bluuebunny/crossref_metadata_2025_split huggingface dataset:
BIOM-23. DEUTERIUM METABOLIC IMAGING OF RESPONSE TO PRECISION THERAPY IN BRAF-V600E MUTANT GLIOMAS
Authors: Batsios Georgios , Udutha Suresh , Gillespie Anne Marie , Petritsch Claudia , Mueller Sabine , Viswanath Pavithra 
Published: November 2024

Abstract
Oncogenic BRAF-V600E mutations are frequently observed in low- and high-grade gliomas in adults and children. BRAF transduces signals from receptor tyrosine kinases to downstream effectors such as MEK1/2 and ERK, which regulate both metabolism and proliferation. The combination of the BRAF-V600E inhibitor dabrafenib and the MEK1/2 inhibitor trametinib (Dab/Tra) improves patient survival. However, there is considerable variation in the durability of response, underscoring the need for early biomarkers of treatment response. Magnetic resonance imaging (MRI), which is the gold standard for patient management, does not reliably assess response to therapy. Since the BRAF/MEK pathway regulates metabolism, the goal of this study was to determine whether Dab/Tra induces alterations in glucose metabolism that can be leveraged for non-invasive imaging. Using gene expression profiling, in vivo metabolomics, and stable isotope tracing, we show that Dab/Tra downregulates glucose metabolism to lactate in human and murine BRAF-V600E mutant models (AM38, 2341). In vivo infusion with [U-13C]-glucose in mice bearing intracranial AM38 tumors confirmed that Dab/Tra downregulates glucose metabolism to lactate in the tumor in vivo. Mechanistically, Dab/Tra destabilizes hypoxia inducible factor-1a and downregulates glycolytic genes, including SLC2A1, HK2, PFKFB3, and LDHA. Deuterium metabolic imaging (DMI) is a novel, clinical stage method of tracing glucose metabolism in vivo. Our studies show that lactate production from [6,6-2H]-glucose is reduced in AM38 and 2341 cells treated with Dab/Tra. Importantly, lactate production is reduced within 48 h of treatment with Dab/Tra in mice bearing intracranial AM38 tumors at the clinical magnetic field strength of 3T. Furthermore, this drop in 2H-lactate production is observed in the absence of MRI-detectable volumetric alterations and is predictive of extended survival. Collectively, our studies mechanistically link BRAF/MEK inhibition with downregulation of glycolysis and identify [6,6’-2H]-glucose as a novel contrast agent for imaging early response to therapy. Clinical translation of our studies will enable precision imaging of response to therapy for patients with BRAF-mutant gliomas.
BIOM-34. INTRACRANIAL MANAGEMENT OF HER-2 OVEREXPRESSION BREAST CANCER WITH EXTENSIVE VOLUME OR SYMPTOMATIC BRAIN METASTASES
Authors: Li Juan , Zhen Junjie , Ai Ruyu , Lai Mingyao , Wang Hui , Cai Linbo 
Published: November 2024

Abstract

BACKGROUND
HER-2 overexpression in breast cancer often leads to brain metastases, necessitating effective intracranial control strategies. This study aimed to evaluate the correlation between intracranial disease volume, symptomatic presentation, and treatment outcomes in HER-2 overexpressing breast cancer patients with brain metastases.

METHODS
A retrospective analysis was conducted on cases of HER-2 overexpressing breast cancer patients with brain metastases. Clinical records were reviewed to extract patient demographics, treatment modalities, and intracranial disease characteristics. Intracranial tumor burden was quantified at diagnosis and post-initial treatment. High intracranial tumor burden was defined as either total metastatic volume &gt;15 cc, or the largest lesion &gt;3 cm. Responses were assessed using established criteria. The correlation between intracranial disease parameters and intracranial progression-free survival (PFS) and overall survival (OS) was determined.

