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患者来源的类器官和原发及复发性脑胶质瘤的原位异种移植为精准肿瘤学提供了相关的患者替身。

Patient-derived organoids and orthotopic xenografts of primary and recurrent gliomas represent relevant patient avatars for precision oncology.

机构信息

NORLUX Neuro-Oncology Laboratory, Department of Oncology, Luxembourg Institute of Health, 84, Val Fleuri, 1526, Luxembourg, Luxembourg.

National Center of Genetics, Laboratoire National de Santé, 3555, Dudelange, Luxembourg.

出版信息

Acta Neuropathol. 2020 Dec;140(6):919-949. doi: 10.1007/s00401-020-02226-7. Epub 2020 Oct 3.

Abstract

Patient-based cancer models are essential tools for studying tumor biology and for the assessment of drug responses in a translational context. We report the establishment a large cohort of unique organoids and patient-derived orthotopic xenografts (PDOX) of various glioma subtypes, including gliomas with mutations in IDH1, and paired longitudinal PDOX from primary and recurrent tumors of the same patient. We show that glioma PDOXs enable long-term propagation of patient tumors and represent clinically relevant patient avatars that retain histopathological, genetic, epigenetic, and transcriptomic features of parental tumors. We find no evidence of mouse-specific clonal evolution in glioma PDOXs. Our cohort captures individual molecular genotypes for precision medicine including mutations in IDH1, ATRX, TP53, MDM2/4, amplification of EGFR, PDGFRA, MET, CDK4/6, MDM2/4, and deletion of CDKN2A/B, PTCH, and PTEN. Matched longitudinal PDOX recapitulate the limited genetic evolution of gliomas observed in patients following treatment. At the histological level, we observe increased vascularization in the rat host as compared to mice. PDOX-derived standardized glioma organoids are amenable to high-throughput drug screens that can be validated in mice. We show clinically relevant responses to temozolomide (TMZ) and to targeted treatments, such as EGFR and CDK4/6 inhibitors in (epi)genetically defined subgroups, according to MGMT promoter and EGFR/CDK status, respectively. Dianhydrogalactitol (VAL-083), a promising bifunctional alkylating agent in the current clinical trial, displayed high therapeutic efficacy, and was able to overcome TMZ resistance in glioblastoma. Our work underscores the clinical relevance of glioma organoids and PDOX models for translational research and personalized treatment studies and represents a unique publicly available resource for precision oncology.

摘要

基于患者的癌症模型是研究肿瘤生物学和评估转化背景下药物反应的重要工具。我们报告了建立了一个大型独特类器官和患者来源的原位异种移植(PDOX)队列,涵盖了各种神经胶质瘤亚型,包括 IDH1 突变的神经胶质瘤,以及来自同一患者原发和复发性肿瘤的配对纵向 PDOX。我们表明,神经胶质瘤 PDOX 能够长期传播患者肿瘤,并代表具有临床相关性的患者替身,保留了亲本肿瘤的组织病理学、遗传学、表观遗传学和转录组学特征。我们没有发现神经胶质瘤 PDOX 中存在小鼠特异性克隆进化的证据。我们的队列捕获了个体分子基因型,用于精准医学,包括 IDH1、ATR、TP53、MDM2/4、EGFR、PDGFRA、MET、CDK4/6、MDM2/4 的突变,以及 CDKN2A/B、PTCH 和 PTEN 的缺失。匹配的纵向 PDOX 再现了患者治疗后观察到的神经胶质瘤有限的遗传进化。在组织学水平上,与小鼠相比,我们观察到大鼠宿主中的血管生成增加。PDOX 衍生的标准化神经胶质瘤类器官可用于高通量药物筛选,并可在小鼠中验证。我们根据 MGMT 启动子和 EGFR/CDK 状态,在(表型)遗传定义的亚组中分别显示了替莫唑胺(TMZ)和针对 EGFR 和 CDK4/6 抑制剂等靶向治疗的临床相关反应。二氢脱水半乳糖醇(VAL-083)是当前临床试验中一种有前途的双功能烷化剂,显示出高治疗效果,并能够克服胶质母细胞瘤中的 TMZ 耐药性。我们的工作强调了神经胶质瘤类器官和 PDOX 模型在转化研究和个性化治疗研究中的临床相关性,并代表了一个独特的、可供公众使用的精准肿瘤学资源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be7c/7666297/47d25516f9bb/401_2020_2226_Fig1_HTML.jpg

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