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Akter F, Simon B, de Boer NL, Redjal N, Wakimoto H, Shah K. Pre-clinical tumor models of primary brain tumors: Challenges and opportunities. Biochim Biophys Acta Rev Cancer 2021; 1875:188458. [PMID: 33148506 PMCID: PMC7856042 DOI: 10.1016/j.bbcan.2020.188458] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 02/09/2023]
Abstract
Primary brain tumors are a heterogeneous group of malignancies that originate in cells of the central nervous system. A variety of models tractable for preclinical studies have been developed to recapitulate human brain tumors, allowing us to understand the underlying pathobiology and explore potential treatments. However, many promising therapeutic strategies identified using preclinical models have shown limited efficacy or failed at the clinical trial stage. The inability to develop therapeutic strategies that significantly improve survival rates in patients highlight the compelling need to revisit the design of currently available animal models and explore the use of new models that allow us to bridge the gap between promising preclinical findings and clinical translation. In this review, we discuss current strategies used to model glioblastoma, the most malignant brain tumor in adults and highlight the shortcomings of specific models that must be circumvented for the development of innovative therapeutic strategies.
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Affiliation(s)
- Farhana Akter
- Center for Stem Cell Therapeutics and Imaging (CSTI), Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America
| | - Brennan Simon
- Center for Stem Cell Therapeutics and Imaging (CSTI), Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America
| | - Nadine Leonie de Boer
- Center for Stem Cell Therapeutics and Imaging (CSTI), Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America
| | - Navid Redjal
- Center for Stem Cell Therapeutics and Imaging (CSTI), Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America
| | - Hiroaki Wakimoto
- Center for Stem Cell Therapeutics and Imaging (CSTI), Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America; Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, United States of America.
| | - Khalid Shah
- Center for Stem Cell Therapeutics and Imaging (CSTI), Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States of America; Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02138, United States of America.
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de Boer NL, Brandt-Kerkhof ARM, Madsen EVE, Diepeveen M, van Meerten E, van Eerden RAG, de Man FM, Bouamar R, Koolen SLW, de Hingh IHJT, Bakkers C, Rovers KP, Creemers GJM, Deenen MJ, Kranenburg OW, Constantinides A, Mathijssen RHJ, Verhoef C, Burger JWA. Concomitant intraperitoneal and systemic chemotherapy for extensive peritoneal metastases of colorectal origin: protocol of the multicentre, open-label, phase I, dose-escalation INTERACT trial. BMJ Open 2019; 9:e034508. [PMID: 31818845 PMCID: PMC6924694 DOI: 10.1136/bmjopen-2019-034508] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has become standard of care for patients with peritoneal metastases of colorectal origin with a low/moderate abdominal disease load. In case of a peritoneal cancer index (PCI) score >20, CRS-HIPEC is not considered to be beneficial. Patients with a PCI >20 are currently offered palliative systemic chemotherapy. Previous studies have shown that systemic chemotherapy is less effective against peritoneal metastases than it is against haematogenous spread of colorectal cancer. It is suggested that patients with peritoneal metastases may benefit from the addition of intraperitoneal chemotherapy to systemic chemotherapy. Aim of this study is to establish the maximum tolerated dose of intraperitoneal irinotecan, added to standard of care systemic therapy for colorectal cancer. Secondary endpoints are to determine the safety and feasibility of this treatment and to establish the pharmacokinetic profile of intraperitoneally administered irinotecan. METHODS AND ANALYSIS This phase I, '3+3' dose-escalation, study is performed in two Dutch tertiary referral centres. The study population consists of adult patients with extensive peritoneal metastases of colorectal origin who have a good performance status and no extra-abdominal metastases. According to standard work-up for CRS-HIPEC, patients will undergo a diagnostic laparoscopy to score the PCI. In case of a PCI >20, a peritoneal access port will be placed in the abdomen of the patient. Through this port we will administer intraperitoneal irinotecan, in combination with standard systemic treatment consisting of 5-fluorouracil/leucovorin with oxaliplatin and the targeted agent bevacizumab. Therapy consists of a maximum of 12 cycles 2-weekly. ETHICS AND DISSEMINATION This study protocol is approved by a research medical ethics committee (Rotterdam, Netherlands) and the Dutch Competent Authority (CCMO, The Hague, Netherlands). The results of this trial will be submitted for publication in a peer-reviewed scientific journal. TRAIL REGISTRATION NUMBER NL6988 and NL2018-000479-33; Pre-results.
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Affiliation(s)
- Nadine Leonie de Boer
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | | | - Eva V E Madsen
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marjolein Diepeveen
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Esther van Meerten
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Ruben A G van Eerden
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Femke M de Man
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Rachida Bouamar
- Department of Hospital Pharmacy, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Stijn L W Koolen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Department of Hospital Pharmacy, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | | | - Checca Bakkers
- Department of Surgery, Catharina Cancer Institute, Eindhoven, The Netherlands
| | - Koen P Rovers
- Department of Surgery, Catharina Cancer Institute, Eindhoven, The Netherlands
| | - Geert-Jan M Creemers
- Department of Medical Oncology, Catharina Cancer Institute, Eindhoven, The Netherlands
| | - Maarten J Deenen
- Department of Clinical Pharmacy, Catharina Hospital, Eindhoven, The Netherlands
| | - Onno W Kranenburg
- Department of Surgical Oncology and Utrecht Platform for Organoid Technology, UMC Utrecht Cancer Centre, Utrecht, The Netherlands
| | - Alexander Constantinides
- Department of Surgical Oncology and Utrecht Platform for Organoid Technology, UMC Utrecht Cancer Centre, Utrecht, The Netherlands
| | - Ron H J Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Cornelis Verhoef
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Jacobus W A Burger
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Department of Surgery, Catharina Cancer Institute, Eindhoven, The Netherlands
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