Epidermal growth factor receptor antibody plus recombinant human endostatin in treatment of hepatic metastases after remnant gastric cancer resection. World J Gastroenterol. 2007;13:6115-6118. [PMID: 18023113 DOI: 10.3748/wjg.13.6115]

Deciphering the anti-angiogenic effect of endostatin/cyclophosphamide to normalize tumor micrangium through notch signaling pathway in colon cancer

Background

The invasion of colon cancer is associated with the tumor angiogenesis. Endostatin is an important anti-angiogenic agent, and the additive effect of endostatin with a chemotherapeutic agent, cyclophosphamide, on micrangium has not been established.

Methods

Male BALB/c strain nude mice were injected with human colorectal carcinoma cells (HCT-116). The mice were divided into four groups (n = 15, each group) and were treated with different concentrations of endostatin (15, 10, and 5 mg/kg/day), cyclophosphamide (20, 10, and 5 mg/kg/day), and combination of endostatin/cyclophosphamide (15 + 20, 15 + 10, and 15 + 5 mg/kg/day). The tumor inhibition rate was evaluated, followed by the quantification of messenger ribonucleic acid (mRNA) and protein expression of notch signaling components NOTCH-1, NOTCH-3, NOTCH-4, JAG-1, DLL-4, Hes-1, and Hey-1 using quantitative polymerase chain reaction (qPCR). The protein expression of NOTCH-3, JAG-1, and DLL-4 was confirmed using western blotting. Microvessel density (MVD) was evaluated to detect micrangium following the treatment.

Results

The endostatin/cyclophosphamide-treated samples exhibited an additive effect on the tumor inhibition rate and the microvessel count. NOTCH-1, NOTCH-3, NOTCH-4, JAG-1, Hes-1, and Hey-1 expression levels were highly correlated and downregulated in the treated samples, whereas DLL-4 expression was upregulated that accounted for its anti-angiogenic property.

Conclusions

The combination treatment of colon cancer with endostatin and a chemotherapeutic agent, cyclophosphamide proves to be an efficient therapeutic strategy to inhibit the rapid vasculature formation confirmed by the differential expression of notch signaling components.

Endostar in combination with modified FOLFOX6 as an initial therapy in advanced colorectal cancer patients: a phase I clinical trial

PURPOSE

Endostar is a recombinant human endostatin with antiangiogenic properties that has been useful in treating a wide range of cancers and shows promise for use in combination treatment for advanced colorectal cancer. This study aimed to evaluate the drug safety and tolerability of continuous intravenous infusion (CIV) of endostar in combination with modified FOLFOX6 (mFOLFOX6) as an initial therapy in advanced colorectal cancer patients.

METHODS

This was a single-center, single-arm, open, dose-escalation study in patients with advanced colorectal cancer at Fudan University Shanghai Cancer Center between August 2010 and January 2012. A total of 21 patients were included. Standard dosage of mFOLFOX6 was used. CIV endostar commenced on day 4 to day 14 ascending from 7.5 to 15, 30, 45, 60, and 75 mg/m(2)/day. Primary outcomes were dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of CIV endostar in combination with mFOLFOX6. Secondary outcomes were pharmacokinetic parameters. Physical examination, performance status, standard blood tests and electrocardiograms were performed.

RESULTS

MTD was 75 mg/m(2)/day. Adverse events included leucopenia (n = 17, 81 %), neutropenia (n = 12, 57.1 %), anemia (n = 5, 23.8 %), anorexia (n = 6, 28.6 %) and constipation (n = 4, 19.0 %). One patient with an allergic reaction stopped chemotherapy. Two patients stopped endostar treatment, one with level 3 ventricular premature beat (DLT at 15 mg/m(2)/day) and one with a level 1 ventricular arrhythmia (30 mg/m(2)/day). The main ECG changes were ST-segment and T wave changes. Exposure to endostar and CIV dose was linear between 7.5 and 30 mg/m(2)/day (R (2) = 0.974).

CONCLUSIONS

Endostar in combination with mFOLFOX6 was generally safe and well tolerated.

Evaluation of efficacy of anti-angiogenesis therapy for VX2 hepatic tumors in rabbits by spectral CT and CT perfusion imaging

AIM: To explore the efficacy of anti-angiogenesis therapy for VX2 hepatic tumors in rabbits by spectral computed tomography (CT) imaging and CT perfusion imaging.

METHODS: Sixty New Zealand white rabbits with implanted VX2 hepatic tumors were randomly divided into two groups (A and B), with each group containing 30 rabbits. On day 14 after tumor implantation, group B received intravenous endostatin at a dose of 3 mg/kg for 7 d. Both groups underwent spectral CT and CT perfusion scans on day 21 after tumor implantation. The animals were then sacrificed, and the expression of VEGF mRNA and FGF2 protein in the tumor rim (TR) and the normal region (NR) was detected by RT-PCR and Western blot, respectively.

