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Liu D, Ma X, Xiao D, Jia Y, Wang Y. Efficacy and safety of targeting VEGFR drugs in treatment for advanced or metastatic gastric cancer: a systemic review and meta-analysis. Oncotarget 2018; 9:8120-8132. [PMID: 29487720 PMCID: PMC5814287 DOI: 10.18632/oncotarget.23429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 11/29/2017] [Indexed: 12/21/2022] Open
Abstract
The value of targeting VEGFR (vascular endothelial growth factor receptor) drugs has demonstrated encouraging anti-cancer activity in advanced solid tumors within current clinical trials. This study aimed to serve as the first systemic review to assess their safety and efficacy according to biochemical characteristics of targeting VEGFR drugs in gastric cancer. We analyzed eight clinical trials on targeting VEGFR drugs in gastric cancer. Results showed that targeting VEGFR drugs significantly improved overall survival (OS) [Hazard Ratio (HR) 0.69, 95% confidence interval (CI) (0.55, 0.83), P < 0.001], progression free survival (PFS) [HR 0.50, 95% CI (0.34, 0.66), P < 0.001], disease control rate (DCR) [Odds Ratio (OR) 3.83, 95% CI (2.39, 6.15), P < 0.001] and significantly decreased the progressive disease rate(PDR)[OR 0.45, 95% CI (0.34, 0.59), P < 0.001], but not objective response rate (ORR) [OR 1.46, 95% CI (0.93, 2.29), P = 0.098]. Further subgroup revealed that VEGFR antibody (VEGFR-Ab) drugs were superior to VEGFR tyrosine kinase inhibitor (VEGFR-TKI) drugs in terms of the OS, PFS and PDR. To determine the toxic effect of targeting VEGFR drugs, the relative risk of adverse events (grade ≥ 3) of special interest(AESIs) were estimated. Most of these were predictable and manageable. Furthermore, less AESIs were observed in the VEGFR-Ab than the VEGFR-TKI drugs. In conclusion, VEGFR drugs were effective targeted therapy in advanced or metastatic gastric cancer, and its toxicity is within a controllable range. VEGFR-Ab drugs were more effective than VEGFR-TKI drugs in terms of the OS, PFS and PDR of gastric cancer patients with little toxicity.
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Affiliation(s)
- Duanrui Liu
- Central Laboratory, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, People's Republic of China
| | - Xiaoli Ma
- Central Laboratory, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, People's Republic of China
| | - Dongjie Xiao
- Central Laboratory, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, People's Republic of China
| | - Yanfei Jia
- Central Laboratory, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, People's Republic of China
- Shandong Province Key Lab of Tumor Target Molecule, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, People's Republic of China
| | - Yunshan Wang
- Central Laboratory, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, People's Republic of China
- Shandong Province Key Lab of Tumor Target Molecule, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, People's Republic of China
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Affiliation(s)
- David Barras
- Bioinformatician, Bioinformatics Core Facility, Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Sevtap Savas
- Associate Professor of Genetics and Oncology, Memorial University of Newfoundland, St. John's, Canada
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Yin JH, Zhu XY, Shi WD, Liu LM. Huachansu injection inhibits metastasis of pancreatic cancer in mice model of human tumor xenograft. Altern Ther Health Med 2014; 14:483. [PMID: 25496480 PMCID: PMC4320457 DOI: 10.1186/1472-6882-14-483] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 09/30/2014] [Indexed: 12/17/2022]
Abstract
Background Huachansu injection (HCS) is a water-soluble preparation made from Bufo gargarizans’s skin, which has been widely used in clinics for tumor therapy in China. Though the anti-cancer activity of HCS has been verified through studies in vitro and in vivo, there is little research about its potential anti-metastasis effect. The primary objective of this study was to assess the effects of HCS on both the invasion of pancreatic cancer cells in vitro and on the progression of liver metastasis in vivo in this study. Methods HCS anti-metastasis potential was accessed using both assay of Cell viability and invasion in vitro, and then further Establishing xenograft model in nude mice. In the cell-based assay, mRNA and protein expression of MMP-2, MMP-9 and VEGF was detected by semi-quantitative RT-PCR and western blotting. In animal experiment, liver metastasis nodules and change of liver-body ratio was observed. Meanwhile, correlation of the CA19-9 and CEA content in serum with the progression of liver metastasis was analyzed. Result We observed that HCS prevented the invasion of cancer cells, with inhibiting the expressions of MMP-2 and MMP-9, and reduced not only the number of metastasis nodules but the ratio of liver-body weight as well. Furthermore, HCS decreased the expression of MMP-2, MMP-9 and VEGF in liver metastasis, while also reducing CA19-9 contents in serum. In addition, correlation analysis indicated that the level of CA19-9 in serum was closely related to the number of liver metastasis nodules. Conclusion Our experimental results suggest that HCS has some anti-metastasis potential to suppress the growth of liver metastasis by decreasing the expression of MMP-2 and MMP-9 as well as VEGF. Electronic supplementary material The online version of this article (doi:10.1186/1472-6882-14-483) contains supplementary material, which is available to authorized users.
