Evidence map›Paper›PMID 41667704›Full record

ArticleNPJ precision oncology2026

Valproic acid reverses macrophage-mediated temozolomide resistance in macrophage-rich gliomas.

Xiangrong Ni, Wubing Chen, Pengfei Xu, Yuelu Yang, Minghao Chen, Furong Chen, Chengcheng Guo, Ji Zhang, Xiangdong Qi, Zhongping Chen

Abstract read
In one paragraph

Article in NPJ precision oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Xiangrong Ni *Department of Plastic and Aesthetic Surgery, Translational Medicine Research Center, Zhujiang Hospital, Southern Medical University, Guangdong, China.
Wubing Chen *Department of Radiology, Wuxi Fifth People's Hospital, Jiangnan University, Wuxi, Jiangsu, China.
Pengfei Xu *Department of Neurosurgry, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, Guangdong, China.
Yuelu YangDepartment of Plastic and Aesthetic Surgery, Translational Medicine Research Center, Zhujiang Hospital, Southern Medical University, Guangdong, China.
Minghao ChenDepartment of Plastic and Aesthetic Surgery, Translational Medicine Research Center, Zhujiang Hospital, Southern Medical University, Guangdong, China.
Furong ChenDepartment of Neurosurgery/Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangdong, China.
Chengcheng GuoDepartment of Neurosurgery/Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangdong, China.
Ji ZhangDepartment of Neurosurgery/Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangdong, China. zhangji@sysucc.org.cn.
Xiangdong QiDepartment of Plastic and Aesthetic Surgery, Translational Medicine Research Center, Zhujiang Hospital, Southern Medical University, Guangdong, China. qixiangdong@smu.edu.cn.
Zhongping ChenDepartment of Neurosurgery/Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangdong, China. chenzhp@sysucc.org.cn.

Funding

Cancer Innovative Research Program of Sun Yat-sen University Cancer Center CIRP-SYSUCC-PT13120101the China Postdoctoral Science Foundation 2022M721513 and 2024T170384the National Natural Science Foundation of China 81872059the Natural Science Foundation of Guangdong Province 2025A1515012554the President Foundation of Zhujiang Hospital, Southern Medical University yzjj2022qn06
6 · The paper itself

Abstract

Glioma therapy often fails due to the acquisition of temozolomide (TMZ) resistance. Antiepileptic drugs, valproic acid (VPA) and levetiracetam (LEV) are commonly used during the perioperative period of glioma patients, and have been proposed for repurposing to augment TMZ efficacy. Our previous studies revealed that LEV could increase TMZ efficacy through downregulation of O-6-methylguanine-DNA methyltransferase (MGMT) and VPA could promote glioma cells apoptosis. Recently, tumor-associated macrophages (TAMs) have been considered as important modulators of TMZ resistance. As for LEV or VPA, which one is better to improve TMZ efficacy for macrophage-rich gliomas remains unclear. In this study, we investigated whether VPA or LEV could mitigate macrophage-mediated exceptional TMZ resistance. Our in vitro experiments revealed that VPA rather than LEV could polarize TAMs into M1 phenotypes. In vivo, glioma mouse models could benefit more from TMZ + VPA regimen by increasing intratumoral M1 macrophage infiltration. We conclude that VPA might be more useful than LEV to improve the therapeutic effect of TMZ for macrophage-rich gliomas. This study provides critical preclinical evidence for the optimal selection of the antiepileptic drug to overcome TAM-mediated chemoresistance, offering translational implications for personalized therapeutic strategies for macrophage-rich gliomas.

Identifiers

PMID41667704
PMCPMC13000238

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.