Prognostic value of cerebrospinal fluid tumor cell count in leptomeningeal disease from solid tumors.

PURPOSE: Treatment decisions for leptomeningeal disease (LMD) rely on patient risk stratification, since clinicians lack objective prognostic tools. The introduction of rare cell capture technology for identification of cerebrospinal fluid tumor cells (CSF-TCs), such as CNSide assay, improved the sensitivity of LMD diagnosis, but prognostic value is unknown. This study assesses the prognostic value of CSF-TC density in patients with LMD from solid tumors. METHODS: We conducted a retrospective cohort study of patients with newly diagnosed or previously treated LMD from a single institution who had CNSide assay testing for CSF-TCs from 2020 to 2023. Univariable and multivariable survival analyses were conducted with Cox proportional-hazards modeling. Maximally-selected rank statistics were used to determine an optimal cutpoint for CSF-TC density and survival. RESULTS: Of 31 patients, 29 had CSF-TCs detected on CNSide. Median (interquartile range [IQR]) CSF-TC density was 67.8 (4.7-639) TCs/mL. CSF cytology was positive in 16 of 29 patients with positive CNSide (CNSide diagnostic sensitivity = 93.5%, negative predictive value = 85.7%). Median (IQR) survival from time of CSF-TC detection was 176 (89-481) days. On univariable and multivariable analysis, CSF-TC density was significantly associated with survival. An optimal cutpoint for dichotomizing survival by CSF-TC density was 19.34 TCs/mL. The time-dependent sensitivity and specificity for survival using this stratification were 76% and 67% at 6 months and 65% and 67% at 1 year, respectively. CONCLUSIONS: CSF-TC density may carry prognostic value in patients with LMD from solid tumors. Integrating CSF-TC density into LMD patient risk-stratification may help guide treatment decisions.

Transferencia génica asistida por campos magnéticos: Estudios en células gliales / Magnetic field-assisted gene transfer: Studies in glial cells / Transferência gênica assistida por camposmagnéticos: Estudos em células gliais

Las nanopartículas magnéticas (MNP) complejadas con vectores génicos pueden, en presencia de un campo magnético externo, amplificar sustancialmente la eficiencia de la transferencia génica. Esta técnica, denominada magnetofección, es de gran interés en el campo de la terapia génica. En este estudio se caracterizó la mejora de transferencia génica en células gliales B92 utilizando complejos constituidos por diferentes proporciones de MNP asociadas a dos vectores adenovirales, a saber: los complejos entre las MNP denominadas PEI-Mag2 asociadas al adenovector RAd-GFP que expresa la proteína fluorescente verde GFP o al adenovector RAd-DsRed que expresa la proteína fluorescente roja DsRed2. Se demostró que para ambos vectores, a medida que la relación MNP/partícula viral física (PVF) va aumentando, la amplificación de la transfección también aumenta hasta que se llega a una relación MNP/PVF a partir de la cual el factor de amplificación alcanza un plateau. Se determinó que para el complejo PEI-Mag2/RAd-GFP la relación a partir de la cual se alcanza el plateau es de aproximadamente 0,5 fg Fe/PVF mientras que para el complejo PEI-Mag2/RAd-DsRed, esta relación corresponde a aproximadamente 71 fg Fe/PVF. Se concluye que los dos complejos magnéticos estudiados representan promisorias herramientas para mejorar la eficiencia en la terapia génica en células cerebrales.

It is known that certain types of magnetic nanoparticles (MNPs) complexed to gene vectors can, in the presence of an external magnetic field, greatly enhance gene transfer into cells. This technique, called magnetofection, is of great relevance to gene therapy. In the present study the ability of MNP/adenovector complexes to enhance gene transfer to B92 glial cells was assessed. Two complexes were assessed, namely PEI-Mag2/RAd-GFP and PEI-Mag2/RAd-DsRed, which are constituted by the MNP PEI-Mag2 complexed to the adenovector RAd-GFP (expressing the green fluorescent protein GFP) and RAd-DsRed (expressing the red fluorescent protein DsRed2), respectively. It was shown that for both vectors, an increase in the ratio MNP/PVP (physical viral particle) is paralleled by an increase in transduction efficiency, up to a certain threshold value at which an efficiency plateau is reached. This threshold value was 0.5 fg Fe/PVP for the RAd-GFP complex and about 71 fg Fe/PVP for the RAd-DsRed complex. It can be concluded that both magnetic complexes assessed in this study represent promising tools for enhancing the efficiency of gene therapy in brain cells.

As nanopartículas magnéticas (MNPs) complexadas com vetores de genes podem, em presença de um campo magnético externo, aumentar consideravelmente a eficiência da transferência gênica. Esta técnica, chamada magnetofecção, é de grande relevância para a terapia genética. No presente estudo, foi caracterizada a melhoria de transferência de genes em células gliais B92 utilizando complexos constituídos por diferentes proporções de MNP associadas a dois vetores adenovirais, a saber: os complexos entre as MNP denominadas PEI-Mag2 associadas ao adenovetor RAd-GFP que expressa a proteína fluorescente verde GFP ou ao adenovetor RAd-DsRed que expressa a proteína fluorescente vermelha DsRed2. Foi demonstrado que para ambos os vetores, enquanto a relação MNP/partícula viral física (PVF) vai aumentando, a amplificação da transfecção também aumenta até que se chega a uma relação MNP/PVF a partir da qual o fator de amplificação alcança um limiar. Determinou-se que para o complexo PEI-Mag2/RAd-GFP a relação a partir da qual se atinge o limiar é de aproximadamente 0,5 fg Fe/PVF ao passo que para o complexo PEI-Mag2/RAd-DsRed, esta relação corresponde a aproximadamente 71 fg Fe/PVF. Conclui-se que os dois complexos magnéticos estudados representam promissoras ferramentas para melhorar a eficiência na terapia de genes em células cerebrais.