Abstract BACKGROUND GB is the most common, most aggressive primary brain tumor with a deleterious prognosis. ASPP2 is a tumor suppressor, directly interacting with p53. We recently identified a dominant-negative isoform of ASPP2, named ASPP2κ, lacking the important p53 binding sites and show that ASPP2κ is highly expressed and functionally active in glioblastoma, affecting all classical hallmarks of cancer. MATERIAL AND METHODS Grade IV glioma (n=46) were assessed for ASPP2κ expression. Isogenic GB models, stably suppressing or overexpressing ASPP2κ, were established in A-172, U-251 and T98g cell lines and from resected GB tissue. The role of ASPP2κ in induction of apoptosis, cellular proliferation, migration and invasion was assessed in vitro and in vivo. Proteome arrays allowed to study pathways involved in ASPP2κ signaling. Two ASPP2κ knock-down (KD) NOD/SCID xenotransplant mouse models were established to study ASPP2κ in tumor engraftment and progression. RESULTS Frequent overexpression of ASPP2κ was confirmed in virtually all patients analyzed compared to tumor-free tissue. Expression thereby varied widely in between patients (2-40 fold). Functional analyses confirm that ASPP2κ directly affects multiple cancer hallmarks in GB, resulting in a more aggressive phenotype with impaired induction of apoptosis (avg. -25 %), higher proliferation (avg. +25%), migration (avg. +65%) and invasion (avg. +70%) rates. Silencing of ASPP2κ rescues the ASPP2 wt tumor suppressor phenotype, rendering cells more susceptible towards temozolomide (TMZ, avg. +25%), γ-irradiation (avg. +40%) or combinational approaches. Upregulation of p53 phosphorylation sites (S15: 2,5x/S46: 1,5x) and cell cycle regulators (p21: 2x, p27: 3x and pRAD: 2,5x) thereby confirms restoration of important p53-mediated pathways. GB mouse models confirm attenuated tumor engraftment and progression of ASPP2κ KD tumors in vivo. Mice carrying ASPP2κ-KD tumors presented with statistically significant increased overall survival in both models (p= 0.03 and p=0.005) and attenuated tumor growth (p=0.0001). Importantly, neo-angiogenesis was strongly regulated in relation to ASPP2κ expression, impairing tumor growth and metastasis in the ASPP2κ KD models. Downregulation of pro-angiogenic (VEGF 20x, angiogenin 4x) and upregulation of anti-angiogenic (endostatin 2x, LAP 2,5x) players in ASPP2κ KD models were confirmed. CONCLUSION ASPP2κ is highly expressed in GB, affecting all classical hallmarks of cancer, including regulation of apoptosis, cell cycle, invasion/metastasis and angiogenesis. ASPP2κ contributes to aggressiveness of disease and resistance to therapy and silencing of ASPP2κ re-activates crucial p53-mediated tumorsuppressor pathways. Studies evaluating ASPP2κ as a target for therapy are ongoing.
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