Cancer of Head and NeckNCT03954691
Targeting Potassium Channels to Reprogram Glioblastoma Microenvironment: in Vitro and in Vivo Studies
An observational study of Cancer of Head and Neck, run by Neuromed IRCCS at 2 sites in Italy.
Trial summary
The investigators want to verify the hypothesis that targeting the calcium-activated (KCa3.1) and the voltage-dependent K channel (Kv1.3) could be a valuable therapeutic strategy to reprogram cells of the innate immune system, with the aim to fight glioma, a deadly CNS tumor. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Cancer of Head and Neck
- What is being tested?
- brain tumor-immune cells communication
- How many people
- 50 participants
- Where
- 2 sitesItaly
- Study dates
- 1 Oct 2019to 1 Oct 2021
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Child, Adult, Older adult
Study population: glioma patients who undergo neurosurgery for glioblastoma surgical eradication
Who may be able to join
- glioma patients who undergo neurosurgery
Who cannot join
- biopsies from patients with brain tumor different than glioma
Trial locations and contacts
2 sites in 1 country.
Italy2 sites
Cristina Limatola
Pozzilli, Is, 86007
Cristina Limatola
Pozzilli, 86077
About this study
The investigators want to verify the hypothesis that targeting the calcium-activated (KCa3.1) and the voltage-dependent K channel (Kv1.3) could be a valuable therapeutic strategy to reprogram cells of the innate immune system, with the aim to fight glioma, a deadly CNS tumor. The investigators will use murine models of glioma, injecting GL261 cells in the brain of syngeneic C57BL6 mice, to study the effect of K channel inhibition on the activation of microglia (M), macrophages (Mf) and NK cells. The investigators will use M and vesicles released from these cells, re-educated toward an anti-tumor phenotype, to interfere with the vicious circle responsible of uncontrolled tumor growth and will study the role of NK cells in tumor-M/Mf communication. The investigators will also investigate how K channels interfere with the communication of innate immune cells and brain cells like neurons and astrocytes, with experiments focused on synaptic transmission and calcium imaging, investigating the effect of modulation of the tumor microenvironment.
Read the detailed description
Specific Aim 1:
Specific Aim 3:
To investigate whether M, or Mf-derived micro-vesicles, delivered to the brain of mouse bearing glioma could affect glioma growth and mice survival. This will allow to better define the role of M in controlling glioma growth as a function of its activation state and of KCa3.1 and Kv1.3 channel expression and activity. OBJECTIVE: from this aim the investigators expect to verify whether brain delivery of differently polarized M (or M-derived vesicles), or M/Mf, could represent a meaningful approach to counteract glioma growth and to lengthen mice survival.
Investigate the relationship between CD11b+ and NK cells upon KCa3.1 and Kv1.3 inhibition or NK cell depletion. OBJECTIVE: data obtained will help to understand whether the activation state of M/Mf affects NK cell accumulation in the tumor site and their cytotoxic activity, whether NK cells modulate M/Mf activation, with effects on tumor growth, and the eventual role played by K+ channels. Our preliminary data showing that TRAM-34 treatment increased the mRNA level of IL-15 in the brain of glioma-bearing mice (FIG3) would suggest an IL-15-mediated increased accumulation of NK cells in the tumor region, similarly to previous evidence (19).
To investigate the roles of KCa3.1 and Kv1.3 channels in the interaction between glioma and the surrounding parenchyma. OBJECTIVE: to identify possible mechanisms of altered communication in the brain of mice treated with K+ channel inhibitors by studying K+ currents, excitatory and inhibitory synaptic transmission and astrocytes activation state, under normal and hypoxic conditions (corresponding to different position in the tumor mass). Altered expression and function of ion channels in glioma cells isolated from mice treated with functionally different M and M-derived vesicles will also be investigated.
