bluuebunny/crossref_metadata_2025_split huggingface dataset:
BIOM-13. ASSOCIATION OF HAND-FOOT SKIN REACTIONS WITH SURVIVAL IN RECURRENT GLIOBLASTOMA PATIENTS TREATED WITH REGORAFENIB
Authors: Werner Jan-Michael , Hau Peter , Kowalski Thomas , Treiber Hannes , Roth Patrick , Wollring Michael , Stetter Isabelle , Tscherpel Caroline , Rosen Elena , Ceccon Garry , Chapuy Claudia , Schlegel Uwe , Weller Michael , Fink Gereon , Galldiks Norbert 
Published: November 2023

Abstract

INTRODUCTION
The phase 2 REGOMA trial suggested a survival benefit of the multikinase inhibitor regorafenib for treating patients with glioblastoma at first recurrence. Hand-foot skin reactions (HFSR) following multikinase inhibitor therapy have been reported to predict prolonged overall survival (OS) in patients with solid tumors. The predictive value of HFSR in patients with recurrent glioblastoma undergoing regorafenib therapy remains to be investigated.

METHODS
Fifty-seven patients (age range, 35-77 years) with recurrent IDH-wildtype glioblastomas were retrospectively identified from five centers in Germany and Switzerland. Regorafenib was administered at 160 mg/d for the first three weeks of each 4-week cycle, with individual dose adjustments according to toxicity. Patients were stratified into two groups based on the occurrence of HFSR following regorafenib. Group differences were investigated using the Mann-Whitney rank-sum and Fisher's exact tests. Kaplan-Meier analysis was used for univariate analyses, and the Cox proportional hazards regression model for multivariate analyses.

RESULTS
Patients received a median of two regorafenib cycles (range, 1-14 cycles). Median follow-up after recurrence was 7.0 months (range, 0.6-35.9 months). The median number of previous treatment lines was 2 (range, 1-6 lines). At the time of data analysis, 47 patients (82%) had died. HFSR were observed in 14 out of 57 patients (25%) and associated with a significantly longer OS (10.6 vs. 6.0 months; P = 0.040). No significant group differences (HFSR compared to no HFSR) were observed regarding age, the extent of resection, MGMT promoter methylation, Karnofsky performance status, or the number of completed regorafenib cycles (all P &gt; 0.05). Cox proportional hazards regression analysis confirmed that HFSR were associated with longer OS (P = 0.039; HR, 0.438), independent of age, Karnofsky performance status, and the number of previous treatment lines (all P &gt; 0.05).

CONCLUSION
Our data suggest that the occurrence of HFSR following regorafenib is associated with longer OS in recurrent glioblastoma patients.
BIOM-16. LONGITUDINAL GLIOMA CEREBROSPINAL FLUID CELL-FREE DNA FOR MONITORING AND TREATMENT RESPONSE ASSESSMENT
Authors: Riviere-Cazaux Cecile , Dong Xiaoxi , Mo Wei , Luo Shujun , Wang Amy , Du Pan , Ghadimi Keyvan , Warrington Arthur , Burns Terry 
Published: November 2023