RESULTS
The study comprised 65 patients with HER-2 overexpression breast cancer and brain metastases. Symptomatic presentation was observed in 69.2% of patients at the diagnosis of brain metastases. Treatment with HER-2 target therapy alone or in combination with other modalities resulted in substantial intracranial responses, with 81.5% achieving at least a partial response at 3 months from therapy initiation. Median intracranial PFS and OS for patients with high intracranial burden were 9 and 22 months, respectively. Patients with high intracranial burden and symptomatic presentation at diagnosis demonstrated worse PFS and OS to those with lower burden and absence of symptoms (p &lt; 0.05 for each).

CONCLUSION
Intracranial control in HER-2 overexpressing breast cancer patients with large volume or symptomatic brain metastases appears promising with combination with HER-2 targeted therapy and radiotherapy. Despite the varying intracranial disease burdens and symptomatic presentations, the use of HER-2 targeted therapy combined with radiotherapy demonstrates favorable intracranial responses, highlighting their potential in managing such cases.
BIOM-37. EXPLORING L-TYPE AMINO ACID TRANSPORTER 1 (LAT1) AS A DIAGNOSTIC MARKER AND THERAPEUTIC TARGET IN MALIGNANT PERIPHERAL NERVE SHEATH TUMORS (MPNST)
Authors: Wang Guangfeng , Borcherding Dana , Zhang Xiaochun , He Kevin , Fettig Nikki , Shoghi Kooresh , Hirbe Angela 
Published: November 2024

Abstract

OBJECTIVES
Malignant peripheral nerve sheath tumors (MPNST) are aggressive soft tissue sarcomas that frequently arise from benign plexiform neurofibromas (PN). Approximately half of MPNST are associated with Neurofibromatosis type 1 (NF1). Despite partial elucidation of the molecular mechanisms underlying MPNST, diagnosis remains challenging, and prognosis is poor. Previously, we found that MPNST cells have elevated βIII-spectrin, a cytoskeletal protein involved in cell morphology and regulation of transporters, including L-type Amino Acid Transporter 1 (LAT1). LAT1 facilitates transport of large neutral amino acids and is upregulated in other cancer types. Our objective is to investigate LAT1 as a diagnostic marker and therapeutic target for MPNST.

METHODS
Gene and protein expression were determined by qPCR and WES protein analysis, respectively. The effect of shRNA knockdown of LAT1 in MPNST cells was assessed using IncuCyte proliferation assays as well as multiple mouse models. Tumor uptake of [18F] FDOPA, primarily transported by LAT1, in MPNST PDX tumors was assessed using PET/CT imaging.

RESULTS
LAT1 was expressed in MPNST (n=14) vs. benign PN tissues (n=6). Additionally, in human and murine MPNST cells, shRNA-mediated knockdown of LAT1 suppressed proliferation of MPNST cells in vitro and tumor growth in vivo. In a subcutaneous tumor growth model, intratumor injection of shLAT1 lentivirus reduced tumor volume to approximately 50% of control. Furthermore, uptake of [18F] FDOPA by LAT1 in MPNST PDX tumors was detected by PET/CT imaging. WU-356 PDX tissues exhibited higher LAT1 expression as well as increased uptake of [18F] FDOPA in tumors. Conversely, PET imaging showed significantly lower uptake of [18F] FDOPA in LAT1 knockdown tumors (p&lt;0.05).

CONCLUSIONS
These results suggest that LAT1 promotes the growth and survival of MPNST cells. In addition, these findings demonstrate the potential use of LAT1 and the radiotracer [18F] FDOPA as a diagnostic biomarker in the management of MPNST.
BIOM-41. HMGB2 IS A CANDIDATE PROGNOSTIC BIOMARKER IN BOTH ADULT AND PEDIATRIC DIFFUSE GLIOMAS
Authors: Becker Aline , Becker Valesio , Sirhan Zaid , McElroy Joseph , Haque S Jaharul , Chakravarti Arnab 
Published: November 2024

Abstract

Few prognostic molecular markers are common to pediatric- and adult diffuse gliomas (PDG and ADG). HMGB2 is a protein expressed in human brain development and in de-differentiated high-grade gliomas (HGG), which we have recently described as a putative prognostic and predictive biomarker in ADG, associated with proliferative activity and EIF2 signaling pathway upregulation. Additionally, we showed that HMGB2 shRNA knockdown (HMGB2-KD) reduced cell proliferation and colony formation, and radio-sensitized ADG cell lines. Aims: To assess the prognostic potential of HMGB2 in PDG and its association with stemness.