Experimental Design Aim 1:
Experimental Design Aim 2:
Experimental Design Aim 3:
This will be investigated with M polarized in culture, treated with TRAM-34 or PAP-1, silenced by siRNA specific for KCa3.1 (9) or isolated from KCa3.1-/- or Kv1.3 -/- mice and transplanted in the brain of glioma bearing mice by brain injection or intranasal delivery. Brain injection of M will be performed similarly to glioma injection (21). Intranasal (i.n.) cell application will be performed during a short isoflurane anesthesia. Before treatment, all animals will receive 100 U hyaluronidase i.n. dissolved in 12 µL of sterile PBS and one hour later a microglia suspension (3 × 105 in 12 µL of sterile PBS) or vehicle (PBS) will be applied using the same procedure. Microglia application will be repeated every 3 days until mice sacrifice. To check for M delivery in brain tumor region, control experiments will be performed using GFP-labeled M, obtained from sibling CX3CR1GFP/+ mice, already available in our laboratory. To prepare micro-vesicles, M will be treated with ATP (1mM) for 30 min (20). Different centrifugation steps will be performed and the homogeneity of vesicle dimension will be evaluated in parallel experiments by dynamic light scattering. Fixed volumes of this preparation (4microL) will be administrated intra nasally every 3 days until mice sacrifice. M and Mf-derived micro-vesicle-transplanted mice will then be analyzed for tumor volume and mice survival investigated as described (9).
This will be performed on cells isolated (by human biopsy and mice brain) by FACS sorting or by magnetic separator (CD11b+ cells), and assayed in vitro for phagocytic and cytotoxic activity. The investigators will also perform analysis of gene expression and electrophysiological recordings (patch clamp) of ion channel function on M and on tumor cells in vitro and ex vivo in brain slices. These experiments will be performed in TRAM-34 or PAP-1 treated or in KCa3.1-/- or KV1.3-/- glioma bearing mice. M/Mf-NK cell interaction will be also studied looking at NK-induced M/Mf alteration and M/Mf-induced NK alteration. At this aim the investigators will deplete NK cell population with repeated injection of anti NK1.1 antibody in glioma bearing mice, to analyze the activation state of M/Mf cell population.
For this aim the investigators will use electrophysiological, fluorescence and confocal microscope analysis in acute brain slice preparations. A detailed description of the functional role of microglial K+ channels in modulating glioma progression will be provided. In particular, the functional properties of KCa3.1 and Kv1.3 channels expressed by microglial cells in control and glioma injected mice will be evaluated in acute brain slices by means of the patch-clamp techniques. The effects of K channel blockade on neuronal signaling and on astrocytes reactivity will be also evaluated in the same conditions. Fluorescence-based digital Ca2+ imaging will be used to assess the role of these channels in microglial [Ca2+]i regulation. Using electrophysiological measurements, in combination with immunochemical, PCR, siRNA analysis, the investigators will also analyze the modulation of K channels in glioma. Using acute brain slices from glioma-injected mice, the investigators will also assess whether treatment of mice with polarized M affects the expression and function of glioma ion channels known to contribute to the transformed phenotype, such as KCa3.1 channels, BK channels, and volume-activated Cl channels. These experiments will be performed in hypoxic and non-hypoxic areas of the tumor, identified ex post by evaluating the HIF-1alfa expression.
Methodologies and statistical analyses: The iterative method of "Camussi et al." (20) will be followed. The investigators will use the following relation where n is the number of animals: n>2sigma^2 (z alpha/D)^2. As an example, to estimate the number of mice necessary to obtain a significance alpha=0.09, a difference D in treatment effect on a given parameter, the investigators need to know the standard deviation sigma. Since sigma^2 is unknown, it must be substituted with an estimate of sampling variance s^2. If the investigators give to s^2=0.01, the investigators have that n>18, so the investigators predict to use 20 mice per experimental group. Our experience with mice suggests that it is a reasonable number. Statistical significance will be assessed by one-way ANOVA for parametrical data, as indicated; "Holm-Sidak" test will be used as post-hoc test; "Mann and Withney" test for non-parametrical data. Where appropriate, Student's t-test or analysis of variance (ANOVA) will be used.
