Glioma SOX2 expression decreased after adjuvant therapy

Abstract

SOX2 is regarded as an important marker in stem cell. The change of SOX2 expression after adjuvant therapy in high grade glioma (HGG) remains unknown so far. Few patients with recurrent glioma have opportunity to undergo operation once again, so the recurrent glioma samples are scarce. This study tries to analyze SOX2 expression in paired primary and recurrent HGG, aims to better understand the transformation law of SOX2 after adjuvant therapy in HGG.Methods Twenty-four recurrent HGG patients who undergone a second resection were included. 16 patients received adjuvant therapy, the remaining 8 patients didn’t receive any adjuvant therapy at all. The protein expression of SOX2 in paired primary and recurrent HGG was tested by immunohistochemistry. The statistical analysis was conducted by IBM SPSS Statistics 19.0.Results In primary HGG, SOX2 expression of 3+,2+,1+ and 0+ were seen in 20 (83.3%), 1 (4.2%), 1 (4.2%) and 2 cases (8.3%), respectively. The expression of SOX2 was decreased in recurrent HGG compared to the paired primary sample (p=0.001). The decrease of SOX2 was often seen in patients received chemotherapy, radiotherapy or both (p=0.003). Patients with SOX2 high expression in primary glioma had a longer median PFS than those with SOX2 low expression with marginal statistic significance (12.7 vs. 5.4 months, p=0.083). For cases with SOX2 high expression in the primary glioma, those had SOX2 low expression after recurrence seemed to have worse prognosis as compared to patients with stable SOX2 high expression (PFS: 10.4 vs. 14.9 months, p=0.036; OS: 27.0 vs 49.5 months, p=0.005).Conclusions This is the first study comparing the protein expression of SOX2 in recurrent HGG and its paired primary tumor. SOX2 high expression is common in brain HGG, a tendency of decreased SOX2 expression in recurrent gliomas was evidenced. Lower SOX2 expression was seen in those patients who received adjuvant chemotherapy and/or radiotherapy. Patients with low SOX2 expression in primary HGG usually have poorer prognosis, those with SOX2 expression decreased in recurrent HGG had worse outcome.

Collagen Type III Alpha 1 chain regulated by GATA‐Binding Protein 6 affects Type II IFN response and propanoate metabolism in the recurrence of lower grade glioma

“…And estimated by the American Cancer Society, it will be 23,890 new cases and 18,020 death in America 4 . Generally, the prognosis of primary LGG is better than higher grade glioma, and the median overall survival is 5‐10 years 5 . However, the recurrence, progression and deterioration make the therapy tough.…”

“…4 Generally, the prognosis of primary LGG is better than higher grade glioma, and the median overall survival is 5-10 years. 5 However, the recurrence, progression and deterioration make the therapy tough. And the recurrence rates of grade Ⅰ and Ⅱ are 84.5% 6 and 57.6%, 6 respectively.…”

A SOX2-engineered epigenetic silencer factor represses the glioblastoma genetic program and restrains tumor development

“…The mesenchymal glioblastoma state is the natural progression of recurring tumors mainly due to the treatments (e.g., irradiation and TMZ) and subsequent chronic brain inflammation (15,16,30,31). Mesenchymal tumors have been reported to exhibit less or none SOX2 dependency contrary to the other subtypes (32)(33)(34). Thus, we wondered whether SES treatment could also be effective against mesenchymal GBM cancer cells.…”