | | - Alba Loras
- Department of Medicine, Jaume I University of Castellon, 12071 Castellon, Spain
| | - Luis G Gonzalez-Bonet
- Department of Neurosurgery, Castellon General University Hospital, 12004 Castellon, Spain
| | | | - José M Estrela
- Scientia BioTech S.L., 46002 Valencia, Spain
- Department of Physiology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
- Department of Physiology, Faculty of Pharmacy, University of Valencia, 46100 Burjassot, Spain
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11
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Boccacino JM, Dos Santos Peixoto R, Fernandes CFDL, Cangiano G, Sola PR, Coelho BP, Prado MB, Melo-Escobar MI, de Sousa BP, Ayyadhury S, Bader GD, Shinjo SMO, Marie SKN, da Rocha EL, Lopes MH. Integrated transcriptomics uncovers an enhanced association between the prion protein gene expression and vesicle dynamics signatures in glioblastomas. BMC Cancer 2024; 24:199. [PMID: 38347462 PMCID: PMC10863147 DOI: 10.1186/s12885-024-11914-6] [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: 06/01/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Glioblastoma (GBM) is an aggressive brain tumor that exhibits resistance to current treatment, making the identification of novel therapeutic targets essential. In this context, cellular prion protein (PrPC) stands out as a potential candidate for new therapies. Encoded by the PRNP gene, PrPC can present increased expression levels in GBM, impacting cell proliferation, growth, migration, invasion and stemness. Nevertheless, the exact molecular mechanisms through which PRNP/PrPC modulates key aspects of GBM biology remain elusive. METHODS To elucidate the implications of PRNP/PrPC in the biology of this cancer, we analyzed publicly available RNA sequencing (RNA-seq) data of patient-derived GBMs from four independent studies. First, we ranked samples profiled by bulk RNA-seq as PRNPhigh and PRNPlow and compared their transcriptomic landscape. Then, we analyzed PRNP+ and PRNP- GBM cells profiled by single-cell RNA-seq to further understand the molecular context within which PRNP/PrPC might function in this tumor. We explored an additional proteomics dataset, applying similar comparative approaches, to corroborate our findings. RESULTS Functional profiling revealed that vesicular dynamics signatures are strongly correlated with PRNP/PrPC levels in GBM. We found a panel of 73 genes, enriched in vesicle-related pathways, whose expression levels are increased in PRNPhigh/PRNP+ cells across all RNA-seq datasets. Vesicle-associated genes, ANXA1, RAB31, DSTN and SYPL1, were found to be upregulated in vitro in an in-house collection of patient-derived GBM. Moreover, proteome analysis of patient-derived samples reinforces the findings of enhanced vesicle biogenesis, processing and trafficking in PRNPhigh/PRNP+ GBM cells. CONCLUSIONS Together, our findings shed light on a novel role for PrPC as a potential modulator of vesicle biology in GBM, which is pivotal for intercellular communication and cancer maintenance. We also introduce GBMdiscovery, a novel user-friendly tool that allows the investigation of specific genes in GBM biology.
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Affiliation(s)
- Jacqueline Marcia Boccacino
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524 room 431, Sao Paulo, 05508000, Brazil
| | - Rafael Dos Santos Peixoto
- Department of Automation and Systems, Technological Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Camila Felix de Lima Fernandes
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524 room 431, Sao Paulo, 05508000, Brazil
| | - Giovanni Cangiano
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524 room 431, Sao Paulo, 05508000, Brazil
| | - Paula Rodrigues Sola
- Cellular and Molecular Biology Laboratory (LIM 15), Department of Neurology, Faculdade de Medicina (FMUSP), University of Sao Paulo, Sao Paulo, Brazil
| | - Bárbara Paranhos Coelho
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524 room 431, Sao Paulo, 05508000, Brazil
| | - Mariana Brandão Prado
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524 room 431, Sao Paulo, 05508000, Brazil
| | - Maria Isabel Melo-Escobar
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524 room 431, Sao Paulo, 05508000, Brazil
| | - Breno Pereira de Sousa
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524 room 431, Sao Paulo, 05508000, Brazil
| | - Shamini Ayyadhury
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- The Donnelly Centre, University of Toronto, Toronto, Ontario, Canada
| | - Gary D Bader
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- The Donnelly Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Department of Computer Science, University of Toronto, Toronto, Ontario, Canada
| | - Sueli Mieko Oba Shinjo
- Cellular and Molecular Biology Laboratory (LIM 15), Department of Neurology, Faculdade de Medicina (FMUSP), University of Sao Paulo, Sao Paulo, Brazil
| | - Suely Kazue Nagahashi Marie
- Cellular and Molecular Biology Laboratory (LIM 15), Department of Neurology, Faculdade de Medicina (FMUSP), University of Sao Paulo, Sao Paulo, Brazil
| | - Edroaldo Lummertz da Rocha
- Department of Microbiology, Immunology, and Parasitology, Biological Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, 88040-900, Brazil.
| | - Marilene Hohmuth Lopes
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524 room 431, Sao Paulo, 05508000, Brazil.
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12
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Pichardo-Rojas PS, Angulo-Lozano JC, Alvarez-Castro JA, Vázquez-Alva D, Osuna-Lau RA, Choque-Ayala LC, Tandon N, Esquenazi Y. Intraoperative Magnetic Resonance Imaging (MRI)-Guided Resection of Glioblastoma: A Meta-Analysis of 1,847 Patients. World Neurosurg 2024; 182:e807-e822. [PMID: 38101537 DOI: 10.1016/j.wneu.2023.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Affiliation(s)
- Pavel S Pichardo-Rojas
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas, USA.
| | - Juan Carlos Angulo-Lozano
- Laboratory of Molecular Genetics and Immunology, The Rockefeller University, New York, New York, USA
| | - José Alfonso Alvarez-Castro
- Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, Mexico
| | - Diego Vázquez-Alva
- Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | - Luz Camila Choque-Ayala
- Facultad de Medicina, Universidad Católica Boliviana San Pablo, Santa Cruz de la Sierra, Bolivia
| | - Nitin Tandon
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas, USA
| | - Yoshua Esquenazi
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas, USA
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13
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Aiudi D, Iacoangeli A, Dobran M, Polonara G, Chiapponi M, Mattioli A, Gladi M, Iacoangeli M. The Prognostic Role of Volumetric MRI Evaluation in the Surgical Treatment of Glioblastoma. J Clin Med 2024; 13:849. [PMID: 38337543 PMCID: PMC10856584 DOI: 10.3390/jcm13030849] [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: 09/25/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Glioblastoma is the most common primary brain neoplasm in adults, with a poor prognosis despite a constant effort to improve patient survival. Some neuroradiological volumetric parameters seem to play a predictive role in overall survival (OS) and progression-free survival (PFS). The aim of this study was to analyze the impact of the volumetric areas of contrast-enhancing tumors and perineoplastic edema on the survival of patients treated for glioblastoma. Methods: A series of 87 patients who underwent surgery was retrospectively analyzed; OS and PFS were considered the end points of the study. For each patient, a multidisciplinary revision was conducted in collaboration with the Neuroradiology and Neuro-Oncology Board. Manual and semiautomatic measurements were adopted to perform the radiological evaluation, and the following quantitative parameters were retrospectively analyzed: contrast enhancement preoperative tumor volume (CE-PTV), contrast enhancement postoperative tumor volume (CE-RTV), edema/infiltration preoperative volume (T2/FLAIR-PV), edema/infiltration postoperative volume (T2/FLAIR-RV), necrosis volume inside the tumor (NV), and total tumor volume including necrosis (TV). Results: The median OS value was 9 months, and the median PFS value was 4 months; the mean values were 12.3 and 6.9 months, respectively. Multivariate analysis showed that the OS-related factors were adjuvant chemoradiotherapy (p < 0.0001), CE-PTV < 15 cm3 (p = 0.03), surgical resection > 95% (p = 0.004), and the presence of a "pseudocapsulated" radiological morphology (p = 0.04). Conclusions: Maximal safe resection is one of the most relevant predictive factors for patient survival. Semiautomatic preoperative MRI evaluation could play a key role in prognostically categorizing these tumors.
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Affiliation(s)
- Denis Aiudi
- Department of Neurosurgery, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60121 Ancona, Italy; (A.I.); (M.D.); (M.C.); (A.M.); (M.G.); (M.I.)
| | - Alessio Iacoangeli
- Department of Neurosurgery, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60121 Ancona, Italy; (A.I.); (M.D.); (M.C.); (A.M.); (M.G.); (M.I.)
| | - Mauro Dobran
- Department of Neurosurgery, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60121 Ancona, Italy; (A.I.); (M.D.); (M.C.); (A.M.); (M.G.); (M.I.)
| | - Gabriele Polonara
- Department of Neuroradiology, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60121 Ancona, Italy;
| | - Mario Chiapponi
- Department of Neurosurgery, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60121 Ancona, Italy; (A.I.); (M.D.); (M.C.); (A.M.); (M.G.); (M.I.)
| | - Andrea Mattioli
- Department of Neurosurgery, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60121 Ancona, Italy; (A.I.); (M.D.); (M.C.); (A.M.); (M.G.); (M.I.)
| | - Maurizio Gladi
- Department of Neurosurgery, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60121 Ancona, Italy; (A.I.); (M.D.); (M.C.); (A.M.); (M.G.); (M.I.)
| | - Maurizio Iacoangeli
- Department of Neurosurgery, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60121 Ancona, Italy; (A.I.); (M.D.); (M.C.); (A.M.); (M.G.); (M.I.)
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14
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Shah S. Novel Therapies in Glioblastoma Treatment: Review of Glioblastoma; Current Treatment Options; and Novel Oncolytic Viral Therapies. Med Sci (Basel) 2023; 12:1. [PMID: 38249077 PMCID: PMC10801585 DOI: 10.3390/medsci12010001] [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: 10/27/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
One of the most prevalent primary malignant brain tumors is glioblastoma (GB). About 6 incidents per 100,000 people are reported annually. Most frequently, these tumors are linked to a poor prognosis and poor quality of life. There has been little advancement in the treatment of GB. In recent years, some innovative medicines have been tested for the treatment of newly diagnosed cases of GB and recurrent cases of GB. Surgery, radiotherapy, and alkylating chemotherapy are all common treatments for GB. A few of the potential alternatives include immunotherapy, tumor-treating fields (TTFs), and medications that target specific cellular receptors. To provide new multimodal therapies that focus on the molecular pathways implicated in tumor initiation and progression in GB, novel medications, delivery technologies, and immunotherapy approaches are being researched. Of these, oncolytic viruses (OVs) are among the most recent. Coupling OVs with certain modern treatment approaches may have significant benefits for GB patients. Here, we discuss several OVs and how they work in conjunction with other therapies, as well as virotherapy for GB. The study was based on the PRISMA guidelines. Systematic retrieval of information was performed on PubMed. A total of 307 articles were found in a search on oncolytic viral therapies for glioblastoma. Out of these 83 articles were meta-analyses, randomized controlled trials, reviews, and systematic reviews. A total of 42 articles were from the years 2018 to 2023. Appropriate studies were isolated, and important information from each of them was understood and entered into a database from which the information was used in this article. One of the most prevalent malignant brain tumors is still GB. Significant promise and opportunity exist for oncolytic viruses in the treatment of GB and in boosting immune response. Making the most of OVs in the treatment of GB requires careful consideration and evaluation of a number of its application factors.
