MRP3: a molecular target for human glioblastoma multiforme immunotherapy.


BACKGROUND: Glioblastoma multiforme (GBM) is refractory to conventional therapies. To overcome the problem of heterogeneity, more brain tumor markers are required for prognosis and targeted therapy. We have identified and validated a promising molecular therapeutic target that is expressed by GBM: human multidrug-resistance protein 3 (MRP3). METHODS: We investigated MRP3 by genetic and immunohistochemical (IHC) analysis of human gliomas to determine the incidence, distribution, and localization of MRP3 antigens in GBM and their potential correlation with survival. To determine MRP3 mRNA transcript and protein expression levels, we performed quantitative RT-PCR, raising MRP3-specific antibodies, and IHC analysis with biopsies of newly diagnosed GBM patients. We used univariate and multivariate analyses to assess the correlation of RNA expression and IHC of MRP3 with patient survival, with and without adjustment for age, extent of resection, and KPS. RESULTS: Real-time PCR results from 67 GBM biopsies indicated that 59/67 (88%) samples highly expressed MRP3 mRNA transcripts, in contrast with minimal expression in normal brain samples. Rabbit polyvalent and murine monoclonal antibodies generated against an extracellular span of MRP3 protein demonstrated reactivity with defined MRP3-expressing cell lines and GBM patient biopsies by Western blotting and FACS analyses, the latter establishing cell surface MRP3 protein expression. IHC evaluation of 46 GBM biopsy samples with anti-MRP3 IgG revealed MRP3 in a primarily membranous and cytoplasmic pattern in 42 (91%) of the 46 samples. Relative RNA expression was a strong predictor of survival for newly diagnosed GBM patients. Hazard of death for GBM patients with high levels of MRP3 RNA expression was 2.71 (95% CI: 1.54-4.80) times that of patients with low/moderate levels (p = 0.002). CONCLUSIONS: Human GBMs overexpress MRP3 at both mRNA and protein levels, and elevated MRP3 mRNA levels in GBM biopsy samples correlated with a higher risk of death. These data suggest that the tumor-associated antigen MRP3 has potential use for prognosis and as a target for malignant glioma immunotherapy.





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Publication Info

Kuan, Chien-Tsun, Kenji Wakiya, James E Herndon, Eric S Lipp, Charles N Pegram, Gregory J Riggins, Ahmed Rasheed, Scott E Szafranski, et al. (2010). MRP3: a molecular target for human glioblastoma multiforme immunotherapy. BMC Cancer, 10. p. 468. 10.1186/1471-2407-10-468 Retrieved from

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Chien-Tsun Kuan

Adjunct Associate Professor in the Department of Pathology

Research Interests:
Conventional therapy for malignant brain tumors is ineffective. Targeted therapy using tumor-specific antibodies (MAb) alone or MAbs armed with radionuclides or toxins is a promising alternative approach for increasing therapeutic efficacy and decreasing toxicity to normal tissue. The major factors that influence antibody-targeted therapy for cancer treatment, including glioma therapy, are specificity, affinity, tumor penetration, toxicity and immunogenicity. The effective use of radioimmunotherapy (RAIT) for the treatment of solid malignancies has been limited by inadequate tumor penetration and non-targeted myelotoxicity resulting from the presence of radioimmunoconjugates in circulation. We believe that these limitations to direct RAIT can be overcome by using smaller engineered antibody-based molecules as vehicles and by selecting therapeutic radioisotopes with physical properties that complement the pharmacokinetics and pharmacodynamics of the antibody.

Our research is focused upon exploiting engineered antibody fragments to treat brain tumors by targeting to glioma-associated, oncofetal epitopes such as tenascin, glioma variant epidermal growth factor variant III (EGFRvIII), medulloblastoma-associated developmental markers, as well as the newly identified glioma-associated antigens, GPNMB and MRP3, by serial analysis of gene expression (SAGE). Projects performed in the current years have: 1) produced and evaluated the monovalent single-chain Fv (scFv) against EGRvIII in athymic mice bearing human glioma xenografts; 2) begun the development of divalent form of scFv, including diabody and minibody, to increase the efficacy of therapeutic agents in vivo; 3) generated CH2 domain-deleted Ch81C6 vs tenascin and evaluated the pharmacokinetics in mice and canines; 4) begun an extensive analysis of GPNMB and MRP3 protein expression correlated with measurement of RNA transcript levels and degree of DNA amplification.

Unarmed antibody can be effective against both subcutaneous and intracranial tumor models. The unarmed antibody approach with Mab Y10 vs EGFRvIII is very similar to the successful use of HerceptinTM. The mechanism is most likely both a direct antiproliferative effect with the induction of apoptosis and an indirect effect through the mobilization of antibody-mediated immune effector functions, such as complement and antibody-dependent cell-mediated cytotoxicity (ADCC). We also have begun to construct human/mouse chimeric Y10 to reduce immunogenicity of the Mab reagent and possibly enhance ADCC.

Our objectives for the coming years are to continue the optimization of engineered-antibody systems for in vivo application, namely; a) development of human/mouse chimeric anti-EGFRvIII murine Y10 with the same affinity and specificity but reduced immunogenicity and enhanced ADCC for in vivo application; b) to generate a totally human scFv specific to EGFRvIII but with anti-proliferative activity via screening from human phage libraries; c) generation of monomeric and dimeric anti-GPNMB/MRP3 scFvs and construction of immunoconjugate toxins or radiolabeled to determine the efficacy of therapeutic reagents in athymic rodent in athymic rodent in vivo models of intracranial glioma.


James Emmett Herndon

Professor of Biostatistics & Bioinformatics

Current research interests have application to the design and analysis of cancer clinical trials. Specifically, interests include the use of time-dependent covariables within survival models, the design of phase II cancer clinical trials which minimize some of the logistical problems associated with their conduct, and the analysis of longitudinal studies with informative censoring (in particular, quality of life studies of patients with advanced cancer).


Roger Edwin McLendon

Professor of Pathology

Brain tumors are diagnosed in more than 20,000 Americans annually. The most malignant neoplasm, glioblastoma, is also the most common. Similarly, brain tumors constitute the most common solid neoplasm in children and include astrocytomas of the cerebellum, brain stem and cerebrum as well as medulloblastomas of the cerebellum.  My colleagues and I have endeavored to translate the bench discoveries of genetic mutations and aberrant protein expressions found in brain tumors to better understand the processes involved in the etiology, pathogenesis, and treatment of brain tumors.  Using the resources of the Preston Robert Brain Tumor Biorepository at Duke, our team, consisting of Henry Friedman, Allan Friedman, and Hai Yan and lead by Darell Bigner, have helped to identify mutations in Isocitrate Dehydrogenase (IDH1 and IDH2) as a marker of good prognosis in gliomas of adults.  This test is now offered at Duke as a clinical test.  Working with the Molecular Pathology Laboratory at Duke, we have also brought testing for TERT promoter region mutations as another major test for classifying gliomas in adults.  Our collaboration with the Toronto Sick Kids Hospital has resulted in prognostic testing for childhood medulloblastomas, primitive neuroectodermal tumors, and ependymomas at Duke.

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