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Ocaña-Tienda B, Pérez-Beteta J, Romero-Rosales JA, Asenjo B, Ortiz de Mendivil A, Pérez Romasanta LA, Albillo Labarra JD, Nagib F, Vidal Denis M, Luque B, Arana E, Pérez-García VM. Volumetric analysis: Rethinking brain metastases response assessment. Neurooncol Adv 2024; 6:vdad161. [PMID: 38187872 PMCID: PMC10771272 DOI: 10.1093/noajnl/vdad161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Background The Response Assessment in Neuro-Oncology for Brain Metastases (RANO-BM) criteria are the gold standard for assessing brain metastases (BMs) treatment response. However, they are limited by their reliance on 1D, despite the routine use of high-resolution T1-weighted MRI scans for BMs, which allows for 3D measurements. Our study aimed to investigate whether volumetric measurements could improve the response assessment in patients with BMs. Methods We retrospectively evaluated a dataset comprising 783 BMs and analyzed the response of 185 of them from 132 patients who underwent stereotactic radiotherapy between 2007 and 2021 at 5 hospitals. We used T1-weighted MRIs to compute the volume of the lesions. For the volumetric criteria, progressive disease was defined as at least a 30% increase in volume, and partial response was characterized by a 20% volume reduction. Results Our study showed that the proposed volumetric criteria outperformed the RANO-BM criteria in several aspects: (1) Evaluating every lesion, while RANO-BM failed to evaluate 9.2% of them. (2) Classifying response effectively in 140 lesions, compared to only 72 lesions classified by RANO-BM. (3) Identifying BM recurrences a median of 3.3 months earlier than RANO-BM criteria. Conclusions Our study demonstrates the superiority of volumetric criteria in improving the response assessment of BMs compared to the RANO-BM criteria. Our proposed criteria allow for evaluation of every lesion, regardless of its size or shape, better classification, and enable earlier identification of progressive disease. Volumetric criteria provide a standardized, reliable, and objective tool for assessing treatment response.
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Affiliation(s)
- Beatriz Ocaña-Tienda
- Mathematical Oncology Laboratory, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Julián Pérez-Beteta
- Mathematical Oncology Laboratory, University of Castilla-La Mancha, Ciudad Real, Spain
| | | | - Beatriz Asenjo
- Department of Radiology, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Ana Ortiz de Mendivil
- Department of Radiology, Sanchinarro University Hospital, HM Hospitales, Madrid, Spain
| | | | | | - Fátima Nagib
- Department of Radiology, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - María Vidal Denis
- Department of Radiology, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Belén Luque
- Mathematical Oncology Laboratory, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Estanislao Arana
- Department of Radiology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Víctor M Pérez-García
- Mathematical Oncology Laboratory, University of Castilla-La Mancha, Ciudad Real, Spain
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2
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Ocaña-Tienda B, Pérez-Beteta J, Jiménez-Sánchez J, Molina-García D, Ortiz de Mendivil A, Asenjo B, Albillo D, Pérez-Romasanta LA, Valiente M, Zhu L, García-Gómez P, González-Del Portillo E, Llorente M, Carballo N, Arana E, Pérez-García VM. Growth exponents reflect evolutionary processes and treatment response in brain metastases. NPJ Syst Biol Appl 2023; 9:35. [PMID: 37479705 PMCID: PMC10361973 DOI: 10.1038/s41540-023-00298-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023] Open
Abstract
Tumor growth is the result of the interplay of complex biological processes in huge numbers of individual cells living in changing environments. Effective simple mathematical laws have been shown to describe tumor growth in vitro, or simple animal models with bounded-growth dynamics accurately. However, results for the growth of human cancers in patients are scarce. Our study mined a large dataset of 1133 brain metastases (BMs) with longitudinal imaging follow-up to find growth laws for untreated BMs and recurrent treated BMs. Untreated BMs showed high growth exponents, most likely related to the underlying evolutionary dynamics, with experimental tumors in mice resembling accurately the disease. Recurrent BMs growth exponents were smaller, most probably due to a reduction in tumor heterogeneity after treatment, which may limit the tumor evolutionary capabilities. In silico simulations using a stochastic discrete mesoscopic model with basic evolutionary dynamics led to results in line with the observed data.
