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  • American Association for Cancer Research (AACR)  (7)
  • 1
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 29, No. 19 ( 2023-10-02), p. 3892-3900
    Abstract: The EORTC-26101 study was a randomized phase II and III clinical trial of bevacizumab in combination with lomustine versus lomustine alone in progressive glioblastoma. Other than for progression-free survival (PFS), there was no benefit from addition of bevacizumab for overall survival (OS). However, molecular data allow for the rare opportunity to assess prognostic biomarkers from primary surgery for their impact in progressive glioblastoma. Experimental Design: We analyzed DNA methylation array data and panel sequencing from 170 genes of 380 tumor samples of the EORTC-26101 study. These patients were comparable with the overall study cohort in regard to baseline characteristics, study treatment, and survival. Results: Of patients' samples, 295/380 (78%) were classified into one of the main glioblastoma groups, receptor tyrosine kinase (RTK)1, RTK2 and mesenchymal. There were 10 patients (2.6%) with isocitrate dehydrogenase mutant tumors in the biomarker cohort. Patients with RTK1 and RTK2 classified tumors had lower median OS compared with mesenchymal (7.6 vs. 9.2 vs. 10.5 months). O6-methylguanine DNA-methyltransferase (MGMT) promoter methylation was prognostic for PFS and OS. Neurofibromin (NF)1 mutations were predictive of response to bevacizumab treatment. Conclusions: Thorough molecular classification is important for brain tumor clinical trial inclusion and evaluation. MGMT promoter methylation and RTK1 classifier assignment were prognostic in progressive glioblastoma. NF1 mutation may be a predictive biomarker for bevacizumab treatment.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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    detail.hit.zdb_id: 2036787-9
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  • 2
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 22, No. 23 ( 2016-12-01), p. 5765-5771
    Abstract: Purpose: Antiangiogenic treatment with bevacizumab, a mAb to the VEGF, is the single most widely used therapeutic agent for patients with recurrent glioblastoma. A major challenge is that there are currently no validated biomarkers that can predict treatment outcome. Here we analyze the potential of radiomics, an emerging field of research that aims to utilize the full potential of medical imaging. Experimental Design: A total of 4,842 quantitative MRI features were automatically extracted and analyzed from the multiparametric tumor of 172 patients (allocated to a discovery and validation set with a 2:1 ratio) with recurrent glioblastoma prior to bevacizumab treatment. Leveraging a high-throughput approach, radiomic features of patients in the discovery set were subjected to a supervised principal component (superpc) analysis to generate a prediction model for stratifying treatment outcome to antiangiogenic therapy by means of both progression-free and overall survival (PFS and OS). Results: The superpc predictor stratified patients in the discovery set into a low or high risk group for PFS (HR = 1.60; P = 0.017) and OS (HR = 2.14; P & lt; 0.001) and was successfully validated for patients in the validation set (HR = 1.85, P = 0.030 for PFS; HR = 2.60, P = 0.001 for OS). Conclusions: Our radiomic-based superpc signature emerges as a putative imaging biomarker for the identification of patients who may derive the most benefit from antiangiogenic therapy, advances the knowledge in the noninvasive characterization of brain tumors, and stresses the role of radiomics as a novel tool for improving decision support in cancer treatment at low cost. Clin Cancer Res; 22(23); 5765–71. ©2016 AACR.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2016
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  • 3
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 71, No. 8_Supplement ( 2011-04-15), p. 3458-3458
    Abstract: Pilocytic astrocytoma (PA) comprises the most common primary brain tumor in children. Although this WHO grade I neoplasm shows a relatively benign biologic behavior many patients suffer from therapy-related long term neurologic impairment and up to 20% of patients experience tumor recurrence. Due to the slow growing nature of PA, adjuvant radiation and chemotherapy are only moderately effective. In order to pre-clinically evaluate novel therapy approaches, we aimed to establish a murine model of these tumors. Based on our previous work which showed that the MAPK intermediate BRAF is altered by duplication, activating mutation (V600E) or translocation of its kinase domain in a vast majority of cases, we applied somatic gene transfer using the Replication-Competent ASLV long terminal repeat (LTR) with a Splice acceptor (RCAS)/Tv-a technique to ectopically express different BRAF variants in Nestin-positive neural progenitors in the brains of newborn mice. While expression of either the BRAF i) full length wildtype, ii) full length V600E or iii) isolated kinase domain wildtype did not induce neoplastic lesions in mice, expression of the iv) isolated V600E mutated kinase domain induced tumors either in the cerebral hemispheres or in the brainstem depending on the site of injection. Although showing no clinical symptoms after an observation period of 4 months, post mortem