Page 12 - Read Online

Topic: Neuroimmunology and Cancer

Integrins and focal adhesion kinase in the

malignant behavior of gliomas

2
Efstathia Giannopoulou , Andreas Tzakos , Andreas A. Argyriou 3
1
1 Clinical Oncology Laboratory, Division of Oncology, Department of Medicine, University of Patras, 26504 Patras, Greece.
2 Section of Organic Chemistry and Biochemistry, Department of Chemistry, University of Ioannina, 45110 Ioannina, Greece.
3 Department of Neurology, “Saint Andrew’s” General Hospital, 26335 Patras, Greece.

ABSTRA CT

Glioblastoma multiforme (GBM) is the most common type of glioma and is associated with a very poor prognosis. The standard
treatment includes radiotherapy concurrent with temozolomide, however recently the Food and Drug Administration approved
bevacizumab for use in patients with progressive glioblastoma following prior therapy. The limited number of treatment options
points to the need for novel effective therapeutic approaches. A promising approach is the use of tyrosine kinase inhibitors (TKIs)
in GBM treatment. However, the results from the majority of clinical trials using TKIs are not very encouraging. One growing area is
the development of tumor‑homing peptides that resemble the integrin recognition sequence RGD. In this article, the role of integrins
and focal adhesion kinase in malignant glioma is reviewed, and an experimental study is proposed that will apply a strategy for
peptide‑mediated delivery of compounds deep into tumor parenchyma using tumor‑homing peptides.

Key words: Focal adhesion kinase, glioblastoma multiforme, integrins

INTRODUCTION peritumoral area. [2-4] Other restricting factors include
potential interactions between antiepileptic drugs and
Malignant glioma (MG), including glioblastoma chemotherapeutic agents, use of glucocorticosteroids,
multiforme (GBM) and anaplastic astrocytoma, ranks and the implication of specific genetic transformation
among the most common primary brain tumors. Apart and characteristics of GBMs. In particular, the multidrug
from maximally safe surgical resection, the first-line resistance system is considered to be mainly responsible
treatment consists of radiotherapy and concomitant for the development of treatment resistance. [4]
systemic application of chemotherapy-usually with
temozolomide-following the Stupp regimen, which PATHOGENETIC ASPECTS OF GLIOBLASTOMA
represents the standard conventional treatment for MULTIFORMES
GBM. Nonetheless, the median survival time of patients
with MGs, and consequently their outcome, remains The pathological hallmarks of GBMs include rapid
very poor. [1-3] progression, neovascularization, necrosis, and intense
apoptotic resistance. Common genetic alterations
Several mechanisms of GBM resistance to standard associated with malignant phenotypic characteristics
chemotherapy have been proposed. The use of are commonly found in tumors. However, the
chemotherapy has been reported as being limited, molecular mechanisms leading to these phenotypic
due to the fact that the blood-brain barrier restricts features are as yet vaguely defined, mainly due to
the accumulation of conventional cytotoxic agents genetic heterogeneity, even within the same tumor.
[5]
to therapeutic concentrations in the tumor and the However, there are some known mutations, deletions,
or alterations in gene expression that have been linked
Access this article online
to the genesis of GBMs. [3,6] Several signaling pathways
Quick Response Code: leading to malignant behavior in MGs, induction
Website: of cell migration, and tumor invasiveness have also
www.nnjournal.net
been implicated. These pathways are regulated by
DOI: amplification and/or overexpression of several growth
10.4103/2347-8659.149395 factor receptors linked with tyrosine kinases, such as the
epidermal growth factor receptor (EGFR), insulin-like

Corresponding Author: Dr. Efstathia Giannopoulou, Clinical Oncology Laboratory, Division of Oncology, Department of
Medicine, University of Patras, 26504 Patras, Greece. E‑mail: giannop@upatras.gr

4 Neuroimmunol Neuroinflammation | Volume 2 | Issue 1 | January 15, 2015