METHODS
1) We singled out HMGB2 from proteomic profiles of an independent PDG cohort previously associated with EIF2 and MYCN signaling upregulation for survival analysis. 2) PDG cells SF188 were de-differentiated with substitution of DMEM by a neurobasal (NB) medium devoid of serum for stemness association studies. 3) We generated HMGB2-KD clones of PDG cell lines SF188 (grown in DMEM and NB) and KNS42 with 3 different shRNAs.

RESULTS
HMGB2 expression was significantly related to histological grade in PDG (grade 3 vs. grade 2 and grade 4 vs. grade 2: fold change= 8.16 and 9.39; p=0.0045 and &lt;0.001; FDR= 0.04 and 0.0006, respectively) and survival (p=0.004, FDR=0.142 for PFS and p=0.03, FDR=0.291 for OS), in a Cox model including age and grade as covariables. Compared with cells growing in DMEM, SF188 cells growing in NB medium had a morphological change from stellate cells to round cells growing in spheres, with 2-fold increase in C-MYC and HMGB2 expression by Western analysis. HMGB2-KD resulted in &gt;90% reduction of HMGB2 expression in SF188 and &gt;70% in KNS42.

CONCLUSION
Collectively, our preliminary results suggest that HMGB2 is associated with stemness, has similar roles in PDG and ADG, and may be validated as prognostic/predictive biomarker in both adult and pediatric populations. Mechanistic studies of radiation response are underway.
BIOM-62. CIRCULATING TUMOR CELLS IN MEDULLOBLASTOMA: A NOVEL PERIPHERAL BIOMARKER FOR CNS DISEASE
Authors: Ozkaya Tevhide , Chien Franklin , Boya Mert , Gray Rachel , Arthur Robert , Claussen Henry , Velazquez Vega Jose Velazquez-Vega , Schneiderjan Matthew , Bhasin Manoj , Sarioglu Fatih , MacDonald Tobey 
Published: November 2024

Abstract

BACKGROUND
Medulloblastoma is an embryonal tumor of the cerebellum and the most common pediatric malignancy of the central nervous system (CNS). Diagnosis, staging, and disease monitoring require invasive neurosurgical biopsy or MRI. No blood or cerebrospinal fluid (CSF) biomarkers exist. We demonstrate the presence of circulating tumor cell clusters (CTCCs) in patients with medulloblastoma and use a transcriptomic approach to describe their gene expression. Design/Method: We enrolled 34 total patients in a longitudinal study: 24 with medulloblastoma and 10 without malignancy. CTCCs are captured from unprocessed whole blood using a physics-based label-free approach to CTCC isolation. RNA sequencing was performed on 21 samples at time of diagnostic resection from 6 patients with medulloblastoma. Sequencing reads were assessed for quality control, trimmed, and aligned to the human genome. Differential gene expression (DGE) was performed against whole blood from healthy controls. Reactome pathway database of curated, peer-reviewed gene sets are used for gene set enrichment analysis (GSEA).

RESULTS
The presence of peripherally CTCC patients with medulloblastoma is not previously known and was detected in all patients with medulloblastoma whereas none were observed from patients with non-malignant hematological conditions. RNA-sequencing demonstrate separation on principal component analysis and gene-expression heatmap against whole blood healthy control. DGE shows upregulation of genes indicating stem-like state. GSEA show enrichment of medulloblastoma molecular pathways and gene sets defining integrin, extracellular matrix remodeling, and cell adhesion pathways. Transient elevation of peripheral CTCC followed by return to baseline levels was associated with durable disease response to therapy, whereas persistence or elevation of CTCC in CSF correlated with disease recurrence.

