Changes in growth pattern of human squamous-cell carcinomas of the head and neck during serial passages in nude mice

Erythropoietin suppresses the activation of pro-apoptotic genes in head and neck squamous cell carcinoma xenografts exposed to surgical trauma

Background

Several studies on the use of erythropoietin (Epo) to treat anaemia in patients undergoing cancer treatment have shown adverse effects on tumour control and survival. Experimental studies indicate that this could be linked to an interaction with wound healing processes and not an effect on tumour cells per se. We have previously shown that erythropoietin in combination with surgical trauma stimulates tumour growth. In the present study, we investigated the effect of surgery and Epo on gene expression.

Methods

Human tumours from oral squamous cell cancer were xenotransplanted to nude mice treated with Epo. The tumours were then transected in a standardised procedure to mimic surgical trauma and the change in gene expression of the tumours was investigated by microarray analysis. qRT-PCR was used to measure the levels of mRNAs of pro-apoptotic genes. The frequency of apoptosis in the tumours was assessed using immunohistochemistry for caspase-3.

Results

There was little change in the expression of genes involved in tumour growth and angiogenesis but a significant down-regulation of the expression of genes involved in apoptosis. This effect on apoptosis was confirmed by a general decrease in the expression of mRNA for selected pro-apoptotic genes. Epo-treated tumours had a significantly lower frequency of apoptosis as measured by immunohistochemistry for caspase 3.

Conclusions

Our results suggest that the increased tumour growth during erythropoietin treatment might be due to inhibition of apoptosis, an effect that becomes significant during tissue damage such as surgery.

This further suggests that the decreased survival during erythropoietin treatment might be due to inhibition of apoptosis.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2407-14-648) contains supplementary material, which is available to authorized users.

Tumor grafts derived from patients with head and neck squamous carcinoma authentically maintain the molecular and histologic characteristics of human cancers

BACKGROUND

The patient-derived xenograft (PDX) model is likely to reflect human tumor biology more accurately than cultured cell lines because human tumors are implanted directly into animals; maintained in an in vivo, three-dimensional environment; and never cultured on plastic. PDX models of head and neck squamous cell carcinoma (HNSCC) have been developed previously but were not well characterized at the molecular level. HNSCC is a deadly and disfiguring disease for which better systemic therapy is desperately needed. The development of new therapies and the understanding of HNSCC biology both depend upon clinically relevant animal models. We developed and characterized the patient-derived xenograft (PDX) model because it is likely to recapitulate human tumor biology.

METHODS

We transplanted 30 primary tumors directly into mice. The histology and stromal components were analyzed by immunohistochemistry. Gene expression analysis was conducted on patient tumors and on PDXs and cell lines derived from one PDX and from independent, human tumors.

RESULTS

Five of 30 (17%) transplanted tumors could be serially passaged. Engraftment was more frequent among HNSCC with poor differentiation and nodal disease. The tumors maintained the histologic characteristics of the parent tumor, although human stromal components were lost upon engraftment. The degree of difference in gene expression between the PDX and its parent tumor varied widely but was stable up to the tenth generation in one PDX. For genes whose expression differed between parent tumors and cell lines in culture, the PDX expression pattern was very similar to that of the parent tumor. There were also significant expression differences between the human tumors that subsequently grew in mice and those that did not, suggesting that this model enriches for cancers with distinct biological features. The PDX model was used successfully to test targeted drugs in vivo.

CONCLUSION

The PDX model for HNSCC is feasible, recapitulates the histology of the original tumor, and generates stable gene expression patterns. Gene expression patterns and histology suggested that the PDX more closely recapitulated the parental tumor than did cells in culture. Thus, the PDX is a robust model in which to evaluate tumor biology and novel therapeutics.

Early changes in 2-deoxy-2-[18F]fluoro-D-glucose metabolism in squamous-cell carcinoma during chemotherapy in vivo and in vitro

AIM

The aim of this study was to investigate early changes in uptake of 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) in vivo and in vitro in a squamous-cell carcinoma (SCC) cell line originating from a human head and neck SCC during cytotoxic therapy with respect to metabolism in tumor cells and in surrounding stromal tissue.

MATERIALS AND METHODS

In 60 nude mice with xenografted SCC, 50 animals were treated with cisplatin. Early changes in the tumor FDG uptake following therapy were evaluated sequentially with phosphor imaging. Using this technique, areas with focal hypermetabolism were detected. The cells creating the focal hypermetabolism were then identified histopathologically on the corresponding sections. In addition, early FDG uptake versus the number of viable tumor cells was measured in vitro following cisplatin treatment.