RESULTS: For CT perfusion parameters, group A showed increased blood flow (BF), blood volume (BV), permeability surface (PS) and hepatic arterial fraction (HAF) and decreased mean transit time (MTT) in the TR compared with NR (P < 0.05). From days 14 to 21, BF and PS showed an increasing trend, while MTT decreased with tumor growth (P < 0.05). The standardization of iodine (NIC) during arterial phase of the TR and NR exhibited a statistically significant difference (P < 0.05). The NIC of the TR during the arterial phase was significantly higher on day 21 than on day 14. Compared with group A on day 21, BF, BV, PS and HAF decreased, and MTT increased in group B. Pearson correlation analysis showed that these parameters were positively correlated with VEGF mRNA and FGF2 protein expression.

CONCLUSION: Spectral imaging and CT perfusion imaging can provide hemodynamic information of liver lesions and quantitatively reflect the efficacy of anti-angiogenesis therapy.

Anti-tumor effect of a novel soluble recombinant human endostatin: administered as a single agent or in combination with chemotherapy agents in mouse tumor models

Background

Angiogenesis has become an attractive target in cancer treatment. Endostatin is one of the potent anti-angiogenesis agents. Its recombinant form expressed in the yeast system is currently under clinical trials. Endostatin suppresses tumor formation through the inhibition of blood vessel growth. It is anticipated that combined therapy using endostatin and cytotoxic compounds may exert an additive effect. In the present study, we expressed and purified recombinant human endostatin (rhEndostatin) that contained 3 additional amino acid residues (arginine, glycine, and serine) at the amino-terminus and 6 histidine residues in its carboxyl terminus. The recombinant protein was expressed in E. Coli and refolded into a soluble form in a large scale purification process. The protein exhibited a potent anti-tumor activity in bioassays. Furthermore, rhEndostatin showed an additive effect with chemotherapy agents including cyclophosphamide (CTX) and cisplatin (DDP).

Methods

rhEndostatin cDNA was cloned into PQE vector and expressed in E. Coli. The protein was refolded through dialysis with an optimized protocol. To establish tumor models, nude mice were subcutaneously injected with human cancer cells (lung carcinoma A549, hepatocellular carcinoma QGY-7703, or breast cancer Bcap37). rhEndostatin and/or DDP was administered peritumorally to evaluate the rate of growth inhibition of A549 tumors. For the tumor metastasis model, mice were injected intravenously with mouse melanoma B16 cells. One day after tumor cell injection, a single dose of rhEndostatin, or in combination with CTX, was administered intravenously or at a site close to the tumor.

Results

rhEndostatin reduced the growth of A549, QGY-7703, and Bcap37 xenograft tumors in a dose dependent manner. When it was administered peritumorally, rhEndostatin exhibited a more potent inhibitory activity. Furthermore, rhEndostatin displayed an additive effect with CTX or DDP on the inhibition of metastasis of B16 tumors or growth of A549 tumors.

Conclusion

Soluble rhEndostatin exhibits a potent anti-tumor activity in mouse xenograft models and it also has an additive effect with CTX and DDP, implying possible applications in clinical settings.

CTA combined with CT perfusion for assessing the efficacy of anti-angiogenic therapy in rabbit VX2 tumors

RATIONALE AND OBJECTIVES

The aim of this study was to validate the feasibility of assessing the efficacy of antiangiogenic therapy on VX2 tumors using three-dimensional computed tomographic (CT) angiography (CTA) combined with CT perfusion.

MATERIALS AND METHODS

Forty rabbits with VX2 tumors were randomly assigned to four groups according to different doses of antiangiogenic drug, which were administered intraperitoneally daily for 14 days. In each group, 10 animals were scanned using three-dimensional CTA and CT perfusion on days 1 and 2 after the latest administration of the drug. Tumor masses were sectioned, stained by immunohistochemistry, and processed for correlation between CT imaging and histology.

RESULTS

The numbers of new tumor vessels from CTA were significantly different among the four groups (P < .001). As the dose of the drug increased, blood flow and blood volume on CT perfusion increased linearly, but the mean transit time and permeability surface-area product decreased linearly (P < .001). Immunohistochemical analyses showed that microvascular density decreased, while both luminal vascular number and mature vessel number increased linearly as the drug dose increased (P < .001). CT manifestations were correlated well with histologic findings (P < .05).

CONCLUSIONS

It is feasible to assess the efficacy of antiangiogenic therapy on VX2 tumors using three-dimensional CTA combined with CT perfusion. Three-dimensional CTA can display the morphologic changes of tumor vessels, while CT perfusion can predict the functional changes of tumor vessels after antiangiogenic therapy.