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Affiliation(s)
| | | | | | | | | | - Beatriz Asenjo
- Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | | | - Manuel Valiente
- Brain Metastasis Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Lucía Zhu
- Brain Metastasis Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Pedro García-Gómez
- Brain Metastasis Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
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3
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Ocaña-Tienda B, Pérez-Beteta J, Villanueva-García JD, Romero-Rosales JA, Molina-García D, Suter Y, Asenjo B, Albillo D, Ortiz de Mendivil A, Pérez-Romasanta LA, González-Del Portillo E, Llorente M, Carballo N, Nagib-Raya F, Vidal-Denis M, Luque B, Reyes M, Arana E, Pérez-García VM. A comprehensive dataset of annotated brain metastasis MR images with clinical and radiomic data. Sci Data 2023; 10:208. [PMID: 37059722 PMCID: PMC10104872 DOI: 10.1038/s41597-023-02123-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/30/2023] [Indexed: 04/16/2023] Open
Abstract
Brain metastasis (BM) is one of the main complications of many cancers, and the most frequent malignancy of the central nervous system. Imaging studies of BMs are routinely used for diagnosis of disease, treatment planning and follow-up. Artificial Intelligence (AI) has great potential to provide automated tools to assist in the management of disease. However, AI methods require large datasets for training and validation, and to date there have been just one publicly available imaging dataset of 156 BMs. This paper publishes 637 high-resolution imaging studies of 75 patients harboring 260 BM lesions, and their respective clinical data. It also includes semi-automatic segmentations of 593 BMs, including pre- and post-treatment T1-weighted cases, and a set of morphological and radiomic features for the cases segmented. This data-sharing initiative is expected to enable research into and performance evaluation of automatic BM detection, lesion segmentation, disease status evaluation and treatment planning methods for BMs, as well as the development and validation of predictive and prognostic tools with clinical applicability.
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Affiliation(s)
- Beatriz Ocaña-Tienda
- Mathematical Oncology Laboratory (MOLAB), University of Castilla-La Mancha, Ciudad Real, Spain.
| | - Julián Pérez-Beteta
- Mathematical Oncology Laboratory (MOLAB), University of Castilla-La Mancha, Ciudad Real, Spain
| | | | - José A Romero-Rosales
- Mathematical Oncology Laboratory (MOLAB), University of Castilla-La Mancha, Ciudad Real, Spain
| | - David Molina-García
- Mathematical Oncology Laboratory (MOLAB), University of Castilla-La Mancha, Ciudad Real, Spain
| | - Yannick Suter
- Medical Image Analysis Group, ARTORG Research Center, Bern, Switzerland
| | - Beatriz Asenjo
- Radiology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - David Albillo
- Radiology Department, MD Anderson Cancer Center, Madrid, Spain
| | | | | | | | - Manuel Llorente
- Radiology Department, MD Anderson Cancer Center, Madrid, Spain
| | | | - Fátima Nagib-Raya
- Radiology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Maria Vidal-Denis
- Radiology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Belén Luque
- Mathematical Oncology Laboratory (MOLAB), University of Castilla-La Mancha, Ciudad Real, Spain
| | - Mauricio Reyes
- Medical Image Analysis Group, ARTORG Research Center, Bern, Switzerland
| | - Estanislao Arana
- Radiology Department, Fundación Instituto Valenciano de Oncología, Valencia, Spain.
