A Novel Nanoparticle Therapy for Glioblastoma
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A novel nanoparticle therapy for glioblastoma Victor M. Lu A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy (PhD) University of New South Wales Faculty of Medicine Prince of Wales Clinical School Adult Cancer Program Cure Brain Cancer Foundation Biomarkers and Translational Research January 2019 i THESIS/DISSERTATION SHEET Thesis/Dissertation Sheet Surname/Family Name : LU Given Name/s : VICTOR MING YUAN Abbreviation for degree as give in the University calendar : PHD Faculty : MEDICINE School : PRINCE OF WALES CLINICAL SCHOOL Thesis Title : A NOVEL NANOPARTICLE THERAPY FOR GLIOBLASTOMA Abstract 350 words maximum: (PLEASE TYPE) Glioblastoma (GBM) is a malignant brain tumour with a median overall survival of 15 months, despite best management of surgical resection, radiation therapy (RT) and chemotherapy with temozolomide (TMZ). This outlook has not changed in the last decade. Nanoparticle (NP) therapy presents an exciting novel consideration due to its ability to be formulated and target the brain. This thesis describes the evaluation of rare earth oxide (REO) NP therapies as potential treatment for GBM given the chemical properties of rare earth elements (REEs) have been shown to exert anti-cancer effects. In characterising and testing a series of four different REO NPs, it was shown that they can penetrate into a GBM cell, and that they have potential to not only be cytotoxic to both immortalised and patient-derived GBM cell lines, but also augment the therapeutic effects of RT and TMZ as well. In particular, REO La2O3 was found to be the most cytotoxic NP tested, and further investigation into determining mechanisms of effect were pursued. The cause of cell death by La2O3 was found to be multifaceted. Involvement of both intrinsic and extrinsic apoptosis pathways was demonstrated, as well as pathways involving direct DNA damage and autophagy. Interaction with adjuvant RT and TMZ was also shown to occur via reactive oxygen species (ROS) and alteration in apoptosis tendencies respectively. Finally, the biocompatibility and biodistribution of La2O3 NP therapy was evaluated in a balb/c nude mouse model. We observed that not only does the NP reach the brain, it behaves quite similarly to other NP therapies in terms of biodistribution. There were no short- or long-term adverse events observed with our designed therapeutic regimen. Concurrent adjuvant RT and TMZ did not affect the compatibility or distribution of the NP. In summary, this thesis describes the initial investigation of a REO NP therapy to improve GBM management and prognosis. Its anti-GBM effects have been demonstrated and rationalised in a number of GBM cell lines, and its shown biocompatibility and biodistribution in a biological system justify future GBM xenograft survival studies to elucidate the transfer from bench to bedside of this novel therapy. Declaration relating to disposition of project thesis/dissertation I hereby grant to the University of New South Wales or its agents the right to archive and to make available my thesis or dissertation in whole or in part in the University libraries in all forms of media, now or here after known, subject to the provisions of the Copyright Act 1968. I retain all property rights, such as patent rights. I also retain the right to use in future works (such as articles or books) all or part of this thesis or dissertation. I also authorise University Microfilms to use the 350 word abstract of my thesis in Dissertation Abstracts International (this is applicable to doctoral theses only). …5… February….…………… 2019………...…….… Signature Witness Signature Date The University recognises that there may be exceptional circumstances requiring restrictions on copying or conditions on use. Requests for restriction for a period of up to 2 years must be made in writing. Requests for a longer period of restriction may be considered in exceptional circumstances and require the approval of the Dean of Graduate Research. FOR OFFICE USE ONLY Date of completion of requirements for Award: ii ORIGINALITY STATEMENT ORIGINALITY STATEMENT ‘I hereby declare that this submission is my own work and to the best of my knowledge it contains no materials previously published or written by another person, or substantial proportions of material which have been accepted for the award of any other degree or diploma at UNSW or any other educational institution, except where due acknowledgement is made in the thesis. Any contribution made to the research by others, with whom I have worked at UNSW or elsewhere, is explicitly acknowledged in the thesis. I also declare that the intellectual content of this thesis is the product of my own work, except to the extent that assistance from others in the project's design and conception or in style, presentation and linguistic expression is acknowledged.’ Signed …………………………………………….............. 