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Release of HMGB1 in response to proapoptotic glioma killing strategies: efficacy and neurotoxicity.


ABSTRACT: In preparation for a phase I clinical trial using a combined cytotoxic/immunotherapeutic strategy with adenoviruses (Ad) expressing Flt3L (Ad-Flt3L) and thymidine kinase (Ad-TK) to treat glioblastoma (GBM), we tested the hypothesis that Ad-TK+GCV would be the optimal tumor-killing agent in relation to efficacy and safety when compared with other proapoptotic approaches.The efficacy and neurotoxicity of Ad-TK+GCV was compared with Ads encoding the proapoptotic cytokines [tumor necrosis factor-alpha, tumor necrosis factor-related apoptosis-inducing factor (TRAIL), and Fas ligand (FasL)], alone or in combination with Ad-Flt3L. In rats bearing small GBMs (day 4), only Ad-TK+GCV or Ad-FasL improved survival.In rats bearing large GBMs (day 9), the combination of Ad-Flt3L with Ad-FasL did not improve survival over FasL alone, whereas Ad-Flt3L combined with Ad-TK+GCV led to 70% long-term survival. Expression of FasL and TRAIL caused severe neuropathology, which was not encountered when we used Ad-TK+/-Ad-Flt3L. In vitro, all treatments elicited release of high mobility group box 1 protein (HMGB1) from dying tumor cells. In vivo, the highest levels of circulating HMGB1 were observed after treatment with Ad-TK+GCV+Ad-Flt3L; HMGB1 was necessary for the therapeutic efficacy of AdTK+GCV+Ad-Flt3L because its blockade with glycyrrhizin completely blocked tumor regression. We also showed the killing efficacy of Ad-TK+GCV in human GBM cell lines and GBM primary cultures, which also elicited release of HMGB1.Our results indicate that Ad-TK+GCV+Ad-Flt3L exhibit the highest efficacy and safety profile among the several proapoptotic approaches tested. The results reported further support the implementation of this combined approach in a phase I clinical trial for GBM.

SUBMITTER: Candolfi M 

PROVIDER: S-EPMC2769255 | biostudies-literature | 2009 Jul

REPOSITORIES: biostudies-literature

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Release of HMGB1 in response to proapoptotic glioma killing strategies: efficacy and neurotoxicity.

Candolfi Marianela M   Yagiz Kader K   Foulad David D   Alzadeh Gabrielle E GE   Tesarfreund Matthew M   Muhammad A K M Ghulam AK   Puntel Mariana M   Kroeger Kurt M KM   Liu Chunyan C   Lee Sharon S   Curtin James F JF   King Gwendalyn D GD   Lerner Jonathan J   Sato Katsuaki K   Mineharu Yohei Y   Xiong Weidong W   Lowenstein Pedro R PR   Castro Maria G MG  

Clinical cancer research : an official journal of the American Association for Cancer Research 20090701 13


<h4>Purpose</h4>In preparation for a phase I clinical trial using a combined cytotoxic/immunotherapeutic strategy with adenoviruses (Ad) expressing Flt3L (Ad-Flt3L) and thymidine kinase (Ad-TK) to treat glioblastoma (GBM), we tested the hypothesis that Ad-TK+GCV would be the optimal tumor-killing agent in relation to efficacy and safety when compared with other proapoptotic approaches.<h4>Experimental design</h4>The efficacy and neurotoxicity of Ad-TK+GCV was compared with Ads encoding the proap  ...[more]

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