Ren Jun, Amoozgar Zohreh, Uccello Taylor P, Lei Pin-Ji, Zhao Yuhui, Ho William W, Huang Peigen, Kardian Alisha, Mack Stephen C, Duda Dan G, Xu Lei, Jain Rakesh K
Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114.
Center of Excellence in Neuro-Oncology Sciences, St Jude Children's Research Hospital, Memphis, TN 38105.
Proc Natl Acad Sci U S A. 2025 Jan 28;122(4):e2319474122. doi: 10.1073/pnas.2319474122. Epub 2025 Jan 22.
Ependymoma (EPN) is a common form of brain tumor in children, often resistant to available cytotoxic therapies. Molecular profiling studies have led to a better understanding of EPN subtypes and revealed a critical role of oncogenes ZFTA-RELA fusion and EPHB2 in supratentorial ependymoma (ST-EPN). However, the immune system's role in tumor progression and response to therapy remains poorly understood. New treatments for various molecular subtypes of EPN are desperately needed. Using ST-EPN-ZFTA subtype-specific syngeneic mouse models, we found an increased frequency of M2-like tumor-associated macrophages (TAMs), which proportionally increased with tumor size during tumor progression. Transcriptomic profiling of ST-EPN-ZFTA and analysis of a human EPN dataset revealed multiple protein kinases as potential druggable targets. By matching transcriptomic signatures with the target spectrum of FDA-approved drugs, we found that the multikinase inhibitor dasatinib potently inhibited the growth of EPN both in vitro and in vivo, mainly through blocking EPHB2 and ABL1. Treatment with dasatinib reprogrammed the EPN immune microenvironment by polarizing TAMs toward an M1-like phenotype and increasing CD8 T cell activation. Furthermore, dasatinib treatment induced complete regression of established EPN tumors in 78% of the animals and protected survivors against tumor recurrence. Depletion of CD8 cells compromised the durability of EPN responses and reduced overall survival. These data indicate that dasatinib has the potential to be an effective therapy for ST-EPN-ZFTA molecular subgroup of EPN and support further investigation of dasatinib in clinical trials.
室管膜瘤(EPN)是儿童常见的一种脑肿瘤,通常对现有的细胞毒性疗法具有抗性。分子谱分析研究有助于更好地了解EPN亚型,并揭示了致癌基因ZFTA-RELA融合和EPHB2在幕上室管膜瘤(ST-EPN)中的关键作用。然而,免疫系统在肿瘤进展和对治疗的反应中的作用仍知之甚少。迫切需要针对EPN各种分子亚型的新疗法。利用ST-EPN-ZFTA亚型特异性同基因小鼠模型,我们发现M2样肿瘤相关巨噬细胞(TAM)的频率增加,在肿瘤进展过程中,其比例随肿瘤大小成比例增加。对ST-EPN-ZFTA的转录组分析和对人类EPN数据集的分析揭示了多种蛋白激酶是潜在的可成药靶点。通过将转录组特征与FDA批准药物的靶点谱进行匹配,我们发现多激酶抑制剂达沙替尼在体外和体内均能有效抑制EPN的生长,主要是通过阻断EPHB2和ABL1。达沙替尼治疗通过将TAM极化为M1样表型并增加CD8 T细胞活化,对EPN免疫微环境进行了重编程。此外,达沙替尼治疗使78%的动物体内已建立的EPN肿瘤完全消退,并保护幸存者免受肿瘤复发。CD8细胞耗竭损害了EPN反应的持久性并降低了总生存率。这些数据表明,达沙替尼有可能成为治疗EPN的ST-EPN-ZFTA分子亚组的有效疗法,并支持在临床试验中对达沙替尼进行进一步研究。
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