title: MR Studies of Glioblastoma Models Treated with Dual PI3K/mTOR Inhibitor and Temozolomide:Metabolic Changes Are Associated with Enhanced Survival.
abstract: The current standard of care for glioblastoma (GBM) is surgical resection, radiotherapy, and treatment with temozolomide (TMZ). However, resistance to current therapies and recurrence are common. To improve survival, agents that target the PI3K signaling pathway, which is activated in approximately 88% of GBM, are currently in clinical trials. A challenge with such therapies is that tumor shrinkage is not always observed. New imaging methods are therefore needed to monitor response to therapy and predict survival. The goal of this study was to determine whether hyperpolarized (13)C magnetic resonance spectroscopic imaging (MRSI) and (1)H magnetic resonance spectroscopy (MRS) can be used to monitor response to the second-generation dual PI3K/mTOR inhibitor voxtalisib (XL765, SAR245409), alone or in combination with TMZ. We investigated GS-2 and U87-MG GBM orthotopic tumors in mice, and used MRI, hyperpolarized (13)C MRSI, and (1)H MRS to monitor the effects of treatment. In our study, (1)H MRS could not predict tumor response to therapy. However, in both our models, we observed a significantly lower hyperpolarized lactate-to-pyruvate ratio in animals treated with voxtalisib, TMZ, or combination therapy, when compared with controls. This metabolic alteration was observed prior to MRI-detectable changes in tumor size, was consistent with drug action, and was associated with enhanced animal survival. Our findings confirm the potential translational value of the hyperpolarized lactate-to-pyruvate ratio as a biomarker for noninvasively assessing the effects of emerging therapies for patients with GBM. Mol Cancer Ther; 15(5); 1113-22. ©2016 AACR.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
authors.forename: Marina
authors.initials: M
authors.lastname: Radoul
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
authors.forename: Myriam M
authors.initials: MM
authors.lastname: Chaumeil
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
authors.forename: Pia
authors.initials: P
authors.lastname: Eriksson
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Wang
authors.affiliation: Brain Tumor Research Center, University of California San Francisco, San Francisco, California. Neuropathology Division, Department of Pathology, UCSF School of Medicine, UCSF Medical Center, San Francisco, California.
authors.forename: Joanna J
authors.initials: JJ
authors.lastname: Phillips
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California. Brain Tumor Research Center, University of California San Francisco, San Francisco, California. sabrina.ronen@ucsf.edu.
authors.forename: Sabrina M
authors.initials: SM
authors.lastname: Ronen
mesh_terms: D000818:Animals; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality*; D045744:Cell Line, Tumor; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000494:pharmacology; D004195:Disease Models, Animal; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D051379:Mice; D019869:Phosphatidylinositol 3-Kinases / Q000378:metabolism; D000081082:Phosphoinositide-3 Kinase Inhibitors; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000494:pharmacology*; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors* / Q000378:metabolism; D000077204:Temozolomide; D023041:Xenograft Model Antitumor Assays
chemical_list: D003606:Dacarbazine; D019869:Phosphatidylinositol 3-Kinases; D000081082:Phosphoinositide-3 Kinase Inhibitors; D047428:Protein Kinase Inhibitors; D058570:TOR Serine-Threonine Kinases; D000077204:Temozolomide