analysis revealed presence of tumors in & gt;90% of cases. By histopathologic analysis, presence of strongly GFAP-positive lesions with a proliferation index (Ki67) below 1% could be identified. The slow tumor growth compared to other tumors induced with this technique together with presence of piloid-like tumor cells and eosinophilic structures (Rosenthal fibers) closely recapitulate clinical and biological features of human PA. Further analysis using primary murine Ntv-a astrocytes transduced with either of the four constructs in vitro revealed that expression of the isolated BRAF V600E kinase domain led to a twofold increase in proliferation compared to full length BRAF V600E or wild type BRAF kinase domain, while cells transduced with either full length wild type BRAF or GFP (control) showed almost no proliferation. Furthermore, this increase in proliferation could be markedly decreased by in vitro treatment with the kinase inhibitor Sorafenib at a concentration of 5 µM. This could be correlated with the amount of phosphorylation of the MAP kinases MEK and ERK, the downstream targets of BRAF. Treatment of mice with Sorafenib upon tumor induction is currently being conducted using ultrahigh field magnetic resonance imaging to monitor tumor growth and therapy response. Taken together, our data provide first in vivo evidence for the oncogenic role of BRAF in pediatric pilocytic astrocytomas and it will be of paramount clinical importance to use this first animal model for pre-clinical testing of novel treatment approaches. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3458. doi:10.1158/1538-7445.AM2011-3458
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
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  • 4
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 20, No. 24 ( 2014-12-15), p. 6304-6313
    Abstract: Purpose: Preclinical data indicate anti-invasive activity of APG101, a CD95 ligand (CD95L)–binding fusion protein, in glioblastoma. Experimental Design: Patients (N = 91) with glioblastoma at first or second progression were randomized 1:2 between second radiotherapy (rRT; 36 Gy; five times 2 Gy per week) or rRT+APG101 (400 mg weekly i.v.). Patient characteristics [N = 84 (26 patients rRT, 58 patients rRT+APG101)] were balanced. Results: Progression-free survival at 6 months (PFS-6) rates were 3.8% [95% confidence interval (CI), 0.1–19.6] for rRT and 20.7% (95% CI, 11.2–33.4) for rRT+APG101 (P = 0.048). Median PFS was 2.5 (95% CI, 2.3–3.8) months and 4.5 (95% CI, 3.7–5.4) months with a hazard ratio (HR) of 0.49 (95% CI, 0.27–0.88; P = 0.0162) adjusted for tumor size. Cox regression analysis adjusted for tumor size revealed a HR of 0.60 (95% CI, 0.36–1.01; P = 0.0559) for rRT+APG101 for death of any cause. Lower methylation levels at CpG2 in the CD95L promoter in the tumor conferred a stronger risk reduction (HR, 0.19; 95% CI, 0.06–0.58) for treatment with APG101, suggesting a potential biomarker. Conclusions: CD95 pathway inhibition in combination with rRT is an innovative concept with clinical efficacy. It warrants further clinical development. CD95L promoter methylation in the tumor may be developed as a biomarker. Clin Cancer Res; 20(24); 6304–13. ©2014 AACR.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2014
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  • 5
    In: Molecular Cancer Research, American Association for Cancer Research (AACR), Vol. 16, No. 5 ( 2018-05-01), p. 767-776
    Abstract: CD95 (Fas/APO-1), a death receptor family member, activity has been linked to tumorigenicity in multiple cancers, including glioblastoma multiforme (GBM). A phase II clinical trial on relapsed glioblastoma patients demonstrated that targeted inhibition of CD95 signaling via the CD95 ligand (CD95L) binding and neutralizing Fc-fusion protein APG101 (asunercept) prolonged patient survival. Although CD95 signaling may be relevant for multiple aspects of tumor growth, the mechanism of action of APG101 in glioblastoma is not clear. APG101 action was examined by in vitro proliferation, apoptosis, and invasion assays with human and murine glioma and human microglial cells, as well as in vivo therapy studies with orthotopic gliomas and clinical data. APG101 inhibits CD95L-mediated invasion of glioma cells. APG101 treatment was effective in glioma-bearing mice, independently of the presence or absence of CD4 and CD8 T lymphocytes, which should be sensitive to CD95L. Combined with radiotherapy, APG101 demonstrated a reduction of tumor growth, fewer tumor satellites, reduced activity of matrix metalloproteinases (MMP) as well as prolonged survival of tumor-bearing mice compared with radiotherapy alone. Inhibiting rather than inducing CD95 activity is a break-of-paradigm therapeutic approach for malignant gliomas. Evidence, both in vitro and in vivo, is provided that CD95L-binding fusion protein treatment enhanced the efficacy of radiotherapy and reduced unwanted proinfiltrative effects by reducing metalloproteinase activity by directly affecting the tumor cells. Implications: APG101 (asunercept) successfully used in a controlled phase II glioblastoma trial (NCT01071837) acts anti-invasively by inhibiting matrix metalloproteinase signaling, resulting in additive effects together with radiotherapy and helping to further develop a treatment for this devastating disease. Mol Cancer Res; 16(5); 767–76. ©2018 AACR.