RESULTS

An early transient increase in FDG uptake in tumor cells was seen on day 1 in treated tumors, followed by a rapid decrease confirmed by subsequent tumor regression. This metabolic flare was present in all treated tumors but not in the controls. In vitro, an increase in FDG uptake per cell was observed.

CONCLUSIONS

Our results provide new insights into the early metabolic changes in squamous-cell carcinomas subjected to cytotoxic therapy and thus contribute to the discussion on the feasibility of early predictive PET studies.

p53 mutation and cyclin D1 amplification correlate with cisplatin sensitivity in xenografted human squamous cell carcinomas from head and neck

To investigate the response of tumour growth to cisplatin treatment, in relation to p53 mutation and cyclin D1 dysregulation on DNA and protein level, biopsies from seven xenografted human squamous cell carcinomas from the head and neck were analysed with immunohistochemistry for p53 expression and cyclin D1 expression. Polymerase chain reaction-singlestranded conformation polymorphism was used to determine p53 mutations. Fluorescence in situ hybridization was performed to analyse cyclin D1 amplification. The mice were injected i.p. with NaCl (controls) or cisplatin. After injection the tumour volume were measured. The inhibition of tumour growth by cisplatin was defined as the area under the growth curves, and compared with the growth curves of the tumours in the control group. Xenografts with p53 mutation showed significantly higher resistance to cisplatin (p < 0.001) and also tumours with cyclin D1 amplification showed significantly higher resistance (p < 0.001).

Comparison of mathematical formulas used for estimation of DNA synthesis time of bromodeoxyuridine-labelled cell populations with different proliferative characteristics

Growth kinetic data of human tumours, obtained by flow cytometric analysis of cells labelled with bromodeoxyuridine (BrdUrd) might provide prognostic information and allow prediction of response to radio- and chemotherapy. However, the theoretical models applied for calculation of growth kinetic data are not fully evaluated. The purpose of this study was to investigate the dependence of the estimation of DNA synthesis time (Ts) on sampling time after BrdUrd labelling, using four different mathematical formulas (Begg et al., White & Meistrich, White et al. and Johansson et al.) which have been developed for the evaluation of flow cytometry-derived data of BrdUrd-labelled cells. In addition, we have investigated the influence of the growth kinetic properties of the cell populations using two cultured cell lines (one slow and one fast growing), and two hetero-transplanted human tumours. The dependence of the estimation of Ts on sampling time was more or less pronounced, depending on the cell population examined and on the formula used. In the fast growing cell line, the estimates of Ts did not vary significantly with sampling time when using the formulas by White et al., whereas in the slow growing cell line, the estimates of Ts did not show any significant dependence on sampling time when using the formula by Johansson et al. In the tumours, the estimation of Ts depended on sampling time with all formulas used, although to different degrees. In one of the tumours, this was mainly caused by the influence of mouse cells, as we demonstrate. Our results indicate that the proliferative characteristics of a cell population should be taken into consideration when choosing a mathematical formula in order to attain Ts values that are independent of sampling time.

Transplantation of large granular lymphocyte leukemia in congenitally athymic rats

Twenty-two congenitally athymic nude (rnu/rnu) rats were transplanted with large granular lymphocyte leukemia derived from F344 rats and then compared with ten similar rats inoculated with a suspension of normal F344 rat spleen cells. The normal spleen cells and tumor cells from a spontaneous, naturally occurring leukemia did not grow or cause clinical disease in any of the rats. All rats inoculated with a serially passaged leukemia cell inoculum had local growth at the inoculation site that spread widely and resulted in progressive tumor growth. Death occurred between 16 and 38 days after inoculation. The 22 rats that received passaged tumor cells developed leukemia and splenomegaly. Spleens were diffusely infiltrated by tumor cells and had severe depletion of lymphocytes in the white pulp. Leukemic rats were thrombocytopenic and had hemolytic anemia characterized by increased osmotic fragility, red cell width, and many nucleated erythrocytes. The disease syndrome appears similar to that of F344 rats transplanted with the same inoculum. Because the host rats lacked T cells, it is concluded that the hemolytic anemia and thrombocytopenia that develop in transplanted rats are independent of T cell function.

