Prognostic value of the Glasgow Prognostic Score for glioblastoma multiforme patients treated with radiotherapy and temozolomide

Topkan, Erkan; Selek, Uğur; Özdemir, Yurday; Yıldırım, Berna Akkuş; Güler, Ozan Cem; Çîner, Fuat; Mertsoylu, Hüseyin; Tufan, Kadır

doi:10.1007/s11060-018-2879-4

Cited by 25 publications

(17 citation statements)

References 41 publications

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“…GB is the deadliest of all brain tumors, with a median patient survival up to 16 months, even with treatment (Topkan et al, 2018). Here, we demonstrated multiple pathways of host and GB-CD73 contribution to GB pathogenesis, such as GB angiogenesis, invasion, and its chemoresistance.…”

Section: Discussionmentioning

confidence: 71%

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CD73 Promotes Glioblastoma Pathogenesis and Enhances Its Chemoresistance via A_2BAdenosine Receptor Signaling

et al. 2019

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Glioblastoma (GB) is one of the deadliest brain cancers to afflict humans, and it has a very poor survival rate even with treatment. The extracellular adenosine-generating enzyme CD73 is involved in many cellular functions that can be usurped by tumors, including cell adhesion, proliferation, invasion, and angiogenesis. We set out to determine the role of CD73 in GB pathogenesis. To do this, we established a unique GB mouse model (CD73-FLK) in which we spatially expressed CD73 on endothelial cells in CD73 Ϫ/Ϫ mice. This allowed us to elucidate the mechanism of host CD73 versus GB-expressed CD73 by comparing GB pathogenesis in WT, CD73 Ϫ/Ϫ , and CD73-FLK mice. GB in CD73 Ϫ/Ϫ mice had decreased tumor size, decreased tumor vessel density, and reduced tumor invasiveness compared with GB in WT mice. Interestingly, GBs in CD73-FLK mice were much more invasive and caused complete distortion of the brain morphology. We showed a 20-fold upregulation of A 2B AR on GB compared with sham, and its activation induced matrix metalloproteinase-2, which enhanced GB pathogenesis. Inhibition of A 2B AR signaling decreased multidrug resistance transporter protein expression, including permeability glycoprotein (P-gp) and multidrug resistance-associated protein 1 (MRP1). Further, we showed that blockade of A 2B AR signaling potently increased GB cell death induced by the chemotherapeutic drug temozolomide. Together, these findings suggest that CD73 and A 2B AR play a multifaceted role in GB pathogenesis and progression and that targeting the CD73-A 2B AR axis can benefit GB patients and inform new approaches for therapy to treat GB patients.

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Section: Discussionmentioning

confidence: 71%

“…Further, the impermeability of the blood-brain barrier (BBB) makes chemotherapeutic drug delivery challenging for GB treatment (Neuwelt et al, 1982). Currently, the median survival for GB patients is 16 months even with treatment (Topkan et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

CD73 Promotes Glioblastoma Pathogenesis and Enhances Its Chemoresistance via A_2BAdenosine Receptor Signaling

et al. 2019

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“…A number of studies have also found similar results for the prognostic role CAR or GPS in various types of cancers. [7][8][9][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62] This highlighted the general prognostic role of these two inflammation-based scores in malignancies.…”

Section: Discussionmentioning

confidence: 99%

<p>Prognostic Value of Inflammation Biomarkers for Survival of Patients with Neuroblastoma</p>

Chen

Liu

Feng

et al. 2020

CMAR

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The prognostic significance of inflammation-based biomarkers for neuroblastoma (NB) has not been investigated before. The aim of this study was to evaluate the prognostic value of pre-treatment inflammation biomarkers in children patients with NB. Patients and Methods: Patients diagnosed with NB from 2008 to 2016 in our institution were enrolled in this study. The clinical data and survival outcomes were retrospectively reviewed. Inflammation biomarkers or scores including C-reactive protein (CRP), albumin (ALB), Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), high-sensitivity modified Glasgow Prognostic Score (Hs-mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and system inflammation index (SII) were tested in this study. Univariate and multivariate survival analyses were performed to assess the prognostic value of these inflammation indicators for overall survival (OS) of children with NB. Kaplan-Meier survival curves were also conducted. Results: A total of 70 children diagnosed with neuroblastoma were enrolled in this study. NLR, PLR, LMR and SII were found to be not predictive of OS for NB patients. However, CRP, ALB, GPS and CAR were significantly associated with OS of NB patients. Multivariate analysis adjusting for age, sex, histology, tumor size, tumor stage and metastasis revealed that ALB, CAR, GPS and Hs-mGPS were significantly associated with OS of NB patients. Receiver operating characteristic (ROC) curves and Akaike Information Criterion (AIC) analyses revealed that Hs-mGPS is superior to other inflammation biomarkers in predicting OS of NB patients. Subgroup survival analysis for immature NB patients revealed similar results. Conclusion: Hs-mGPS is an effective prognostic factor for OS of patients with NB and is promising to be used as a factor for risk stratification and an indicator for more aggressive therapy.

