Cited by 76Glioma Diagnosis and TreatmentCancer-related Molecular PathwaysCancer Mechanisms and Therapy

Targeting Resistance against the MDM2 Inhibitor RG7388 in Glioblastoma Cells by the MEK Inhibitor Trametinib

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Berberich, Anne, Kessler, Tobias, Thomé, Carina M., Pusch, Stefan, Hielscher, Thomas, Sahm, Felix, Oezen, Iris, Schmitt, Lara-Marie +10 more·2019·Clinical Cancer Research

Published version of a preprint

Abstract

Purpose: Resistance is an obstacle of glioma therapy. Despite targeted interventions, tumors harbor primary resistance or become resistant over short course of treatment. This study examined the mouse double minute 2 (MDM2) inhibitor RG7388 together with radiotherapy and analyzed strategies to overcome acquired MDM2 inhibitor resistance in glioblastoma. Experimental Design: Effects of RG7388 and radiotherapy were analyzed in p53 wild-type glioblastoma cell lines and glioma-initiating cells. RG7388 resistant cells were generated by increasing RG7388 doses over 3 months. Regulated pathways were investigated by microarray, qRT-PCR, and immunoblot analysis and specifically inhibited to evaluate rational salvage therapies at RG7388 resistance. Effects of RG7388 and trametinib treatment were challenged in an orthotopical mouse model with RG7388 resistant U87MG glioblastoma cells. Results: MDM2 inhibition required functional p53 and showed synergistic activity with radiotherapy in first-line treatment. Long-term exposure to RG7388 induced resistance by activation of the extracellular signal-regulated kinases 1/2 (ERK1/2)–insulin growth factor binding protein 1 (IGFBP1) signaling cascade, which was specifically overcome by ERK1/2 pathway inhibition with trametinib and knockdown of IGFBP1. Combining trametinib with continued RG7388 treatment enhanced antitumor effects at RG7388 resistance in vitro and in vivo. Conclusions: These data provide a rationale for combining RG7388 and radiotherapy as first-line therapy with a specific relevance for tumors insensitive to alkylating standard chemotherapy and for the addition of trametinib to continued RG7388 treatment as salvage therapy after acquired resistance against RG7388 for clinical practice.

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Crossref · 10.1158/1078-0432.ccr-18-1580

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Authors
Berberich, A., Kessler, T., Thomé, C. M., Pusch, S., Hielscher, T., Sahm, F., Oezen, I., Schmitt, L.-M., Ciprut, S., Hucke, N., Ruebmann, P., Fischer, M., Lemke, D., Breckwoldt, M. O., von Deimling, A., Bendszus, M., Platten, M., & Wick, W.
Affiliations
  • German Cancer Research Center (DE)
  • University Hospital Heidelberg (DE)
  • 3Clinical Cooperation Unit Neuropathology, DKTK, DKFZ, Heidelberg, Germany.
Corresponding author
Wick, Wolfgang
Venue
Clinical Cancer Research
Published
2019-01-01
Volume
25
Issue
1
Pages
253-265
ISSN
  • 1078-0432 (ISSN-L)
  • 1557-3265
OpenAlex
W2895467863
Cited by
75
References
42
Citations by year
2026: 5 · 2025: 10 · 2024: 9 · 2023: 11 · 2022: 10 · 2021: 15 · 2020: 9 · 2019: 6
FWCI
4.25
Type
journal article
Language
en
Open access
Locations
  • Clinical Cancer Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
DKFZ (G370)
Topics
  • Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
  • Health Sciences › Medicine › Oncology › Cancer-related Molecular Pathways
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Cancer Mechanisms and Therapy
Keywords
RG7388, MDM2 inhibitors, glioblastoma, acquired drug resistance, trametinib, MEK inhibition, ERK signaling, IGFBP-1, combined radiotherapy, p53, glioma stem cells, salvage therapy, U87 cells
MeSH terms
Animals, Antineoplastic Combined Chemotherapy Protocols, Glioblastoma, Humans, Pyridones, Pyrimidinones, Pyrrolidines, Signal Transduction, Tumor Suppressor Protein p53, Insulin-Like Growth Factor Binding Protein 1, Drug Resistance, Neoplasm, Cell Line, Tumor, Mice, Proto-Oncogene Proteins c-mdm2, para-Aminobenzoates, Heterografts

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