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Cilengitide in newly diagnosed glioblastoma: biomarker expression and outcome

Authors: Weller, Michael; Nabors, Louis Burt; Gorlia, Thierry; Leske, Henning; Rushing, Elisabeth J; Bady, Pierre; Hicking, Christine; +10 Authors

Cilengitide in newly diagnosed glioblastoma: biomarker expression and outcome

Abstract

Integrins αvβ3 and αvβ5 regulate angiogenesis and invasiveness in cancer, potentially by modulating activation of the transforming growth factor (TGF)-β pathway. The randomized phase III CENTRIC and phase II CORE trials explored the integrin inhibitor cilengitide in patients with newly diagnosed glioblastoma with versus without O6-methylguanine DNA methyltransferase (MGMT) promoter methylation. These trials failed to meet their primary endpoints. Immunohistochemistry was used to assess the levels of the target integrins of cilengitide, αvβ3 and αvβ5 integrins, of αvβ8 and of their putative target, phosphorylation of SMAD2, in tumor tissues from CENTRIC (n=274) and CORE (n=224). αvβ3 and αvβ5 expression correlated well in tumor and endothelial cells, but showed little association with αvβ8 or pSMAD2 levels. In CENTRIC, there was no interaction between the biomarkers and treatment for prediction of outcome. In CORE, higher αvβ3 levels in tumor cells were associated with improved progression-free survival by central review and with improved overall survival in patients treated with cilengitide. Integrins αvβ3, αvβ5 and αvβ8 are differentially expressed in glioblastoma. Integrin levels do not correlate with the activation level of the canonical TGF-β pathway. αvβ3 integrin expression may predict benefit from integrin inhibition in patients with glioblastoma lacking MGMT promoter methylation.

Country
Switzerland
Keywords

TGF-β, Adult, Male, integrin, 10208 Institute of Neuropathology, 610 Medicine & health, Smad2 Protein, Cohort Studies, Young Adult, 10049 Institute of Pathology and Molecular Pathology, Biomarkers, Tumor, Humans, Receptors, Vitronectin, pSmad, 610 Medicine & health, Aged, Neoplasm Staging, Aged, 80 and over, Adult; Aged; Aged, 80 and over; Biomarkers, Tumor/metabolism; Cohort Studies; Female; Follow-Up Studies; Gene Expression Regulation, Neoplastic/drug effects; Glioblastoma/drug therapy; Glioblastoma/metabolism; Glioblastoma/pathology; Humans; Integrin alphaVbeta3/metabolism; Male; Middle Aged; Neoplasm Staging; Prognosis; Receptors, Vitronectin/metabolism; Smad2 Protein/metabolism; Snake Venoms/therapeutic use; Survival Rate; Young Adult; TGF-β; biomarker; glioblastoma; integrin; pSmad, glioblastoma, Middle Aged, Integrin alphaVbeta3, Prognosis, 10040 Clinic for Neurology, Gene Expression Regulation, Neoplastic, Survival Rate, 10032 Clinic for Oncology and Hematology, biomarker, 2730 Oncology, Female, Glioblastoma, Research Paper, Follow-Up Studies, Snake Venoms

  • BIP!
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    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    79
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
79
Top 10%
Top 10%
Top 1%
Green
gold