An impressive response to pazopanib in a patient with metastatic endometrial carcinoma

The incidence of endometrial carcinoma is rising and the patients with distant metastases have a poor prognosis, especially when progression of disease occurs after systemic treatment with hormonal therapy or chemotherapy. Pazopanib, a multi-targeted inhibitor of several oncogenic receptor tyrosine kinases, has been investigated in patients with chemotherapy-resistant endometrial carcinoma or patients for whom chemotherapy is contraindicated. In this report we will describe a spectacular response to pazopanib in a patient with recurrent metastatic endometrial carcinoma.

Characterisation of tumour vasculature in mouse brain by USPIO contrast-enhanced MRI

To enhance the success rate of antiangiogenic therapies in the clinic, it is crucial to identify parameters for tumour angiogenesis that can predict response to these therapies. In brain tumours, one such parameter is vascular leakage, which is a response to tumour-derived vascular endothelial growth factor-A and can be measured by Gadolinium-DTPA (Gd-DTPA)-enhanced magnetic resonance imaging (MRI). However, as vascular permeability and angiogenesis are not strictly coupled, tumour blood volume may be another potentially important parameter. In this study, contrast-enhanced MR imaging was performed in three orthotopic mouse models for human brain tumours (angiogenic melanoma metastases and E34 and U87 human glioma xenografts) using both Gd-DTPA to detect vascular leakage and ultrasmall iron oxide particles (USPIO) to measure blood volume. Pixel-by-pixel maps of the enhancement in the transverse relaxation rates (Delta R(2) and Delta R(2)(*)) after injection of USPIO provided an index proportional to the blood volume of the microvasculature and macrovasculature, respectively, for each tumour. The melanoma metastases were characterised by a blood volume and vessel leakage higher than both glioma xenografts. The U87 glioblastoma xenografts displayed higher permeability and blood volume in the rim than in the core. The E34 glioma xenografts were characterised by a relatively high blood volume, accompanied by only a moderate blood-brain barrier disruption. Delineation of the tumour was best assessed on post-USPIO gradient-echo images. These findings suggest that contrast-enhanced MR imaging using USPIOs and, in particular, Delta R(2) and Delta R(2)(*) quantitation, provides important additional information about tumour vasculature.

Development of luciferase tagged brain tumour models in mice for chemotherapy intervention studies

The blood-brain barrier (BBB) is considered one of the major causes for the low efficacy of cytotoxic compounds against primary brain tumours. The aim of this study was to develop intracranial tumour models in mice featuring intact or locally disrupted BBB properties, which can be used in testing chemotherapy against brain tumours. These tumours were established by intracranial injection of suspensions of different tumour cell lines. All cell lines had been transfected with luciferase to allow non-invasive imaging of tumour development using a super-cooled CCD-camera. Following their implantation, tumours developed which displayed the infiltrative, invasive or expansive growth patterns that are also found in primary brain cancer or brain metastases. Contrast-enhanced magnetic resonance imaging showed that the Mel57, K1735Br2 and RG-2 lesions grow without disruption of the BBB, whereas the BBB was leaky in the U87MG and VEGF-A-transfected Mel57 lesions. This was confirmed by immunohistochemistry. Bioluminescence measurements allowed the visualisation of tumour burden already within 4 days after injection of the tumour cells. The applicability of our models for performing efficacy studies was demonstrated in an experiment using temozolomide as study drug. In conclusion, we have developed experimental brain tumour models with partly disrupted, or completely intact BBB properties. In vivo imaging by luciferase allows convenient follow-up of tumour growth and these models will be useful for chemotherapeutic intervention studies.

In vivo activities of mutants of vascular endothelial growth factor (VEGF) with differential in vitro activities

VEGF mutants in which Cys51 or Cys60 are converted into a serine are poor inducers of proliferation in human umbilical vein endothelial cells, but they have wild-type activity in the Miles vascular permeability assay. To assess the contribution of proliferation vs. other VEGF activities such as vascular permeability, to tumor angiogenesis and growth, C127I cells, transfected with BPV-based expression plasmids carrying wild-type or mutated VEGF cDNAs, were injected subcutaneously in BALB/c nu/nu mice. From C127I cells expressing wtVEGF(165), intensely vascularized and invasive tumors developed within 2 to 3 weeks. From cells expressing VEGF-Cys51Ser or VEGF-Cys60Ser, tumors developed only after 2 to 3 months, comparable to the time of development of control tumors, i.e., tumors from cells transfected with empty vector. Despite the late take, the VEGF-Cys51Ser and VEGF-Cys60Ser tumors developed an extensive vascular bed with an architecture comparable to that of recombinant wtVEGF-producing tumors whereas control tumors had a considerably lower vascular density. No metastases were detected in mice carrying either wtVEGF or mutant VEGF expressing tumors. Thus, because proliferation-defective VEGF-mutants cannot induce angiogenesis, we conclude that the proliferation-inducing effect of VEGF is crucial for tumor angiogenesis and growth. The hypervasculature in the tumors expressing these VEGF-mutants suggests, however, that other VEGF-activities, such as the induction of vascular permeability, strongly affects vascular density and vascular structure. Furthermore, neither overexpression of VEGF or a high vascular density or hyperpermeability of tumor vasculature is necessarily followed by metastasis.