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Affiliation(s)
- Siddharth Shah
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
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Panada J, Klopava V, Kulahava T, Koran S, Faletrov Y, Frolova N, Fomina E, Shkumatov V. Differential induction of C6 glioma apoptosis and autophagy by 3β-hydroxysteroid-indolamine conjugates. Steroids 2023; 200:109326. [PMID: 37827441 DOI: 10.1016/j.steroids.2023.109326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023]
Abstract
In a previous work, we reported the synthesis of four novel indole steroids and their effect on rat C6 glioma proliferation in vitro. The steroid derived from dehydroepiandrosterone and tryptamine (IS-1) was the most active (52 % inhibition at 10 µM), followed by one of the epimers derived from pregnenolone and tryptamine (IS-3, 36 % inhibition at 10 µM). By contrast, the steroid derived from estrone and tryptamine (IS-2) showed negligible activity at 10 µM. No necrosis, increase in intracellular calcium or ROS levels was observed. In this work, the effect of compounds on C6 glioma apoptosis and autophagy is examined by fluorimetry and fluorescent microscopy. The IS-3 epimers disrupt the mitochondrial membrane potential and induce apoptosis in vitro moderately whereas IS-1 and IS-2 do not. However, IS-1 produces a large increase in monodansylcadaverine-positive autophagic vesicles over 24 h. The antiproliferative effect of indole steroids is ameliorated by autophagy inhibitor hydroxychloroquine, suggesting an autophagy-dependent mechanism of cell death.
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Affiliation(s)
- Jan Panada
- Research Institute for Physical Chemical Problems of the Belarusian State University, 220006, 14 Lieninhradskaja str., Minsk, Belarus
| | - Valeriya Klopava
- Research Institute for Physical Chemical Problems of the Belarusian State University, 220006, 14 Lieninhradskaja str., Minsk, Belarus
| | - Tatsiana Kulahava
- Institute for Nuclear Problems of the Belarusian State University, 220006, 11 Babrujskaja str., Minsk, Belarus
| | - Siarhei Koran
- Republican Research and Practical Center for Epidemiology and Microbiology, 220114, 23 Filimonava str., Minsk, Belarus
| | - Yaroslav Faletrov
- Research Institute for Physical Chemical Problems of the Belarusian State University, 220006, 14 Lieninhradskaja str., Minsk, Belarus; Department of Chemistry, Belarusian State University, 220050, 4 Independence ave., Minsk, Belarus
| | - Nina Frolova
- Research Institute for Physical Chemical Problems of the Belarusian State University, 220006, 14 Lieninhradskaja str., Minsk, Belarus
| | - Elena Fomina
- Republican Research and Practical Center for Epidemiology and Microbiology, 220114, 23 Filimonava str., Minsk, Belarus
| | - Vladimir Shkumatov
- Research Institute for Physical Chemical Problems of the Belarusian State University, 220006, 14 Lieninhradskaja str., Minsk, Belarus; Department of Chemistry, Belarusian State University, 220050, 4 Independence ave., Minsk, Belarus.
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Farzana W, Basree MM, Diawara N, Shboul ZA, Dubey S, Lockhart MM, Hamza M, Palmer JD, Iftekharuddin KM. Prediction of Rapid Early Progression and Survival Risk with Pre-Radiation MRI in WHO Grade 4 Glioma Patients. Cancers (Basel) 2023; 15:4636. [PMID: 37760604 PMCID: PMC10526762 DOI: 10.3390/cancers15184636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/09/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Recent clinical research describes a subset of glioblastoma patients that exhibit REP prior to the start of radiation therapy. Current literature has thus far described this population using clinicopathologic features. To our knowledge, this study is the first to investigate the potential of conventional radiomics, sophisticated multi-resolution fractal texture features, and different molecular features (MGMT, IDH mutations) as a diagnostic and prognostic tool for prediction of REP from non-REP cases using computational and statistical modeling methods. The radiation-planning T1 post-contrast (T1C) MRI sequences of 70 patients are analyzed. An ensemble method with 5-fold cross-validation over 1000 iterations offers an AUC of 0.793 ± 0.082 for REP versus non-REP classification. In addition, copula-based modeling under dependent censoring (where a subset of the patients may not be followed up with until death) identifies significant features (p-value < 0.05) for survival probability and prognostic grouping of patient cases. The prediction of survival for the patients' cohort produces a precision of 0.881 ± 0.056. The prognostic index (PI) calculated using the fused features shows that 84.62% of REP cases fall under the bad prognostic group, suggesting the potential of fused features for predicting a higher percentage of REP cases. The experimental results further show that multi-resolution fractal texture features perform better than conventional radiomics features for prediction of REP and survival outcomes.
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Affiliation(s)
- Walia Farzana
- Vision Lab, Department of Electrical & Computer Engineering, Old Dominion University, Norfolk, VA 23529, USA; (W.F.); (Z.A.S.)
| | - Mustafa M. Basree
- Department of Internal Medicine, OhioHealth Riverside Methodist Hospital, Columbus, OH 43214, USA; (M.M.B.); (S.D.)
| | - Norou Diawara
- Department of Mathematics & Statistics, Old Dominion University, Norfolk, VA 23529, USA;
| | - Zeina A. Shboul
- Vision Lab, Department of Electrical & Computer Engineering, Old Dominion University, Norfolk, VA 23529, USA; (W.F.); (Z.A.S.)
| | - Sagel Dubey
- Department of Internal Medicine, OhioHealth Riverside Methodist Hospital, Columbus, OH 43214, USA; (M.M.B.); (S.D.)
| | | | - Mohamed Hamza
- Department of Neurology, OhioHealth, Columbus, OH 43214, USA;
| | - Joshua D. Palmer
- Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA;
| | - Khan M. Iftekharuddin
- Vision Lab, Department of Electrical & Computer Engineering, Old Dominion University, Norfolk, VA 23529, USA; (W.F.); (Z.A.S.)
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Tamas C, Tamas F, Kovecsi A, Serban G, Boeriu C, Balasa A. The Role of Ketone Bodies in Treatment Individualization of Glioblastoma Patients. Brain Sci 2023; 13:1307. [PMID: 37759908 PMCID: PMC10526163 DOI: 10.3390/brainsci13091307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Glioblastoma is the most common and aggressive primary brain tumor in adults. According to the 2021 WHO CNS, glioblastoma is assigned to the IDH wild-type classification, fulfilling the specific characteristic histopathology. We have conducted a prospective observational study to identify the glucose levels, ketone bodies, and the glucose-ketone index in three groups of subjects: two tumoral groups of patients with histopathological confirmation of glioblastoma (9 male patients, 7 female patients, mean age 55.6 years old) or grade 4 astrocytoma (4 male patients, 2 female patients, mean age 48.1 years old) and a control group (13 male patients, 9 female patients, mean age 53.9 years old) consisting of subjects with no personal pathological history. There were statistically significant differences between the mean values of glycemia (p value = 0.0003), ketones (p value = 0.0061), and glucose-ketone index (p value = 0.008) between the groups of patients. Mortality at 3 months in glioblastoma patients was 0% if the ketone levels were below 0.2 mM and 100% if ketones were over 0.5 mM. Patients with grade 4 astrocytoma and the control subjects all presented with ketone values of less than 0.2 mM and 0.0% mortality. In conclusion, highlighting new biomarkers which are more feasible to determine such as ketones or glucose-ketone index represents an essential step toward personalized medicine and survival prolongation in patients suffering from glioblastoma and grade 4 astrocytoma.
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Affiliation(s)
- Corina Tamas
- Doctoral School, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania; (C.T.); (G.S.)
- Neurosurgery Department, Emergency Clinical County Hospital, 540136 Targu Mures, Romania;
- Department of Neurosurgery, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
| | - Flaviu Tamas
- Doctoral School, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania; (C.T.); (G.S.)
- Neurosurgery Department, Emergency Clinical County Hospital, 540136 Targu Mures, Romania;
- Department of Neurosurgery, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
| | - Attila Kovecsi
- Department of Morphopathology, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania;
- Department of Morphopathology, Emergency Clinical County Hospital, 540136 Targu Mures, Romania
| | - Georgiana Serban
- Doctoral School, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania; (C.T.); (G.S.)
- Department of Anesthesiology and Intensive Care, Emergency Clinical County Hospital, 540136 Targu Mures, Romania
| | - Cristian Boeriu
- Department of Emergency Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Targu Mures, Romania;
- Department of Emergency Medicine, Emergency Clinical County Hospital, 540136 Targu Mures, Romania
| | - Adrian Balasa
- Neurosurgery Department, Emergency Clinical County Hospital, 540136 Targu Mures, Romania;
- Department of Neurosurgery, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
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Olivet MM, Brown MC, Reitman ZJ, Ashley DM, Grant GA, Yang Y, Markert JM. Clinical Applications of Immunotherapy for Recurrent Glioblastoma in Adults. Cancers (Basel) 2023; 15:3901. [PMID: 37568717 PMCID: PMC10416859 DOI: 10.3390/cancers15153901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Glioblastoma (GBM) is the most common malignant primary brain tumor in adults. Despite standard therapies, including resection and chemoradiation, recurrence is virtually inevitable. Current treatment for recurrent glioblastoma (rGBM) is rapidly evolving, and emerging therapies aimed at targeting primary GBM are often first tested in rGBM to demonstrate safety and feasibility, which, in recent years, has primarily been in the form of immunotherapy. The purpose of this review is to highlight progress in clinical trials of immunotherapy for rGBM, including immune checkpoint blockade, oncolytic virotherapy, chimeric antigen receptor (CAR) T-cell therapy, cancer vaccine and immunotoxins. Three independent reviewers covered literature, published between the years 2000 and 2022, in various online databases. In general, the efficacy of immunotherapy in rGBM remains uncertain, and is limited to subsets/small cohorts of patients, despite demonstrating feasibility in early-stage clinical trials. However, considerable progress has been made in understanding the mechanisms that may preclude rGBM patients from responding to immunotherapy, as well as in developing new approaches/combination strategies that may inspire optimism for the utility of immunotherapy in this devastating disease. Continued trials are necessary to further assess the best therapeutic avenues and ascertain which treatments might benefit each patient individually.
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Affiliation(s)
- Meagan Mandabach Olivet
- Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35233, USA;
| | - Michael C. Brown
- Department of Neurosurgery, Duke University, Durham, NC 27710, USA; (M.C.B.); (D.M.A.); (G.A.G.)
| | - Zachary J. Reitman
- Department of Radiation Oncology, Duke University, Durham, NC 27710, USA;
| | - David M. Ashley
- Department of Neurosurgery, Duke University, Durham, NC 27710, USA; (M.C.B.); (D.M.A.); (G.A.G.)
| | - Gerald A. Grant
- Department of Neurosurgery, Duke University, Durham, NC 27710, USA; (M.C.B.); (D.M.A.); (G.A.G.)
| | - Yuanfan Yang
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
| | - James M. Markert
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
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Abolfathi S, Zare M. The evaluation of chitosan hydrogel based curcumin effect on DNMT1, DNMT3A, DNMT3B, MEG3, HOTAIR gene expression in glioblastoma cell line. Mol Biol Rep 2023:10.1007/s11033-023-08531-0. [PMID: 37268862 DOI: 10.1007/s11033-023-08531-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/17/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Cancer is one of the most important causes of death worldwide. Some types of cancer, including glioblastoma, with a high potential for growth, invasion, and resistance to general treatments, chemotherapy, and radiotherapy, have a high potential for recurrence. Many chemical drugs have been used to treat it, but herbal drugs are more effective with fewer side effects; Therefore, this research aims to investigate the effect of curcumin-chitosan nano-complex on the expression of MEG3, HOTAIR, DNMT1, DNMT3A, DNMT3B genes in the glioblastoma cell line. METHODS In this research, glioblastoma cell line, PCR and spectrophotometry techniques, MTT test and transmission, field emission transmission, and fluorescent electron microscopes were used. RESULTS The morphological examination of the curcumin-chitosan nano-complex was without clumping, and the fluorescent microscope examination showed the nano-complex enters the cell and affects the genes expression. In its bioavailability studies, it was found that it significantly increases the death of cancer cells in a dose- and time-dependent manner. Gene expression tests showed that this nano-complex increased MEG3 gene expression compared to the control group, which is statistically significant (p < 0.05). It also decreased HOTAIR gene expression compared to the control group, which was not statistically significant (p > 0.05). It decreased the expression of DNMT1, DNMT3A, and DNMT3B genes compared to the control group, which is statistically significant (p < 0.05). CONCLUSION By using active plant substances such as curcumin, the active demethylation of brain cells can be directed to the path of inhibiting the growth of brain cancer cells and eliminating them.