CONCLUSION
The universal and specific finding of peripherally captured CTCC arising from parent tumor in the CNS within our patient cohort suggests a utility as a tumor biomarker. Future sequencing is planned comparing CTCC transcriptome against parent tumor.
BIOM-63. LONG-TERM SURVIVAL AND MOLECULAR CHARACTERIZATION OF IDH-WILDTYPE GLIOBLASTOMA IN AN ASIAN COHORT
Authors: Lee Wing Lun , Ko Elaine Yee-Ling , Lecoultre Marc , Ho Isaac , Chiu Matthew Kin-liang , Chiang Chi-Leung , Leung Dennis , Leung Gilberto Ka-Kit , Chow Joyce Shuk-wan , Woo Peter Yat Ming , Lam Tai Chung , Aya El Helali 
Published: November 2024

Abstract

BACKGROUND
Glioblastoma (GB), the most aggressive form of brain tumor, presents a significant clinical challenge with a devastating prognosis. Globally, the median overall survival (OS) for GB is typically 12-15 months, largely due to its inherent resistance to chemotherapy and radiotherapy. However, some patients exhibit prolonged survival, and their specific demographic and genomic characteristics remain poorly defined. Understanding the clinical profile of these exceptional responders holds great promise for informing improved management strategies for GB.

METHODS
In a retrospective two-center study conducted in Hong Kong (IRB: UW 21-189), we recruited 80 patients diagnosed with IDH wildtype glioblastoma. All patients underwent next-generation sequencing as part of their treatment. Long-term survivor (LTS) was defined as &gt;=36 months from diagnosis, while medium-term survivor (MTS) was defined as &gt;=18 months, and &lt;18 months as short-term survivors (STS). When appropriate, descriptive statistics were used to report frequency with percentage or median with range. Fisher’s exact test was employed to analyze categorical variables, while continuous variables were assessed using the Kruskal-Wallis test. All statistical analyses were conducted using R (version 4.2.3). Result: Among the cohort of 80 recruited patients, the median survival was 18.8 months (95% CI 17.2-24.8). Notably, 21% (n=17) were LTS, 31% (n=25) were MTS, and 48% (n=38) were STS. A statistically significant variation (p &lt; 0.05) was evident across three groups: gender distribution, the number of resections performed, the proportion of patients receiving genomic-guided treatment, and their participation in clinical trials. However, no significant difference was observed in MGMT promoter status and ECOG score.

CONCLUSION
Identifying these clinical factors enhances the clinical management of GB. The implications of these findings underscore the potential importance of incorporating genomic-guided treatment in both local and global clinical practices in GB.
BIOM-64. EXPLOITING CELL-FREE DNA TO DISSECT MECHANISMS OF RESISTANCE TO TEMOZOLOMIDE IN GLIOBLASTOMA CELLS
Authors: Mankame Sharvari , Kyriakidou Maria , Tang Nanyun , Reid George , Berens Micheal , Barthel Floris P 
Published: November 2024