    Type of Medium: Online Resource
    ISSN: 1541-7786 , 1557-3125
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2018
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  • 6
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 70, No. 8_Supplement ( 2010-04-15), p. 1308A-1308A
    Abstract: Two key properties of glioblastomas are vascular proliferation and invasion of tumor cells into the surrounding tissues, both limiting the efficacy of surgery and radiochemotherapy treatment regimens. Inhibition of mammalian target of rapamycin (mTOR) by Temsirolimus (CCI-779) only has modest single compound activity in recurrent glioma. Given the fact that postoperative radiochemotherapy is the standard of care in the first-line treatment of newly diagnosed glioblastoma, the first part of the presented project aims at analyzing combined mTOR/radiotherapy in the syngeneic, orthotopic VM/Dk/SMA-560 mouse glioma model. The combined treatment of CCI-779, a small-molecule inhibitor of the mTOR kinase complex 1 (mTORC1) approved for advanced renal cell carcinoma and mantle cell lymphoma, at 20 mg/KG from day 3 until day 17 and focal irradiation at 6 Gy on day 5 after tumor inocculation demonstrated remarkable antiangiogenic and antitumoral activity as well as prolonged survival of tumor bearing animals of 9 days, significant compared with irradiation- or CCI-779-treatment alone. Loss of phosphatase and tensin homologue on chromosome ten (PTEN), which is a common event in glioblastoma, results in activation of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mTOR signaling pathway, leading to neovascularisation, cell cycle progression and escape from apoptosis. So far, conflicting data on the sensitivity of PTEN wild-type (wt) versus mutant cells exist. Similarly, the relevance of the feedback activation of Akt by mTOR inhibition is debated. Here, analysis of PTEN on mRNA, promoter methylation as well as protein levels clearly demonstrates for cell lines as well as primary glioma cells that proliferation of PTEN wt cells is also sensitive to mTOR inhibition albeight at higher concentrations. We further demonstrate by differential effects on the mTOR complexes (mTORC) 1 and 2 by shRNA as compared to sole mTORC 1 inhibition by CCI-779 that feedback activation of Akt, which is more prominent in PTEN mutant than in wild-type cells, may in fact have additional therapeutic antiinvasive and angiogenic effects via inhibition of a G-protein-interacting protein and vascular endothelial growth factor receptor (VEGFR)-2, respectively. CCI-779 exerted marked anti-angiogenic effects both by reducing levels of VEGFR and by inhibiting radiation-enhanced proliferation of brain endothelial cells. Moreover, CCI-779 applied after radiosensibilization inhibited glioma invasiveness in a supra-additive way and reverted the proinvasive effect of sublethal irradiation alone. The results support the clinical evaluation of combined targeted mTOR inhibition with CCI-779 and radiotherapy in patients with newly diagnosed glioblastomas that is going to be conducted in the European Organization for Research and Treatment of Cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1308A.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2010
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  • 7
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 25, No. 1 ( 2019-01-01), p. 253-265
    Abstract: Resistance is an obstacle of glioma therapy. Despite targeted interventions, tumors harbor primary resistance or become resistant over short course of treatment. This study examined the mouse double minute 2 (MDM2) inhibitor RG7388 together with radiotherapy and analyzed strategies to overcome acquired MDM2 inhibitor resistance in glioblastoma. Experimental Design: Effects of RG7388 and radiotherapy were analyzed in p53 wild-type glioblastoma cell lines and glioma-initiating cells. RG7388 resistant cells were generated by increasing RG7388 doses over 3 months. Regulated pathways were investigated by microarray, qRT-PCR, and immunoblot analysis and specifically inhibited to evaluate rational salvage therapies at RG7388 resistance. Effects of RG7388 and trametinib treatment were challenged in an orthotopical mouse model with RG7388 resistant U87MG glioblastoma cells. Results: MDM2 inhibition required functional p53 and showed synergistic activity with radiotherapy in first-line treatment. Long-term exposure to RG7388 induced resistance by activation of the extracellular signal-regulated kinases 1/2 (ERK1/2)–insulin growth factor binding protein 1 (IGFBP1) signaling cascade, which was specifically overcome by ERK1/2 pathway inhibition with trametinib and knockdown of IGFBP1. Combining trametinib with continued RG7388 treatment enhanced antitumor effects at RG7388 resistance in vitro and in vivo. Conclusions: These data provide a rationale for combining RG7388 and radiotherapy as first-line therapy with a specific relevance for tumors insensitive to alkylating standard chemotherapy and for the addition of trametinib to continued RG7388 treatment as salvage therapy after acquired resistance against RG7388 for clinical practice.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2019
    detail.hit.zdb_id: 1225457-5
    detail.hit.zdb_id: 2036787-9
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