1. Everolimus improves the efficacy of dasatinib in PDGFR[alpha]-driven glioma
- Author
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Miklja, Zachary, Yadav, Viveka Nand, Cartaxo, Rodrigo T., Siada, Ruby, Thomas, Chase C., Cummings, Jessica R., Mullan, Brendan, Stallard, Stefanie, Paul, Alyssa, Bruzek, Amy K., Wierzbicki, Kyle, Yang, Tao, Garcia, Taylor, Wolfe, Ian, Leonard, Marcia, Robertson, Patricia L., Garton, Hugh J.L., Wahl, Daniel R., Parmar, Hemant, Sarkaria, Jann N., Kline, Cassie, Mueller, Sabine, Nicolaides, Theodore, Glasser, Chana, Leary, Sarah E.S., Venneti, Sriram, Kumar-Sinha, Chandan, Chinnaiyan, Arul M., Mody, Rajen, Pai, Manjunath P., Phoenix, Timothy N., Marini, Bernard L., and Koschmann, Carl
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Gliomas -- Drug therapy ,Tumor proteins -- Drug therapy ,Child health ,Lenvatinib ,Antineoplastic agents ,Health care industry - Abstract
Pediatric and adult high-grade gliomas (HGGs) frequently harbor PDGFR[alpha] alterations. We hypothesized that cotreatment with everolimus may improve the efficacy of dasatinib in PDGFR[alpha]-driven glioma through combinatorial synergism and increased tumor accumulation of dasatinib. We performed dose-response, synergism, P-glycoprotein inhibition, and pharmacokinetic studies in in vitro and in vivo human and mouse models of HGG. Six patients with recurrent PDGFR[alpha]-driven glioma were treated with dasatinib and everolimus. We found that dasatinib effectively inhibited the proliferation of mouse and human primary HGG cells with a variety of PDGFR[alpha] alterations. Dasatinib exhibited synergy with everolimus in the treatment of HGG cells at low nanomolar concentrations of both agents, with a reduction in mTOR signaling that persisted after dasatinib treatment alone. Prolonged exposure to everolimus significantly improved the CNS retention of dasatinib and extended the survival of PPK tumor-bearing mice (mutant TP53, mutant PDGFR[alpha], H3K27M). Six pediatric patients with glioma tolerated this combination without significant adverse events, and 4 patients with recurrent disease (n = 4) had a median overall survival of 8.5 months. Our results show that the efficacy of dasatinib treatment of PDGFR[alpha]-driven HGG was enhanced with everolimus and suggest a promising route for improving targeted therapy for this patient population., Introduction High-grade gliomas (HGGs) are common and aggressive pediatric and adult brain tumors. The median overall survival (OS) of adult patients diagnosed with glioblastoma (GBM), grade IV glioma, is 12.6 [...]
- Published
- 2020
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