2021
DOI: 10.3390/cells10051225
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From Laboratory Studies to Clinical Trials: Temozolomide Use in IDH-Mutant Gliomas

Abstract: In this review, we discuss the use of the alkylating agent temozolomide (TMZ) in the treatment of IDH-mutant gliomas. We describe the challenges associated with TMZ in clinical (drug resistance and tumor recurrence) and preclinical settings (variabilities associated with in vitro models) in treating IDH-mutant glioma. Lastly, we summarize the emerging therapeutic targets that can potentially be used in combination with TMZ.

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Cited by 19 publications
(14 citation statements)
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“…However, GSCs are known to exhibit resistance towards temozolomide treatment, a standard care for glioblastoma. GSCs were shown to express multidrug resistance-related proteins (MGMT) [ 3 , 31 , 32 , 34 , 35 , 36 ] and to produce extracellular vesicles, which are disseminating factors of therapy resistance [ 31 ]. Furthermore, standard treatment with temozolomide promotes drug-induced tumorigenicity, i.e., de-differentiation of non-GSCs tumor cells into GSCs [ 5 , 33 , 34 ].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…However, GSCs are known to exhibit resistance towards temozolomide treatment, a standard care for glioblastoma. GSCs were shown to express multidrug resistance-related proteins (MGMT) [ 3 , 31 , 32 , 34 , 35 , 36 ] and to produce extracellular vesicles, which are disseminating factors of therapy resistance [ 31 ]. Furthermore, standard treatment with temozolomide promotes drug-induced tumorigenicity, i.e., de-differentiation of non-GSCs tumor cells into GSCs [ 5 , 33 , 34 ].…”
Section: Discussionmentioning
confidence: 99%
“…Despite numerous studies that have appointed Lyn as a key molecule of tumorigenesis, specific inhibitors for this kinase are still lacking. Several inhibitors can potently block the kinase activity of Lyn as part of a pan-SFK inhibition through their interaction with the catalytic domain, but all have wide spectra of additional targets, most likely due to the homolog of the fold of the kinase domain, which is similar to all other known protein kinases [ 3 , 4 ]. This can partially explain the limited efficacy of dasatinib in some tumor entities including glioblastoma, despite its high potency to induce tumor cell death [ 5 , 6 ].…”
Section: Introductionmentioning
confidence: 99%
“…Taking into account the relevance of the epigenetic landscape in gliomas and, in particular, in the prediction of treatment sensitivity, in recent years, pharmacological research is increasingly considering the possibility of including epidrugs in therapeutic options for GBM, with particular regard to personalized therapy ( Zang et al, 2018 ; Phillips et al, 2020 ). Several clinical trials are currently evaluating the effect of different epigenetic modulators, including DNA-methyltransferase inhibitors (DNMTi), used alone or in combined therapies with TMZ or radiations ( ClinicalTrials.gov, 2021 ; Wu et al, 2021 ), and various studies have proposed epidrugs and DNMTi, among other, to optimize the use of TMZ for personalized medicine in GBM ( Seelan et al, 2018 ; Yamashita et al, 2019 ; Belter et al, 2020 ; Gallitto et al, 2020 ; Moon et al, 2020 ; Sun and Turcan, 2021 ).…”
Section: Discussionmentioning
confidence: 99%
“…However, these mutations occur in only up to 12% of GBMs [ 31 ]. Increasingly, IDH mutation and malignant transformation are being linked to numerous alterations at the cellular level [ 32 ], e.g., cellular epigenetics, DNA repair pathways, and redox homeostasis [ 33 ]. This could provide potential opportunities for targeting these pathways [ 34 ] or complementing currently available approved therapeutic protocols [ 33 , 35 , 36 ].…”
Section: Introductionmentioning
confidence: 99%