DW-MRI as a biomarker to compare therapeutic outcomes in radiotherapy regimens incorporating temozolomide or gemcitabine in glioblastoma

PLoS One. 2012;7(4):e35857. doi: 10.1371/journal.pone.0035857. Epub 2012 Apr 20.

Abstract

The effectiveness of the radiosensitizer gemcitabine (GEM) was evaluated in a mouse glioma along with the imaging biomarker diffusion-weighted magnetic resonance imaging (DW-MRI) for early detection of treatment effects. A genetically engineered murine GBM model [Ink4a-Arf(-/-) Pten(loxP/loxP)/Ntv-a RCAS/PDGF(+)/Cre(+)] was treated with gemcitabine (GEM), temozolomide (TMZ) +/- ionizing radiation (IR). Therapeutic efficacy was quantified by contrast-enhanced MRI and DW-MRI for growth rate and tumor cellularity, respectively. Mice treated with GEM, TMZ and radiation showed a significant reduction in growth rates as early as three days post-treatment initiation. Both combination treatments (GEM/IR and TMZ/IR) resulted in improved survival over single therapies. Tumor diffusion values increased prior to detectable changes in tumor volume growth rates following administration of therapies. Concomitant GEM/IR and TMZ/IR was active and well tolerated in this GBM model and similarly prolonged median survival of tumor bearing mice. DW-MRI provided early changes to radiosensitization treatment warranting evaluation of this imaging biomarker in clinical trials.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Antineoplastic Agents, Alkylating / therapeutic use*
  • Biomarkers
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy*
  • Cell Line
  • Chemoradiotherapy
  • Dacarbazine / analogs & derivatives*
  • Dacarbazine / therapeutic use
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / therapeutic use
  • Diffusion Magnetic Resonance Imaging*
  • Drug Screening Assays, Antitumor
  • Gemcitabine
  • Glioblastoma / pathology
  • Glioblastoma / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Mice
  • Mice, Transgenic
  • Neoplasms, Experimental / pathology
  • Neoplasms, Experimental / therapy
  • Radiation-Sensitizing Agents / therapeutic use*
  • Temozolomide
  • Treatment Outcome
  • Tumor Burden / drug effects
  • Tumor Burden / radiation effects

Substances

  • Antineoplastic Agents, Alkylating
  • Biomarkers
  • Radiation-Sensitizing Agents
  • Deoxycytidine
  • Dacarbazine
  • Temozolomide
  • Gemcitabine