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Gil Delgado M, Delgado FM, Khayat D. Role of aflibercept in the treatment of advanced colorectal cancer. COLORECTAL CANCER 2014. [DOI: 10.2217/crc.13.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
SUMMARY Colorectal cancer is the third most common cancer in men, representing 10% of cases, and the second most common cancer in women, representing 9.4% of cases, worldwide. It is estimated that 50–60% of patients will develop metastases during the course of their disease, while 15–25% will present with synchronous metastatic lesions, reducing the probability of 5-year survival to 12%. Colon cancer represents the fourth most common cause of death from cancer worldwide and the second most common cause in developed countries. First-line therapy of advanced or metastatic colorectal carcinoma (mCRC) usually consists of the administration of oxaliplatin or irinotecan in combination with leucovorin and 5-fluorouracil. In the first- or second-line settings, monoclonal antibodies can be added to chemotherapy. Bevacizumab (anti-VEGF monoclonal antibody) is utilized with fluoropyrimidine-containing regimens in combination with oxaliplatin or irinotecan. Cetuximab can be administered in combination with irinotecan or as a single agent in patients who have wild-type KRAS. Panitumumab has also been approved for third-line single-agent therapy in KRAS wild-type patients and recently in first- and second-line therapy in combination with chemotherapy. There are no standard second-line treatments of mCRC specifically used in combination with FOLFIRI, and no drugs have been approved for patients with prior bevacizumab treatment. Aflibercept is a new angiogenesis inhibitor with a unique mechanism of action. Aflibercept is a recombinant fusion protein consisting of VEGF-binding portions from extracellular domains of the human VEGFR1 and 2 fused to the Fc portion of human IgG1. Aflibercept acts as a soluble decoy receptor that binds to VEGF-A with higher affinity than its native receptors, as well as the related ligands PIGF and VEGF-B. Aflibercept interferes with the biological actions of VEGF by ‘trapping’ VEGF and preventing it from interacting with its receptors on endothelial cells, blocking the activation of VEGFRs and the subsequent proliferation of endothelial cells; this results in inhibition of the growth of new vessels. The role of aflibercept in the management of mCRC was studied in the VELOUR trial, which showed that its addition to the FOLFIRI regimen resulted in a survival benefit, giving a statistically significant log-rank test with p = 0.0032 (hazard ratio: 0.817; 95.34% CI: 0.713–0.937). This benefit was supported by subgroup and sensitivity analyses, the increased median progression-free survival, and improved response rates observed in the aflibercept arm. Aflibercept toxicity is acceptable, manageable and within the established range of other VEGF inhibitors.
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Affiliation(s)
- Marian Gil Delgado
- Groupe Hospitalier Pitié Salpêtrière, Service d’Oncologie Médicale, 47 Boulevard de l’Hôpital, 75013 Paris, France
| | - François Michel Delgado
- Groupe Hospitalier Pitié Salpêtrière, Service d’Oncologie Médicale, 47 Boulevard de l’Hôpital, 75013 Paris, France
| | - David Khayat
- Groupe Hospitalier Pitié Salpêtrière, Service d’Oncologie Médicale, 47 Boulevard de l’Hôpital, 75013 Paris, France
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Martinelli E, Troiani T, Morgillo F, Orditura M, De Vita F, Belli G, Ciardiello F. Emerging VEGF-receptor inhibitors for colorectal cancer. Expert Opin Emerg Drugs 2012; 18:25-37. [PMID: 23216053 DOI: 10.1517/14728214.2013.749856] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Targeted agents have dramatically improved and enriched the therapeutical choices for patients with metastatic colorectal cancer (mCRC). By better understanding the role of the angiogenic pathway in colorectal cancer (CRC), new therapies have been developed. Bevacizumab, the first anti-angiogenetic agent approved for the treatment of mCRC provide a proof of concept since it has improved the progression-free survival and overall survival when combined with cytotoxic chemotherapy. AREAS COVERED This review is focused on the most recent findings on the VEGF signaling pathway and new therapeutic drugs explored in clinical trials. EXPERT OPINION Despite the advantage offered by bevacizumab, the median overall survival of mCRC patient exceeds 21 months; thus, investigational efforts are needed. Several antiangiogenic agents for the treatment of mCRC are being tested in preclinical and clinical Phase I/II trials. Unfortunately a discrete number of Phase III trials produced negative results. Recently aflibercept and regorafenib, two new antiangiogenic drugs, have been approved as the new-targeted agents for the treatment of mCRC, according to the positive findings from the VELOUR and the CORRECT studies. In order to maximize clinical impact it will be important to validate predictive biomarkers and best combination treatments to offer for mCRC patients; further research and intense investigation is still required.