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Affiliation(s)
- Sanaz Abolfathi
- Department of Biology, Faculty of Sciences, Payame Noor University, Shahre Rey, Iran
| | - Maryam Zare
- Department of Biology, Faculty of Sciences, Payame Noor University, Tehran, Iran.
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You F, Li C, Zhang S, Zhang Q, Hu Z, Wang Y, Zhang T, Meng Q, Yu R, Gao S. Sitagliptin inhibits the survival, stemness and autophagy of glioma cells, and enhances temozolomide cytotoxicity. Biomed Pharmacother 2023; 162:114555. [PMID: 36966667 DOI: 10.1016/j.biopha.2023.114555] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
The standard regimen treatment has improved GBM outcomes, but the survival rate of patients is still unsatisfactory. Temozolomide (TMZ) resistance is one of main reasons limiting the therapeutic efficacy of GBM. However, there are currently no TMZ-sensitizing drugs available in the clinic. Here we aimed to study whether the antidiabetic drug Sitagliptin can inhibit the survival, stemness and autophagy of GBM cells, and thus enhance TMZ cytotoxicity. We used CCK-8, EdU, colony formation, TUNEL and flow cytometry assays to assess cell proliferation and apoptosis; sphere formation and limiting dilution assays to measure self-renewal and stemness of glioma stem cells (GSCs); Western blot, qRT-PCR or immunohistochemical analysis to measure the expression of proliferation or stem cell markers; Western blot/fluorescent analysis of LC3 and other molecules to evaluate autophagy formation and degradation in glioma cells. We found that Sitagliptin inhibited proliferation and induced apoptosis in GBM cells and suppressed self-renewal and stemness of GSCs. The in vitro findings were further confirmed in glioma intracranial xenograft models. Sitagliptin administration prolonged the survival time of tumor-bearing mice. Sitagliptin could inhibit TMZ-induced protective autophagy and enhance the cytotoxicity of TMZ in glioma cells. In addition, Sitagliptin acted as a dipeptidyl peptidase 4 inhibitor in glioma as well as in diabetes, but it did not affect the blood glucose level and body weight of mice. These findings suggest that Sitagliptin with established pharmacologic and safety profiles could be repurposed as an antiglioma drug to overcome TMZ resistance, providing a new option for GBM therapy.
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Rončević A, Koruga N, Soldo Koruga A, Rončević R, Rotim T, Šimundić T, Kretić D, Perić M, Turk T, Štimac D. Personalized Treatment of Glioblastoma: Current State and Future Perspective. Biomedicines 2023; 11:1579. [PMID: 37371674 DOI: 10.3390/biomedicines11061579] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
Glioblastoma (GBM) is the most aggressive glial tumor of the central nervous system. Despite intense scientific efforts, patients diagnosed with GBM and treated with the current standard of care have a median survival of only 15 months. Patients are initially treated by a neurosurgeon with the goal of maximal safe resection of the tumor. Obtaining tissue samples during surgery is indispensable for the diagnosis of GBM. Technological improvements, such as navigation systems and intraoperative monitoring, significantly advanced the possibility of safe gross tumor resection. Usually within six weeks after the surgery, concomitant radiotherapy and chemotherapy with temozolomide are initiated. However, current radiotherapy regimens are based on population-level studies and could also be improved. Implementing artificial intelligence in radiotherapy planning might be used to individualize treatment plans. Furthermore, detailed genetic and molecular markers of the tumor could provide patient-tailored immunochemotherapy. In this article, we review current standard of care and possibilities of personalizing these treatments. Additionally, we discuss novel individualized therapeutic options with encouraging results. Due to inherent heterogeneity of GBM, applying patient-tailored treatment could significantly prolong survival of these patients.
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Affiliation(s)
- Alen Rončević
- Department of Neurosurgery, University Hospital Center Osijek, 31000 Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Nenad Koruga
- Department of Neurosurgery, University Hospital Center Osijek, 31000 Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Anamarija Soldo Koruga
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Neurology, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Robert Rončević
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Diagnostic and Interventional Radiology, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Tatjana Rotim
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Diagnostic and Interventional Radiology, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Tihana Šimundić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Nephrology, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Domagoj Kretić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Diagnostic and Interventional Radiology, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Marija Perić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Cytology, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Tajana Turk
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Diagnostic and Interventional Radiology, University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Damir Štimac
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Radiology, National Memorial Hospital Vukovar, 32000 Vukovar, Croatia
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Kalita O, Kazda T, Reguli S, Jancalek R, Fadrus P, Slachta M, Pospisil P, Krska L, Vrbkova J, Hrabalek L, Smrcka M, Lipina R. Effects of Reoperation Timing on Survival among Recurrent Glioblastoma Patients: A Retrospective Multicentric Descriptive Study. Cancers (Basel) 2023; 15:cancers15092530. [PMID: 37173996 PMCID: PMC10177480 DOI: 10.3390/cancers15092530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Glioblastoma inevitably recurs, but no standard regimen has been established for treating this recurrent disease. Several reports claim that reoperative surgery can improve survival, but the effects of reoperation timing on survival have rarely been investigated. We, therefore, evaluated the relationship between reoperation timing and survival in recurrent GBM. A consecutive cohort of unselected patients (real-world data) from three neuro-oncology cancer centers was analyzed (a total of 109 patients). All patients underwent initial maximal safe resection followed by treatment according to the Stupp protocol. Those meeting the following criteria during progression were indicated for reoperation and were further analyzed in this study: (1) The tumor volume increased by >20-30% or a tumor was rediscovered after radiological disappearance; (2) The patient's clinical status was satisfactory (KS ≥ 70% and PS WHO ≤ gr. 2); (3) The tumor was localized without multifocality; (4) The minimum expected tumor volume reduction was above 80%. A univariate Cox regression analysis of postsurgical survival (PSS) revealed a statistically significant effect of reoperation on PSS from a threshold of 16 months after the first surgery. Cox regression models that stratified the Karnofsky score with age adjustment confirmed a statistically significant improvement in PSS for time-to-progression (TTP) thresholds of 22 and 24 months. The patient groups exhibiting the first recurrence at 22 and 24 months had better survival rates than those exhibiting earlier recurrences. For the 22-month group, the HR was 0.5 with a 95% CI of (0.27, 0.96) and a p-value of 0.036. For the 24-month group, the HR was 0.5 with a 95% CI of (0.25, 0.96) and a p-value of 0.039. Patients with the longest survival were also the best candidates for repeated surgery. Later recurrence of glioblastoma was associated with higher survival rates after reoperation.
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Affiliation(s)
- Ondrej Kalita
- Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital Olomouc, Zdravotníků 248/7, 779 00 Olomouc, Czech Republic
- Department of Health Care Science, Faculty of Humanities, T. Bata University in Zlin, Stefanikova 5670, 760 01 Zlín, Czech Republic
| | - Tomas Kazda
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Masaryk Memorial Cancer Institute, Zluty Kopec 7, 656 53 Brno, Czech Republic
| | - Stefan Reguli
- Department of Neurosurgery, Faculty of Medicine, University of Ostrava, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52 Ostrava, Czech Republic
| | - Radim Jancalek
- Department of Neurosurgery, Faculty of Medicine, Masaryk University, St. Anne's University Hospital in Brno, Pekarska 664/53, 602 00 Brno, Czech Republic
| | - Pavel Fadrus
- Department of Neurosurgery, Faculty of Medicine, Masaryk University, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic
| | - Marek Slachta
- Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital Olomouc, Zdravotníků 248/7, 779 00 Olomouc, Czech Republic
| | - Petr Pospisil
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Masaryk Memorial Cancer Institute, Zluty Kopec 7, 656 53 Brno, Czech Republic
| | - Lukas Krska
- Department of Neurosurgery, Faculty of Medicine, University of Ostrava, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52 Ostrava, Czech Republic
| | - Jana Vrbkova
- Institute of Molecular and Translate Medicine, Faculty of Medicine and Dentistry, Palacky University in Olomouc, Hnevotinska 133/5, 779 00 Olomouc, Czech Republic
| | - Lumir Hrabalek
- Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital Olomouc, Zdravotníků 248/7, 779 00 Olomouc, Czech Republic
| | - Martin Smrcka
- Department of Neurosurgery, Faculty of Medicine, Masaryk University, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic
| | - Radim Lipina
- Department of Neurosurgery, Faculty of Medicine, University of Ostrava, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52 Ostrava, Czech Republic
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Teske N, Teske NC, Niyazi M, Belka C, Thon N, Tonn JC, Forbrig R, Karschnia P. Frequency and Prognostic Relevance of Volumetric MRI Changes in Contrast- and Non-Contrast-Enhancing Tumor Compartments between Surgery and Radiotherapy of IDHwt Glioblastoma. Cancers (Basel) 2023; 15:cancers15061745. [PMID: 36980633 PMCID: PMC10046652 DOI: 10.3390/cancers15061745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/23/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
In newly diagnosed IDH-wildtype glioblastoma, the frequency and prognostic relevance of tumor regrowth between resection and the initiation of adjuvant radiochemotherapy are unclear. In this retrospective single-center study we included 64 consecutive cases, for whom magnetic resonance imaging (MRI) was available for both the volumetric assessment of the extent of resection immediately after surgery as well as the volumetric target delineation before the initiation of adjuvant radiochemotherapy (time interval: 15.5 ± 1.9 days). Overall, a median new contrast-enhancement volume was seen in 21/64 individuals (33%, 1.5 ± 1.5 cm3), and new non-contrast lesion volume in 18/64 patients (28%, 5.0 ± 2.3 cm3). A multidisciplinary in-depth review revealed that new contrast-enhancement was either due to (I) the progression of contrast-enhancing tumor remnants in 6/21 patients or (II) distant contrast-enhancing foci or breakdown of the blood–brain barrier in previously non-contrast-enhancing tumor remnants in 5/21 patients, whereas it was unspecific or due to ischemia in 10/21 patients. For non-contrast-enhancing lesions, three of eighteen had progression of non-contrast-enhancing tumor remnants and fifteen of eighteen had unspecific changes or changes due to ischemia. There was no significant association between findings consistent with tumor regrowth and a less favorable outcome (overall survival: 14 vs. 19 months; p = 0.423). These findings support the rationale that analysis of the postsurgical remaining tumor-volume for prognostic stratification should be carried out on immediate postoperative MRI (<72 h), as unspecific changes are common. However, tumor regrowth including distant foci may occur in a subset of IDH-wildtype glioblastoma patients diagnosed per WHO 2021 classification. Thus, MRI imaging prior to radiotherapy should be obtained to adjust radiotherapy planning accordingly.