| | - Víctor M Pérez-García
- Mathematical Oncology Laboratory (MOLAB), University of Castilla-La Mancha, Ciudad Real, Spain
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4
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Duraj T, García-Romero N, Carrión-Navarro J, Madurga R, Ortiz de Mendivil A, Prat-Acin R, Garcia-Cañamaque L, Ayuso-Sacido A. Beyond the Warburg Effect: Oxidative and Glycolytic Phenotypes Coexist within the Metabolic Heterogeneity of Glioblastoma. Cells 2021; 10:202. [PMID: 33498369 PMCID: PMC7922554 DOI: 10.3390/cells10020202] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/16/2021] [Accepted: 01/18/2021] [Indexed: 12/12/2022] Open
Abstract
Glioblastoma (GBM) is the most aggressive primary brain tumor, with a median survival at diagnosis of 16-20 months. Metabolism represents a new attractive therapeutic target; however, due to high intratumoral heterogeneity, the application of metabolic drugs in GBM is challenging. We characterized the basal bioenergetic metabolism and antiproliferative potential of metformin (MF), dichloroacetate (DCA), sodium oxamate (SOD) and diazo-5-oxo-L-norleucine (DON) in three distinct glioma stem cells (GSCs) (GBM18, GBM27, GBM38), as well as U87MG. GBM27, a highly oxidative cell line, was the most resistant to all treatments, except DON. GBM18 and GBM38, Warburg-like GSCs, were sensitive to MF and DCA, respectively. Resistance to DON was not correlated with basal metabolic phenotypes. In combinatory experiments, radiomimetic bleomycin exhibited therapeutically relevant synergistic effects with MF, DCA and DON in GBM27 and DON in all other cell lines. MF and DCA shifted the metabolism of treated cells towards glycolysis or oxidation, respectively. DON consistently decreased total ATP production. Our study highlights the need for a better characterization of GBM from a metabolic perspective. Metabolic therapy should focus on both glycolytic and oxidative subpopulations of GSCs.
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Affiliation(s)
- Tomás Duraj
- Faculty of Medicine, Institute for Applied Molecular Medicine (IMMA), CEU San Pablo University, 28668 Madrid, Spain;
| | - Noemí García-Romero
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, 28223 Madrid, Spain; (N.G.-R.); (J.C.-N.); (R.M.)
- Brain Tumor Laboratory, Fundación Vithas, Grupo Hospitales Vithas, 28043 Madrid, Spain
| | - Josefa Carrión-Navarro
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, 28223 Madrid, Spain; (N.G.-R.); (J.C.-N.); (R.M.)
- Brain Tumor Laboratory, Fundación Vithas, Grupo Hospitales Vithas, 28043 Madrid, Spain
| | - Rodrigo Madurga
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, 28223 Madrid, Spain; (N.G.-R.); (J.C.-N.); (R.M.)
- Brain Tumor Laboratory, Fundación Vithas, Grupo Hospitales Vithas, 28043 Madrid, Spain
| | | | - Ricardo Prat-Acin
- Neurosurgery Department, Hospital Universitario La Fe, 46026 Valencia, Spain;
| | | | - Angel Ayuso-Sacido
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, 28223 Madrid, Spain; (N.G.-R.); (J.C.-N.); (R.M.)
