A role for ABCB1 in prognosis, invasion and drug resistance in ependymoma

Sabnis, Durgagauri H.; Storer, Lisa C. D.; Liu, Jo-Fen; Jackson, Hannah K.; Kilday, J. P.; Grundy, Richard G.; Kerr, Ian D.; Coyle, Beth

Abstract

© 2019, The Author(s). Three of the hallmarks of poor prognosis in paediatric ependymoma are drug resistance, local invasion and recurrence. We hypothesised that these hallmarks were due to the presence of a sub-population of cancer stem cells expressing the multi-drug efflux transporter ABCB1. ABCB1 gene expression was observed in 4 out of 5 paediatric ependymoma cell lines and increased in stem cell enriched neurospheres. Functional inhibition of ABCB1 using vardenafil or verapamil significantly (p ≤ 0.05–0.001) potentiated the response to three chemotherapeutic drugs (vincristine, etoposide and methotrexate). Both inhibitors were also able to significantly reduce migration (p ≤ 0.001) and invasion (p ≤ 0.001). We demonstrate that ABCB1 positive patients from an infant chemotherapy-led trial (CNS9204) had a shorter mean event free survival (EFS) (2.7 versus 8.6 years; p = 0.007 log-rank analysis) and overall survival (OS) (5.4 versus 12 years; p = 0.009 log-rank analysis). ABCB1 positivity also correlated with reduced event free survival in patients with incompletely resected tumours who received chemotherapy across CNS9204 and CNS9904 (a radiotherapy-led SIOP 1999-04 trial cohort; p = 0.03). ABCB1 is a predictive marker of chemotherapy response in ependymoma patients and vardenafil, currently used to treat paediatric pulmonary hypertension in children, could be repurposed to reduce chemoresistance, migration and invasion in paediatric ependymoma patients at non-toxic concentrations.

Citation

Sabnis, D. H., Storer, L. C. D., Liu, J.-F., Jackson, H. K., Kilday, J. P., Grundy, R. G., Kerr, I. D., & Coyle, B. (2019). A role for ABCB1 in prognosis, invasion and drug resistance in ependymoma. Scientific Reports, 9(1), 1-9. https://doi.org/10.1038/s41598-019-46700-z

• Journal Article Type: Article
• Acceptance Date: Jun 27, 2019
• Online Publication Date: Jul 16, 2019
• Publication Date: 2019-12
• Deposit Date: Aug 5, 2019
• Publicly Available Date: Aug 5, 2019
• Journal: Scientific Reports
• Electronic ISSN: 2045-2322
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 1
• Article Number: 10290
• Pages: 1-9
• DOI: https://doi.org/10.1038/s41598-019-46700-z
• Keywords: Multidisciplinary
• Public URL: https://nottingham-repository.worktribe.com/output/2318641
• Publisher URL: https://www.nature.com/articles/s41598-019-46700-z
• Additional Information: Received: 4 October 2018; Accepted: 27 June 2019; First Online: 16 July 2019; : The authors declare no competing interests.
• Contract Date: Aug 5, 2019