Department of Pathology, Leiden University Medical Center, Leiden, t he Netherlands.
Clin Orthop Relat Res. 2023 Mar 1;481(3):608-619. doi: 10.1097/CORR.0000000000002483. Epub 2022 Dec 13.
Chondrosarcomas are well known for their resistance to conventional chemotherapy and radiotherapy treatment regimens, which is particularly detrimental in patients who have unresectable tumors. Recently, inhibition of poly(ADP-ribose) polymerase (PARP) by talazoparib was shown to sensitize chondrosarcoma cell lines to chemotherapy (temozolomide) or radiotherapy, irrespective of isocitrate dehydrogenase (IDH) mutation status. Because two-dimensionally grown cell lines have limitations and may not accurately represent the clinical response to drug treatment, we aimed to use a more representative three-dimensional alginate spheroid chondrosarcoma model. It is important to test therapeutic agents in vitro before testing them in animals or humans; therefore, we aimed to determine the effectiveness of a PARP inhibitor in reducing the viability of chondrosarcoma spheroids. Using a more stringent, complex in vitro model refines future therapeutic options for further investigation in animal models, increasing efficiency, reducing unnecessary animal use, and saving time and cost.
QUESTIONS/PURPOSES: (1) Does talazoparib treatment slow or inhibit the growth of chondrosarcoma spheroids, and does an increased treatment duration change the drug's effect? (2) Does talazoparib work in synergy with temozolomide treatment to reduce the viability of chondrosarcoma spheroids? (3) Does talazoparib work in synergy with radiotherapy treatment to reduce the viability of chondrosarcoma spheroids?
Three representative conventional chondrosarcoma cell lines (CH2879 [IDH wildtype], JJ012 [IDH1 mutant], and SW1353 [IDH2 mutant]) were cultured as alginate spheroids and treated with talazoparib (0.001 to 10 µM), temozolomide (0.01 to 100 µM), or combinations of these drugs for 3, 7, and 14 days, representing different stages of spheroid growth. The cell lines were selected to represent a variety of IDH mutation statuses and were previously validated in spheroid culturing. Temozolomide was chosen because of its previous success when combined with PARP inhibitors, dissimilar to other commonly used chemotherapies. The effect on spheroid viability was assessed using three cell viability assays. Additionally, spheroid count, morphology, proliferation, and apoptosis were assessed. The effect of talazoparib (5 to 10 nM) combined with ƴ-radiation applied using a 137 C source (0 to 6 Gy) was assessed as surviving fractions by counting the number of spheroids (three). The therapeutic synergy of low-concentration talazoparib (5 to 10 nM) with temozolomide or radiotherapy was determined by calculating Excess over Bliss scores.
Talazoparib treatment reduced the spheroid viability of all three cell lines after 14 days (IC 50 ± SD of CH2879: 0.1 ± 0.03 µM, fold change: 220; JJ012: 12 ± 1.4 µM, fold change: 4.8; and SW1353: 1.0 ± 0.2 µM, fold change: 154), compared with 3-day treatments of mature spheroids. After 14 days of treatment, the Excess over Bliss scores for 100 µM temozolomide and talazoparib indicated synergistic efficacy (Excess over Bliss scores: CH2879 59% [lower 95% CI 52%], JJ012 18% [lower 95% CI 8%], and SW1353 55% [lower 95% CI 25%]) of this combination treatment. A stable synergistic effect of talazoparib and radiotherapy was present only in JJ012 spheroids at a 4Gƴ radiation dose (Excess over Bliss score: 22% [lower 95% CI 6%]).
In our study, long-term PARP inhibition was more effective than short-term treatment, and only one of the three chondrosarcoma spheroid lines was sensitive to combined PARP inhibition and radiotherapy. These findings suggest subsequent animal studies should focus on long-term PARP inhibition, and temozolomide combined with talazoparib has a higher chance of success than combination with radiotherapy.
