Gan Hui K, Kaye Andrew H, Luwor Rodney B
Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Canada.
J Clin Neurosci. 2009 Jun;16(6):748-54. doi: 10.1016/j.jocn.2008.12.005. Epub 2009 Mar 25.
Glioblastoma multiforme (GBM) is the most common brain tumour and has the worst prognosis. Epidermal growth factor receptor (EGFR) gene amplification, mutation and re-arrangement (all of which enhance tumour growth, survival, progression and resistance to therapy) are frequently observed in primary GBM. The most common EGFR variant in GBM, the EGFRvIII, is characterised by a deletion of 267 amino acids in the extracellular domain, leading to a receptor which is unable to bind ligand yet is constitutively active. Together with its impaired internalisation and degradation, the EGFRvIII enhances the tumourigenic potential of GBM by activating and sustaining mitogenic, anti-apoptotic and pro-invasive signalling pathways. This EGFRvIII-mediated enhanced tumourigenicity combined with the lack of EGFRvIII expression in normal tissue makes it an ideal candidate for targeted therapy. This review summarizes the current knowledge about the role of EGFRvIII in GBM and discusses therapeutic agents targeting EGFRvIII that are being evaluated as treatments for GBM.
多形性胶质母细胞瘤(GBM)是最常见的脑肿瘤,预后最差。在原发性GBM中经常观察到表皮生长因子受体(EGFR)基因扩增、突变和重排(所有这些都会增强肿瘤生长、存活、进展及对治疗的抗性)。GBM中最常见的EGFR变体EGFRvIII的特征是细胞外结构域缺失267个氨基酸,导致一种无法结合配体但组成性激活的受体。连同其内化和降解受损,EGFRvIII通过激活和维持促有丝分裂、抗凋亡和促侵袭信号通路增强GBM的致瘤潜力。这种由EGFRvIII介导的增强的致瘤性,加上正常组织中缺乏EGFRvIII表达,使其成为靶向治疗的理想候选者。本综述总结了目前关于EGFRvIII在GBM中的作用的知识,并讨论了正在评估作为GBM治疗药物的靶向EGFRvIII的治疗剂。