Ical gains offered by these approaches have been limited, largely based on the complex nature of signaling networks associated with tumorigenesis and the inability to delineate the key “functional” signaling pathways actually driving Anlotinib growth in an individual tumor [3]. Regardless of the upstream “driving” signaling pathway, rapidly growing tumors require efficient means to allow them to adapt to fluctuating, toxic tumor microenvironments, whichconsist of hypoxia, nutrient deprivation, and acidosis. The unfolded protein response (UPR) represents a conserved, critical defense mechanism allowing cells to respond to these adverse conditions [4]. Therefore, cancer cells may be particularly reliant upon the adaptive mechanisms offered by the UPR for continued growth and survival in these otherwise cytotoxic conditions and modulating this adaptive response may represent a unique strategy for cancer therapy [5]. The chaperone protein glucose related protein 78 (GRP78), also referred to as the immunoglobulin binding protein (BiP), serves as a master UPR regulator that plays 15481974 a central role in modulating its downstream signaling. Under non-stressed environmental conditions, GRP78 binds to its client proteins protein kinase RNA (PKR)-like ER kinase (PERK), activating transcription factor-6 (ATF6), and inositol-requiring protein-1 (IRE1). However, when the ER is “stressed”, GRP78 binds to the accumulating unfolded proteins in the ER, freeing its specific client proteins, leading to pathway activation [6]. Although regarded as a pro-survival mechanism, persistent or high-level activation of the UPR leads to apoptotic cell death [7], suggesting the potential for GRP78 to serve as a therapeutic target [5]. Several investigators have explored the potential for aberrant expression of UPR related proteins and their prognostic implications in cancer [8]. One of the first studies demonstrating thisTargeting the UPR in Glioblastoma with EGF-SubAreliance of cancer cells on the UPR was presented by Jamora et al [9], in which GRP78-knockdown fibrosarcoma cells demonstrated similar in vitro growth characteristics as their parental line, however were not able to sustain growth in vivo in a mouse model. Since this discovery, several studies have validated the important role UPR related proteins play in tumorigenesis. Specific to glioma, Pyrko et al demonstrated that GRP78 is expressed at low levels in adult brain, but significantly elevated in malignant glioma and glioma cell lines [10]. Using microarray analysis, Lee et al similarly found that GRP78 expression was up-regulated in glioma and that its expression correlated with tumor grade [11]. Further, GRP78 expression had prognostic implications in glioblastoma, with increased expression portending poor survival. These studies also demonstrated that GRP78 contributed towards resistance to a variety of chemotherapeutics, including temozolomide, 5fluorouracil, CPT-11, etoposide, cisplatin, and ionizing radiation [10,11]. It has also been shown that GRP78 is highly elevated in the vasculature derived from human glioma specimens [12,13] and powerfully regulates VEGF expression [14]. Selective destruction of GRP78 became possible with the discovery of a novel bacterial toxin SubA, which selectively cleaves only one protein, GRP78, at a single site, di-leucine motif 
(L416L417) in the hinge region connecting the ATPase and proteinbinding HIV-RT inhibitor 1 manufacturer domains of the molecule [15]. GRP78 cleavage is rapid and virtually all intac.Ical gains offered by these approaches have been limited, largely based on the complex nature of signaling networks associated with tumorigenesis and the inability to delineate the key “functional” signaling pathways actually driving growth in an individual tumor [3]. Regardless of the upstream “driving” signaling pathway, rapidly growing tumors require efficient means to allow them to adapt to fluctuating, toxic tumor microenvironments, whichconsist of hypoxia, nutrient deprivation, and acidosis. The unfolded protein response (UPR) represents a conserved, critical defense mechanism allowing cells to respond to these adverse conditions [4]. Therefore, cancer cells may be particularly reliant upon the adaptive mechanisms offered by the UPR for continued growth and survival in these otherwise cytotoxic conditions and modulating this adaptive response may represent a unique strategy for cancer therapy [5]. The chaperone protein glucose related protein 78 (GRP78), also referred to as the immunoglobulin binding protein (BiP), serves as a master UPR regulator that plays 15481974 a central role in modulating its downstream signaling. Under non-stressed environmental conditions, GRP78 binds to its client proteins protein kinase RNA (PKR)-like ER kinase (PERK), activating transcription factor-6 (ATF6), and inositol-requiring protein-1 (IRE1). However, when the ER is “stressed”, GRP78 binds to the accumulating unfolded proteins in the ER, freeing its specific client proteins, leading to pathway activation [6]. Although regarded as a pro-survival mechanism, persistent or high-level activation of the UPR leads to apoptotic cell death [7], suggesting the potential for GRP78 to serve as a therapeutic target [5]. Several investigators have explored the potential for aberrant expression of UPR related proteins and their prognostic implications in cancer [8]. One of the first studies demonstrating thisTargeting the UPR in Glioblastoma with EGF-SubAreliance of cancer cells on the UPR was presented by Jamora et al [9], in which GRP78-knockdown fibrosarcoma cells demonstrated similar in vitro growth characteristics as their parental line, however were not able to sustain growth in vivo in a mouse model. Since this discovery, several studies have validated the important role UPR related proteins play in tumorigenesis. Specific to glioma, Pyrko et al demonstrated that GRP78 is expressed at low levels in adult brain, but significantly elevated in malignant glioma and glioma cell lines [10]. Using microarray analysis, Lee et al similarly found that GRP78 expression was up-regulated in glioma and that its expression correlated with tumor grade [11]. Further, GRP78 expression had prognostic implications in glioblastoma, with increased expression portending poor survival. These studies also demonstrated that GRP78 contributed towards resistance to a variety of chemotherapeutics, including temozolomide, 5fluorouracil, CPT-11, etoposide, cisplatin, and ionizing radiation [10,11]. It has also been shown that GRP78 is highly elevated in the vasculature derived from human glioma specimens [12,13] and powerfully regulates VEGF expression [14]. Selective destruction of GRP78 became possible with the discovery of a novel bacterial toxin SubA, which selectively cleaves only one protein, GRP78, at a single site, di-leucine motif (L416L417) in the hinge region connecting the 
ATPase and proteinbinding domains of the molecule [15]. GRP78 cleavage is rapid and virtually all intac.