Glioblastoma (GBM) is the most malignant brain tumor characterized by intrinsic or acquired resistance to chemotherapy. GBM tumors show nuclear factor-κB (NF-κB) activity that has been associated with tumor formation, growth, and increased resistance to therapy. We investigated the effect of NF-κB inhibitor BAY 11-7082 with Temozolomide (TMZ) on the signaling pathways in GBM pathogenesis. GBM cells and patient-derived GBM cells cultured in 3D microwells were co-treated with BAY 11-7082 and TMZ or BAY 11-7082 and TMZ alone, and combined experiments of cell proliferation, apoptosis, wound healing assay, as well as reverse-phase protein arrays, western blot and immunofluorescence staining were used to evaluate the effects of drugs on GBM cells. The results revealed that the co-treatment significantly altered cell proliferation by decreasing GBM viability, suppressed NF-κB pathway and enhanced apoptosis. Moreover, it was found that the co-treatment of BAY 11-7082 and TMZ significantly contributed to a decrease in the migration pattern of patientderived GBM cells by modulating actin cytoskeleton pathway. These findings suggest that in addition to TMZ treatment, NF-κB can be used as a potential target to increase the treatment's outcomes. The drug combination strategy, which is significantly improved by NF-κB inhibitor could be used to better understand the underlying mechanism of GBM pathways in vivo and as a potential therapeutic tool for GBM treatment. Glioblastoma multiforme (GBM) is the most malignant primary brain tumor in the central nervous system. Current standard of care therapy includes surgery followed by radiotherapy and concomitant and adjuvant chemotherapy with the alkylating agent Temozolomide (TMZ), which provides survival benefits for patients with GBM 1. However, even with the advances in surgical resection combined with TMZ therapy and irradiation, the prognosis for newly diagnosed GBM patients remains poor. In fact, due to its rapid proliferation, increased invasion and migration capacity and chemoresistance to the alkylating agents the median survival is only 14.6 months with the 'Stupp' regimen (radiation with daily TMZ × 4-6 weeks followed by cyclic TMZ) 2 and 5-year survival rate is less than 6%, which is the lowest long-term survival rate of malignant brain tumors 3-5. TMZ methylates DNA at the O 6 positions of guanine and DNA repair enzyme O 6-methylguanine methyltransferase (MGMT) removes alkyl groups from O 6 position of guanine in DNA making cells resistant to TMZ 6. Therefore, new therapies are necessary to prevent cell proliferation and induce apoptosis for GBM patients. Nuclear factor-kappa B (NF-κB) is a regulatory transcription factor of the Rel gene family including p50, c-Rel, RelB, or p65 subunits. It is involved in the control of tumor cell proliferation, migration, immune response and apoptosis 7-10. Studies have shown that NF-κB gene was involved in the regulation pathways of different cancer types such as thyroid cancer, head and neck squamous cell carcinoma and colorectal canc...
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