Combination treatment of talazoparib and temozolomide was effective in reducing the viability of chondrosarcoma spheroids and spheroid growth, regardless of IDH mutation status, providing rationale to replicate this treatment combination in an animal chondrosarcoma model.
软骨肉瘤以对常规化疗和放疗治疗方案的耐药性而闻名,这对于无法切除肿瘤的患者尤其不利。最近,聚(ADP-核糖)聚合酶(PARP)的抑制剂他拉唑帕尼被证明可以使软骨肉瘤细胞系对化疗(替莫唑胺)或放疗敏感,而与异柠檬酸脱氢酶(IDH)突变状态无关。因为二维培养的细胞系有局限性,可能无法准确反映临床对药物治疗的反应,所以我们旨在使用更具代表性的三维藻酸盐球体软骨肉瘤模型。在动物或人类中进行测试之前,在体外测试治疗剂非常重要;因此,我们旨在确定 PARP 抑制剂在降低软骨肉瘤球体活力方面的有效性。使用更严格、更复杂的体外模型可以进一步研究动物模型中的未来治疗选择,提高效率,减少不必要的动物使用,并节省时间和成本。
问题/目的:(1)他拉唑帕尼治疗是否会减缓或抑制软骨肉瘤球体的生长,延长治疗时间是否会改变药物的作用?(2)他拉唑帕尼与替莫唑胺联合治疗是否能降低软骨肉瘤球体的活力?(3)他拉唑帕尼与放射治疗联合治疗是否能降低软骨肉瘤球体的活力?
三种代表性的传统软骨肉瘤细胞系(CH2879[IDH 野生型]、JJ012[IDH1 突变型]和 SW1353[IDH2 突变型])被培养成藻酸盐球体,并接受他拉唑帕尼(0.001 至 10 μM)、替莫唑胺(0.01 至 100 μM)或这些药物的组合治疗,持续 3、7 和 14 天,分别代表球体生长的不同阶段。选择这些细胞系来代表各种 IDH 突变状态,并在球体培养中得到验证。选择替莫唑胺是因为它与 PARP 抑制剂联合使用时取得了成功,与其他常用的化疗药物不同。使用三种细胞活力测定法评估对球体活力的影响。此外,还评估了球体计数、形态、增殖和凋亡。用 137C 源(0 至 6 Gy)应用γ辐射(5 至 10 nM)评估他拉唑帕尼(5 至 10 nM)与放射治疗联合的效果,通过计算球体数量(三个)来评估存活分数。通过计算 Excess over Bliss 评分来确定低浓度他拉唑帕尼(5 至 10 nM)与替莫唑胺或放射治疗联合的治疗协同作用。
与成熟球体的 3 天治疗相比,他拉唑帕尼治疗后所有三种细胞系的球体活力在 14 天(CH2879:0.1±0.03 μM,倍数变化:220;JJ012:12±1.4 μM,倍数变化:4.8;SW1353:1.0±0.2 μM,倍数变化:154)时降低。在 14 天的治疗后,100 μM 替莫唑胺和他拉唑帕尼的 Excess over Bliss 评分表明联合治疗具有协同作用(CH2879 的 Excess over Bliss 评分:59%[置信区间下限 52%],JJ012:18%[置信区间下限 8%],SW1353:55%[置信区间下限 25%])。只有 JJ012 球体在 4Gγ 辐射剂量(Excess over Bliss 评分:22%[置信区间下限 6%])时显示出稳定的协同效应。
在我们的研究中,长期 PARP 抑制比短期治疗更有效,而且只有三种软骨肉瘤球体系中的一种对 PARP 抑制和放射治疗联合敏感。这些发现表明,随后的动物研究应侧重于长期 PARP 抑制,并且替莫唑胺联合他拉唑帕尼比联合放射治疗更有成功的机会。
他拉唑帕尼和替莫唑胺联合治疗可有效降低软骨肉瘤球体的活力和球体生长,无论 IDH 突变状态如何,为在动物软骨肉瘤模型中复制这种治疗联合提供了依据。