State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, 610041, P. R. China.
School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, P. R. China.
Small. 2023 Jan;19(2):e2205354. doi: 10.1002/smll.202205354. Epub 2022 Nov 18.
Durable glioblastoma multiforme (GBM) management requires long-term chemotherapy after surgery to eliminate remaining cancerous tissues. Among chemotherapeutics, temozolomide is considered as the first-line drug for GBM therapy, but the treatment outcome is not satisfactory. Notably, regorafenib, an oral multi-kinase inhibitor, has been reported to exert a markedly superior effect on GBM suppression compared with temozolomide. However, poor site-specific delivery and bioavailability significantly restrict the efficient permeability of regorafenib to brain lesions and compromise its treatment efficacy. Therefore, human H-ferritin (HFn), regorafenib, and Cu are rationally designed as a brain-targeted nanoplatform (HFn-Cu-REGO NPs), fulfilling the task of site-specific delivery and manipulating autophagy and cuproptosis against GBM. Herein, HFn affords a preferential accumulation capacity to GBM due to transferrin receptor 1 (TfR1)-mediated active targeting and pH-responsive delivery behavior. Moreover, regorafenib can inhibit autophagosome-lysosome fusion, resulting in lethal autophagy arrest in GBM cells. Furthermore, Cu not only facilitates the encapsulation of regorafenib to HFn through coordination interaction but also disturbs copper homeostasis for triggering cuproptosis, resulting in a synergistical effect with regorafenib-mediated lethal autophagy arrest against GBM. Therefore, this work may broaden the clinical application scope of Cu and regorafenib in GBM treatment via modulating autophagy and cuproptosis.
持久的胶质母细胞瘤(GBM)管理需要在手术后进行长期化疗,以消除残留的癌细胞组织。在化疗药物中,替莫唑胺被认为是 GBM 治疗的一线药物,但治疗效果并不理想。值得注意的是,口服多激酶抑制剂regorafenib 被报道对 GBM 抑制具有明显优于替莫唑胺的效果。然而,较差的靶向特异性和生物利用度显著限制了 regorafenib 向脑部病变的有效渗透,从而影响了其治疗效果。因此,人类铁蛋白(HFn)、regorafenib 和 Cu 被合理设计为脑靶向纳米平台(HFn-Cu-REGO NPs),实现了靶向特异性递药,并通过操纵自噬和铜死亡来对抗 GBM。在此,由于转铁蛋白受体 1(TfR1)介导的主动靶向和 pH 响应性递药行为,HFn 赋予了 GBM 优先的积累能力。此外,regorafenib 可以抑制自噬体-溶酶体融合,导致 GBM 细胞中致命的自噬停滞。此外,Cu 不仅通过配位相互作用促进了 regorafenib 包封到 HFn 中,还干扰了铜稳态以引发铜死亡,从而与 regorafenib 介导的致命自噬停滞对 GBM 产生协同作用。因此,本工作可能通过调节自噬和铜死亡,拓宽 Cu 和 regorafenib 在 GBM 治疗中的临床应用范围。