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Affiliation(s)
- Nico Teske
- Department of Neurosurgery, Munich University Hospital, LMU Munich, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
- Correspondence: (N.T.); (P.K.); Tel.: +49-(0)89-4400-711361 (N.T.); +49-(0)89-4400-711365 (P.K.); Fax: +49-(0)89-4400-72592 (N.T. & P.K.)
| | - Nina C. Teske
- Department of Neurosurgery, Munich University Hospital, LMU Munich, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
| | - Maximilian Niyazi
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
- Department of Radiation Oncology, Munich University Hospital, LMU Munich, 81377 Munich, Germany
- Bavarian Center for Cancer Research (BZKF), 91054 Erlangen, Germany
| | - Claus Belka
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
- Department of Radiation Oncology, Munich University Hospital, LMU Munich, 81377 Munich, Germany
- Bavarian Center for Cancer Research (BZKF), 91054 Erlangen, Germany
| | - Niklas Thon
- Department of Neurosurgery, Munich University Hospital, LMU Munich, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
| | - Joerg-Christian Tonn
- Department of Neurosurgery, Munich University Hospital, LMU Munich, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
| | - Robert Forbrig
- Institute of Neuroradiology, Munich University Hospital, LMU Munich, 81377 Munich, Germany
| | - Philipp Karschnia
- Department of Neurosurgery, Munich University Hospital, LMU Munich, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
- Correspondence: (N.T.); (P.K.); Tel.: +49-(0)89-4400-711361 (N.T.); +49-(0)89-4400-711365 (P.K.); Fax: +49-(0)89-4400-72592 (N.T. & P.K.)
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24
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Willman M, Willman J, Figg J, Dioso E, Sriram S, Olowofela B, Chacko K, Hernandez J, Lucke-Wold B. Update for astrocytomas: medical and surgical management considerations. EXPLORATION OF NEUROSCIENCE 2023; 2:1-26. [PMID: 36935776 PMCID: PMC10019464 DOI: 10.37349/en.2023.00009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/10/2022] [Indexed: 02/25/2023]
Abstract
Astrocytomas include a wide range of tumors with unique mutations and varying grades of malignancy. These tumors all originate from the astrocyte, a star-shaped glial cell that plays a major role in supporting functions of the central nervous system (CNS), including blood-brain barrier (BBB) development and maintenance, water and ion regulation, influencing neuronal synaptogenesis, and stimulating the immunological response. In terms of epidemiology, glioblastoma (GB), the most common and malignant astrocytoma, generally occur with higher rates in Australia, Western Europe, and Canada, with the lowest rates in Southeast Asia. Additionally, significantly higher rates of GB are observed in males and non-Hispanic whites. It has been suggested that higher levels of testosterone observed in biological males may account for the increased rates of GB. Hereditary syndromes such as Cowden, Lynch, Turcot, Li-Fraumeni, and neurofibromatosis type 1 have been linked to increased rates of astrocytoma development. While there are a number of specific gene mutations that may influence malignancy or be targeted in astrocytoma treatment, O 6-methylguanine-DNA methyltransferase (MGMT) gene function is an important predictor of astrocytoma response to chemotherapeutic agent temozolomide (TMZ). TMZ for primary and bevacizumab in the setting of recurrent tumor formation are two of the main chemotherapeutic agents currently approved in the treatment of astrocytomas. While stereotactic radiosurgery (SRS) has debatable implications for increased survival in comparison to whole-brain radiotherapy (WBRT), SRS demonstrates increased precision with reduced radiation toxicity. When considering surgical resection of astrocytoma, the extent of resection (EoR) is taken into consideration. Subtotal resection (STR) spares the margins of the T1 enhanced magnetic resonance imaging (MRI) region, gross total resection (GTR) includes the margins, and supramaximal resection (SMR) extends beyond the margin of the T1 and into the T2 region. Surgical resection, radiation, and chemotherapy are integral components of astrocytoma treatment.
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Affiliation(s)
- Matthew Willman
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jonathan Willman
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - John Figg
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Emma Dioso
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
| | - Sai Sriram
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Bankole Olowofela
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Kevin Chacko
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jairo Hernandez
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
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25
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Vymazal J, Kazda T, Novak T, Slanina P, Sroubek J, Klener J, Hrbac T, Syrucek M, Rulseh AM. Eighteen years' experience with tumor treating fields in the treatment of newly diagnosed glioblastoma. Front Oncol 2023; 12:1014455. [PMID: 36741707 PMCID: PMC9892904 DOI: 10.3389/fonc.2022.1014455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction The prognosis of glioblastoma remains unfavorable. TTFields utilize low intensity electric fields (frequency 150-300 kHz) that disrupt cellular processes critical for cancer cell viability and tumor progression. TTFields are delivered via transducer arrays placed on the patients' scalp. Methods: Between the years 2004 and 2022, 55 patients (20 female), aged 21.9-77.8 years (mean age 47.3±11.8 years; median 47.6 years) were treated with TTFields for newly-diagnosed GBM, and compared to 54 control patients (20 females), aged 27.0-76.7 years (mean age 51.4±12.2 years; median 51.7 years) (p=0.08). All patients underwent gross total or partial resection of GBM. One patient had biopsy only. When available, MGMT promoter methylation status and IDH mutation was detected. Results Patients on TTFields therapy demonstrated improvements in PFS and OS relative to controls (hazard ratio: 0.64, p=0.031; and 0.61, p=0.028 respectively). TTFields average time on therapy was 74.8% (median 82%): median PFS of these patients was 19.75 months. Seven patients with TTFields usage ≤60% (23-60%, mean 46.3%, median 53%) had a median PFS of 7.95 months (p=0.0356). Control patients with no TTFields exposure had a median PFS of 12.45 months. Median OS of TTF patients was 31.67 months compared to 24.80 months for controls. Discussion This is the most extensive study on newly-diagnosed GBM patients treated with TTFields, covering a period of 18 years at a single center and presenting not only data from clinical trials but also a group of 36 patients treated with TTFields as a part of routine clinical practice.
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Affiliation(s)
- Josef Vymazal
- Department of Radiology and Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czechia,*Correspondence: Josef Vymazal, ; Aaron M. Rulseh,
| | - Tomas Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Tomas Novak
- Department of Radiation Oncology, Central Military Hospital and Faculty Hospital Motol, Prague, Czechia
| | - Petr Slanina
- Department of Radiology and Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czechia
| | - Jan Sroubek
- Department of Neurosurgery, Na Homolce Hospital, Prague, Czechia
| | - Jan Klener
- Department of Neurosurgery, Na Homolce Hospital, Prague, Czechia
| | - Tomas Hrbac
- Department of Neurosurgery, Faculty Hospital Ostrava, Ostrava, Czechia
| | - Martin Syrucek
- Department of Pathology, Na Homolce Hospital, Prague, Czechia
| | - Aaron M. Rulseh
- Department of Radiology and Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czechia,*Correspondence: Josef Vymazal, ; Aaron M. Rulseh,
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26
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Lazarević M, Jovanović N, Cvetković VJ, Tošić S, Vitorović J, Stamenković S, Nikolov V, Vidović N, Kostić Perić J, Jovanović M, Mitrović T. A Comparison of MGMT Testing by MSP and qMSP in Paired Snap-Frozen and Formalin-Fixed Paraffin-Embedded Gliomas. Diagnostics (Basel) 2023; 13:diagnostics13030360. [PMID: 36766464 PMCID: PMC9914267 DOI: 10.3390/diagnostics13030360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/30/2022] [Accepted: 01/12/2023] [Indexed: 01/21/2023] Open
Abstract
Comparative analysis of the conventional methylation-specific PCR (MSP) vs. the quantitative MSP (qMSP) assessment of the O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status in 34 snap-frozen (SF) glioma samples was performed. The accuracy of the semi-quantitative MSP was compared with the corresponding qMSP semi-quantitative values using two semi-quantitative cut-off values (0-unmethylated and 1-weakly methylated) to discriminate methylated from unmethylated samples. In the case of the cut-off value 0, MSP test showed 80.0% sensitivity and 78.9% specificity compared to the reference qMSP analysis. However, when using the cut-off value 1, the diagnostic accuracy of the MSP test was significantly higher (85.7% sensitivity, 85.2% specificity). Fleiss' Kappa statistical analyses indicated moderate agreement (Fleiss' Kappa Coefficient = 0.509; 70.59% agreement) between MSP and qMSP semi-quantitative measurements of MGMT promoter methylation in glioma patients, justifying the conventional MSP use in diagnostics and confirming its high reliability. Further, we aimed to compare the validity of SF and formalin-fixed paraffin-embedded (FFPE) glioma samples for MGMT testing. Statistical analyses indicated moderate overall agreement of FFPE glioma samples and SF MSP semi-quantitative measurements (Fleiss' Kappa Coefficient = 0.516/0.509; 70.0% agreement) and emphasized their low reliability in the assessment of highly methylated MGMT promoter samples.
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Affiliation(s)
- Milica Lazarević
- Laboratory for Molecular Biology and Biotechnology, Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, 18000 Niš, Serbia
| | - Nikola Jovanović
- Laboratory for Molecular Biology and Biotechnology, Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, 18000 Niš, Serbia
- Correspondence: or ; Tel.: +381-18-533015
| | - Vladimir J. Cvetković
- Laboratory for Molecular Biology and Biotechnology, Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, 18000 Niš, Serbia
| | - Svetlana Tošić
- Laboratory for Molecular Biology and Biotechnology, Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, 18000 Niš, Serbia
| | - Jelena Vitorović
- Laboratory for Molecular Biology and Biotechnology, Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, 18000 Niš, Serbia
| | - Slaviša Stamenković
- Laboratory for Molecular Biology and Biotechnology, Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, 18000 Niš, Serbia
| | - Vesna Nikolov
- Faculty of Medicine, Clinic of Neurosurgery, Clinical Centre, University of Niš, 18000 Niš, Serbia
| | - Nataša Vidović
- Faculty of Medicine, Pathology and Pathological Anathomy Centre, Clinical Centre, University of Niš, 18000 Niš, Serbia
| | - Jelena Kostić Perić
- Laboratory for Molecular Biomedicine, Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11042 Belgrade, Serbia
| | - Marija Jovanović
- Laboratory for Molecular Biology and Biotechnology, Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, 18000 Niš, Serbia
| | - Tatjana Mitrović
- Laboratory for Molecular Biology and Biotechnology, Department of Biology and Ecology, Faculty of Sciences and Mathematics, University of Niš, 18000 Niš, Serbia
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Spinal Metastasis in a Patient with Supratentorial Glioblastoma with Primitive Neuronal Component: A Case Report with Clinical and Molecular Evaluation. Diagnostics (Basel) 2023; 13:diagnostics13020181. [PMID: 36672991 PMCID: PMC9858260 DOI: 10.3390/diagnostics13020181] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/27/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
Glioblastoma (GBM) is regarded as an aggressive brain tumor that rarely develops extracranial metastases. Despite well-investigated molecular alterations in GBM, there is a limited understanding of these associated with the metastatic potential. We herein present a case report of a 43-year-old woman with frontal GBM with primitive neuronal component who underwent gross total resection followed by chemoradiation. Five months after surgery, the patient was diagnosed with an intraspinal GBM metastasis. Next-generation sequencing analysis of both the primary and metastatic GBM tissues was performed using the Illumina TruSight Tumor 170 assay. The number of single nucleotide variants observed in the metastatic sample was more than two times higher. Mutations in TP53, PTEN, and RB1 found in the primary and metastatic tissue samples indicated the mesenchymal molecular GBM subtype. Among others, there were two inactivating mutations (Arg1026Ile, Trp1831Ter) detected in the NF1 gene, two novel NOTCH3 variants of unknown significance predicted to be damaging (Pro1505Thr, Cys1099Tyr), one novel ARID1A variant of unknown significance (Arg1046Ser), and one gene fusion of unknown significance, EIF2B5-KIF5B, in the metastatic sample. Based on the literature evidence, the alterations of NF1, NOTCH3, and ARID1A could explain, at least in part, the acquired invasiveness and metastatic potential in this particular GBM case.