Histopathologic comparison between human oral squamous cell carcinomas and their xenografts in nude mice

Tumor portions were obtained from 11 oral squamous cell carcinomas and used to produce tumors in a xenogeneic gnotobiotic nude mouse model system. The tumors that developed were examined histologically. The cellular features and tumor growth patterns were compared between the original oral squamous cell carcinoma (T0) and the tumor that developed in the xenogeneic host (T1). The T1 tumors were more highly differentiated in comparison with the T0 tumors. The T1 tumors exhibited less cellular pleomorphism and a more uniform pattern of stratification. The cells in the T1 tumors exhibited an increased mitotic index but did not contain abnormal mitoses. The T1 tumors usually exhibited nodular growth patterns rather than the infiltrating pattern exhibited by the parenchyma of the T0 tumors. The desmoplastic reaction was markedly reduced in the T1 tumors. The results indicated that the gnotobiotic nude mouse model system either selects for or induces a more differentiated pattern of tumor growth than that found in the original human oral squamous cell carcinomas.

Metoclopramide enhances the effect of ionizing radiation on xenografted squamous cell carcinoma of the head and neck

The commonly used drug metoclopramide, a benzamide derivative, has been shown previously in our laboratory to enhance the effect of cisplatin on xenografted squamous cell carcinomas of the head and neck. In the present study, we show that metoclopramide also enhances the effect of ionizing radiation. Two human squamous cell carcinoma lines of the head and neck xenografted to nude mice have been used. Doses of radiation were chosen (5 and 8 Gy single doses) which caused only a slight retardation of tumor growth when administered alone. Tumor response to ionizing radiation was assessed with and without metoclopramide (2.0 mg kg-1), and administered at the time of radiation and 24 and 48 hr after treatment. The effects of these schedules on the tumors were compared using the reduction of the area under the growth curves and specific growth delay. The dose schedule with metoclopramide alone did not induce any significant reduction in the area under the growth curves. The addition of metoclopramide to the radiated groups caused a significant enhancement of the radiation-induced reduction of the area under the growth curves in both of the tumor lines studied.

Preclinical chemotherapy on human head and neck cancer xenografts grown in athymic nude mice

This study was undertaken to investigate the potential role of xenografts established from human head and neck squamous cell carcinoma (HNSCC) in the selection of new anticancer agents for phase II clinical trials. Eight HNSCC tumor lines were established in NMRI nude mice. The tumor-bearing animals were then treated with drugs at the maximum tolerated dose level. Treatment with drugs known for their activity in 15%-30% of HNSCC patients [cisplatin (CDDP), bleomycin (BLEO), 5-fluorouracil (5-Fu), cyclophosphamide (CY), and doxorubicin (DOX)] caused strong responses in up to 38% and moderate responses in 50%-67% of the HNSCC tumor lines. Methotrexate (MTX), known to cause remissions in about 40% of HNSCC patients, was only minimally active in this model system. A clinically ineffective drug, amsacrine (m-AMSA), was included as a negative control and showed no or minimal activity in all four HNSCC lines tested. A number of experimental drugs that have promising preclinical activity were also tested. Brequinar sodium (Dup 785) and 10-ethyl, 10-deaza-aminopterin (10-EdAM) showed activity in three of five, and two of the four tested tumor lines respectively. N,N-dimethylformamide (DMF) and 5-aza-2'-deoxycytidine (5-aza-dCyd), agents with the capacity to induce differentiation in in vitro systems, showed moderate activity in 43% and 40%, and strong activity in 14% and 40% of the lines, respectively. Our results indicate that the nude mouse xenograft model may play a role in the screening of new drugs, and in particular, it could be of help in the selection of drugs to be tested in phase II HNSCC clinical trials.

Effect of human interferon-alpha and interferon-gamma on growth, histology, and DNA content of human osteosarcomas in nude mice