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“…Even though preceding research confirmed the individual poor prognostic worth of both elevated CRP and reduced Alb levels [24][25][26][27][28][29], to our best information, the present study represents the first attempt to assess the prognostic value of CRP/Alb in newly diagnosed GBM patients intended to undergo RT and TMZ. Only recently, Xu et al [33] and Topkan et al [34] examined the prognostic essentialness of Alb as a component of prognostic indices. In Xu's study, two combined prognostic indices, namely, the albumin-to-globulin ratio (AGR) and Onodera's prognostic nutritional index (PNI), were examined, and both the low AGR (<0.75) and PNI (<48) were reported to be associated with inferior OS durations in GBM [33].…”

Section: Discussionmentioning

confidence: 99%

“…In Xu's study, two combined prognostic indices, namely, the albumin-to-globulin ratio (AGR) and Onodera's prognostic nutritional index (PNI), were examined, and both the low AGR (<0.75) and PNI (<48) were reported to be associated with inferior OS durations in GBM [33]. In the more recent study, Topkan et al [34] tested the prognostic value of the Glasgow Prognostic Score (GPS), a combination of CRP and Alb, in 142 newly diagnosed GBM patients treated with RT and concurrent plus adjuvant TMZ. In this study, the GPS was found to be useful in prognostic stratification of GBM patients into three distinctive survival groups (P < 0.001), which resembled the RTOG RPA classification.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of C-Reactive Protein to Albumin Ratio in Glioblastoma Multiforme Patients Treated with Concurrent Radiotherapy and Temozolomide

Topkan

Beşen

Mertsoylu

et al. 2020

International Journal of Inflammation

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Objective. We investigated the prognostic impact of C-reactive protein to albumin ratio (CRP/Alb) on the survival outcomes of newly diagnosed glioblastoma multiforme (GBM) patients treated with radiotherapy (RT) and concurrent plus adjuvant temozolomide (TMZ). Methods. The pretreatment CRP and Alb records of GBM patients who underwent RT and concurrent plus adjuvant TMZ were retrospectively analyzed. The CRP/Alb was calculated by dividing serum CRP level by serum Alb level obtained prior to RT. The availability of significant cutoff value for CRP/Alb that interacts with survival was assessed with the receiver-operating characteristic (ROC) curve analysis. The primary endpoint was the association between the CRP/Alb and the overall survival (OS). Results. A total of 153 patients were analyzed. At a median follow-up of 14.7 months, median and 5-year OS rates were 16.2 months (95% CI: 12.5–19.7) and 9.5%, respectively, for the entire cohort. The ROC curve analysis identified a significant cutoff value at 0.75 point (area under the curve: 74.9%; sensitivity: 70.9%; specificity: 67.7%; P<0.001) for CRP/Alb that interacts with OS and grouped the patients into two: CRP/Alb <0.75 (n = 61) and ≥0.75 (n = 92), respectively. Survival comparisons revealed that the CRP/Alb <0.75 was associated with a significantly superior median (22.5 versus 15.7 months; P<0.001) and 5-year (20% versus 0%) rates than the CRP/Alb ≥0.75, which retained its independent significance in multivariate analysis (P<0.001). Conclusion. Present results suggested the pretreatment CRP/Alb as a significant and independent inflammation-based index which can be utilized for further prognostic lamination of GBM patients.

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Prognostic value of the Glasgow Prognostic Score for glioblastoma multiforme patients treated with radiotherapy and temozolomide

Abstract: The GPS appeared to be useful in prognostic stratification of GBM patients into three groups with significantly different survival durations resembling the RTOG RPA classification.

Cited by 25 publications

References 41 publications

CD73 Promotes Glioblastoma Pathogenesis and Enhances Its Chemoresistance via A_2BAdenosine Receptor Signaling

CD73 Promotes Glioblastoma Pathogenesis and Enhances Its Chemoresistance via A_2BAdenosine Receptor Signaling

<p>Prognostic Value of Inflammation Biomarkers for Survival of Patients with Neuroblastoma</p>

Prognostic Value of C-Reactive Protein to Albumin Ratio in Glioblastoma Multiforme Patients Treated with Concurrent Radiotherapy and Temozolomide

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Prognostic value of the Glasgow Prognostic Score for glioblastoma multiforme patients treated with radiotherapy and temozolomide

Abstract: The GPS appeared to be useful in prognostic stratification of GBM patients into three groups with significantly different survival durations resembling the RTOG RPA classification.

Cited by 25 publications

References 41 publications

CD73 Promotes Glioblastoma Pathogenesis and Enhances Its Chemoresistance via A2BAdenosine Receptor Signaling

CD73 Promotes Glioblastoma Pathogenesis and Enhances Its Chemoresistance via A2BAdenosine Receptor Signaling

<p>Prognostic Value of Inflammation Biomarkers for Survival of Patients with Neuroblastoma</p>

Prognostic Value of C-Reactive Protein to Albumin Ratio in Glioblastoma Multiforme Patients Treated with Concurrent Radiotherapy and Temozolomide

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CD73 Promotes Glioblastoma Pathogenesis and Enhances Its Chemoresistance via A_2BAdenosine Receptor Signaling

CD73 Promotes Glioblastoma Pathogenesis and Enhances Its Chemoresistance via A_2BAdenosine Receptor Signaling