Unraveling the extracellular matrix-tumor cell interactions to aid better targeted therapies for neuroblastoma

Int J Pharm. 2021 Oct 25:608:121058. doi: 10.1016/j.ijpharm.2021.121058. Epub 2021 Aug 28.


Treatment in children with high-risk neuroblastoma remains largely unsuccessful due to the development of metastases and drug resistance. The biological complexity of these tumors and their microenvironment represent one of the many challenges to face. Matrix glycoproteins such as vitronectin act as bridge elements between extracellular matrix and tumor cells and can promote tumor cell spreading. In this study, we established through a clinical cohort and preclinical models that the interaction of vitronectin and its ligands, such as αv integrins, are related to the stiffness of the extracellular matrix in high-risk neuroblastoma. These marked alterations found in the matrix led us to specifically target tumor cells within these altered matrices by employing nanomedicine and combination therapy. Loading the conventional cytotoxic drug etoposide into nanoparticles significantly increased its efficacy in neuroblastoma cells. We noted high synergy between etoposide and cilengitide, a high-affinity cyclic pentapeptide αv integrin antagonist. The results of this study highlight the need to characterize cell-extracellular matrix interactions, to improve patient care in high-risk neuroblastoma.

Keywords: Cilengitide; Etoposide; Nanomedicine; Neuroblastoma; Tumor microenvironment.

MeSH terms

  • Antineoplastic Agents* / pharmacology
  • Cell Communication
  • Extracellular Matrix
  • Humans
  • Neuroblastoma* / drug therapy
  • Tumor Microenvironment
  • Vitronectin


  • Antineoplastic Agents
  • Vitronectin