Relationship between ornithine decarboxylase levels in anaplastic gliomas and progression-free survival in patients treated with DFMO-PCV chemotherapy

Int J Cancer. 2007 Nov 15;121(10):2279-83. doi: 10.1002/ijc.22914.

Abstract

The purpose of this study was to assess the relationship between progression-free survival (PFS) in patients treated with DFMO + PCV (procarbazine, CCNU, vincristine) chemotherapy for malignant gliomas with tumor cell ornithine decarboxylase (ODC) activity. Formalin-fixed slides were obtained for study patients with anaplastic gliomas (AGs) and glioblastoma treated on protocol DM92-035. ODC levels were measured using an antibody to ODC coupled to Alexa 647 dye (Ab-ODC-Alexa 647). Ab-ODC-Alexa 647 intensity in transgenic murine hearts of differing ODC activity was used to calculate ODC activity in tumor cell nucleoplasm. In total, tumor specimens for 31 of 114 (27%) patients treated on the AG strata and 10 patients from the GBM strata were obtained. We found that tumor ODC level heterogeneity increased with increasing tumor malignancy. In a Cox proportional hazards model, PFS was found to be inversely related to median tumor ODC activity, with an unadjusted hazard ratio for median ODC group (>3.3 vs. </=3.3 nmol/30 min/mug protein) of 5.8 (p < 0.0001); a median PFS of 522 weeks for patients with AGs with median ODC activity </= 3.3 and 31 weeks for the 8 AG and 10 glioblastoma patients with ODC activity > 3.3 nmol/30 min/mug protein. Of AG tumors in which ODC activity was evaluated, 26% had ODC levels > 3.3 nmol/30 min/mug protein. This study shows that Ab-ODC-Alexa 647 fluorescence intensity can be used as a surrogate marker of ODC biochemical activity in AGs and can predict PFS to DFMO-based chemotherapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anaplasia / drug therapy
  • Anaplasia / enzymology
  • Anaplasia / pathology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Disease Progression
  • Eflornithine / therapeutic use*
  • Glioma / drug therapy*
  • Glioma / enzymology*
  • Glioma / pathology
  • Humans
  • Ornithine Decarboxylase / metabolism*
  • Survival Rate
  • Vindesine / therapeutic use

Substances

  • Cyclophosphamide
  • Ornithine Decarboxylase
  • Cisplatin
  • Vindesine
  • Eflornithine

Supplementary concepts

  • PCV regimen