- Brain Tumor Laboratory, Fundación Vithas, Grupo Hospitales Vithas, 28043 Madrid, Spain
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5
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Pérez-García VM, Calvo GF, Bosque JJ, León-Triana O, Jiménez J, Perez-Beteta J, Belmonte-Beitia J, Valiente M, Zhu L, García-Gómez P, Sánchez-Gómez P, Hernández-San Miguel E, Hortigüela R, Azimzade Y, Molina-García D, Martinez Á, Rojas ÁA, de Mendivil AO, Vallette F, Schucht P, Murek M, Pérez-Cano M, Albillo D, Honguero Martínez AF, Jiménez Londoño GA, Arana E, García Vicente AM. Universal scaling laws rule explosive growth in human cancers. Nat Phys 2020; 16:1232-1237. [PMID: 33329756 PMCID: PMC7116451 DOI: 10.1038/s41567-020-0978-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Most physical and other natural systems are complex entities composed of a large number of interacting individual elements. It is a surprising fact that they often obey the so-called scaling laws relating an observable quantity with a measure of the size of the system. Here we describe the discovery of universal superlinear metabolic scaling laws in human cancers. This dependence underpins increasing tumour aggressiveness, due to evolutionary dynamics, which leads to an explosive growth as the disease progresses. We validated this dynamic using longitudinal volumetric data of different histologies from large cohorts of cancer patients. To explain our observations we put forward increasingly-complex biologically-inspired mathematical models that captured the key processes governing tumor growth. Our models predicted that the emergence of superlinear allometric scaling laws is an inherently three-dimensional phenomenon. Moreover, the scaling laws thereby identified allowed us to define a set of metabolic metrics with prognostic value, thus providing added clinical utility to the base findings.
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Affiliation(s)
- Víctor M. Pérez-García
- Mathematical Oncology Laboratory, Universidad de Castilla-La Mancha, Spain
- Correspondence and requests for materials should be addressed to V.M. Pérez-García (>)
| | - Gabriel F. Calvo
- Mathematical Oncology Laboratory, Universidad de Castilla-La Mancha, Spain
| | - Jesús J. Bosque
- Mathematical Oncology Laboratory, Universidad de Castilla-La Mancha, Spain
| | | | - Juan Jiménez
- Mathematical Oncology Laboratory, Universidad de Castilla-La Mancha, Spain
| | | | | | - Manuel Valiente
- Brain Metastasis Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Lucía Zhu
- Brain Metastasis Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Pedro García-Gómez
- Brain Metastasis Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | | | | | - Rafael Hortigüela
- Neuro-oncology Unit, Health Institute Carlos III-UFIEC, Madrid, Spain
| | | | | | - Álvaro Martinez
- Mathematical Oncology Laboratory, Universidad de Castilla-La Mancha, Spain
- Department of Mathematics, Universidad de Cádiz, Spain
| | - Ángel Acosta Rojas
- Department of Radiation Oncology, Sanchinarro University Hospital, HM Hospitales, Spain
| | | | - Francois Vallette
- Inserm U1232, Centre de Recherche en Cancérologie et Immunologie Nantes-Angers, Nantes, F-44007, France
| | | | | | - María Pérez-Cano
- Mathematical Oncology Laboratory, Universidad de Castilla-La Mancha, Spain
| | - David Albillo
- Radiology Unit, MD Anderson Cancer Center, Madrid, Spain
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6
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García-Romero N, Carrión-Navarro J, Areal-Hidalgo P, Ortiz de Mendivil A, Asensi-Puig A, Madurga R, Núñez-Torres R, González-Neira A, Belda-Iniesta C, González-Rumayor V, López-Ibor B, Ayuso-Sacido A. BRAF V600E Detection in Liquid Biopsies from Pediatric Central Nervous System Tumors. Cancers (Basel) 2019; 12:cancers12010066. [PMID: 31881643 PMCID: PMC7016762 DOI: 10.3390/cancers12010066] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/14/2019] [Accepted: 12/19/2019] [Indexed: 12/17/2022] Open
Abstract
Pediatric Central Nervous System (CNS) tumors are the most fatal cancer diseases in childhood. Due to their localization and infiltrative nature, some tumor resections or biopsies are not feasible. In those cases, the use of minimally invasive methods as diagnostic, molecular marker detection, prognostic or monitoring therapies are emerging. The analysis of liquid biopsies which contain genetic information from the tumor has been much more widely explored in adults than in children. We compare the detection of BRAF V600E targetable mutation by digital-PCR from cell-free-DNA and EV-derived DNA (ctDNA) in serum, plasma and cerebrospinal fluid (CSF) isolated from a cohort of 29 CNS pediatric patients. Here we demonstrate that ctDNA isolated from serum and plasma could be successfully analyzed to obtain tumor genetic information which could be used to guide critical treatment decisions.
