A novel patient stratification strategy to enhance the therapeutic efficacy of dasatinib in glioblastoma

一种新的患者分层策略可增强达沙替尼对胶质母细胞瘤的治疗效果

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作者:Obada T Alhalabi, Michael N C Fletcher, Thomas Hielscher, Tobias Kessler, Tolga Lokumcu, Ulrich Baumgartner, Elena Wittmann, Silja Schlue, Mona Göttmann, Shaman Rahman, Ling Hai, Lea Hansen-Palmus, Laura Puccio, Ichiro Nakano, Christel Herold-Mende, Bryan W Day, Wolfgang Wick, Felix Sahm, Emma Phill

Background

Glioblastoma is the most common primary malignancy of the central nervous system with a dismal prognosis. Genomic signatures classify isocitrate dehydrogenase 1 (IDH)-wildtype glioblastoma into three subtypes: proneural, mesenchymal, and classical. Dasatinib, an inhibitor of proto-oncogene kinase Src (SRC), is one of many therapeutics which, despite promising preclinical

Conclusion

This work highlights further molecular-based patient selection strategies in clinical trials and suggests the mesenchymal subtype as well as SERPINH1 to be associated with response to dasatinib. Our findings indicate that stratification based on gene expression subtyping should be considered in future dasatinib trials.

Methods

We carried out in silico analyses on glioblastoma gene expression (TCGA) and single-cell RNA-Seq data. In addition, in vitro experiments using glioblastoma stem-like cells (GSCs) derived from primary patient tumors were performed, with complementary gene expression profiling and immunohistochemistry analysis of tumor samples.

Results

Patients with the mesenchymal subtype of glioblastoma showed higher SRC pathway activation based on gene expression profiling. Accordingly, mesenchymal GSCs were more sensitive to SRC inhibition by dasatinib compared to proneural and classical GSCs. Notably, SRC phosphorylation status did not predict response to dasatinib treatment. Furthermore, serpin peptidase inhibitor clade H member 1 (SERPINH1), a collagen-related heat-shock protein associated with cancer progression, was shown to correlate with dasatinib response and with the mesenchymal subtype.

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