- Conditions
- Cancer of Head and Neck
- Being tested
- brain tumor-immune cells communication
- Medical subject headings
- Head and Neck Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
brain tumor-immune cells communicationOther
tumoral and immune cell isolation from biopsis
What is being measured
The primary outcome is the main question the study is designed to answer.
glioblastoma cells
observational studies on cells isolated from tumor specimens
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 May 2019
- Study start1 Oct 2019 (estimated)
- Primary completion1 Apr 2020 (estimated)
- Study completion1 Oct 2021 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Cancer of Head and NeckStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case only
- Time perspective
- Retrospective
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Neuromed IRCCS
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Cristina Limatola, Neuromed IRCCS
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03954691
- Sponsor's protocol ID
- RF-2018-12366215
- Status last verified
- May 2019
- First submitted
- 11 May 2019
- Last updated
- 21 May 2019
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 21 May 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Targeting Potassium Channels to Reprogram Glioblastoma Microenvironment: in Vitro and in Vivo Studies
- ClinicalTrials.gov ID
- NCT03954691
- Acronym / sponsor ID
- RF-2018-12366215
- Conditions
- Cancer of Head and Neck
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- Neuromed IRCCSUniversity, hospital or other
- Study start
- 1 Oct 2019 (estimated)
- Primary completion
- 1 Apr 2020 (estimated)
- Study completion
- 1 Oct 2021 (estimated)
- First posted
- 17 May 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators want to verify the hypothesis that targeting the calcium-activated (KCa3.1) and the voltage-dependent K channel (Kv1.3) could be a valuable therapeutic strategy to reprogram cells of the innate immune system, with the aim to fight glioma, a deadly CNS tumor. The investigators will use murine models of glioma, injecting GL261 cells in the brain of syngeneic C57BL6 mice, to study the effect of K channel inhibition on the activation of microglia (M), macrophages (Mf) and NK cells. The investigators will use M and vesicles released from these cells, re-educated toward an anti-tumor phenotype, to interfere with the vicious circle responsible of uncontrolled tumor growth and will study the role of NK cells in tumor-M/Mf communication. The investigators will also investigate how K channels interfere with the communication of innate immune cells and brain cells like neurons and astrocytes, with experiments focused on synaptic transmission and calcium imaging, investigating the effect of modulation of the tumor microenvironment.
Detailed description
Specific Aim 1:
Specific Aim 3:
To investigate whether M, or Mf-derived micro-vesicles, delivered to the brain of mouse bearing glioma could affect glioma growth and mice survival. This will allow to better define the role of M in controlling glioma growth as a function of its activation state and of KCa3.1 and Kv1.3 channel expression and activity. OBJECTIVE: from this aim the investigators expect to verify whether brain delivery of differently polarized M (or M-derived vesicles), or M/Mf, could represent a meaningful approach to counteract glioma growth and to lengthen mice survival.
Investigate the relationship between CD11b+ and NK cells upon KCa3.1 and Kv1.3 inhibition or NK cell depletion. OBJECTIVE: data obtained will help to understand whether the activation state of M/Mf affects NK cell accumulation in the tumor site and their cytotoxic activity, whether NK cells modulate M/Mf activation, with effects on tumor growth, and the eventual role played by K+ channels. Our preliminary data showing that TRAM-34 treatment increased the mRNA level of IL-15 in the brain of glioma-bearing mice (FIG3) would suggest an IL-15-mediated increased accumulation of NK cells in the tumor region, similarly to previous evidence (19).
To investigate the roles of KCa3.1 and Kv1.3 channels in the interaction between glioma and the surrounding parenchyma. OBJECTIVE: to identify possible mechanisms of altered communication in the brain of mice treated with K+ channel inhibitors by studying K+ currents, excitatory and inhibitory synaptic transmission and astrocytes activation state, under normal and hypoxic conditions (corresponding to different position in the tumor mass). Altered expression and function of ion channels in glioma cells isolated from mice treated with functionally different M and M-derived vesicles will also be investigated.
Experimental Design Aim 1:
Experimental Design Aim 2:
Experimental Design Aim 3:
This will be investigated with M polarized in culture, treated with TRAM-34 or PAP-1, silenced by siRNA specific for KCa3.1 (9) or isolated from KCa3.1-/- or Kv1.3 -/- mice and transplanted in the brain of glioma bearing mice by brain injection or intranasal delivery. Brain injection of M will be performed similarly to glioma injection (21). Intranasal (i.n.) cell application will be performed during a short isoflurane anesthesia. Before treatment, all animals will receive 100 U hyaluronidase i.n. dissolved in 12 µL of sterile PBS and one hour later a microglia suspension (3 × 105 in 12 µL of sterile PBS) or vehicle (PBS) will be applied using the same procedure. Microglia application will be repeated every 3 days until mice sacrifice. To check for M delivery in brain tumor region, control experiments will be performed using GFP-labeled M, obtained from sibling CX3CR1GFP/+ mice, already available in our laboratory. To prepare micro-vesicles, M will be treated with ATP (1mM) for 30 min (20). Different centrifugation steps will be performed and the homogeneity of vesicle dimension will be evaluated in parallel experiments by dynamic light scattering. Fixed volumes of this preparation (4microL) will be administrated intra nasally every 3 days until mice sacrifice. M and Mf-derived micro-vesicle-transplanted mice will then be analyzed for tumor volume and mice survival investigated as described (9).
