Treatment with 5-azacitidine delay growth of glioblastoma xenografts: a potential new treatment approach for glioblastomas

  • Tobias Kratzsch
  • Susanne Antje Kuhn
  • Andreas Joedicke
  • Uwe Karsten Hanisch
  • Peter Vajkoczy
  • Jens Hoffmann
  • Iduna Fichtner
Original Article – Cancer Research



Glioblastoma multiforme (GBM) is the most lethal primary brain tumor in adults. The epigenetically active ribonucleoside analog 5-azacitidine is a new therapy option that changes tumor cell chromatin, which is frequently modified by methylation and deacetylation in malignant gliomas.


In vitro, we analyzed cell viability, cell apoptosis, and migration of human GBM cells. In vivo, we established subcutaneous and intracerebral GBM mouse models originating from U87MG, U373MG, and primary GBM cells as well as one patient-derived xenograft. Xenografts were treated with 5-azacitidine as well as valproic acid, bevacizumab, temozolomide, and phosphate buffered saline. The tumor sizes and Ki67 proliferation indices were determined. Glioma angiogenesis was examined immunohistochemically by expression analysis of endothelial cells (CD31) and pericytes (PDGFRβ).


In vitro, 5-azacitidine treatment significantly reduced human glioblastoma cell viability, increased cellular apoptosis, and reduced cellular migration. In vivo, 5-azacitidine significantly reduced growth in two intracerebral GBM models. Notably, this was also shown for a xenograft established from a patient surgery sample; whereas, epigenetically acting valproic acid did not show any growth reduction. Highly vascularized tumors responded to treatment, whereas low-vascularized xenografts showed no response. Furthermore, intracerebral glioblastomas treated with 5-azacitidine showed a clearly visible reduction of tumor angiogenesis and lower numbers of endothelial cells and tumor vessel pericytes.


Our data show significant growth inhibition as well as antiangiogenic effects in intracerebral as well as patient-derived GBM xenografts. This encourages to investigate in detail the multifactorial effects of 5-azacitidine on glioblastomas.


Glioblastoma Xenografts Epigenetics 5-Azacitidine Valproic acid Temozolomide 



We would like to thank Dr. J. Walter (Department of Neurosurgery; University Hospital of Jena; Jena, Germany) for providing human primary glioblastoma cells. We would also like to thank Margit Lemm and Carsta Werner (MaxDelbrückCenter for Molecular Medicine; Berlin, Germany) for excellent technical assistance.


No funding received.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Supplementary material

432_2018_2600_MOESM1_ESM.ppt (651 kb)
Suppl. 1 Five-azacitidine elicited no antiangiogenic effects in scanty vascularized CX1 and CX2 GBM xenografts. (A, B) In CX1 GBMs, CD31 labeling revealed no significant reduction of the number of endothelial cells after 5-azacitidine therapy (p > 0.05), in comparison to the antiangiogenic effects of the positive controls bevacizumab and temozolomide (p < 0.001). (C, D) Vascularization was also not significantly affected by 5-azacitidine therapy in CX2 xenografts (p > 0.05), compared to the reduced number in the positive controls bevacizumab (p < 0.001) and temozolomide (p < 0.05), as demonstrated by CD31 labeling. (E) Otherwise, in highly vascularized subcutaneous U87MG GBMs, 5-azacitidine as well as bevacizumab therapy significantly (p < 0.001) reduced the number of CD31 positive endothelial cells. (PPT 651 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryCharité University HospitalBerlinGermany
  2. 2.Department of NeurosurgeryErnst von Bergmann HospitalPotsdamGermany
  3. 3.Department of NeurosurgeryVivantes Hospital Berlin NeuköllnBerlinGermany
  4. 4.Institute of NeuropathologyUniversity HospitalGöttingenGermany
  5. 5.Paul Flechsig Institute for Brain ResearchUniversity of LeipzigLeipzigGermany
  6. 6.Experimental Pharmacology and Oncology GmbHBerlinGermany
  7. 7.Max Delbrueck Center for Molecular MedicineBerlinGermany

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