Effects of PreOperative radiotherapy in a preclinical glioblastoma model: a paradigm-shift approach.

IF 3.2 2区 医学 Q2 CLINICAL NEUROLOGY
Journal of Neuro-Oncology Pub Date : 2024-09-01 Epub Date: 2024-07-22 DOI:10.1007/s11060-024-04765-5
Beatriz I Fernandez-Gil, Paula Schiapparelli, Juan P Navarro-Garcia de Llano, Andrea Otamendi-Lopez, Maria Jose Ulloa-Navas, Loizos Michaelides, Carla A Vazquez-Ramos, Steven M Herchko, Melissa E Murray, Yesesri Cherukuri, Yan W Asmann, Daniel M Trifiletti, Alfredo Quiñones-Hinojosa
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引用次数: 0

Abstract

Purpose: PreOperative radiotherapy (RT) is commonly used in the treatment of brain metastasis and different cancer types but has never been used in primary glioblastoma (GBM). Here, we aim to establish, describe, and validate the use of PreOperative RT for the treatment of GBM in a preclinical model.

Methods: Rat brains were locally irradiated with 30-Gy, hypofractionated in five doses 2 weeks before or after the resection of intracranial GBM. Kaplan-Meier analysis determined survival. Hematoxylin-eosin staining was performed, and nuclei size and p21 senescence marker were measured in both resected and recurrent rodent tumors. Immunohistochemistry assessed microglia/macrophage markers, and RNAseq analyzed gene expression changes in recurrent tumors. Akoya Multiplex Staining on two human patients from our ongoing Phase I/IIa trial served as proof of principle.

Results: PreOperative RT group median survival was significantly higher than PostOperative RT (p < 0.05). Radiation enlarged cytoplasm and nuclei in PreOperative RT resected tumors (p < 0.001) and induced senescence in PostOperative RT recurrent tumors (p < 0.05). Gene Set Enrichment Analysis (GSEA) suggested a more proliferative profile in PreOperative RT group. PreOperative RT showed lower macrophage/microglia recruitment in recurrent tumors (p < 0.01) compared to PostOperative RT. Akoya Multiplex results indicated TGF-ß accumulation in the cytoplasm of TAMs and CD4 + lymphocyte predominance in PostOperative group.

Conclusions: This is the first preclinical study showing feasibility and longer overall survival using neoadjuvant radiotherapy before GBM resection in a mammalian model. This suggests strong superiority for new clinical radiation strategies. Further studies and trials are required to confirm our results.

Abstract Image

术前放疗在临床前胶质母细胞瘤模型中的效果:一种范式转换方法。
目的:术前放疗(RT)常用于治疗脑转移瘤和不同类型的癌症,但从未用于原发性胶质母细胞瘤(GBM)。在此,我们旨在建立、描述和验证在临床前模型中使用术前 RT 治疗 GBM 的方法:方法:在颅内 GBM 切除术前后 2 周,对大鼠大脑进行局部 30-Gy、分 5 次低剂量照射。Kaplan-Meier 分析确定存活率。对切除和复发的啮齿类动物肿瘤进行了血红素-伊红染色,并测量了细胞核大小和p21衰老标记物。免疫组化评估了小胶质细胞/巨噬细胞标记物,RNAseq分析了复发肿瘤的基因表达变化。对我们正在进行的 I/IIa 期试验中的两名人类患者进行的 Akoya 多重染色可作为原理验证:结果:术前 RT 组的中位生存期明显高于术后 RT 组(p 结论:术前 RT 组的中位生存期明显高于术后 RT 组(p这是第一项临床前研究,在哺乳动物模型中显示了在 GBM 切除术前使用新辅助放疗的可行性和更长的总生存期。这表明新的临床放射策略具有很强的优越性。需要进一步的研究和试验来证实我们的结果。
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来源期刊
Journal of Neuro-Oncology
Journal of Neuro-Oncology 医学-临床神经学
CiteScore
6.60
自引率
7.70%
发文量
277
审稿时长
3.3 months
期刊介绍: The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.
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