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Affiliation(s)
- Noemi García-Romero
- Fundación de Investigación HM Hospitales, HM Hospitales, 28015 Madrid, Spain; (N.G.-R.); (J.C.-N.); (P.A.-H.); (A.O.d.M.); (R.M.); (C.B.-I.)
| | - Josefa Carrión-Navarro
- Fundación de Investigación HM Hospitales, HM Hospitales, 28015 Madrid, Spain; (N.G.-R.); (J.C.-N.); (P.A.-H.); (A.O.d.M.); (R.M.); (C.B.-I.)
| | - Pilar Areal-Hidalgo
- Fundación de Investigación HM Hospitales, HM Hospitales, 28015 Madrid, Spain; (N.G.-R.); (J.C.-N.); (P.A.-H.); (A.O.d.M.); (R.M.); (C.B.-I.)
- Pediatric Hematology and Oncology Unit, Madrid Montepríncipe Hospital, 28660 Madrid, Spain
| | - Ana Ortiz de Mendivil
- Fundación de Investigación HM Hospitales, HM Hospitales, 28015 Madrid, Spain; (N.G.-R.); (J.C.-N.); (P.A.-H.); (A.O.d.M.); (R.M.); (C.B.-I.)
| | | | - Rodrigo Madurga
- Fundación de Investigación HM Hospitales, HM Hospitales, 28015 Madrid, Spain; (N.G.-R.); (J.C.-N.); (P.A.-H.); (A.O.d.M.); (R.M.); (C.B.-I.)
| | - Rocio Núñez-Torres
- Spanish National Cancer Research Center (CNIO), 28029 Madrid, Spain; (R.N.-T.); (A.G.-N.)
| | - Anna González-Neira
- Spanish National Cancer Research Center (CNIO), 28029 Madrid, Spain; (R.N.-T.); (A.G.-N.)
| | - Cristobal Belda-Iniesta
- Fundación de Investigación HM Hospitales, HM Hospitales, 28015 Madrid, Spain; (N.G.-R.); (J.C.-N.); (P.A.-H.); (A.O.d.M.); (R.M.); (C.B.-I.)
| | | | - Blanca López-Ibor
- Fundación de Investigación HM Hospitales, HM Hospitales, 28015 Madrid, Spain; (N.G.-R.); (J.C.-N.); (P.A.-H.); (A.O.d.M.); (R.M.); (C.B.-I.)
- Pediatric Hematology and Oncology Unit, Madrid Montepríncipe Hospital, 28660 Madrid, Spain
- Correspondence: (B.L.-I.); (A.A.-S.); Tel.: +34-91372-4700 (A.A.-S.)
| | - Angel Ayuso-Sacido
- Fundación de Investigación HM Hospitales, HM Hospitales, 28015 Madrid, Spain; (N.G.-R.); (J.C.-N.); (P.A.-H.); (A.O.d.M.); (R.M.); (C.B.-I.)
- Facultad de Medicina (IMMA), Universidad San Pablo-CEU, 28668 Madrid, Spain
- Correspondence: (B.L.-I.); (A.A.-S.); Tel.: +34-91372-4700 (A.A.-S.)