Abstract
Few methods exist via which to assess treatment response with high fidelity in gliomas. While CSF has previously been used as a source of cfDNA, it remains unknown how cfDNA abundance and sequencing changes throughout treatment and inevitable recurrence in gliomas. We utilized our biobank of longitudinal intracranial CSF specimens to determine the potential utility of CSF cfDNA as a monitoring tool for treatment response in patients with gliomas. Longitudinal CSF specimens were acquired via Ommaya reservoirs (NCT04692337) or ventriculoperitoneal shunts (NCT04692324) in patients with gliomas. cfDNA was extracted from 1-5 mL of CSF, and next-Generation sequencing or low-pass whole genome sequencing (LPWGS) was performed by Predicine, Inc. CSF acquired prior to versus after resection demonstrated an increase in quantified cfDNA (2.97x, range: 1.58-5.26x), consistent with the impact of increased parenchymal disruption and closer contact with CSF. Thereafter, CSF cfDNA continued to decrease throughout chemoradiation and adjuvant treatment and increased at recurrence, including in patients co-enrolled in immunotherapy trials for IL-7 agonists and pembrolizumab. Copy number burden (CNB) increased by the time of recurrence in three patients with known disease progression, and continued to decrease throughout immunotherapy treatment in one patient despite concerns of pseudoprogression. In one patient with a hypermutated glioblastoma, CSF cfDNA revealed over 59 genomic alterations, including MAP2K1, KIT, and PDGFRA, excluding even more variants of unknown significance, each of which had been detected in sequencing of the tissue acquired at resection and subsequently decreased with chemoradiation. In another patient with a known progressing EGFR-amplified GBM, over 200 new variants were identified by the patient’s final sample and EGFR copy number increased from 2 to over 30. In conclusion, cfDNA analysis over a patient’s disease course, including resection and treatment with standard-of-care and experimental therapies, may be of use for disease monitoring and treatment response.
BIOM-28. PROGNOSTIC BIOMARKERS IN GLIOBLASTOMA PATIENTS TREATED WITH TEMOZOLOMIDE
Authors: Zhang Shuodan , Mcmillan Nadia , McGuinness Matthew , Trudeau Stephen , Uhlmann Erik 
Published: November 2023

Abstract

OBJECTIVE
Identifying blood biomarkers that predict favorable outcomes for patients with glioblastoma treated with temozolomide (TMZ).

BACKGROUND
Glioblastoma is the most aggressive primary brain tumor. The standard of care is maximum safe resection, then radiation plus oral TMZ, followed by six months of cyclic oral TMZ. Previous studies have revealed that TMZ-induced myelosuppression is associated with improved overall survival.

METHODS
Adults with glioblastoma who completed radiation therapy and received temozolomide for at least 6-months at Beth Israel Deaconess Medical Center between 2018-2021 were identified. Baseline and nadir white blood cell count, absolute neutrophil count, absolute lymphocyte count, red blood cells, and platelets were collected retrospectively. Additionally, IDH1 R132H, MGMT promoter methylation, progression free survival (PFS), and overall survival (OS) were also collected retrospectively. Data was combined with that of Vaios et al. and Ho et al. Kaplan-Meier analysis and multivariate testing were performed.

RESULTS
Leukopenia is associated with increased overall survival (p = 0.008) and progression free status (p = 0.02). Grade 3 thrombocytopenia is associated with decreased PFS (p = 0.0005) and OS (p = 0.0006). Grade 1 & 2 lymphopenia is associated with increased progression free survival (p = 0.01 and p = 0.03). Lower baseline absolute lymphocyte count is associated with improved OS (p = 0.007). Higher baseline absolute neutrophil count is associated with worse OS (p = 0.002).

CONCLUSION
Cytopenia may serve as a prognostic biomarker for OS and PFS. Leukopenia may reflect adequate temozolomide dosing, anti-tumor activity, or changes in the tumor micro-environment. Peripheral biomarker monitoring may improve prognostic stratification and lead to personalized treatment with improved outcomes.
BIOM-30. CELL LINE STUDY OF NUCLEOSOME-BASED BIOMARKERS IN THE DIAGNOSIS AND DETECTION OF RELAPSES IN GLIOBLASTOMA
Authors: Decarpentrie Jonathan , Van den Ackerveken Priscilla , Govaerts Adrien , Lobbens Alison , Beine Edeline , Donis Nathalie , Herzog Marielle , Douxfils Jonathan 
Published: November 2023

