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Modeling and Bioinformatics Identify Responders to G-CSF in Patients With Amyotrophic Lateral Sclerosis
Johannesen, Siw Wollebæk, Huie, J. Russell, Budeus, Bettina, Peters, Sebastian, Wirth, Anna M., Iberl, Sabine, Kammermaier, Tina, Kobor, Ines, Wirkert, Eva, Küspert, Sabrina, Tahedl, Marlene, Grassinger, Jochen, Pukrop, Tobias, Schneider, Armin, Aigner, Ludwig, Schulte-Mattler, Wilhelm
, Schuierer, Gerhard, Koch, Winfried, Bruun, Tim-Henrik, Ferguson, Adam R. und Bogdahn, Ulrich
(2021)
Modeling and Bioinformatics Identify Responders to G-CSF in Patients With Amyotrophic Lateral Sclerosis.
Frontiers in Neurology 12 (616289), S. 1-5.
Veröffentlichungsdatum dieses Volltextes: 18 Mrz 2021 17:22
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.45256
Zusammenfassung
Objective: Developing an integrative approach to early treatment response classification using survival modeling and bioinformatics with various biomarkers for early assessment of filgrastim (granulocyte colony stimulating factor) treatment effects in amyotrophic lateral sclerosis (ALS) patients. Filgrastim, a hematopoietic growth factor with excellent safety, routinely applied in oncology and ...
Objective: Developing an integrative approach to early treatment response classification using survival modeling and bioinformatics with various biomarkers for early assessment of filgrastim (granulocyte colony stimulating factor) treatment effects in amyotrophic lateral sclerosis (ALS) patients. Filgrastim, a hematopoietic growth factor with excellent safety, routinely applied in oncology and stem cell mobilization, had shown preliminary efficacy in ALS. Methods: We conducted individualized long-term filgrastim treatment in 36 ALS patients. The PRO-ACT database, with outcome data from 23 international clinical ALS trials, served as historical control and mathematical reference for survival modeling. Imaging data as well as cytokine and cellular data from stem cell analysis were processed as biomarkers in a non-linear principal component analysis (NLPCA) to identify individual response. Results: Cox proportional hazard and matched-pair analyses revealed a significant survival benefit for filgrastim-treated patients over PRO-ACT comparators. We generated a model for survival estimation based on patients in the PRO-ACT database and then applied the model to filgrastim-treated patients. Model-identified filgrastim responders displayed less functional decline and impressively longer survival than non-responders. Multimodal biomarkers were then analyzed by PCA in the context of model-defined treatment response, allowing identification of subsequent treatment response as early as within 3 months of therapy. Strong treatment response with a median survival of 3.8 years after start of therapy was associated with younger age, increased hematopoietic stem cell mobilization, less aggressive inflammatory cytokine plasma profiles, and preserved pattern of fractional anisotropy as determined by magnetic resonance diffusion tensor imaging (DTI-MRI). Conclusion: Long-term filgrastim is safe, is well-tolerated, and has significant positive effects on disease progression and survival in a small cohort of ALS patients. Developing and applying a model-based biomarker response classification allows use of multimodal biomarker patterns in full potential. This can identify strong individual treatment responders (here: filgrastim) at a very early stage of therapy and may pave the way to an effective individualized treatment option.
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| Dokumentenart | Artikel | ||||
| Titel eines Journals oder einer Zeitschrift | Frontiers in Neurology | ||||
| Verlag: | Frontiers | ||||
|---|---|---|---|---|---|
| Ort der Veröffentlichung: | LAUSANNE | ||||
| Band: | 12 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 616289 | ||||
| Seitenbereich: | S. 1-5 | ||||
| Datum | 18 März 2021 | ||||
| Institutionen | Medizin > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medizin > Lehrstuhl für Neurologie Medizin > Lehrstuhl für Psychiatrie und Psychotherapie Medizin > Zentrum für Neuroradiologie | ||||
| Identifikationsnummer |
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| Stichwörter / Keywords | ; amyotrophic lateral sclerosis; granulocyte-colony stimulating factor (G-CSF); filgrastim; biomarker; modeling; principal component analysis (PCA); cytokines; stem cell | ||||
| Dewey-Dezimal-Klassifikation | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status | Veröffentlicht | ||||
| Begutachtet | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden | Ja | ||||
| URN der UB Regensburg | urn:nbn:de:bvb:355-epub-452566 | ||||
| Dokumenten-ID | 45256 |
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