A SORT1/EGFR molecular interplay as a prognostic biomarker in glioblastoma vasculogenic mimicry: implications in the transcriptional regulation of cancer stemness and drug resistance.

BACKGROUND: The epidermal growth factor receptor (EGFR) plays a significant role in vasculogenic mimicry (VM), a process by which aggressive cancer cells within hypoxic solid tumors form blood vessel-like structures independent of endothelial cells. Mostly attributed to cancer stem cells (CSC), VM is strongly associated with chemoresistance and poor prognosis in glioblastomas (GBMs). The trafficking of EGFR from the plasma membrane is in part regulated by Sortilin (SORT1), a type I membrane glycoprotein with receptor sorting functions. Notably, EGFR and SORT1 have been reported to also localize within exosomes. This study questions whether the EGFR/SORT1 interplay impacts in vitro VM in human GBM-derived cell models. METHODS: In silico analysis was used to compare GBM to healthy brain tissue transcripts levels. cDNA arrays and RT-qPCR were performed to assess transcript levels in U87, U118, U138, and U251 GBM cells. Immunoblotting was used to assess protein expression levels. In vitro 3D VM was performed on Cultrex, while real-time chemotaxis was measured using the xCELLigence system. Transient gene silencing was achieved using sequence-specific siRNA. RESULTS: Increased levels of EGFR, along with tetraspanins exosomal markers CD9, CD63, and CD81 were observed in GBM. Interaction predictions further identified EGFR as a central hub linking SORT1 to exosomal biomarkers. Elevated SORT1 protein and gene expression were found in human stage IV GBM-derived U87, U118 and U251 cell lines. This was consistent with cDNA array analyses from clinically annotated GBM demonstrating higher SORT1 levels in stage III-IV compared to stage I-II tumors. Pharmacological inhibition of SORT1 function by AF38469 or siRNA-mediated transient silencing of SORT1 abrogated chemotactic cell migration and reduced in vitro VM in U87 and U251 GBM cells. SORT1 silencing prevented EGFR gene and protein expression upon in vitro VM, as well as reduced chemoresistance (ABCB1, ABCB5) and CSC (PROM1/CD133, SOX2) molecular signature. CONCLUSIONS: These findings underscore the complex interplay of the EGFR/SORT1 axis in regulating VM and in driving to the transcriptional regulation of chemoresistance and CSC molecular signatures of GBM associated with VM. These insights could inspire novel therapeutic strategies targeting the EGFR/SORT1 complex in GBM.