Abstract
Currently, glioblastoma (GBM) diagnosis and monitoring rely on neuroimaging and histopathological confirmation. However, overall survival has not improved in last decades due to therapeutic failure and to a lack of biomarkers for relapses’ detection. Liquid biopsies (i.e. blood or CSF) using nucleosomes-containing-histone post-translational modifications (PTMs) have the potential to become valuable biomarkers for diagnosis and monitoring GBM. Four glioblastoma cell lines (SF-126, U-87MG, U-118MG, and U-138MG) compared to a healthy microglia cell line (HMC3) and other solid cancer cell lines including pancreas (MIA-PaCa-2), liver (HepG2), and cervix/uterus (HeLa) have been analyzed to identify their epigenetic profile. Nucleosomes were extracted and analyzed with the Nu.Q® Discover immunoassays platform addressing 13 histone-PTMs. Quantitative results of PTMs expression were normalized on quantification of total H3.1-nucleosomes. The immunoassay identified three candidate biomarkers compared to control cell lines (n = 4): citrullinated-histone-H3 (H3R8Cit) (control = 4.68%; GBM = 13.88%; p&lt; 0.05), phosphorylation of H3S10 (H3S10Ph) (control = 2.31%; GBM = 5.57%; p&lt; 0.05), and a trend in H3K4Me2 elevation (control = 0.43%; GBM = 1.07%; p = 0.066) in GBM cell lines (n = 4). These results were confirmed by western blot. Moreover, principal component analysis revealed a segregation between GBM and control cells, mainly driven by these three PTMs. Moreover, to demonstrate the capacity of the Nu.Q® assays to quantitatively monitor PTMs, GBM cell line SF-126 (n = 3) was treated with an EZH2 inhibitor (responsible of H3K27 methylation) (iEZH2). After 24 hours and 48 hours of exposure, the expression level of H3K27Me3 –expressed as ratio of total nucleosomes– was decreased by 32% (control = 14.67%±0.58%; iEZH2= 10.00%±1.73%; p&lt; 0.05) and 41% (control = 15.33%±1.53%; iEZH2= 9.00%±0.00%; p&lt; 0.05), respectively. Those results were also confirmed by western blot analysis. In conclusion, we identified three specific in vitro epigenetic-based marks of GBM and demonstrated that the Nu.Q® technology is a valuable tool to monitor the degree of PTMs expression.
BIOM-32. EVS CARRYING TENASCIN-C ENABLE TUMOR-SPECIFIC MUTATION ANALYSIS IN GLIOBLASTOMA PATIENTS
Authors: Salviano-Silva Amanda , Maire Cecile , Wollmann Kathrin , Reimer Rudolph , Neumann Julia , Dottermusch Matthias , Schüller Ulrich , Gempt Jens , Heiland Dieter Henrik , Westphal Manfred , Lamszus Katrin , Ricklefs Franz L 
Published: November 2023

Abstract
Extracellular vesicles (EVs) transport biological and specific information from tumors into the bloodstream, enabling non-invasive detection of tumor material and disease monitoring. Based on a proteomics screen, we performed immunophenotyping of eight glioma-related antigens (tenascin-C (TNC), integrin-beta 1 (ITGB1), profilin-1 (PFN1), CD44, CD133, GPNMB, HLA-II, SPARC) and tetraspanins (CD9, CD63 and CD81) in plasma EVs from GBM patients (before and after surgery (n = 38)), from matched GBM relapse patients (n = 11), and from healthy donors (HD, n = 12) using imaging flow cytometry. Double-positive TNC+/CD9+ EVs showed the strongest differences per mL of plasma in primary (FC = 7.6, p&lt; .0001, ROC analysis AUC = 81%) and relapsed GBM (FC = 16.5, p&lt; .0001; AUC = 90%) compared to HD subjects. High TNC signals were also observed in GBM-EVs by immunogold electron microscopy compared to HD-EVs. In paired analysis, TNC+/CD9+ EVs showed a 3.9-fold decrease after tumor removal (p&lt; .001) and re-increased at GBM recurrence in these patients (FC = 8.4, p&lt; .05; AUC = 84%). In tissue samples, TNC levels were 5.4-fold higher in GBM patients than in non-neoplastic cortex controls (p&lt; .01) measured by immunohistochemistry and correlated positively with plasma TNC+/CD9+ EV levels in RTK-I/II GBM patients (r = 0.42, p&lt; .05). Accordingly, spatial transcriptomics of GBM tissue sections revealed that TNC is specifically overexpressed in GBM cells. Furthermore, magnetic sorting of TNC in plasma EVs allowed detection of GBM-specific TERT*C228T mutations by digital droplet PCR. Mutated TERT DNA was enriched in TNC+ EVs (n = 13) compared to TNC- EVs (FC = 110, p&lt; 0.0001), total EV DNA (FC = 36.7, p&lt; 0.01), and cfDNA (FC = 7.2, p &lt; 0.05). In conclusion, we identified TNC as a biomarker in circulating EVs from GBM patients that can be isolated and used for tumor-specific mutation analysis.
BIOM-34. NON-NEOPLASTIC PLASMA EV SUBPOPULATIONS CORRELATE WITH TUMOR SIZE AND OVERALL SURVIVAL IN GLIOBLASTOMA INDEPENDENT OF STEROID USAGE
Authors: Aibaidula Abudumijiti (Zack) , Bauman Megan , Ghaith Abdul Karim , Bouchal Samantha , Parney Ian 
Published: November 2023

