Wells Elizabeth, Kambhampati Madhuri, Damsker Jesse M, Gordish-Dressman Heather, Yadavilli Sridevi, Becher Oren J, Gittens Jamila, Stampar Mojca, Packer Roger J, Nazarian Javad
Research Center for Genetic Medicine, Children's National Health System, Washington, DC, USA.
Brain Tumor Institute, Center for Neuroscience and Behavioral Medicine, Children's National Health System, Washington, DC, USA.
Oncotarget. 2017 Feb 7;8(6):9366-9374. doi: 10.18632/oncotarget.14070.
Corticosteroids, such as dexamethasone, are routinely used as palliative care in neuro-oncology for their anti-inflammatory benefits, however many patients experience dose limiting side effects caused by glucocorticoid response element (GRE)-mediated transcription. The purpose of this study was to use a murine model to investigate a new steroid alternative, vamorolone, which promises to reduce side effects through dissociating GRE-mediated transcription and NF-κB -mediated anti-inflammatory actions. To compare vamorolone to dexamethasone in reducing pro-inflammatory signals in vitro, murine glioma cells were treated with dexamethasone, vamorolone or vehicle control. Changes in mRNA expression were assessed using the nanostring inflammatory platform. Furthermore, drug efficacy, post-treatment behavioral activity and side effects were assessed by treating two cohorts of brain tumor bearing mice with dexamethasone, vamorolone, or vehicle control. Our investigation showed that treatment with vamorolone resulted in a reduction of pro-inflammatory signals in tumor cells in vitro similar to treatment with dexamethasone. Treatment with vamorolone resulted in a better safety profile in comparison to dexamethasone treatment. Vamorolone- treated mice showed similar or better activity and survival when compared to dexamethasone-treated mice. Our data indicate vamorolone is a potential steroid-sparing alternative for treating patients with brain tumors.
皮质类固醇,如地塞米松,因其抗炎作用而在神经肿瘤学中常规用作姑息治疗药物,然而许多患者会经历由糖皮质激素反应元件(GRE)介导的转录所引起的剂量限制性副作用。本研究的目的是使用小鼠模型来研究一种新的类固醇替代物——伐莫罗龙,它有望通过解离GRE介导的转录和NF-κB介导的抗炎作用来减少副作用。为了在体外比较伐莫罗龙和地塞米松在减少促炎信号方面的效果,用 地塞米松、伐莫罗龙或溶剂对照处理小鼠胶质瘤细胞。使用纳米串炎症平台评估mRNA表达的变化。此外,通过用地塞米松、伐莫罗龙或溶剂对照处理两组荷脑肿瘤小鼠来评估药物疗效、治疗后的行为活动和副作用。我们的研究表明,用伐莫罗龙治疗在体外可使肿瘤细胞中的促炎信号减少,类似于用地塞米松治疗的效果。与地塞米松治疗相比,用伐莫罗龙治疗具有更好的安全性。与地塞米松治疗的小鼠相比,用伐莫罗龙治疗的小鼠表现出相似或更好的活动能力和存活率。我们的数据表明,伐莫罗龙是治疗脑肿瘤患者的一种潜在的类固醇替代药物。