This will be performed on cells isolated (by human biopsy and mice brain) by FACS sorting or by magnetic separator (CD11b+ cells), and assayed in vitro for phagocytic and cytotoxic activity. The investigators will also perform analysis of gene expression and electrophysiological recordings (patch clamp) of ion channel function on M and on tumor cells in vitro and ex vivo in brain slices. These experiments will be performed in TRAM-34 or PAP-1 treated or in KCa3.1-/- or KV1.3-/- glioma bearing mice. M/Mf-NK cell interaction will be also studied looking at NK-induced M/Mf alteration and M/Mf-induced NK alteration. At this aim the investigators will deplete NK cell population with repeated injection of anti NK1.1 antibody in glioma bearing mice, to analyze the activation state of M/Mf cell population.
For this aim the investigators will use electrophysiological, fluorescence and confocal microscope analysis in acute brain slice preparations. A detailed description of the functional role of microglial K+ channels in modulating glioma progression will be provided. In particular, the functional properties of KCa3.1 and Kv1.3 channels expressed by microglial cells in control and glioma injected mice will be evaluated in acute brain slices by means of the patch-clamp techniques. The effects of K channel blockade on neuronal signaling and on astrocytes reactivity will be also evaluated in the same conditions. Fluorescence-based digital Ca2+ imaging will be used to assess the role of these channels in microglial [Ca2+]i regulation. Using electrophysiological measurements, in combination with immunochemical, PCR, siRNA analysis, the investigators will also analyze the modulation of K channels in glioma. Using acute brain slices from glioma-injected mice, the investigators will also assess whether treatment of mice with polarized M affects the expression and function of glioma ion channels known to contribute to the transformed phenotype, such as KCa3.1 channels, BK channels, and volume-activated Cl channels. These experiments will be performed in hypoxic and non-hypoxic areas of the tumor, identified ex post by evaluating the HIF-1alfa expression.
Methodologies and statistical analyses: The iterative method of "Camussi et al." (20) will be followed. The investigators will use the following relation where n is the number of animals: n>2sigma^2 (z alpha/D)^2. As an example, to estimate the number of mice necessary to obtain a significance alpha=0.09, a difference D in treatment effect on a given parameter, the investigators need to know the standard deviation sigma. Since sigma^2 is unknown, it must be substituted with an estimate of sampling variance s^2. If the investigators give to s^2=0.01, the investigators have that n>18, so the investigators predict to use 20 mice per experimental group. Our experience with mice suggests that it is a reasonable number. Statistical significance will be assessed by one-way ANOVA for parametrical data, as indicated; "Holm-Sidak" test will be used as post-hoc test; "Mann and Withney" test for non-parametrical data. Where appropriate, Student's t-test or analysis of variance (ANOVA) will be used.
Study design
- Observational model
- Case only
- Time perspective
- Retrospective
Who may qualify
- Sex
- All
- Age groups
- Child, Adult, Older adult
- Study population
- glioma patients who undergo neurosurgery for glioblastoma surgical eradication
Key inclusion criteria (1 listed)
- glioma patients who undergo neurosurgery
Key exclusion criteria (1 listed)
- biopsies from patients with brain tumor different than glioma
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| brain tumor-immune cells communicationtumoral and immune cell isolation from biopsis | Other | – |
Primary outcome
glioblastoma cells
Time frame: 6 months
observational studies on cells isolated from tumor specimens
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 May 2019.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Cancer of Head and Neck, run by Neuromed IRCCS at 2 sites in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 21 May 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Cristina Limatola, PhD (+390865915217, cristina.limatola@uniroma1.it), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
glioblastoma cells (time frame: 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 May 2019.