Abstract

INTRODUCTION
Extracellular Vesicles (EVs) are lipid bilayer particles present in almost all biofluids and carry tumor-specific molecular cargo. Plasma EVs are promising sources of biomarker discovery for glioblastoma (GBM). The clinical relevance of non-neoplastic plasma EVs in GBM remains unclear. In this study, we determine if associations exist between plasma EV subpopulation frequencies in GBM and clinical factors.

METHODS
Platelet-free plasma samples of 63 GBM, 43 Grade 2 glioma, and 45 healthy donors were included. All glioma plasma samples were collected before surgery. Plasma EV subpopulation frequency based on surface expression of EV-associated tetraspanins (CD9/CD81/CD63) and markers of cell origin (CD45/CD41a/CD11b/CD31) was determined by spectral flow cytometry. Clinical information including age, surgery, MGMT methylation status, corticosteroid usage, tumor volume, and overall survival data was recorded.

RESULTS
Compared to normal donors, GBM patients had increased CD9+, CD63+, CD81+, and CD11b+ EVs but decreased CD41a+ EVs. GBM patients also had the highest frequency of myeloid-derived CD9+CD11b+ EVs (20.17%) followed by grade 2 gliomas (13.78%) and normal donors (2.76%, p&lt; 0.001). More GBM patients (29/63, 46.0%) received preoperative corticosteroids than grade 2 glioma patients (9/43, 20.9%; p = 0.008). Corticosteroid use was not associated with differences in EV subpopulation frequencies in GBM or grade 2 glioma patients. Pearson correlation analysis showed weak but statistically significant correlations between GBM total tumor volume and CD9+ EVs (p = 0.014), CD41a+ EVs (p = 0.037), and CD9+/CD63-/CD81- EVs (p = 0.007). In GBM patients, younger age (&lt; 60 yrs, p = 0.01), gross total resection (p = 0.02), MGMT methylation (p = 0.002), high CD9+ EV expression (p = 0.011), low CD9+CD63-CD81- EV expression (p = 0.009) and low CD9+CD11b+ EV expression (p = 0.006) correlated with longer overall survival.

CONCLUSION
Differentially expressed non-neoplastic plasma EV subpopulations have significant clinical relevance in GBM including association with tumor volume and predicting survival. Validation of those markers in larger cohorts could reveal new prognostic biomarkers for GBM.
BIOM-37. EXTRACELLULAR VESICLES AS A PHARMACODYNAMIC REPORTER IN GLIOBLASTOMA
Authors: DeLuca Valerie , Tang Nanyun , Hao Yue , Raju Anjali , Shaffer Charles , Riviere-Cazaux Cecile , Burns Terry , Sarkaria Jann , Parney Ian , Pirotte Patrick , Van Keuren-Jensen Kendall , Berens Michael 
Published: November 2023