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Affiliation(s)
- Erika Martinelli
- Oncologia Medica and Immunologia Clinica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale F. Magrassi e A. Lanzara, Seconda Università degli Studi di Napoli, Via S. Pansini 5, 80131 Napoli, Italia.
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Troiani T, Martinelli E, Orditura M, De Vita F, Ciardiello F, Morgillo F. Beyond bevacizumab: new anti-VEGF strategies in colorectal cancer. Expert Opin Investig Drugs 2012; 21:949-59. [DOI: 10.1517/13543784.2012.689287] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Teresa Troiani
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale F. Magrassi e A. Lanzara, Seconda Università degli Studi di Napoli,
Via S. Pansini 5, 80131 Napoli, Italia
| | - Erika Martinelli
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale F. Magrassi e A. Lanzara, Seconda Università degli Studi di Napoli,
Via S. Pansini 5, 80131 Napoli, Italia
| | - Michele Orditura
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale F. Magrassi e A. Lanzara, Seconda Università degli Studi di Napoli,
Via S. Pansini 5, 80131 Napoli, Italia
| | - Ferdinando De Vita
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale F. Magrassi e A. Lanzara, Seconda Università degli Studi di Napoli,
Via S. Pansini 5, 80131 Napoli, Italia
| | - Fortunato Ciardiello
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale F. Magrassi e A. Lanzara, Seconda Università degli Studi di Napoli,
Via S. Pansini 5, 80131 Napoli, Italia
| | - Floriana Morgillo
- Oncologia Medica, Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale F. Magrassi e A. Lanzara, Seconda Università degli Studi di Napoli,
Via S. Pansini 5, 80131 Napoli, Italia
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Wang TF, Lockhart AC. Aflibercept in the treatment of metastatic colorectal cancer. CLINICAL MEDICINE INSIGHTS-ONCOLOGY 2012; 6:19-30. [PMID: 22253552 PMCID: PMC3256978 DOI: 10.4137/cmo.s7432] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Colorectal cancer is the third most common cancer in the US. In recent decades, an improved understanding of the role of the angiogenesis pathway in colorectal cancer has led to advancements in treatment. Bevacizumab has been shown to improve the progression-free survival and overall survival when combined with cytotoxic chemotherapy in patients with metastatic colorectal cancer, and at present is the only antiangiogenesis agent approved for the treatment of this cancer. Aflibercept is a novel angiogenesis-targeting agent, and has demonstrated efficacy in treating metastatic colorectal cancer in a recent randomized Phase III trial. Here we review the role of angiogenesis in the tumorigenesis of colorectal cancer, strategies for targeting angiogenesis, and the clinical development of aflibercept.
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Affiliation(s)
- Tzu-Fei Wang
- Division of Oncology, Department of Medicine, Washington University Medical School, St. Louis, MO
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Sinha R, DeJoubner N, Flowers C. Novel agents for diffuse large B-cell lymphoma. Expert Opin Investig Drugs 2011; 20:669-80. [PMID: 21443388 DOI: 10.1517/13543784.2011.565745] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Although diffuse large B-cell lymphoma (DLBCL) is commonly considered as a cancer with a high cure rate with conventional therapies recent studies demonstrate that different biological variants of DBLCL exist, and that patients with one DLBCL variant and DLBCL patients who relapse early following rituximab-based therapy have markedly poorer outcomes with conventional management strategies. Over the last decade, there has been an increasing exploration of novel therapies derived from improved understanding of DLBCL biology and tumor-host interactions. AREAS COVERED This review examines the biological basis for novel therapeutic approaches in DLBCL and the early clinical data on compounds derived from this research. A description of the expanding options of novel agents and combination therapies for patients with poor risk DLBCL is provided. EXPERT OPINION Several promising novel agents and novel therapeutic combinations are under development for patients with poor risk DLBCL. Carefully designed clinical trials that build on our improved understanding of DLBCL biology and utilize tissue samples to examine the activity of novel combination therapies should expand treatment options for DLBCL patients in the future.