The antitumor effect of human natural and recombinant interferon-gamma (IFN-gamma) was evaluated in human osteosarcomas grown as xenografts in nude mice. IFN-gamma was given as daily subcutaneous injections, alone or in combination with IFN-alpha. The growth of two out of three tested osteosarcomas was inhibited by 2 x 10(5) IU of natural IFN-gamma. A five times higher dose of recombinant IFN-gamma, as compared with natural (n) IFN-gamma, was needed to obtain growth inhibition of one osteosarcoma. This difference in dose-response could be explained by differences in pharmacokinetics. Hence, subcutaneously administered natural IFN-gamma gave 10 times higher serum levels than obtained with the recombinant type. Combination treatment with IFN-alpha and IFN-gamma induced a potentiation of the antitumor effect in one osteosarcoma. In another osteosarcoma, 2-4 x 10(5) IU of nIFN-gamma did not effect tumor growth and could not potentiate the antitumor effect of 2-4 x 10(5) IU of nIFN-alpha. By using DNA analysis in cell suspension and tissue section, the proportion of aneuploid tumor cells within the xenograft could be estimated. This analysis showed that the antitumor effects of IFN were more pronounced than mere measurement of tumor volume suggested. IFN-inhibited tumors were partly replaced by fibroblasts or bone tissue. In conclusion, at the doses given nIFN-gamma appeared to have similar antitumor effects as IFN-alpha in two osteosarcomas, whereas one was sensitive to only IFN-alpha. Combination IFN treatment induced a potentiation of the antitumor effect in one osteosarcoma but not in another. The differences between the osteosarcomas in obtained antitumor effect of IFN treatment probably reflects individual IFN sensitivity and demonstrates the importance of assessing several tumors of the same neoplastic entity.

A relationship between retinol and cellular retinol-binding protein concentrations in human squamous cell carcinomas

The retinol and retinyl ester concentrations in human xenografted squamous cell carcinomas, with various concentrations of cellular retinol-binding protein (CRBP), were studied, as well as the in vivo uptake and esterification in these tumours of labelled retinol, presented as a complex with plasma RBP. The mean retinol concentration in the different tumours was in the range 3.7-6.2 nmol/g protein, and the mean CRBP concentration was between 16 and 69 nmol/g protein. There was a statistically significant correlation between the retinol and the CRBP concentrations in the same tumour (P less than 0.001; r = 0.622). Calculation of the maximal extent of retinol-saturation of CRBP showed low values (range: 9-26%). Retinyl palmitate, the predominant retinyl ester, comprised approx. 70% of the retinyl esters in the tumours. There was no correlation between the concentration of CRBP and that of retinyl palmitate. The uptake of [3H]retinol from intravenously injected retinol-RBP complex was similar in the four human squamous cell carcinomas studied, and not related to their CRBP concentration. 20% of the radioactivity in tumour specimens was lipid soluble, as compared to 96% in liver specimens, showing that in the former a higher fraction metabolised to polar compounds. Taken together, our results suggest that in these squamous carcinoma cells, factors other than cellular CRBP content are the major determinants of net cellular uptake and esterification of retinol. The cellular retinol concentration, on the other hand, appears proportional to CRBP content.

Metoclopramide enhances the effect of cisplatin on xenografted squamous cell carcinoma of the head and neck

The chromatin-bound enzyme adenosine diphosphate ribosyl transferase is activated by DNA-damaging agents. Substances that inhibit the enzyme, such as benzamide analogues, are known to increase the cytotoxicity of ionising radiation and cytotoxic drugs. The purpose of the present study was to investigate whether the anti-emetic drug metoclopramide, a benzamide derivative (4-amino-N-2-(diethylaminoethyl)-5-chloro-2-methoxybenzamide; MCA), potentiates the effect of cisplatin (cis-diammine-dichloroplatinum; CDDP) on squamous cell carcinoma (SCC). For that purpose human SCC of the head and neck (i.e. tumour line AB and EH) xenografted to nude mice were used. Two administration schedules were tested: (a) MCA (2.0 mg kg-1 i.p.) one hour before CDDP (7.5 mg kg-1 i.p.); and (b) MCA (3 x 2.0 mg kg-1) given concomitant to, 24 and 48 hours after CDDP (7.5 mg kg-1) administration. Treatment efficacies were compared using the area under the growth curves (AUC), tumour volumes and specific growth delay (SGD). There was no mortality and no weight loss of significance in any treatment group. MCA alone did not induce any significant reduction in AUC, tumour volume or SGD with either treatment schedule. CDDP alone gave a significant reduction of tumour growth in tumour line AB but not in tumour line EH. In schedule (a) the addition of MCA did not give any additive effect. However, in schedule (b), for both tumour lines, MCA enhanced the effect of CDDP by significantly reducing the AUC (AB: P less than 0.0001; EH: P less than 0.001) and increasing SGD (AB: P less than 0.012; EH: P less than 0.001) when compared to the tumours given CDDP alone. These effects were observed at a MCA dose currently being administered to humans.