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28
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Datsenko PV, Kobyletskaya TM, Chuguev AS, Belikova AA, Gerasimov VA, Kaprin AD. [Early progression of glioblastoma before radiotherapy]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2023; 87:40-46. [PMID: 37325825 DOI: 10.17116/neiro20238703140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To analyze the influence of continued growth of glioblastoma between surgery and radiotherapy on subsequent survival. MATERIAL AND METHODS Fractionation with a prescribed dose of 2 and 3 Gy was alternately applied using a pairwise modeling strategy in 140 patients with morphologically confirmed glioblastoma (grade 4). Early progression of disease between microsurgery and radiotherapy was diagnosed in 60 patients, and no tumor growth was noted in 80 patients. RESULTS The minimum period of early progression was 0.33 months, maximum - 4.27 months (median 1.1 (95.0% CI: 0.9-1.3)). The most significant predictors of early progression were resection quality (p<0.0001), large residual tumor (p=0.003) and no MGMT promoter methylation (p=0.001). IDH1 status did not affect early progression. In residual tumor ≥1.2 cm3, the median period of early progression was 1.9 months (n=70; 95% Cl: 1.3-2.5), <1.2 cm3 - 3.5 months (n=70; p=0.019). After resection of less than 76% of tumor, this value was 1.1 months (n=28), ≥76% - 3.1 months (n=112; p=0.006). Without tumor growth, the median overall survival was 33.41 months (n=80; 95% Cl: 27.1-39.7), with early progression - 16.03 months (n=60; 95% Cl: 13.5-18.6; p<0.0001). This predictor was significant for fractionation with a prescribed dose of 3 Gy (p<0.0001) and standard radiotherapy (2 Gy; p=0.028). By December 2022, 26 out of 40 patients without early progression survived two years after treatment (3 Gy) (65%, median not reached). In case of fractionation with a prescribed dose of 2 Gy, 20 patients survived this period (50%, median reached). CONCLUSION Almost half of patients with newly diagnosed glioblastoma develop early progression between microsurgery and radiotherapy. Therefore, patients with and without early progression should be probably assigned to different prognostic groups regarding overall survival.
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Affiliation(s)
- P V Datsenko
- National Research Medical Center of Radiology, Moscow, Russia
| | | | - A S Chuguev
- National Research Medical Center of Radiology, Moscow, Russia
| | - A A Belikova
- National Research Medical Center of Radiology, Moscow, Russia
| | - V A Gerasimov
- National Research Medical Center of Radiology, Moscow, Russia
| | - A D Kaprin
- National Research Medical Center of Radiology, Moscow, Russia
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29
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Solár P, Mackerle Z, Hendrych M, Pospisil P, Lakomy R, Valekova H, Hermanova M, Jancalek R. Prolonged survival in patients with local chronic infection after high-grade glioma treatment: Two case reports. Front Oncol 2022; 12:1073036. [PMID: 36591464 PMCID: PMC9800515 DOI: 10.3389/fonc.2022.1073036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
High-grade gliomas are primary brain tumors with poor prognosis, despite surgical treatment followed by radiotherapy and concomitant chemotherapy. We present two cases of long-term survival in patients treated for high-grade glioma and concomitant prolonged bacterial wound infection. The first patient treated for glioblastoma IDH-wildtype had been without disease progression for 61 months from the first resected recurrence. Despite incomplete chemotherapy-induced myelosuppression in the second patient with anaplastic astrocytoma IDH-mutant, she died without disease relapse after 14 years from the diagnosis due to other comorbidities. We assume that the documented prolonged survival could be related to the bacterial infection.
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Affiliation(s)
- Peter Solár
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czechia,Department of Neurosurgery, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Zdenek Mackerle
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czechia,Department of Neurosurgery, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Michal Hendrych
- First Department of Pathology, St. Anne’s University Hospital Brno, Brno, Czechia,First Department of Pathology, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Petr Pospisil
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Radek Lakomy
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Hana Valekova
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czechia,Department of Neurosurgery, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Marketa Hermanova
- First Department of Pathology, St. Anne’s University Hospital Brno, Brno, Czechia,First Department of Pathology, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Radim Jancalek
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Brno, Czechia,Department of Neurosurgery, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia,*Correspondence: Radim Jancalek,
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30
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Fan Y, Wang T, Lei J, Fei F, Liu J, Liu Y. Effects of postoperative radiotherapy and docetaxel and PD-1 inhibitors on the survival and safety of glioblastoma patients: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1326. [PMID: 36660707 PMCID: PMC9843395 DOI: 10.21037/atm-22-2670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
Background The present standard treatment rarely allows the complete removal of glioblastoma (GBM). So postoperative treatments are provided to prevent or delay tumor recurrence. The overall survival (OS) rate and safety of postoperative chemotherapy alone, or combined with radiotherapy (RT), or programmed cell death-1 (PD-1) inhibitor in GBM is still unclear. The present goal was to explore postoperative treatment's effect on the survival and safety of patients with GBM. Methods We searched the mainstream online databases for clinical studies of RT and chemotherapy and PD-1 inhibitors in the treatment of GBM published up to May 2020. The patients in the experimental group accepted an anti-PD-1 drug alone and RT + chemotherapy, whereas the controlled patients were treated with docetaxel alone. The literature qualities were assessed using Cochrane Risk of Bias 2.0, and studies were assigned. The meta-analysis was conducted by RevMan 5.4 software. Results A total of 927 articles were identified through the online database search. The articles unable to meet the inclusion criteria were excluded leaving 6 studies for inclusion in the study. Compared with docetaxel-based chemotherapy for GBM, combined RT chemotherapy and PD-1 inhibitor therapy had better OS [mean difference (MD), -1.75; 95% confidence interval (CI): -2.99 to -0.51; P=0.006] and progression-free survival (PFS) and a lower incidence of adverse reactions (MD, -7.03; 95% CI: -7.64 to -6.42; P<0.00001) above grade III. Conclusions Postoperative combination of RT and chemotherapy and PD-1 inhibitors had some advantages over docetaxel in terms of effectiveness. More clinical trials are needed to confirm effectiveness.
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Affiliation(s)
- Yingjun Fan
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Lei
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Fan Fei
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yanhui Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
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31
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Lee CC, You JF, Wang YC, Lan SW, Wei KC, Chen KT, Huang YC, Wu TWE, Huang APH. Gross Total Resection Promotes Subsequent Recovery and Further Enhancement of Impaired Natural Killer Cell Activity in Glioblastoma Patients. Brain Sci 2022; 12:brainsci12091144. [PMID: 36138881 PMCID: PMC9496976 DOI: 10.3390/brainsci12091144] [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: 07/03/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Highlights Natural killer cell activity is dramatically impaired in patients with glioblastoma. Surgical resection of glioblastoma promotes redistribution of NK cell subsets and increases NK cell activity 30 days after surgery. Gross total resection rather than subtotal resection significantly recovers and further increases the impaired NK cell activity in patients with glioblastoma.
Abstract Glioblastoma is the most common primary malignant brain tumor, and median survival is relatively short despite aggressive standard treatment. Natural killer (NK) cell dysfunction is strongly associated with tumor recurrence and metastasis but is unclear in glioblastoma. NK activity (NKA) represents NK cell-secreted interferon-γ (IFN-γ), which modulates immunity and inhibits cancer progression. This study aimed to analyze NKA in glioblastoma patients to obtain a clearer overview of immunity surveillance. From 2020 to 2021, a total of 20 patients and six healthy controls were recruited. Peripheral blood samples were collected preoperatively and on postoperative days (POD) 3 and 30. Then, NKA was measured using the NK VUE kit. Although NKA decreased on POD3, it recovered and further significantly enhanced on POD30, with a nearly five-fold increase compared to baseline (p = 0.004). Furthermore, the percentage of CD56brightCD16− NK cells decreased significantly on POD3 (p = 0.022) and further recovered on PO30. Subgroup analysis of extent surgical resection further revealed that the recovery of impaired NKA was attributable to gross total resection (GTR) rather than subtotal resection (STR). In conclusion, NKA is significantly impaired in glioblastoma, and GTR has demonstrated superior benefit in improving the suppressed NKA and increased CD56brightCD16− NK subset in glioblastoma patients, which may be associated with subsequent patients’ prognosis. Therefore, the goal of performing GTR for glioblastoma should be achieved when possible since it appears to increase NKA cell immunity.
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Affiliation(s)
- Cheng-Chi Lee
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taoyuan City 33305, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Jeng-Fu You
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan City 33305, Taiwan
| | - Yu-Chi Wang
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taoyuan City 33305, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Shao-Wei Lan
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taoyuan City 33305, Taiwan
| | - Kuo-Chen Wei
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taoyuan City 33305, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Neurosurgery, New Taipei Municipal TuCheng Hospital, New Taipei City 236027, Taiwan
| | - Ko-Ting Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taoyuan City 33305, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Yin-Cheng Huang
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taoyuan City 33305, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Tai-Wei Erich Wu
- Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taoyuan City 33305, Taiwan
| | - Abel Po-Hao Huang
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei City 10663, Taiwan
- Department of Surgery, College of Medicine, National Taiwan University Hospital, Taipei City 100229, Taiwan
- Correspondence:
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Solar P, Hendrych M, Barak M, Valekova H, Hermanova M, Jancalek R. Blood-Brain Barrier Alterations and Edema Formation in Different Brain Mass Lesions. Front Cell Neurosci 2022; 16:922181. [PMID: 35910247 PMCID: PMC9334679 DOI: 10.3389/fncel.2022.922181] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/20/2022] [Indexed: 12/03/2022] Open
Abstract
Differential diagnosis of brain lesion pathologies is complex, but it is nevertheless crucial for appropriate clinical management. Advanced imaging methods, including diffusion-weighted imaging and apparent diffusion coefficient, can help discriminate between brain mass lesions such as glioblastoma, brain metastasis, brain abscesses as well as brain lymphomas. These pathologies are characterized by blood-brain barrier alterations and have been extensively studied. However, the changes in the blood-brain barrier that are observed around brain pathologies and that contribute to the development of vasogenic brain edema are not well described. Some infiltrative brain pathologies such as glioblastoma are characterized by glioma cell infiltration in the brain tissue around the tumor mass and thus affect the nature of the vasogenic edema. Interestingly, a common feature of primary and secondary brain tumors or tumor-like brain lesions characterized by vasogenic brain edema is the formation of various molecules that lead to alterations of tight junctions and result in blood-brain barrier damage. The resulting vasogenic edema, especially blood-brain barrier disruption, can be visualized using advanced magnetic resonance imaging techniques, such as diffusion-weighted imaging and apparent diffusion coefficient. This review presents a comprehensive overview of blood-brain barrier changes contributing to the development of vasogenic brain edema around glioblastoma, brain metastases, lymphomas, and abscesses.