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Affiliation(s)
- Rajni Sinha
- Emory University, Winship Cancer Institute, School of Medicine, Atlanta, GA 30322, USA
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Sakakibara S, Tosato G. Regulation of angiogenesis in malignancies associated with Epstein–Barr virus and Kaposi’s sarcoma-associated herpes virus. Future Microbiol 2009; 4:903-17. [DOI: 10.2217/fmb.09.49] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Tumor angiogenesis is the process by which new blood vessels are formed within emerging or progressing malignancies. The human Epstein–Barr virus and Kaposi’s sarcoma-associated herpesvirus critically contribute to the pathogenesis of selected tumor types, including nasopharyngeal carcinoma and Kaposi’s sarcoma, respectively, where angiogenesis is robust and often disrupted. Lymphangiogenesis, the process by which new lymphatic vessels are formed, is also induced in Epstein–Barr virus and Kaposi’s sarcoma-associated herpesvirus-associated malignancies and in some cases may contribute to metastasis. Recent studies have identified a number of molecules and signaling pathways that underlie angiogenesis and lymphangiogenesis, and clarified the pivotal role of the VEGF family of proteins and their receptors. New treatment modalities that target members of this family have gained approval for clinical use in cancer. Pathogenetic steps are often difficult to dissect in many cancer types, but virus-induced malignancies provide a unique opportunity for understanding the molecular regulation of cancer progression, including angiogenesis. Dissection of viral gene contribution to tumor angiogenesis could result in a better understanding of the angiogenic process, its contribution to cancer and help in the design of rational therapies that target tumor growth and vascularization.
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Affiliation(s)
- Shuhei Sakakibara
- Laboratory of Cellular Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Giovanna Tosato
- Laboratory of Cellular Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Building 37, Room 4124, Bethesda, MD 20892, USA
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Xia NX, Qiu BA, Wen JY, Zhu JY, Liu P. Therapeutic effect of two-pathway chemotherapy in combination with gamma-ray stereotactic radiotherapy on local advanced pancreatic cancer: an analysis of 12 cases. Shijie Huaren Xiaohua Zazhi 2009; 17:1888-1893. [DOI: 10.11569/wcjd.v17.i18.1888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the therapeutic effect of two-pathway chemotherapy combined with gamma-ray stereotactic radiotherapy on local advanced pancreatic cancer.
METHODS: From June 2005 to December 2007, 23 patients with local advanced pancreatic cancer were divided into two groups randomly, namely, combined treatment group (n = 12) and control group (n = 11). The combined treatment group received the two-pathway chemotherapy (regional arterial infusion and systemic venous chemotherapy) combined with gamma-ray stereotactic radiotherapy. The control group were only treated with the two-pathway chemotherapy. The curative effect, relief extent of pain, life span and the adverse reaction were compared in the course of treatment between the two groups.
RESULTS: The proportion of CR and PR in the combined treatment group was 75.0%, much higher than 27.3% of the control group. The survival rates at 6 mo and 9 mo were 83.3% and 75.0% in the combined treatment group, similar to 72.7% and 45.5% of the control group. But the 12 months' survival rate of combined treatment group was 50% which was higher than the control group. The average life span of the combined treatment group was 13.1 mo, higher than that of the control group, which was 8.7 mo (P < 0.05). The data of tumor marker CA199 of combined treatment group dropped significantly compared with that of control group (P < 0.05). Abdominal pain in combined treatment group was relieved more than that in control group (P < 0.05). And the adverse effect between two groups had no significant difference (P > 0.05).
CONCLUSION: The therapeutic model of two-pathway chemotherapy combined with gamma-ray stereotactic radiotherapy could be considered one of choice for the patients with local advanced pancreatic cancer.