The expression of anchorage independence by malignant rat oral keratinocytes after colony formation in vitro and tumour formation in vivo

The expression of anchorage independence in malignant oral epithelial cells retrieved from colonies formed in agarose and tumours formed in athymic mice was examined. The original epithelial cell lines were derived from lingual and palatal squamous cell carcinomas induced in rats by the carcinogen 4-nitroquinoline N-oxide. The capacity to express anchorage independence varied considerably between the original cell lines and essentially increased with passage in culture. In three out of four colony-derived subpopulations, the colony-forming efficiency was significantly greater than that of the original cell lines. Xenograft subpopulations expressed higher colony-forming efficiencies than their original counterparts in only two of five cell lines. Undifferentiated tumour xenografts resulted in more homogeneous tumour-derived subpopulations, in contrast to the more heterogeneous cell lines from well-differentiated tumours. The findings demonstrate functional diversity within and between malignant rat oral epithelial cell lines and their colony- and xenograft-derived subpopulations.

Growth characteristics of head and neck squamous cell carcinoma in nude mice

Growth behaviour of human squamous cell carcinoma from the head and neck region was studied in nude mice. Tumour growth was observed in 10 out of 13 tumours transplanted with a primary take rate of 77 and 100% for serial passaging. The take rate percentage related to the number of tumour inocula used, varied from 10 to 90% in the first passage and from 70 to 100% in the subsequent passages. No significant difference could be established in the growth character, except from the first to the second passage. Histological studies demonstrated preservation of the original histopathological features, micro- and macroinvasion of two tumour lines into the fibrous capsule and cyst formation. Comparison of growth curves with histological features demonstrated that growth curves are not a reliable measure for the number of vital tumour cells present.

Growth and ploidy of human osteosarcoma xenografts in serial passage in nude mice

Six human osteosarcoma tumors have been transplanted to and maintained as xenografts in serial passage in nude mice. The xenografts, characterized by growth rate, histologic appearance, and DNA flow cytometric data, are now in the 6-17 passages in mice. Histologic appearances and growth rates of the xenografts were unchanged through all passages except for one xenograft in which the growth rate doubled in passage 3. All six tumors had hyperploid DNA contents. The ploidy levels were unchanged, compared to their original tumors, in all passages of five xenografts. One xenograft, concomitantly with the increase in growth rate, also doubled the ploidy from 2.8 to 5.6C. There was a good agreement between the proportion of S-phase cells and mitotic indices of the six xenografts. The growth rate, depending also on cell loss, was less related to the proliferative activity of the xenografts. It was concluded that osteosarcomas have a stable aneuploid DNA content in nude mice, but polyploidization can occur after a number of passages.

Lack of effect of methotrexate on human head and neck tumours transplanted in athymic nude mice

Human head and neck tumour tissues derived from 16 different patients were transplanted in athymic nude mice. Treatment of tumour-bearing animals with methotrexate had little or no effect on the doubling time of the xenografts. Included were three tumour lines derived from patients in whom methotrexate did demonstrate antitumour activity. These results are also in contrast to clinical experience with methotrexate, showing remissions in 50% of patients with head and neck cancer. It is unlikely that this lack of effect of methotrexate is attributed to a difference in drug pharmacokinetics between man and nude mouse, since a xenografted rat tumour was found to be sensitive. With regard to possible resistance mechanisms underlying methotrexate inactivity, we found no evidence of increased dihydrofolate reductase activity in the methotrexate-insensitive human xenografts. It is possible that in this model a selection occurs favouring the outgrowth of a resistant subpopulation of tumour cells.

Considerations in the use of nude mice for cancer research

Transplants of human tumors in nude mice have shown a progressive increase during the past 15 years as an experimental model for cancer research. A variety of factors, including relatively fragile health, have been identified that require appropriate experimental controls if the investigator is obtain consistent results. Not all tumors grow in nude mice. The frequency of tumor 'take' varies according to tumor origin, tumor type, inoculation site, age and conditioning of the mouse host, and a variety of other factors. Manipulation of these variables has led to successful propagation of almost every known variety of human malignancy. Following transplant, changes in characteristics have been documented, but the frequency and degree of such changes remains uncertain. Tumor growth rate probably increases after transplantation, requiring great care in the interpretation of chemotherapy experiments, but biochemical characteristics may be more stable. The nude mouse offers great interest as a model for the in vivo study of metastasis, as a number of experimental variables, mainly immunological, have been shown to affect this process. Spontaneous tumors have been shown to arise in these animals, but the controversy over their frequency relative to the thymus-bearing background strain is unresolved. We conclude that the nude mouse/tumor xenograft model, while requiring meticulous experimental controls, is nevertheless an extremely useful tool for cancer research.