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Affiliation(s)
- Peter Solar
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
- Department of Neurosurgery, St. Anne’s University Hospital, Brno, Czechia
| | - Michal Hendrych
- First Department of Pathology, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
- First Department of Pathology, St. Anne’s University Hospital, Brno, Czechia
| | - Martin Barak
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
- Department of Neurosurgery, St. Anne’s University Hospital, Brno, Czechia
| | - Hana Valekova
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
- Department of Neurosurgery, St. Anne’s University Hospital, Brno, Czechia
| | - Marketa Hermanova
- First Department of Pathology, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
- First Department of Pathology, St. Anne’s University Hospital, Brno, Czechia
| | - Radim Jancalek
- Department of Neurosurgery, St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czechia
- Department of Neurosurgery, St. Anne’s University Hospital, Brno, Czechia
- *Correspondence: Radim Jancalek,
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Park JH, Kang I, Lee HK. γδ T Cells in Brain Homeostasis and Diseases. Front Immunol 2022; 13:886397. [PMID: 35693762 PMCID: PMC9181321 DOI: 10.3389/fimmu.2022.886397] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
γδ T cells are a distinct subset of T cells expressing γδ T cell receptor (TCR) rather than αβTCR. Since their discovery, the critical roles of γδ T cells in multiple physiological systems and diseases have been investigated. γδ T cells are preferentially located at mucosal surfaces, such as the gut, although a small subset of γδ T cells can circulate the blood. Additionally, a subset of γδ T cells reside in the meninges in the central nervous system. Recent findings suggest γδ T cells in the meninges have critical roles in brain function and homeostasis. In addition, several lines of evidence have shown γδ T cells can infiltrate the brain parenchyma and regulate inflammatory responses in multiple diseases, including neurodegenerative diseases. Although the importance of γδ T cells in the brain is well established, their roles are still incompletely understood due to the complexity of their biology. Because γδ T cells rapidly respond to changes in brain status and regulate disease progression, understanding the role of γδ T cells in the brain will provide critical information that is essential for interpreting neuroimmune modulation. In this review, we summarize the complex role of γδ T cells in the brain and discuss future directions for research.
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Deciphering of Adult Glioma Vulnerabilities through Expression Pattern Analysis of GABA, Glutamate and Calcium Neurotransmitter Genes. J Pers Med 2022; 12:jpm12040633. [PMID: 35455749 PMCID: PMC9030730 DOI: 10.3390/jpm12040633] [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: 02/01/2022] [Revised: 04/02/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Adult infiltrating gliomas are highly aggressive tumors of the central nervous system with a dismal prognosis despite intensive multimodal therapy (chemotherapy and/or radiotherapy). In this study, we studied the expression, methylation and interacting miRNA profiles of GABA-, glutamate- and calcium-related genes in 661 adult infiltrating gliomas available through the TCGA database. Neurotransmitter-based unsupervised clustering identified three established glioma molecular subgroups that parallel major World Health Organization glioma subclasses (IDH-wildtype astrocytomas, IDH-mutant astrocytomas, IDH-mutant oligodendroglioma). In addition, this analysis also defined a novel, neurotransmitter-related glioma subgroup (NT-1), mostly comprised of IDH-mutated gliomas and characterized by the overexpression of neurotransmitter-related genes. Lower expression of neurotransmission-related genes was correlated with increased aggressivity in hypomethylated IDH-wildtype tumors. There were also significant differences in the composition of the tumor inflammatory microenvironment between neurotransmission-based tumor categories, with lower estimated pools of M2-phenotype macrophages in NT-1 gliomas. This multi-omics analysis of the neurotransmission expression landscape of TCGA gliomas—which highlights the existence of neurotransmission-based glioma categories with different expression, epigenetic and inflammatory profiles—supports the existence of operational neurotransmitter signaling pathways in adult gliomas. These findings could shed new light on potential vulnerabilities to exploit in future glioma-targeting drug therapies.
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Zhang L, Wang C, Zeng X. Risk Factors for Early Hydrocephalus on Post Unilateral Thalamic Tumor Resection. Front Surg 2022; 9:814308. [PMID: 35465419 PMCID: PMC9023863 DOI: 10.3389/fsurg.2022.814308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe outcome of surgical treatment for thalamic tumors is poor. Hydrocephalus is one of the most frequent postoperative complications after unilateral thalamic tumor resection. This study examined the relationship between surgical approaches, pathological grade, image characteristics, preoperative complications, extent of resection, and incidence of postoperative hydrocephalus.MethodsThe study retrospectively reviewed clinical data from 80 patients who underwent resection of thalamic tumors between 2015 and 2021. Data on patient survival and disease progression status were obtained retrospectively to calculate overall survival (OS) and progression free survival (PFS).ResultsNo patients died during the perioperative period and two patients suffered postoperative coma. Tumors were totally resected in 44 cases (55 %), subtotally resected in 21 cases (26.25 %), and partially resected in 15 cases (18.75 %). Thirty-five cases of hydrocephalus occurred within 1 month after operation(43.75%). Surgical approaches associated with hydrocephalus were as follows: hydrocephalus occurred in seven cases after trans-frontal lateral ventricle approach for tumor resection (62.9%), in 17 cases after through parieto-occipital transventricular approach tumor resection (43.58%), and in one case after trans-frontal lateral ventricle approach for tumor resection + third ventriculostomy (7.1%). Postoperative muscle strength decrease occurred in 41 patients (51.25%). Longer PFS and OS were correlated with degree of resection in patients with thalamic glioblastoma (P < 0.05) and had no relationship with hydrocephalus.ConclusionSurgical treatment of thalamic tumors is an effective therapeutic method. The incidence of postoperative hydrocephalus is not associated with tumor size, degree of tumor enhancement, peritumoral edema, tumor invasion, midline crossing, and pathological grade. The incidence of postoperative hydrocephalus was higher in patients with preoperative hydrocephalus and low resection degree, and lower in patients with endoscopic third ventriculostomy. The risk of early postoperative hydrocephalus in thalamic tumors is high. Intraoperative third ventriculostomy could reduce the incidence of early postoperative hydrocephalus. PFS and OS were longer in patients with thalamic glioblastoma with a high resection degree (P < 0.05) and were not associated with hydrocephalus.
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Affiliation(s)
- Linpeng Zhang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chen Wang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Xianwei Zeng
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Xianwei Zeng ; orcid.org/0000-0002-2501-8368
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Park JH, Lee HK. Current Understanding of Hypoxia in Glioblastoma Multiforme and Its Response to Immunotherapy. Cancers (Basel) 2022; 14:1176. [PMID: 35267480 PMCID: PMC8909860 DOI: 10.3390/cancers14051176] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
Hypoxia is a hallmark of glioblastoma multiforme (GBM), the most aggressive cancer of the central nervous system, and is associated with multiple aspects of tumor pathogenesis. For example, hypoxia induces resistance to conventional cancer therapies and inhibits antitumor immune responses. Thus, targeting hypoxia is an attractive strategy for GBM therapy. However, traditional studies on hypoxia have largely excluded the immune system. Recently, the critical role of the immune system in the defense against multiple tumors has become apparent, leading to the development of effective immunotherapies targeting numerous cancer types. Critically, however, GBM is classified as a "cold tumor" due to poor immune responses. Thus, to improve GBM responsiveness against immunotherapies, an improved understanding of both immune function in GBM and the role of hypoxia in mediating immune responses within the GBM microenvironment is needed. In this review, we discuss the role of hypoxia in GBM from a clinical, pathological, and immunological perspective.
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Affiliation(s)
| | - Heung Kyu Lee
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea;
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Waqar M, Roncaroli F, Lehrer EJ, Palmer JD, Villanueva-Meyer J, Braunstein S, Hall E, Aznar M, De Witt Hamer PC, D’Urso PI, Trifiletti D, Quiñones-Hinojosa A, Wesseling P, Borst GR. Rapid early progression (REP) of glioblastoma is an independent negative prognostic factor: Results from a systematic review and meta-analysis. Neurooncol Adv 2022; 4:vdac075. [PMID: 35769410 PMCID: PMC9234755 DOI: 10.1093/noajnl/vdac075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background In patients with newly diagnosed glioblastoma, rapid early progression (REP) refers to tumor regrowth between surgery and postoperative chemoradiotherapy. This systematic review and meta-analysis appraised previously published data on REP to better characterize and understand it. Methods Systematic searches of MEDLINE, EMBASE and the Cochrane database from inception to October 21, 2021. Studies describing the incidence of REP-tumor growth between the postoperative MRI scan and pre-radiotherapy MRI scan in newly diagnosed glioblastoma were included. The primary outcome was REP incidence. Results From 1590 search results, 9 studies were included with 716 patients. The median age was 56.9 years (IQR 54.0-58.8 y). There was a male predominance with a median male-to-female ratio of 1.4 (IQR 1.1-1.5). The median number of days between MRI scans was 34 days (IQR 18-45 days). The mean incidence rate of REP was 45.9% (range 19.3%-72.0%) and significantly lower in studies employing functional imaging to define REP (P < .001). REP/non-REP groups were comparable with respect to age (P = .99), gender (P = .33) and time between scans (P = .81). REP was associated with shortened overall survival (HR 1.78, 95% CI 1.30-2.43, P < .001), shortened progression-free survival (HR 1.78, 95% CI 1.30-2.43, P < .001), subtotal resection (OR 6.96, 95% CI 4.51-10.73, P < .001) and IDH wild-type versus mutant tumors (OR 0.20, 95% CI 0.02-0.38, P = .03). MGMT promoter methylation was not associated with REP (OR 1.29, 95% CI 0.72-2.28, P = .39). Conclusions REP occurs in almost half of patients with newly diagnosed glioblastoma and has a strongly negative prognostic effect. Future studies should investigate its biology and effective treatment strategies.