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7
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García-Romero N, Carrión-Navarro J, Esteban-Rubio S, Lázaro-Ibáñez E, Peris-Celda M, Alonso MM, Guzmán-De-Villoria J, Fernández-Carballal C, de Mendivil AO, García-Duque S, Escobedo-Lucea C, Prat-Acín R, Belda-Iniesta C, Ayuso-Sacido A. DNA sequences within glioma-derived extracellular vesicles can cross the intact blood-brain barrier and be detected in peripheral blood of patients. Oncotarget 2018; 8:1416-1428. [PMID: 27902458 PMCID: PMC5352065 DOI: 10.18632/oncotarget.13635] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/07/2016] [Indexed: 01/01/2023] Open
Abstract
Tumor-cell-secreted extracellular vesicles (EVs) can cross the disrupted blood-brain barrier (BBB) into the bloodstream. However, in certain gliomas, the BBB remains intact, which might limit EVs release. To evaluate the ability of tumor-derived EVs to cross the BBB, we used an orthotopic xenotransplant mouse model of human glioma-cancer stem cells featuring an intact BBB. We demonstrated that all types of tumor cells-derived EVs−apoptotic bodies, shedding microvesicles and exosomes−cross the intact BBB and can be detected in the peripheral blood, which provides a minimally invasive method for their detection compared to liquid biopsies obtained from cerebrospinal fluid (CSF). Furthermore, these EVs can be readily distinguished from total murine EVs, since they carry human-specific DNA sequences relevant for GBM biology. In a small cohort of glioma patients, we finally demonstrated that peripheral blood EVs cargo can be successfully used to detect the presence of IDH1G395A, an essential biomarker in the current management of human glioma
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Affiliation(s)
- Noemí García-Romero
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,IMDEA Nanoscience, Madrid, Spain
| | - Josefa Carrión-Navarro
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
| | - Susana Esteban-Rubio
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
| | - Elisa Lázaro-Ibáñez
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - María Peris-Celda
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Juan Guzmán-De-Villoria
- Servicio de Radiodiagnóstico, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - Sara García-Duque
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain
| | - Carmen Escobedo-Lucea
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Ricardo Prat-Acín
- Departamento de Neurocirugía, Hospital Universitario la Fe, Valencia, Spain
| | - Cristóbal Belda-Iniesta
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
| | - Angel Ayuso-Sacido
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,IMDEA Nanoscience, Madrid, Spain.,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
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8
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Arana E, Kovacs FM, Royuela A, Asenjo B, Pérez-Ramírez U, Zamora J, Abraira V, Alcázar L, Alonso A, Álvarez L, Álvarez MA, Amengual G, Antuña A, Aparici F, Bagó J, Barriga A, Barrios M, Bas P, Begara J, Bravo-Rodríguez F, Cabrera A, Casillas C, Catalán G, Conde AJ, Peñas RDL, Díaz L, Dualde D, Estremera A, Fenollosa J, Fernández C, Fernández E, Fernández-Baillo N, Ferrer P, Fuster S, Galarraga MI, García-Villar C, García-Ferrer L, García MI, García-Duque S, Garde J, González A, González R, Hernández-Fernández A, Hernando O, Hernanz R, Hervás A, Holgado E, Juan MJ, Lavernia J, Lazo A, Lersundi A, López E, Magallón R, Majem M, Martín A, Martín MI, Martínez J, Montoya J, Moreno P, Navarro A, Noguerón E, Mendivil AOD, Palomino JC, Paniagua JC, Pereira D, Pérez-Romasanta LA, Pérez R, Piñera ÁR, Piñero P, Plata-Bello J, Poblete J, Ramírez J, Rivas D, Roldán H, Ruiz F, Sánchez JM, Sancho S, Sarasíbar H, Sepúlveda JM, Silvestre A, Sobrino B, Tomé-Bermejo F, Tovar I, Vallejo MDC, Vanaclocha V, Villanueva A, Zamarro J, Zazpe I. Agreement in the assessment of metastatic spine disease using scoring systems. Radiother Oncol 2015; 115:135-40. [DOI: 10.1016/j.radonc.2015.03.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/13/2015] [Accepted: 03/15/2015] [Indexed: 11/25/2022]
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9
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de Mendivil AO, Alcalá-Galiano A, Ochoa M, Salvador E, Millán JM. Brainstem Stroke: Anatomy, Clinical and Radiological Findings. Semin Ultrasound CT MR 2013; 34:131-41. [DOI: 10.1053/j.sult.2013.01.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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