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DVAP-Exo + mitoxantrone + siRNA targeting Notch1 is an experimental injectable therapeutic platform designed to prevent the postoperative recurrence of glioblastoma multiforme (GBM). The platform utilizes GIC-targeting exosomes (DVAP-Exo) modified with the DVAP peptide to specifically target GRP78-positive glioma-initiating cells (GICs). These exosomes serve as a delivery vehicle for two therapeutic cargoes: mitoxantrone (MIT), a cytotoxic small molecule that kills residual glioma cells and GICs, and a small interfering RNA (siRNA) targeting the Notch1 signaling pathway. By silencing Notch1, the therapy aims to reduce the stemness and self-renewal capacity of GICs, which are primarily responsible for tumor recurrence and chemoresistance. This combination approach targets both the bulk tumor cells and the underlying cancer stem cell population within the brain's tumor microenvironment following surgical resection.
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