Abstract
Temozolomide (TMZ) is a cytotoxic alkylating agent that serves as a cornerstone in glioblastoma (GBM) treatment, yet is notorious for eliciting hypermutation in recurrent tumors that have developed drug resistance by downregulating mismatch repair (MMR). We reasoned that cell-free DNA (cfDNA), a non-invasive measure for detecting tumor-derived biomarkers, could be used to temporally examine the mechanism of resistance to TMZ. We therefore designed an in-vitro experiment using the patient-derived GBM43 cell line. Over five days, batches of cells were treated with either TMZ or vehicle. Cell counts and cfDNA were collected every 24 hours. We observed an associated increase in both dead cell counts and cfDNA yield in treated cells compared to untreated cells. In TMZ-treated samples, cfDNA showed a periodic fragmentation pattern consistent with internucleosomal cleavage and TMZ-induced apoptosis. Intriguingly, higher numbers of variants were found in the cfDNA of untreated samples when compared to treated cfDNA, possibly reflecting TMZ-induced selection of resistant subclones in treated samples. This was further supported by the finding that the average variant allele frequency (VAF) increased over time in TMZ-treated samples, consistent with purifying selection. Conversely, cfDNA from vehicle-treated samples demonstrated a decrease in the average VAF over time, consistent with clonal diversification. Although we did not observe an enrichment of the TMZ-associated mutational signature SBS11, we did find higher levels of defective MMR mutation signature SBS44 in treated samples, potentially indicating the selection of subclones with defective MMR mechanisms. Overall, our preliminary findings show that cfDNA can be used to resolve mechanisms of TMZ resistance over time. We are addressing open questions by performing longer treatment times, testing other patient-derived cell lines, and performing murine xenotransplantation experiments to test TMZ-associated hypermutation in vivo. Our work will contribute to our understanding of TMZ resistance, and importantly push the development of cfDNA-based biomarkers for measuring TMZ-sensitivity in patients.
BIOM-65. ELEVATED MMP9 EXPRESSION IN ADHERENT AND LARGE VESTIBULAR SCHWANNOMAS: A PROMISING THERAPEUTIC TARGET
Authors: Nguyen Han T N , Duhon Bailey H , Kuo Hsuan-Chih , Fisher Melanie , Brickey Olivia M , Zhang Lisa , Otero Jose J , Prevedello Daniel M , Adunka Oliver F , Ren Yin 
Published: November 2024

Abstract

Vestibular schwannoma (VS) is the most common tumor of the cerebellopontine angle affecting up to 1 in 2000 adults and presents significant treatment challenges, especially when the tumor is adherent to the brainstem and cranial nerves. These tumors often require complex surgeries with high risks of complications such as hearing loss, facial paralysis, and incomplete tumor resection. Previous studies have linked immune cell infiltration and protease activation to aggressive VS. MMP9, a protease involved in extracellular matrix (ECM) remodeling, is associated with cancer invasion and progression, suggesting its potential as a biomarker and therapeutic target. This study explores whether MMP9 can classify VS and improve surgical outcomes.

METHODS
Fresh tumors were collected from patients undergoing surgery to establish primary VS cultures. Transcriptomic profiling was performed to examine expression of genes related to ECM remodeling, protease activation, and immune cell infiltration. MMP9 expression during schwannoma progression was validated using immunofluorescence staining and ELISA. Transwell invasion assays were performed to evaluate the role of MMP9 in schwannoma invasion. The efficacy of small molecule inhibitors against eIF4F (a transcription factor that binds to 5’ UTR of MMP9) and against MMP9 was tested in a mouse model of schwannoma.

RESULTS
MMP9 was the most abundantly expressed protease in VS. MMP9 expression increased with tumor size, and was higher in adherent than non-adherent VS (49.7 vs. 13.8 ng/mL, p=0.014). MMP9 expression was abundant in perivascular regions in adherent VS. Inhibition of eIF4F reduced schwannoma cell invasion mediated by MMP9.MMP9 inhibition in vivo- reduced tumor burden by 50% in mice.

CONCLUSIONS
MMP9 is a highly active protease in VS growth and adherent VS. Developing MMP9-targeted therapies could be a breakthrough in managing these challenging tumors.
BIOM-72. INTEGRATION OF ULTRASENSITIVE ELECTROLUMINESCENT IMMUNOASSAY AND CELL-FREE DNAMETHYLATION ANALYSIS FOR NON-INVASIVE MONITORING OF ADULT DIFFUSE GLIOMAS
Authors: Ajisebutu Andrew , Chatanaka Miyo , Patil Vikas , Prassas Ioannis , Eleftherios Diamandis , Zadeh Gelareh 
Published: November 2024