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Verhoef C, de Wilt JHW, ten Hagen TLM, Eggermont AMM. Isolated hepatic perfusion for the treatment of liver tumors: sunset or sunrise? Surg Oncol Clin N Am 2008; 17:877-94, xi. [PMID: 18722924 DOI: 10.1016/j.soc.2008.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Experience with isolated hepatic perfusion (IHP) is limited to a few centers in the world because of the technical difficulties, surgery-related morbidity, and unproved efficacy in randomized trials. Experimental animal IHP models have led to exploring new ways of improving efficacy, reducing technical difficulties, and minimizing regional and systemic toxicity. Future research should be directed to the identification of suitable biologic or chemotherapeutic agents, defining clinical indications, and development of technical modifications to make it more generally applicable and even repeatable.
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Affiliation(s)
- Cornelis Verhoef
- Department of Surgical Oncology, Erasmus University Medical Centre-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands
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12
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First-time use of bevacizumab for aggressive, metastatic hepatocellular carcinoma in an HIV/hepatitis B virus coinfected patient: a case report. Eur J Gastroenterol Hepatol 2008; 20:472-3. [PMID: 18403951 DOI: 10.1097/meg.0b013e3282f16411] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
We present a case of an HIV-1 infected patient with history of chronic hepatitis B and chronic alcohol use without cirrhosis, who presented with aggressive hepatocellular carcinoma with multiple metastases. Systemic chemotherapy combined with use of bevacizumab (anti-vascular endothelium growth factor monoclonal antibody) was without effect and the patient succumbed to his disease within few weeks. To our knowledge, this is the first report in the English literature of bevacizumab use for metastatic hepatocellular carcinoma in HIV-infected patients.
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13
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Verhoef C, de Wilt JHW, Brunstein F, Marinelli AWKS, van Etten B, Vermaas M, Guetens G, de Boeck G, de Bruijn EA, Eggermont AMM. Isolated hypoxic hepatic perfusion with retrograde outflow in patients with irresectable liver metastases; a new simplified technique in isolated hepatic perfusion. Ann Surg Oncol 2008; 15:1367-74. [PMID: 18239976 PMCID: PMC2277449 DOI: 10.1245/s10434-007-9714-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Revised: 10/30/2007] [Accepted: 10/31/2007] [Indexed: 12/16/2022]
Abstract
Background Isolated hepatic perfusion with high-dose chemotherapy is a treatment option for patients with irresectable metastases confined to the liver. Prolonged local control and impact on survival have been claimed. Major drawbacks are magnitude and costs of the procedure. We developed an isolated hypoxic hepatic perfusion (IHHP) with retrograde outflow without the need for a heart-lung machine. Patients and Methods Twenty-four consecutive patients with irresectable metastases of various origins were treated. IHHP inflow was via the hepatic artery, outflow via the portal vein with occlusion of the retrohepatic caval vein. Radiolabeled albumine was used for leakage monitoring. Melphalan was used at 1–2 mg/kg. A 25-minute perfusion period was followed by a complete washout. Local and systemic melphalan concentrations were determined. Results Compared with oxygenated classical IHP, the IHPP procedure reduced operation time from >8 h to 4 hours, blood loss from >4000 to 900 cc and saved material and personnel costs. Leakage was 0% with negligible systemic toxicity and 0% perioperative mortality. Tumor response: complete response (CR) in 4%, partial response (PR) in 58%, and stable disease (SD) in 13%. Median time to progression was 9 months (2–24 months); pharmacokinetics demonstrated intrahepatic melphalan concentrations more than 9 fold higher than postperfusion systemic concentrations. Conclusions IHPP is a relatively simple procedure with reduced costs, reduced blood loss, no mortality, limited toxicity, and response rates comparable to classic IHP. The median duration of 9 months of tumor control should be improved. Hereto, vasoactive drugs, will be explored in further studies.
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Affiliation(s)
- Cornelis Verhoef
- Department of Surgical Oncology, Erasmus University Medical Centre-Daniel den Hoed Cancer Centre, PO Box 5201, 3008 AE, Rotterdam, The Netherlands.
