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MO_7_2896 - Metalloproteinase inhibitor 4 to vascular endothelial growth factor A ratio is a prognostic factor of chemoradiation in glioblastoma

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Metalloproteinase inhibitor 4 to vascular endothelial growth factor A ratio is a prognostic factor of chemoradiation in glioblastoma
W. C. You1, and J. C. Lin2; 1Taichung Veteran General Hospital, Taichung, Taiwan, 2Taichung Veterans General Hospital, Taichung, Taiwan

Purpose/Objective(s): Glioblastoma multiform is highly malignant and comes with worse survival. One of the hallmarks of glioblastoma is angiogenesis. This study evaluated the anti-angiogenesis effect of chemoradiation and investigated the circulating angiogenesis-related factors that may be prognostic on survival.

Materials/Methods: Peripheral venous blood samples from newly diagnosed glioblastoma patients who received chemoradiation with temozolomide were prospectively collected. We used proteome antibody array (R&D Co.) to analyze the human angiogenesis-related proteins simultaneously. Quantification of the expression intensity was measured by digital imaging system (Bio Pioneer Tech Co.). Averages differences across paired pre- and post-chemoradiation samples were calculated by ANOVA. Tumor progression was defined according to RANO criteria by our radiologists. The predictive values on survival were estimated by Cox regression and Kaplan-Meier method.

Results: From July 2015 to April 2017, thirty-four patients were prospectively enrolled in this study. Reduced expression intensity after chemoradiation was observed among fifty-five angiogenesis-related proteins and twenty-six of them were statistically significant. Further uni-variate analysis revealed that higher TIMP4 to vascular endothelial growth factor A ratio (TVR) is associated with worse progression-free survival (PFS) (p=0.048 and p=0.037, pre- and post-chemoradiation respectively). Using the cut-off value of 2, the patients with TVR≥2 have significant worse PFS (6.3±0.6 months vs. 9.9±1.2 months, p=0.017 and 6.1±0.9 months vs. 9.8±1.1 months, p=0.040; pre- and post-chemoradiation respectively).

Conclusion: Our study demonstrated the anti-angiogenesis effect of chemoradiation in glioblastoma. Although the advantage of combination therapy with temozolomide chemoradiation and bevacizumab have not been well established, it is reasonable to encourage the glioblastoma patients with TVR≥2 to receive more intensive therapy like early application of combined anti-angiogenic and chemoradiation..

Author Disclosure: W. You: None.

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