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      EGFR as a Target for Glioblastoma Treatment: An Unfulfilled Promise

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      CNS Drugs
      Springer International Publishing

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          Abstract

          The receptor for epidermal growth factor (EGFR) is a prime target for cancer therapy across a broad variety of tumor types. As it is a tyrosine kinase, small molecule tyrosine kinase inhibitors (TKIs) targeting signal transduction, as well as monoclonal antibodies against the EGFR, have been investigated as anti-tumor agents. However, despite the long-known enigmatic EGFR gene amplification and protein overexpression in glioblastoma, the most aggressive intrinsic human brain tumor, the potential of EGFR as a target for this tumor type has been unfulfilled. This review analyses the attempts to use TKIs and monoclonal antibodies against glioblastoma, with special consideration given to immunological approaches, the use of EGFR as a docking molecule for conjugates with toxins, T-cells, oncolytic viruses, exosomes and nanoparticles. Drug delivery issues associated with therapies for intracerebral diseases, with specific emphasis on convection enhanced delivery, are also discussed.

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          Most cited references119

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          The Principles of Engineering Immune Cells to Treat Cancer

          Chimeric antigen receptor (CAR) T cells have proven that engineered immune cells can serve as a powerful new class of cancer therapeutics. Clinical experience has helped to define the major challenges that must be met to make engineered T cells a reliable, safe, and effective platform that can be deployed against a broad range of tumors. The emergence of synthetic biology approaches for cellular engineering is providing us with a broadly expanded set of tools for programming immune cells. We discuss how these tools could be used to design the next generation of smart T cell precision therapeutics.
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            Mosaic amplification of multiple receptor tyrosine kinase genes in glioblastoma.

            Tumor heterogeneity has been implicated in tumor growth and progression as well as resistance to therapy. We present an example of genetic heterogeneity in human malignant brain tumors in which multiple closely related driver genes are amplified and activated simultaneously in adjacent intermingled cells. We have observed up to three different receptor tyrosine kinases (EGFR, MET, PDGFRA) amplified in single tumors in different cells in a mutually exclusive fashion. Each subpopulation was actively dividing, and the genetic changes resulted in protein production, and coexisting subpopulations shared common early genetic mutations indicating their derivation from a single precursor cell. The stable coexistence of different clones within the same tumor will have important clinical implications for tumor resistance to targeted therapies. Copyright © 2011 Elsevier Inc. All rights reserved.
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              Coactivation of receptor tyrosine kinases affects the response of tumor cells to targeted therapies.

              Targeted therapies that inhibit receptor tyrosine kinases (RTKs) and the downstream phosphatidylinositol 3-kinase (PI3K) signaling pathway have shown promising anticancer activity, but their efficacy in the brain tumor glioblastoma multiforme (GBM) and other solid tumors has been modest. We hypothesized that multiple RTKs are coactivated in these tumors and that redundant inputs drive and maintain downstream signaling, thereby limiting the efficacy of therapies targeting single RTKs. Tumor cell lines, xenotransplants, and primary tumors indeed show multiple concomitantly activated RTKs. Combinations of RTK inhibitors and/or RNA interference, but not single agents, decreased signaling, cell survival, and anchorage-independent growth even in glioma cells deficient in PTEN, a frequently inactivated inhibitor of PI3K. Thus, effective GBM therapy may require combined regimens targeting multiple RTKs.
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                Author and article information

                Contributors
                0049 40 74105 3750 , westphal@uke.de
                Journal
                CNS Drugs
                CNS Drugs
                CNS Drugs
                Springer International Publishing (Cham )
                1172-7047
                1179-1934
                8 August 2017
                8 August 2017
                2017
                : 31
                : 9
                : 723-735
                Affiliations
                ISNI 0000 0001 2180 3484, GRID grid.13648.38, Department of Neurosurgery, , University Hospital Hamburg Eppendorf, ; Martinistrasse 52, 20246 Hamburg, Germany
                Author information
                http://orcid.org/0000-0003-3483-6335
                Article
                456
                10.1007/s40263-017-0456-6
                5573763
                28791656
                e3c75df4-fdfc-4d25-9caf-d65c136502b2
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: Rickertsen Stiftung, Hamburg
                Funded by: Johannes Bauer Stiftung für Hirntumorforschung
                Categories
                Leading Article
                Custom metadata
                © Springer International Publishing AG 2017

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