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Affiliation(s)
- Mueez Waqar
- Department of Neurosurgery, Geoffrey Jefferson Brain Research Centre, Salford Royal NHS Foundation Trust, Manchester, UK
- Division of Cancer Sciences, Faculty of Biology, Medicines and Health, The University of Manchester, Manchester, UK
| | - Federico Roncaroli
- Neuropathology unit, Geoffrey Jefferson Brain Research Centre, Salford Royal NHS Foundation Trust, Manchester, UK
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicines and Health, The University of Manchester, Manchester, UK
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Eric J Lehrer
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicines and Health, The University of Manchester, Manchester, UK
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Joshua D Palmer
- Department of Radiation Oncology, The James Cancer Hospital, Ohio, USA
| | | | - Steve Braunstein
- Department of Radiation Oncology, University of California San Francisco, San Francisco, USA
| | - Emma Hall
- Division of Cancer Sciences, Faculty of Biology, Medicines and Health, The University of Manchester, Manchester, UK
| | - Marianne Aznar
- Division of Cancer Sciences, Faculty of Biology, Medicines and Health, The University of Manchester, Manchester, UK
| | - Philip C De Witt Hamer
- Department of Neurosurgery, Amsterdam University Medical Centers/VUmc, Amsterdam, The Netherlands
| | - Pietro I D’Urso
- Department of Neurosurgery, Geoffrey Jefferson Brain Research Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - Daniel Trifiletti
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Pieter Wesseling
- Department of Pathology, Amsterdam University Medical Centers/VUmc, Amsterdam, The Netherlands
- Laboratory for Childhood Cancer Pathology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Gerben R Borst
- Division of Cancer Sciences, Faculty of Biology, Medicines and Health, The University of Manchester, Manchester, UK
- Department of Radiation Oncology, The Christie NHS Foundation Trust, Manchester, UK
- Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, The Christie National Health Trust, Manchester, UK
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Klement RJ, Popp I, Kaul D, Ehret F, Grosu AL, Polat B, Sweeney RA, Lewitzki V. Accelerated hyper-versus normofractionated radiochemotherapy with temozolomide in patients with glioblastoma: a multicenter retrospective analysis. J Neurooncol 2021; 156:407-417. [PMID: 34940951 PMCID: PMC8817053 DOI: 10.1007/s11060-021-03926-0] [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: 11/10/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022]
Abstract
Background and purpose The standard treatment of glioblastoma patients consists of surgery followed by normofractionated radiotherapy (NFRT) with concomitant and adjuvant temozolomide chemotherapy. Whether accelerated hyperfractionated radiotherapy (HFRT) yields comparable results to NFRT in combination with temozolomide has only sparsely been investigated. The objective of this study was to compare NFRT with HFRT in a multicenter analysis. Materials and methods A total of 484 glioblastoma patients from four centers were retrospectively pooled and analyzed. Three-hundred-ten and 174 patients had been treated with NFRT (30 × 1.8 Gy or 30 × 2 Gy) and HFRT (37 × 1.6 Gy or 30 × 1.8 Gy twice/day), respectively. The primary outcome of interest was overall survival (OS) which was correlated with patient-, tumor- and treatment-related variables via univariable and multivariable Cox frailty models. For multivariable modeling, missing covariates were imputed using multiple imputation by chained equations, and a sensitivity analysis was performed on the complete-cases-only dataset. Results After a median follow-up of 15.7 months (range 0.8–88.6 months), median OS was 16.9 months (15.0–18.7 months) in the NFRT group and 14.9 months (13.2–17.3 months) in the HFRT group (p = 0.26). In multivariable frailty regression, better performance status, gross-total versus not gross-total resection, MGMT hypermethylation, IDH mutation, smaller planning target volume and salvage therapy were significantly associated with longer OS (all p < 0.01). Treatment differences (HFRT versus NFRT) had no significant effect on OS in either univariable or multivariable analysis. Conclusions Since HFRT with temozolomide was not associated with worse OS, we assume HFRT to be a potential option for patients wishing to shorten their treatment time.
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Affiliation(s)
- Rainer J Klement
- Klinik für Strahlentherapie, Leopoldina Krankenhaus Schweinfurt, MVZ Leopoldina Krankenhaus, Robert-Koch-Straße 10, 97422, Schweinfurt, Germany. .,Klinik für Radio-Onkologie, Universitätsspital Zürich, Universität Zürich, 8006, Zurich, Switzerland.
| | - Ilinca Popp
- Klinik für Strahlenheilkunde, Universitätsklinikum Freiburg, 79106, Freiburg, Germany
| | - David Kaul
- Klinik Für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany.,German Cancer Consortium (DKTK), partner site Berlin, Berlin, Germany
| | - Felix Ehret
- Klinik Für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Anca L Grosu
- Klinik für Strahlenheilkunde, Universitätsklinikum Freiburg, 79106, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bülent Polat
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - Reinhart A Sweeney
- Klinik für Strahlentherapie, Leopoldina Krankenhaus Schweinfurt, MVZ Leopoldina Krankenhaus, Robert-Koch-Straße 10, 97422, Schweinfurt, Germany
| | - Victor Lewitzki
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany.
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Easwaran TP, Sterling D, Ferreira C, Sloan L, Wilke C, Neil E, Shah R, Chen CC, Dusenbery KE. Rapid Interval Recurrence of Glioblastoma Following Gross Total Resection: A Possible Indication for GammaTileⓇ Brachytherapy. Cureus 2021; 13:e19496. [PMID: 34912636 PMCID: PMC8666087 DOI: 10.7759/cureus.19496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 11/09/2022] Open
Abstract
Glioblastoma recurrence between initial resection and standard-of-care adjuvant chemoradiotherapy (CRT) is a negative prognostic factor in an already highly aggressive disease. Re-resection with GammaTileⓇ(GT Medical Technologies Inc., Tempe, AZ) placement affords expedited adjuvant radiation to mitigate the likelihood of such growth. Here, we report a glioblastoma patient who underwent re-resection and GammaTileⓇ (GT) placement within two months of the initial gross total resection due to regrowth that reached the size of the original presenting tumor. The patient subsequently received concurrent temozolomide and 60 Gy external beam to regions outside of the brachytherapy range, fulfilling the generally accepted Stupp regimen. The patient tolerated the treatment without complication. The dosimetrics and implications of the case presentation are reviewed.
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Affiliation(s)
- Teresa P Easwaran
- Department of Radiation Oncology, University of Minnesota School of Medicine, Minneapolis, USA
| | - David Sterling
- Department of Radiation Oncology, University of Minnesota School of Medicine, Minneapolis, USA
| | - Clara Ferreira
- Department of Radiation Oncology, University of Minnesota School of Medicine, Minneapolis, USA
| | - Lindsey Sloan
- Department of Radiation Oncology, University of Minnesota School of Medicine, Minneapolis, USA
| | - Christopher Wilke
- Department of Radiation Oncology, University of Minnesota School of Medicine, Minneapolis, USA
| | - Elizabeth Neil
- Department of Neurology, University of Minnesota School of Medicine, Minneapolis, USA
| | - Rena Shah
- Department of Hematology-Oncology, North Memorial Health Cancer Center, Robbinsdale, USA
| | - Clark C Chen
- Department of Neurosurgery, University of Minnesota School of Medicine, Minneapolis, USA
| | - Kathryn E Dusenbery
- Department of Radiation Oncology, University of Minnesota School of Medicine, Minneapolis, USA
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Cucchiara F, Ferraro S, Luci G, Bocci G. Relevant pharmacological interactions between alkylating agents and antiepileptic drugs: Preclinical and clinical data. Pharmacol Res 2021; 175:105976. [PMID: 34785318 DOI: 10.1016/j.phrs.2021.105976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/07/2021] [Accepted: 11/07/2021] [Indexed: 01/01/2023]
Abstract
Seizures are relatively common in cancer patients, and co-administration of chemotherapeutic and antiepileptic drugs (AEDs) is highly probable and necessary in many cases. Nonetheless, clinically relevant interactions between chemotherapeutic drugs and AEDs are rarely summarized and pharmacologically described. These interactions can cause insufficient tumor and seizure control or lead to unforeseen toxicity. This review focused on pharmacokinetic and pharmacodynamic interactions between alkylating agents and AEDs, helping readers to make a rational choice of treatment optimization, and thus improving patients' quality of life. As an example, phenobarbital, phenytoin, and carbamazepine, by increasing the hepatic metabolism of cyclophosphamide, ifosfamide and busulfan, yield smaller peak concentrations and a reduced area under the plasma concentration-time curve (AUC) of the prodrugs; alongside, the maximum concentration and AUC of their active products were increased with the possible onset of severe adverse drug reactions. On the other side, valproic acid, acting as histone deacetylase inhibitor, showed synergistic effects with temozolomide when tested in glioblastoma. The present review is aimed at providing evidence that may offer useful suggestions for rational pharmacological strategies in patients with seizures symptoms undertaking alkylating agents. Firstly, clinicians should avoid the use of enzyme-inducing AEDs in combination with alkylating agents and prefer the use of AEDs, such as levetiracetam, that have a low or no impact on hepatic metabolism. Secondly, a careful therapeutic drug monitoring of both alkylating agents and AEDs (and their active metabolites) is necessary to maintain therapeutic ranges and to avoid serious adverse reactions.
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Affiliation(s)
- Federico Cucchiara
- Unit of Pharmacology, Department of Clinical and Experimental, University of Pisa, Pisa, Italy
| | - Sara Ferraro
- Unit of Pharmacology and Pharmacovigilance, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giacomo Luci
- Unit of Pharmacology, Department of Clinical and Experimental, University of Pisa, Pisa, Italy
| | - Guido Bocci
- Unit of Pharmacology, Department of Clinical and Experimental, University of Pisa, Pisa, Italy.
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Wang Y, Zhang J, Li W, Jiang T, Qi S, Chen Z, Kang J, Huo L, Wang Y, Zhuge Q, Gao G, Wu Y, Feng H, Zhao G, Yang X, Zhao H, Wang Y, Yang H, Kang D, Su J, Li L, Jiang C, Li G, Qiu Y, Wang W, Wang H, Xu Z, Zhang L, Wang R. Guideline conformity to the Stupp regimen in patients with newly diagnosed glioblastoma multiforme in China. Future Oncol 2021; 17:4571-4582. [PMID: 34519220 DOI: 10.2217/fon-2021-0435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Aims: To determine how consistently Chinese glioblastoma multiforme (GBM) patients were treated according to the Stupp regimen. Patients and methods: The proportion of treatments conforming to the Stupp regimen and reasons for nonconformity were evaluated in 202 newly diagnosed GBM patients. Results: Only 15.8% of GBM patients received treatments compliant with the Stupp regimen. The main deviations were temozolomide dosages >75 mg/m2 (58/120; 48.3%) and treatment durations <42 days (84/120; 70.0%) in the concomitant phase and temozolomide dosages <150 mg/m2 (89/101; 88.1%) in the maintenance phase. Median overall survival (27.09 vs 18.21 months) and progression-free survival (14.27 vs 12.10 months) were longer in patients who received Stupp regimen-compliant treatments. Conclusion: Increased conformity to the Stupp regimen is needed for GBM patients in China.