Abstract
Development of a non-invasive test that can measure drug delivery and target engagement in GBM represents an opportunity to enhance knowledge during early phase clinical trials of a new compound’s pharmacological suitability and potential efficacy. We present here data supporting that the cargo within extracellular vesicles (EV) can potentially serve as a liquid biopsy that reports on the pharmacodynamics of GBM therapeutics. We treated short-term PDX cultures with vehicle, temozolomide, MLN4924, or arsenic trioxide. EVs were isolated from culture supernatants using size exclusion chromatography and then analyzed by mass spectrometry (proteomics) and RNA sequencing to characterize and compare cargo profiles for each condition. We found that at the proteome level, FDFT1 and FARSB were detected only in temozolomide EVs across all cell lines. In addition, there were drug-agnostic indications of exposure, including decreased abundance in all treated EV conditions of SLC3A2, C3, PLG, and A1BG, and increased abundance of GSTP1. These cargo changes were further validated by western blotting and ExoView immunofluorescence on isolated EVs. At the EV-transcriptome level, depending on treatment, there were shared alterations in EV cargo between models in the expression of long non-coding RNAs, genes that are overrepresented in biological processes such as cytoplasmic translation and cellular macromolecule biosynthesis, and circular RNAs. Thus, these results indicate that EV cargo post-treatment may be a novel pharmacodynamic reporter in GBM. To allow immunoprecipitation of patient GBM-derived EVs with the selective interrogation, the potential biomarkers, including PTPRZ1, B7H3, IL13RA2, and EGFR were screened across isolated EVs from both pre-clinical and clinical patient samples. Future efforts are focused on evaluating immunoprecipitated GBM-EVs from longitudinally collected patient biofluids. Overall, we anticipate that the results of this study will lead to development of a clinical test that reflects BBB penetration and tumor response, which will likely aid in novel drug development efforts.
BIOM-38. MET FUSIONS AND SPLICING VARIANTS IS A STRONG ADVERSE PROGNOSTIC FACTOR IN ASTROCYTOMA, IDH-MUTANT
Authors: Zhang Kenan , Liu Lingyu , Zhao Zheng , Chen Jing , Liu Xing , Jiang Tao 
Published: November 2023

Abstract

BACKGROUND
Astrocytoma, IDH-mutant is currently characterized by both histological and molecular features according to the WHO CNS5 classification. However, there were still patients with IDH-mutant lower-grade astrocytomas (LGAs, CNS WHO grade 2 and 3) who suffered poor survival. Our previous research demonstrated the enrichment and predictive role of MET fusions and/or splicing variations (MET F/SVs) in previously classified secondary IDH-mutant glioblastoma, which could be a potential complement to the existing grading system.

MATERIALS
We herein presented descriptive, Kaplan-Meier, multivariable Cox regression outcome analyses, and DNA methylation profiling cluster analysis in a large cohort of astrocytomas, IDH-mutant.

RESULTS
A total of 427 astrocytomas, IDH-mutant were included. 28/427 (6.56%) patients were defined as carrying MET F/SVs, including 9/261 (3.45%) LGAs and 19/166 (11.45%) IDH-mutant high-grade astrocytomas (HGAs, CNS WHO grade 4). The distribution of MET F/SVs was significantly different between LGAs and HGAs (p = 0.0011). Kaplan-Meier analysis of PFS and OS confirmed MET F/SVs was significantly associated with inferior survival irrespective of CNS WHO grade. Multivariable Cox regression analysis with PFS and OS as the endpoint showed MET F/SVs were independently associated with worse survival (p = 0.006 for PFS and p &lt; 0.0001 for OS). Moreover, we collected 159 astrocytomas, IDH-mutant with DNA methylation profiles for further analysis. The included patients were classified into the methylation class MC astrocytoma, IDH-mutant in version 12.5 of the Heidelberg brain tumor classifier. On the t-distributed stochastic neighbor embedding (t-SNE) projection, the IDH-mutant astrocytoma with MET F/SVs was more clustered in high-grade astrocytoma (p = 0.017).

CONCLUSION
Collectively, we demonstrated the utmost relevance of MET F/SVs as an adverse prognostic factor in IDH-mutant astrocytoma independent of the current WHO CNS grading system. We proposed that the LGAs with MET F/SVs should be designated into CNS WHO grade 4.
BIOM-40. THERABIOME-GBM: THERAPEUTIC OUTCOMES RELATED TO GUT MICROBIOME IN GLIOBLASTOMA (GBM) PATIENTS RECEIVING CHEMO-RADIATION: A PROSPECTIVE OBSERVATIONAL STUDY
Authors: Ng Terry , Alshamsan Bader , Nguyen Thanh , Butcher James , Stober Carol , Vandermeer Lisa , Nicholas Garth , Stintzi Alain , Nair Vimoj 
Published: November 2023

Abstract

PURPOSE
A major barrier to improving outcomes in glioblastoma multiforme (GBM) is overcoming a heavily immunosuppressed tumor and systemic environment, as demonstrated by several negative phase III randomized studies of nivolumab in both newly diagnosed and recurrent GBM. In several mouse avatar and human studies across several tumor cohorts including in a humanized microbiome GBM model, re-establishing a new gut microbiome (GM) via fecal transplantation led to tumor responses to PD-1/PD-L1 inhibition. A recent scoping review confirmed a paucity of GM clinical data of a uniform GBM cohort with adequate longitudinal GM sample collection. We are conducting a single-center prospective observational study to establish the feasibility of collecting stool samples throughout the time course of GBM treatment and upon recurrence, and to understand the gut microbiome dynamics of newly diagnosed IDH-wild type (WT) GBM patients.