5 February 2019 Date …………………………………………….............. iii INCLUSION OF PUBLICATION STATEMENT INCLUSION OF PUBLICATIONS STATEMENT UNSW is supportive of candidates publishing their research results during their candidature as detailed in the UNSW Thesis Examination Procedure. Publications can be used in their thesis in lieu of a Chapter if: • The student contributed greater than 50% of the content in the publication and is the “primary author”, ie. the student was responsible primarily for the planning, execution and preparation of the work for publication • The student has approval to include the publication in their thesis in lieu of a Chapter from their supervisor and Postgraduate Coordinator. • The publication is not subject to any obligations or contractual agreements with a third party that would constrain its inclusion in the thesis Please indicate whether this thesis contains published material or not. This thesis contains no publications, either published or submitted for publication ☐ (if this box is checked, you may delete all the material on page 2) Some of the work described in this thesis has been published and it has been ☐ documented in the relevant Chapters with acknowledgement (if this box is checked, you may delete all the material on page 2) This thesis has publications (either published or submitted for publication) ☐ incorporated into it in lieu of a chapter and the details are presented below CANDIDATE’S DECLARATION I declare that: • I have complied with the Thesis Examination Procedure • where I have used a publication in lieu of a Chapter, the listed publication(s) below meet(s) the requirements to be included in the thesis. Name Signature Date (dd/mm/yy) VICTOR M LU 05/02/2019 i iv COPYRIGHT STATEMENT 'I hereby grant the University of New South Wales or its agents the right to archive and to make available my thesis or dissertation in whole or part in the University libraries in all forms of media, now or here after known, subject to the provisions of the Copyright Act 1968. I retain all proprietary rights, such as patent rights. I also retain the right to use in future works (such as articles or books) all or part of this thesis or dissertation. I also authorise University Microfilms to use the 350 word abstract of my thesis in Dissertation Abstract International (this is applicable to doctoral theses only). I have either used no substantial portions of copyright material in my thesis or I have obtained permission to use copyright material; where permission has not been granted I have applied/will apply for a partial restriction of the digital copy of sis ::�:: ···························· Date .... �.� ...... /!1/fJ ...... Z-Ql. 1... ......................... AUTHENTICITY STATEMENT 'I certify that the Library deposit digital copy is a direct equivalent of the final officially approved version of my thesis. No emendation of content has occurred and if there are any minor variations in formatting, they are the result of the conversion form Signed ............ Date .... �!...... M./.l:Y........ 2.0{.9.. ............................ Abstract Glioblastoma (GBM) is a malignant brain tumour with a median overall survival of 15 months, despite best management of surgical resection, radiation therapy (RT) and chemotherapy with temozolomide (TMZ). This outlook has not changed in the last decade. Nanoparticle (NP) therapy presents an exciting novel consideration due to its ability to be formulated and target the brain. This thesis describes the evaluation of rare earth oxide (REO) NP therapies as potential treatment for GBM given the chemical properties of rare earth elements (REEs) have been shown to exert anti-cancer effects. In characterising and testing a series of four different REO NPs, it was shown that this novel NP therapy can penetrate into the GBM cell, and that it has potential to not only be cytotoxic to both immortalised and patient-derived GBM cell lines, but also augment the therapeutic effects of RT and TMZ as well. In particular, REO La2O3 was found to be the most cytotoxic REO NP tested, and further investigation into determining mechanisms of effect was pursued. The cause of cell death by La2O3 was found to be multifaceted. Involvement of both intrinsic and extrinsic apoptosis pathways was demonstrated, as well as pathways involving direct DNA damage and autophagy. Interaction with adjuvant RT and TMZ was also shown to occur via reactive oxygen species (ROS) and alteration in mitochondrial apoptosis balance respectively. Finally, the biocompatibility and biodistribution of La2O3 NP therapy was evaluated in a balb/c nude mouse model. It was observed that not only does the NP reach the brain, it also behaves quite similarly to other reported non-REO NP therapies in terms of biodistribution. There were no short- or long-term adverse events observed with the designed therapeutic regimen. Concurrent adjuvant RT and TMZ did not affect the compatibility or distribution of the NP. In summary, this thesis describes the initial investigation of a novel REO NP therapy that has shown basic promise to improve GBM management and prognosis. Its anti-GBM effects have been demonstrated and rationalised in a number of GBM cell lines, as well as its shown biocompatibility and biodistribution in a biological system.