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Morris B, Curtin L, Hawkins-Daarud A, Hubbard ME, Rahman R, Smith SJ, Auer D, Tran NL, Hu LS, Eschbacher JM, Smith KA, Stokes A, Swanson KR, Owen MR. Identifying the spatial and temporal dynamics of molecularly-distinct glioblastoma sub-populations. Math Biosci Eng 2020; 17:4905-4941. [PMID: 33120534 PMCID: PMC8382158 DOI: 10.3934/mbe.2020267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Glioblastomas (GBMs) are the most aggressive primary brain tumours and have no known cure. Each individual tumour comprises multiple sub-populations of genetically-distinct cells that may respond differently to targeted therapies and may contribute to disappointing clinical trial results. Image-localized biopsy techniques allow multiple biopsies to be taken during surgery and provide information that identifies regions where particular sub-populations occur within an individual GBM, thus providing insight into their regional genetic variability. These sub-populations may also interact with one another in a competitive or cooperative manner; it is important to ascertain the nature of these interactions, as they may have implications for responses to targeted therapies. We combine genetic information from biopsies with a mechanistic model of interacting GBM sub-populations to characterise the nature of interactions between two commonly occurring GBM sub-populations, those with EGFR and PDGFRA genes amplified. We study population levels found across image-localized biopsy data from a cohort of 25 patients and compare this to model outputs under competitive, cooperative and neutral interaction assumptions. We explore other factors affecting the observed simulated sub-populations, such as selection advantages and phylogenetic ordering of mutations, which may also contribute to the levels of EGFR and PDGFRA amplified populations observed in biopsy data.
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Affiliation(s)
- Bethan Morris
- School of Mathematical Sciences, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Lee Curtin
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, 85054, USA
| | | | - Matthew E. Hubbard
- School of Mathematical Sciences, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Ruman Rahman
- School of Medicine and Health Sciences, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Stuart J. Smith
- School of Medicine and Health Sciences, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Dorothee Auer
- School of Medicine and Health Sciences, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Nhan L. Tran
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, 85054, USA
- Department of Cancer Biology, Mayo Clinic, Phoenix, Arizona 85054, USA
| | - Leland S. Hu
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, 85054, USA
- Department of Radiology, Mayo Clinic, Phoenix, Arizona 85054, USA
| | - Jennifer M. Eschbacher
- Department of Pathology, Barrow Neurological Institute - St. Joseph’s Hospital and Medical Center, Phoenix, Arizona 85013, USA
| | - Kris A. Smith
- Department of Neurosurgery, Barrow Neurological Institute - St. Joseph’s Hospital and Medical Center, Phoenix, Arizona 85013, USA
| | - Ashley Stokes
- Department of Imaging Research, Barrow Neurological Institute - St. Joseph’s Hospital and Medical Center, Phoenix, Arizona 85013, USA
| | - Kristin R. Swanson
- Mathematical NeuroOncology Lab, Mayo Clinic, Phoenix, Arizona, 85054, USA
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona 85054, USA
| | - Markus R. Owen
- School of Mathematical Sciences, University of Nottingham, Nottingham, NG7 2RD, UK
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Makhlin I, Salinas RD, Zhang D, Jacob F, Ming GL, Song H, Saxena D, Dorsey JF, Nasrallah MP, Morrissette JJD, Binder ZA, O'Rourke DM, Desai AS, Brem S, Bagley SJ. Clinical activity of the EGFR tyrosine kinase inhibitor osimertinib in EGFR-mutant glioblastoma. CNS Oncol 2019; 8:CNS43. [PMID: 31769726 PMCID: PMC6880297 DOI: 10.2217/cns-2019-0014] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 07/10/2019] [Accepted: 09/18/2019] [Indexed: 12/31/2022] Open
Abstract
Glioblastoma (GBM) is the most common primary malignant brain tumor in adults and carries a dismal prognosis. The EGFR gene is among the most commonly deranged genes in GBM and thus an important therapeutic target. We report the case of a young female with heavily pretreated EGFR-mutated GBM, for whom we initiated osimertinib, an oral, third-generation tyrosine kinase inhibitor that irreversibly inhibits EGFR and has significant brain penetration. We then review some of the main challenges in targeting EGFR, including lack of central nervous system penetration with most tyrosine kinase inhibitors, molecular heterogeneity of GBM and the need for enhanced specificity for the EGFR mutations relevant in GBM.
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Affiliation(s)
- Igor Makhlin
- Division of Hematology & Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ryan D Salinas
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Daniel Zhang
- Biochemistry & Molecular Biophysics Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Fadi Jacob
- Department of Neuroscience & Mahoney Institute for Neurosciences, University of Pennsylvania, Philadelphia, PA 19104, USA
- The Solomon H Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Gou-li Ming
- Department of Neuroscience & Mahoney Institute for Neurosciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hongjun Song
- Department of Neuroscience & Mahoney Institute for Neurosciences, University of Pennsylvania, Philadelphia, PA 19104, USA
- GBM Translational Center of Excellence, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Deeksha Saxena
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jay F Dorsey
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - MacLean P Nasrallah
- GBM Translational Center of Excellence, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Pathology & Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jennifer JD Morrissette
- Department of Pathology & Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Personalized Diagnostics, Department of Pathology & Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zev A Binder
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA
- GBM Translational Center of Excellence, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Donald M O'Rourke
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA
- GBM Translational Center of Excellence, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Arati S Desai
- Division of Hematology & Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- GBM Translational Center of Excellence, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Steven Brem
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA
- GBM Translational Center of Excellence, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Stephen J Bagley
- Division of Hematology & Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- GBM Translational Center of Excellence, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
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