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14
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Johnson BF, Clay TM, Hobeika AC, Lyerly HK, Morse MA. Vascular endothelial growth factor and immunosuppression in cancer: current knowledge and potential for new therapy. Expert Opin Biol Ther 2007; 7:449-60. [PMID: 17373897 DOI: 10.1517/14712598.7.4.449] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Two decades of research into the role of immunosuppression and angiogenesis in tumor biology have revealed multiple links between the two. Vascular endothelial growth factor, originally thought to be solely involved in vascular growth and permeability, has emerged as a significant agent of immune tolerance in the tumor microenvironment. This review examines two major elements of this field: the research behind the role of vascular endothelial growth factor in immunosuppression, especially as pertains to dendritic cell function; and the subsequent research into the potential for using antiangiogenic therapy to both starve tumors by hypoxia and enhance the response of tumors to immunotherapy. Several strategies tested so far have yielded incomplete, yet promising, results.
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Affiliation(s)
- Benjamin F Johnson
- Duke University Medical Center, Duke University School of Medicine, Department of Medicine, Program in Molecular Therapeutics, Comprehensive Cancer Center, Box 2606, Durham, NC 27710, USA.
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15
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Pasqualetti G, Danesi R, Del Tacca M, Bocci G. Vascular endothelial growth factor pharmacogenetics: a new perspective for anti-angiogenic therapy. Pharmacogenomics 2007; 8:49-66. [PMID: 17187509 DOI: 10.2217/14622416.8.1.49] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The pharmacogenetic approach to anti-angiogenic therapy should be considered a possible strategy for many pathological conditions with high incidence in Western countries, including solid tumors, age-related macular degeneration or endometriosis. While pharmacogenetic studies are building stronger foundations for the systematic investigations of phenotype–genotype relationships in many research and clinical fields of medicine, pharmacogenetic data regarding anti-angiogenic drugs are still lacking. Here we review preclinical and clinical genetic studies on angiogenic determinants such as vascular endothelial growth factor and vascular endothelial growth factor receptor-2. We suggest that pharmacogenetic profiling of patients who are candidates for the currently available anti-angiogenic agents targeting vascular endothelial growth factor and vascular endothelial growth factor receptor-2 may aid the selection of patients on the basis of their likelihood of responding to the drugs or suffering from toxicity.
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Affiliation(s)
- Giuseppe Pasqualetti
- University of Pisa, Division of Pharmacology and Chemotherapy, Department of Internal Medicine, Via Roma, 55, I-56126 Pisa, Italy
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Portlock C. Anti-angiogenesis and diffuse large B-cell lymphoma: a new treatment opportunity? Leuk Lymphoma 2006; 47:961-2. [PMID: 16840182 DOI: 10.1080/10428190600593125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- C Portlock
- Department of Medicine, Memorial Sloan Kettering, Cancer Center, New York, NY 10021, USA.
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18
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Crozier JEM, McKee RF, McArdle CS, Angerson WJ, Anderson JH, Horgan PG, McMillan DC. The presence of a systemic inflammatory response predicts poorer survival in patients receiving adjuvant 5-FU chemotherapy following potentially curative resection for colorectal cancer. Br J Cancer 2006; 94:1833-6. [PMID: 16721360 PMCID: PMC2361334 DOI: 10.1038/sj.bjc.6603185] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
There is increasing evidence that the presence of a systemic inflammatory response plays an important role in survival following curative resection for colorectal cancer. The present study evaluated the relationship between C-reactive protein concentrations and survival in a cohort of patients receiving adjuvant 5-fluorouracil (5-FU) chemotherapy following potentially curative resection for colorectal cancer. In all, 222 patients undergoing potentially curative resection for colorectal cancer were studied. Of these, 50 patients received adjuvant 5-FU-based chemotherapy. Circulating concentrations of C-reactive protein were measured prior to surgery. The minimum follow-up was 15 months; the median follow-up of the survivors was 38 months. During this period 61 patients died, 32 patients of their cancer and 29 of intercurrent disease. In those patients who did not receive adjuvant chemotherapy, age (P < 0.001), Dukes stage (P < 0.05) and an elevated C-reactive protein (P < 0.01) were significantly associated with survival. In those patients who did receive adjuvant chemotherapy, an elevated C-reactive protein concentration (P < 0.01) was significantly associated with survival. The presence of a systemic inflammatory response is an independent predictor of poor outcome in patients receiving adjuvant 5-FU-based chemotherapy following potentially curative resection for colorectal cancer.
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Affiliation(s)
- J E M Crozier
- University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK
- E-mail:
| | - R F McKee
- University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK
| | - C S McArdle
- University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK
| | - W J Angerson
- University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK
| | - J H Anderson
- University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK
| | - P G Horgan
- University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK
| | - D C McMillan
- University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK
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