METHODS
Patients with newly diagnosed unifocal IDH-1 R132H WT WHO grade 4 GBM, ECOG 0-2, at least 70% tumor resected with plan to receive temozolomide-radiation (TMZ-RT) and adjuvant TMZ +/- Tumor Treating Fields are eligible. Stool samples will be collected prior to TMZ-RT, 4 weeks after TMZ-RT, after adjuvant TMZ, and upon recurrence. The primary endpoint is feasibility, defined as stool sample obtained pre-RT, post-RT (pre-adjuvant TMZ), and at time of recurrence in ≥ 70% of enrolled participants, 75% of target sample size enrolled within 2 years, and stool sample volume and quality sufficient for analysis in ≥ 75% of collected samples. Secondary endpoints include progression-free survival (PFS) in pre-defined GM subgroups, GM taxonomy and diversity in late vs. early progressors, and GM differences in patients with and without post-RT necrosis. Age, sex, race, concurrent medication, corticosteroid use, and diet will be carefully accounted for. Patient reported outcomes using EORTC-QLQ-BN20 and QLQ-C30 will be collected at baseline, 3-, 6-, 9-, and 12-months.
BIOM-45. GLIOMA CSF PROTEOMICS FOR PHARMACODYNAMIC BIOMARKER AND THERAPEUTIC TARGET DISCOVERY
Authors: Riviere-Cazaux Cecile , Carlstrom Lucas , Munoz-Casabella Amanda , Andersen Kari , Ikram Samar , Warrington Arthur , Burns Terry 
Published: November 2023

Abstract
Cerebrospinal fluid (CSF) is emerging as an abundant source of candidate biomarkers, including proteins, for gliomas. Longitudinal CSF access may enable insights into treatment response and resistance. To that end, we have established a growing biobank of CSF samples, many of which have been obtained longitudinally via CSF access devices, such as Ommaya reservoirs, through our ongoing biomarker discovery clinical trials (NCT04692337, 04692324). We have previously presented our initial data demonstrating a conserved proteomic signature of HGG that decreased with resection and increased with recurrence. Since then, samples have been acquired throughout individual patients’ treatment course toward our goal of identifying CSF-derived biomarkers of treatment response. CSF samples obtained prior to, during, and throughout treatment underwent global proteomics analysis via the SomaScan® assay by Somalogic. Fold-changes for each protein were calculated between different timepoints and ranked for each comparison of interest. Treatment with pembrolizumab alone results in increased IL-23 (5.01x), IL-12 (4.25x), lymphocyte activation gene 3 protein (LAG3) (3.26x), and granzyme A (2.93x), suggesting potential for combination with multiple agents. Chemoradiation, with or without pembrolizumab, consistently downregulated NAD kinase, acetyl CoA transferase, and Bcl-2 and upregulated proteins related to neuronal signaling, such as neurexins and cerebellins, in addition to LAG-3, suggesting potential for synergy between chemoradiation and anti-LAG-3 antibodies currently in clinical trials. Interestingly, pembrolizumab and chemoradiation decreased MMP-12 and MMP-9 abundance as compared to chemoradiation alone (0.25x vs. 18.5x; 0.54x vs. 4.99x). Finally, bevacizumab treatment consistently increased VEGF-A (7.32x), VEGF-B (2.21x), and MMP-3 (2.99x) abundance, while decreasing the presence of our previously reported plasma-associated protein signature in CSF. In conclusion, the global CSF proteome can be longitudinally accessed to evaluate response to standard-of-care and experimental therapies. Further studies are ongoing to identify signatures of therapeutic resistance and to assess the impact of novel immunotherapeutic combinations on the CSF proteome.