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Affiliation(s)
- Yu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100010, China
| | - Jianmin Zhang
- Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, 310009, China
| | - Wenbin Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070, China
| | - Taipeng Jiang
- Department of Neurosurgery, Shenzhen Second People's Hospital, 518035, China
| | - Songtao Qi
- Department of Neurosurgery, Nanfang Hospital Southern Medical University, 510515, China
| | - Zhongping Chen
- Department of Neurosurgery, Sun Yat-Sen University Cancer Center, 510060, China
| | - Jingbo Kang
- Tumor Diagnosis & Treatment Center, The Sixth Medical Center of PLA General Hospital, 100048, China
| | - Lei Huo
- Department of Neurosurgery, Xiangya Hospital Central South University, 410008, China
| | - Yunjie Wang
- Department of Neurosurgery, The First Hospital of China Medical University, 110001, China
| | - Qichuan Zhuge
- Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, 325000, China
| | - Guodong Gao
- Department of Neurosurgery, The Fourth Military University Tangdu Hospital, 710032, China
| | - Yuping Wu
- Department of Craniobasal Neurology, Sichuan Cancer Hospital & Institute, The Affiliated Cancer Hospital, School of Medicine, UESTC, 610041, China
| | - Hua Feng
- Department of Neurosurgery, Southwest Hospital, The First Affiliated Hospital of Army Medical University, 400038, China
| | - Gang Zhao
- Department of Neurosurgery, The First Bethune Hospital of Jilin University, 130021, China
| | - Xiaopeng Yang
- Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, 830001, China
| | - Hui Zhao
- Department of Radiotherapy, People's Hospital of Xinjiang Uygur Autonomous Region, 830001, China
| | - Yirong Wang
- Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 310016, China
| | - Hui Yang
- Department of Neurosurgery, Xinqiao Hospital of Army Medical University, 400037, China
| | - Dezhi Kang
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, 350005, China
| | - Jun Su
- Department of Neurosurgery, Tumor Hospital of Harbin Medical University, 150081, China
| | - Liang Li
- Department of Neurosurgery, Peking University First Hospital, 100034, China
| | - Chuanlu Jiang
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, 150001, China
| | - Gang Li
- Department of Neurosurgery, Qilu Hospital of Shandong University, 250012, China
| | - Yongming Qiu
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 200127, China
| | - Weimin Wang
- Department of Neurosurgery, General Hospital of Southern Theatre Command, 510010, China
| | - Handong Wang
- Department of Neurosurgery, General Hospital of Eastern Theatre Command, 210002, China
| | - Zaihua Xu
- Department of Neurosurgery, General Hospital of Northern Theatre Command, 110840, China
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070, China
| | - Renzhi Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100010, China
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Nwagwu CD, Adamson DC. Can we rely on synthetic pharmacotherapy for the treatment of glioblastoma? Expert Opin Pharmacother 2021; 22:1983-1994. [PMID: 34219576 DOI: 10.1080/14656566.2021.1950139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Despite decades of clinical trials utilizing conventional and novel therapeutics, the effective treatment of glioblastoma remains one of the most formidable challenges in oncology. Current standard of care includes surgery and chemoradiation. Synthetic pharmacotherapies continue to be explored as potential therapeutic options for glioblastoma patients.Areas covered: This study reviews synthetic pharmacotherapies that are currently under investigation in phase I-III clinical trials. The authors of this study highlight the mechanisms of action of the synthetic pharmacotherapy agents under investigation, outline the available evidence for their utility based on the literature, and summarize the current landscape.Expert opinion: Although warranting further investigation, the studies generally highlighted here have not shown remarkable changes in clinical benefits beyond what has already been established with radiochemotherapy. As we develop more synthetics, we will likely need to combine them with other synthetics to target multiple separate molecular pathways. There is considerable potential when this treatment strategy is guided by molecular profiling approaches which seek to stratify patients based on treatments that would be most efficacious for them.
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Affiliation(s)
- Chibueze D Nwagwu
- Department of Neurosurgery, Emory University, Atlanta, 30322-1007, United States
| | - David C Adamson
- Department of Neurosurgery, Emory University, Atlanta, 30322-1007, United States
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Halatsch ME, Kast RE, Karpel-Massler G, Mayer B, Zolk O, Schmitz B, Scheuerle A, Maier L, Bullinger L, Mayer-Steinacker R, Schmidt C, Zeiler K, Elshaer Z, Panther P, Schmelzle B, Hallmen A, Dwucet A, Siegelin MD, Westhoff MA, Beckers K, Bouche G, Heiland T. A phase Ib/IIa trial of 9 repurposed drugs combined with temozolomide for the treatment of recurrent glioblastoma: CUSP9v3. Neurooncol Adv 2021; 3:vdab075. [PMID: 34377985 PMCID: PMC8349180 DOI: 10.1093/noajnl/vdab075] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background The dismal prognosis of glioblastoma (GBM) may be related to the ability of GBM cells to develop mechanisms of treatment resistance. We designed a protocol called Coordinated Undermining of Survival Paths combining 9 repurposed non-oncological drugs with metronomic temozolomide—version 3—(CUSP9v3) to address this issue. The aim of this phase Ib/IIa trial was to assess the safety of CUSP9v3. Methods Ten adults with histologically confirmed GBM and recurrent or progressive disease were included. Treatment consisted of aprepitant, auranofin, celecoxib, captopril, disulfiram, itraconazole, minocycline, ritonavir, and sertraline added to metronomic low-dose temozolomide. Treatment was continued until toxicity or progression. Primary endpoint was dose-limiting toxicity defined as either any unmanageable grade 3–4 toxicity or inability to receive at least 7 of the 10 drugs at ≥ 50% of the per-protocol doses at the end of the second treatment cycle. Results One patient was not evaluable for the primary endpoint (safety). All 9 evaluable patients met the primary endpoint. Ritonavir, temozolomide, captopril, and itraconazole were the drugs most frequently requiring dose modification or pausing. The most common adverse events were nausea, headache, fatigue, diarrhea, and ataxia. Progression-free survival at 12 months was 50%. Conclusions CUSP9v3 can be safely administered in patients with recurrent GBM under careful monitoring. A randomized phase II trial is in preparation to assess the efficacy of the CUSP9v3 regimen in GBM.
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Affiliation(s)
| | | | | | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Oliver Zolk
- Department of Clinical Pharmacology, Ulm University Hospital, Ulm, Germany
| | - Bernd Schmitz
- Division of Neuroradiology, Department of Diagnostic and Interventional Radiology, Ulm University Hospital, Ulm, Germany
| | - Angelika Scheuerle
- Division of Neuropathology, Department of Pathology, Ulm University Hospital, Ulm, Germany
| | - Ludwig Maier
- Central Pharmacy, Ulm University Hospital, Ulm, Germany
| | - Lars Bullinger
- Division of Hematology and Oncology, Department of Internal Medicine, Ulm University Hospital, Ulm, Germany
| | - Regine Mayer-Steinacker
- Division of Hematology and Oncology, Department of Internal Medicine, Ulm University Hospital, Ulm, Germany
| | - Carl Schmidt
- Department of Neurosurgery, Ulm University Hospital, Ulm, Germany
| | - Katharina Zeiler
- Department of Neurosurgery, Ulm University Hospital, Ulm, Germany
| | - Ziad Elshaer
- Department of Neurosurgery, Ulm University Hospital, Ulm, Germany
| | - Patricia Panther
- Department of Neurosurgery, Ulm University Hospital, Ulm, Germany
| | - Birgit Schmelzle
- Institute of Experimental Cancer Research, Ulm University Hospital, Ulm, Germany
| | - Anke Hallmen
- Division of Hematology and Oncology, Department of Internal Medicine, Ulm University Hospital, Ulm, Germany
| | - Annika Dwucet
- Department of Neurosurgery, Ulm University Hospital, Ulm, Germany
| | - Markus D Siegelin
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Mike-Andrew Westhoff
- Department of Pediatric and Adolescent Medicine, Basic Research Division, Ulm University Hospital, Ulm, Germany
| | | | | | - Tim Heiland
- Department of Neurosurgery, Ulm University Hospital, Ulm, Germany
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44
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Brennan PM, Borchert R, Coulter C, Critchley GR, Hall B, Holliman D, Phang I, Jefferies SJ, Keni S, Lee L, Liaquat I, Marcus HJ, Thomson S, Thorne L, Vintu M, Wiggins AN, Jenkinson MD, Erridge S. Second surgery for progressive glioblastoma: a multi-centre questionnaire and cohort-based review of clinical decision-making and patient outcomes in current practice. J Neurooncol 2021; 153:99-107. [PMID: 33791952 PMCID: PMC8131335 DOI: 10.1007/s11060-021-03748-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Glioblastoma prognosis is poor. Treatment options are limited at progression. Surgery may benefit, but no quality guidelines exist to inform patient selection. We sought to describe variations in surgical management at progression, highlight where further evidence is needed, and build towards a consensus strategy. METHODS Current practice in selection of patients with progressive GBM for second surgery was surveyed online amongst specialists in the UK and Europe. We complemented this with an assessment of practice in a retrospective cohort study from six United Kingdom neurosurgical units. We used descriptive statistics to analyse the data. RESULTS 234 questionnaire responses were received. Maintaining or improving patient quality of life was key to decision making, with variation as to whether patient age, performance status or intended extent of resection was relevant. MGMT methylation status was not important. Half considered no minimum time after first surgery. 288 patients were reported in the cohort analysis. Median time to second surgery from first surgery 390 days. Median overall survival 815 days, with no association between time to second surgery and time to death (p = 0.874). CONCLUSIONS This is the most wide-ranging examination of contemporaneous practice in management of GBM progression. Without evidence-based guidelines, the variation is unsurprising. We propose consensus guidelines for consideration, to reduce heterogeneity in decision making, support data collection and analysis of factors influencing outcomes, and to inform clinical trials to establish whether second surgery improves patient outcomes, or simply selects to patients already performing well.
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Affiliation(s)
- P M Brennan
- Translational Neurosurgery, Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, Edinburgh BioQuarter, 49 Little France Crescent, Edinburgh, EH16 4SB, UK.
| | - R Borchert
- Addenbrookes University Hospital, Cambridge, UK
| | - C Coulter
- Royal Victoria Hospital, Newcastle, UK
| | - G R Critchley
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - B Hall
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | | | - I Phang
- Lancashire teaching Hospitals, Preston, UK
| | | | - S Keni
- University of Edinburgh medical School, Edinburgh, UK
| | - L Lee
- University of Edinburgh medical School, Edinburgh, UK
| | - I Liaquat
- Department of Clinical Neuroscience, NHS Lothian, Edinburgh, UK
| | - H J Marcus
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | | | - L Thorne
- University College London Hospitals, London, UK
| | - M Vintu
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - A N Wiggins
- Department of Clinical Neuroscience, NHS Lothian, Edinburgh, UK
| | - M D Jenkinson
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - S Erridge
- Department of Clinical Neuroscience, NHS Lothian, Edinburgh, UK
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Wei D, Shen S, Lin K, Lu F, Zheng P, Wu S, Kang D. NPC2 as a Prognostic Biomarker for Glioblastoma Based on Integrated Bioinformatics Analysis and Cytological Experiments. Front Genet 2021; 12:611442. [PMID: 33777094 PMCID: PMC7990766 DOI: 10.3389/fgene.2021.611442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/08/2021] [Indexed: 12/31/2022] Open
Abstract
Glioblastoma (GBM) is one of the most common and fatal malignancies worldwide, while its prognostic biomarkers are still being explored. This study aims to identify potential genes with clinical and prognostic significance by integrating bioinformatics analysis and investigating their function in HNSCC. Based on the Single-cell RNA sequencing (scRNA-seq) results of H3K27M-glioma cells, computational bioinformatics methods were employed for selecting prognostic biomarker for GBM. The protein NPC2 (NPC Intracellular Cholesterol Transporter 2), which has been shown to be related to lipoprotein metabolism and innate immune system, was identified to be upregulated in GBM. NPC2 showed a relatively higher expression in GBM samples, and a negative correlation with tumor purity and tumor infiltrating immune cells. Additionally, NPC2 was knocked down in U87-MG and U251 cells line, and cell proliferation and migration capability were evaluated with CCK-8, scratch and transwell assay, respectively. Cytological experiments has shown that NPC2 overexpression inhibited GBM cells proliferation and migration, indicating its important role in GBM progression. This is the first investigation into the prognostic value of NPC2 interact with GBM. The potential molecular factor NPC2 have been identified as a prognostic biomarker for GBM.
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Affiliation(s)
- De Wei
- Department of Neurosurgery, Fujian Provincial Hospital South Branch, Fuzhou, China.,Department of Neurosurgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Shanghang Shen
- Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Lin
- Department of Neurosurgery, Fujian Provincial Hospital South Branch, Fuzhou, China.,Department of Neurosurgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Feng Lu
- Department of Neurosurgery, Fujian Provincial Hospital South Branch, Fuzhou, China.,Department of Neurosurgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Pengfeng Zheng
- Department of Neurosurgery, Fujian Provincial Hospital South Branch, Fuzhou, China.,Department of Neurosurgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Shizhong Wu
- Department of Neurosurgery, Fujian Provincial Hospital South Branch, Fuzhou, China.,Department of Neurosurgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Dezhi Kang
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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