Abstract
Gliomas are highly aggressive brain tumors with nearly universal recurrence rate. Despite this, the ability to accurately predict and identify tumor recurrence relies solely on serial MRI imaging, which is marred by treatment effects such as radiation necrosis, and necessarily identifies progression retrospectively. It is believe that tumor undergo molecular changes upon tumor progression, however the resampling of tumors upon recurrence imposes significant risks. This highlights the need for novel non-invasive biomarkers capable of identifying tumor recurrence. Due to the low accuracies of individual biomarkers, we have proposed the use of an integrated, multi-platform approach to biomarker discovery. A cohort of 107 glioma plasma samples, including 30 pairs, underwent plasma proteomic analysis, consisting of a panel of serum proteins (FABP4, GFAP, NFL, Tau and MMP3,4 &7) quantified through ultrasensitive electrochemiluminescence multiplexed immunoassays, and plasma DNA methylation analysis, captured through cell-free methylated DNA immunoprecipitation and high-throughput sequencing. Unsupervised hierarchal clustering revealed robust separation of primary and recurrent tumors through plasma proteomics, associated with a distinct plasma methylation signature. NFL, Tau and MMP3 levels differed between primary and recurrent samples; pair-wise analysis revealed increased in NFL and Tau concentrations upon recurrence. Tau levels predicted outcome independent of WHO Grade and IDH status. A predictive generalized linear regression model created through the integration of the proteomic and methylation signatures allowed for the discrimination of primary and recurrent samples in 83% of cases. This work suggests that the combination of DNA methylation and plasma proteomics may improve the ability of these techniques for the serial monitoring of gliomas patients.
BIOM-74. IDENTIFICATION OF EMP2 AS A TARGETABLE BIOMARKER IN GLIOBLASTOMA TUMORS RESISTANT TO ANTI-ANGIOGENIC THERAPIES
Authors: Mekonnen Mahlet , Aguirre Brian , Mehta Riddhi , Chandla Anubhav , Wadehra Madhuri , Yang Isaac 
Published: November 2024

Abstract

BACKGROUND
The role of Epithelial Membrane Protein-2 (EMP2) in mediating resistance to current anti-angiogenic drugs in the treatment of glioblastoma (GBM) is an intriguing hypothesis that may provide insights into improving the limited survival benefits observed in current therapies. Investigating the interaction between EMP2 and anti-angiogenic drugs such as bevacizumab or Aflibercept could lead to a better understanding of the mechanisms underlying resistance, potentially opening up new avenues for more effective treatment strategies.

OBJECTIVE
To use EMP2 as a targetable biomarker for anti-VEGF resistance and test combination therapy with anti-VEGF (Aflibercept or bevacizumab), and a novel anti-EMP2 mAb in SB28 and GL261 GBM mouse models.

METHODS
Tumor tissue was collected prospectively from patients undergoing surgery for suspected glioblastoma and stained for EMP2 and HIF-2a using standard immunohistochemistry. Patients had banked tumor tissue both before and after bevacizumab treatment with 3 months of clinical and radiologic follow-up available. To establish syngeneic models, 10-week-old mice were subcutaneously implanted with murine SB28 or GL261 GBM cells.

RESULTS
Immunohistochemistry conducted on pre- and post-bevacizumab-treated patient samples revealed an increase in EMP2 and HIF-2a protein expression post-treatment. This increase in EMP2 expression correlated with reduced survival time. Similarly, the in vivo models showed a significant upregulation in both markers in the Aflibercept-treated cohort compared to the control. Treatment with either polyclonal sera to VEGF or Aflibercept failed to reduce tumor load or provide a therapeutic benefit. However, combination therapy with Aflibercept and anti-EMP2 mAb was found to significantly reduce tumor volume and weight in both SB28 and GL261 tumors. These findings highlight the potential effectiveness of combination therapies targeting EMP2 and VEGF in reducing tumor load in GBM.

CONCLUSION
Our results suggest that EMP2 can be a promising new therapeutic target that can be combined with anti-VEGF treatment to potentially increase overall survival in GBM patients.