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在小鼠模型中靶向白细胞介素-13受体α2以有效治疗恶性外周神经鞘瘤。

Targeting IL-13Rα2 for effective treatment of malignant peripheral nerve sheath tumors in mouse models.

作者信息

Mrowczynski Oliver D, Payne Russell A, Bourcier Alexandre J, Mau Christine Y, Slagle-Webb Becky, Shenoy Ganesh, Madhankumar Achuthamangalam B, Abramson Stephan B, Wolfe Darren, Harbaugh Kimberly S, Rizk Elias B, Connor James R

机构信息

1Penn State University Department of Neurosurgery, Milton S. Hershey Medical Center.

2Targepeutics, Inc., Hershey, Pennsylvania; and.

出版信息

J Neurosurg. 2018 Nov 30;131(5):1369-1379. doi: 10.3171/2018.7.JNS18284. Print 2019 Nov 1.

Abstract

OBJECTIVE

Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive soft tissue sarcomas that harbor a high potential for metastasis and have a devastating prognosis. Combination chemoradiation aids in tumor control and decreases tumor recurrence but causes deleterious side effects and does not extend long-term survival. An effective treatment with limited toxicity and enhanced efficacy is critical for patients suffering from MPNSTs.

METHODS

The authors recently identified that interleukin-13 receptor alpha 2 (IL-13Rα2) is overexpressed on MPNSTs and could serve as a precision-based target for delivery of chemotherapeutic agents. In the work reported here, a recombinant fusion molecule consisting of a mutant human IL-13 targeting moiety and a point mutant variant of Pseudomonas exotoxin A (IL-13.E13 K-PE4E) was utilized to treat MPNST in vitro in cell culture and in an in vivo murine model.

RESULTS

IL-13.E13 K-PE4E had a potent cytotoxic effect on MPNST cells in vitro. Furthermore, intratumoral administration of IL-13.E13 K-PE4E to orthotopically implanted MPNSTs decreased tumor burden 6-fold and 11-fold in late-stage and early-stage MPNST models, respectively. IL-13.E13 K-PE4E treatment also increased survival by 23 days in the early-stage MPNST model.

CONCLUSIONS

The current MPNST treatment paradigm consists of 3 prongs: surgery, chemotherapy, and radiation, none of which, either singly or in combination, are curative or extend survival to a clinically meaningful degree. The results presented here provide the possibility of intratumoral therapy with a potent and highly tumor-specific cytotoxin as a fourth treatment prong with the potential to yield improved outcomes in patients with MPNSTs.

摘要

目的

恶性外周神经鞘瘤(MPNSTs)是侵袭性软组织肉瘤,具有高转移潜能且预后极差。放化疗联合有助于控制肿瘤并降低肿瘤复发,但会产生有害副作用且不能延长长期生存率。对于MPNSTs患者而言,一种毒性有限且疗效增强的有效治疗方法至关重要。

方法

作者最近发现白细胞介素-13受体α2(IL-13Rα2)在MPNSTs上过度表达,可作为化疗药物递送的精准靶点。在本文报道的研究中,一种由突变型人IL-13靶向部分和铜绿假单胞菌外毒素A的点突变变体(IL-13.E13 K-PE4E)组成的重组融合分子被用于在细胞培养中体外治疗MPNST以及在体内小鼠模型中进行治疗。

结果

IL-13.E13 K-PE4E在体外对MPNST细胞具有强大的细胞毒性作用。此外,在原位植入MPNSTs的瘤内给予IL-13.E13 K-PE4E,在晚期和早期MPNST模型中分别使肿瘤负担降低了6倍和11倍。在早期MPNST模型中,IL-13.E13 K-PE4E治疗还使生存期延长了23天。

结论

目前MPNST的治疗模式包括三个方面:手术、化疗和放疗,其中任何一种单独或联合使用都无法治愈或使生存期延长至具有临床意义的程度。本文呈现的结果提供了用一种强效且高度肿瘤特异性的细胞毒素进行瘤内治疗的可能性,作为第四种治疗方法,有可能改善MPNST患者的治疗效果。

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