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Telomerase inhibition abolishes the tumorigenicity of pediatric ependymoma tumor-initiating cells.

Abstract：

:Pediatric ependymomas are highly recurrent tumors resistant to conventional chemotherapy. Telomerase, a ribonucleoprotein critical in permitting limitless replication, has been found to be critically important for the maintenance of tumor-initiating cells (TICs). These TICs are chemoresistant, repopulate the tumor from which they are identified, and are drivers of recurrence in numerous cancers. In this study, telomerase enzymatic activity was directly measured and inhibited to assess the therapeutic potential of targeting telomerase. Telomerase repeat amplification protocol (TRAP) (n = 36) and C-circle assay/telomere FISH/ATRX staining (n = 76) were performed on primary ependymomas to determine the prevalence and prognostic potential of telomerase activity or alternative lengthening of telomeres (ALT) as telomere maintenance mechanisms, respectively. Imetelstat, a phase 2 telomerase inhibitor, was used to elucidate the effect of telomerase inhibition on proliferation and tumorigenicity in established cell lines (BXD-1425EPN, R254), a primary TIC line (E520) and xenograft models of pediatric ependymoma. Over 60 % of pediatric ependymomas were found to rely on telomerase activity to maintain telomeres, while no ependymomas showed evidence of ALT. Children with telomerase-active tumors had reduced 5-year progression-free survival (29 ± 11 vs 64 ± 18 %; p = 0.03) and overall survival (58 ± 12 vs 83 ± 15 %; p = 0.05) rates compared to those with tumors lacking telomerase activity. Imetelstat inhibited proliferation and self-renewal by shortening telomeres and inducing senescence in vitro. In vivo, Imetelstat significantly reduced subcutaneous xenograft growth by 40 % (p = 0.03) and completely abolished the tumorigenicity of pediatric ependymoma TICs in an orthotopic xenograft model. Telomerase inhibition represents a promising therapeutic approach for telomerase-active pediatric ependymomas found to characterize high-risk ependymomas.

journal_name

Acta Neuropathol

journal_title

Acta neuropathologica

authors

Barszczyk M,Buczkowicz P,Castelo-Branco P,Mack SC,Ramaswamy V,Mangerel J,Agnihotri S,Remke M,Golbourn B,Pajovic S,Elizabeth C,Yu M,Luu B,Morrison A,Adamski J,Nethery-Brokx K,Li XN,Van Meter T,Dirks PB,Rutka JT,Tay

doi

10.1007/s00401-014-1327-6

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

863-77

issue

eissn

0001-6322

issn

1432-0533

journal_volume

128

pub_type

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Telomerase inhibition abolishes the tumorigenicity of pediatric ependymoma tumor-initiating cells.