In vivo activities of mutants of vascular endothelial growth factor (VEGF) with differential in vitro activities

VEGF mutants in which Cys51 or Cys60 are converted into a serine are poor inducers of proliferation in human umbilical vein endothelial cells, but they have wild-type activity in the Miles vascular permeability assay. To assess the contribution of proliferation vs. other VEGF activities such as vascular permeability, to tumor angiogenesis and growth, C127I cells, transfected with BPV-based expression plasmids carrying wild-type or mutated VEGF cDNAs, were injected subcutaneously in BALB/c nu/nu mice. From C127I cells expressing wtVEGF(165), intensely vascularized and invasive tumors developed within 2 to 3 weeks. From cells expressing VEGF-Cys51Ser or VEGF-Cys60Ser, tumors developed only after 2 to 3 months, comparable to the time of development of control tumors, i.e., tumors from cells transfected with empty vector. Despite the late take, the VEGF-Cys51Ser and VEGF-Cys60Ser tumors developed an extensive vascular bed with an architecture comparable to that of recombinant wtVEGF-producing tumors whereas control tumors had a considerably lower vascular density. No metastases were detected in mice carrying either wtVEGF or mutant VEGF expressing tumors. Thus, because proliferation-defective VEGF-mutants cannot induce angiogenesis, we conclude that the proliferation-inducing effect of VEGF is crucial for tumor angiogenesis and growth. The hypervasculature in the tumors expressing these VEGF-mutants suggests, however, that other VEGF-activities, such as the induction of vascular permeability, strongly affects vascular density and vascular structure. Furthermore, neither overexpression of VEGF or a high vascular density or hyperpermeability of tumor vasculature is necessarily followed by metastasis.

Hepatitis delta virus attaches to human hepatocytes via human liver endonexin II, a specific HBsAg binding protein

Recently we identified human liver endonexin II (EII) as a specific hepatitis B surface antigen (HBsAg) binding protein. To investigate whether EII is also able to interact with the HBsAg envelope of the hepatitis delta virus (H delta V), immunoprecipitation experiments were performed. H delta V particles could be co-precipitated by polyclonal rabbit anti-EII, but not by rabbit anti-glutathiontransferase (GST pi) antibodies from an H delta V-enriched fraction containing EII or GST pi. These findings suggest that H delta V particles were co-precipitated by anti-EII as a consequence of the binding between HBsAg present in the H delta V envelope and EII. Furthermore, binding of H delta V particles to human hepatocytes could be inhibited by incubation of the liver cells with rabbit anti-EII IgG or the H delta V particles with anti-idiotypic (anti-HBsAg) antibodies, developed spontaneously in rabbits immunized with EII. These findings support the assumption that small HBsAg present in the H delta V envelope is important for the attachment to the hepatocytes and that EII plays an important role in this process.

Spontaneous development of anti-hepatitis B virus envelope (anti-idiotypic) antibodies in animals immunized with human liver endonexin II or with the F(ab')2 fragment of anti-human liver endonexin II immunoglobulin G: evidence for a receptor-ligand-like relationship between small hepatitis B surface antigen and endonexin II

In a previous study, we have identified endonexin II (E-II) on human liver plasma membranes as a specific, Ca(2+)-dependent, small hepatitis B surface antigen (HBsAg)-binding protein. In this article, we describe the spontaneous development of anti-HBs antibodies in rabbits immunized with native or recombinant human liver E-II and in chickens immunized with the F(ab')2 fragment of rabbit anti-human liver E-II immunoglobulin G. Anti-HBs activity was not observed in rabbits immunized with rat liver E-II. Cross-reactivity of anti-E-II antibodies to HBsAg epitopes was excluded, since anti-HBs and anti-E-II activities can be separated by E-II affinity chromatography. The existence of an anti-idiotypic antibody is further demonstrated by competitive binding of human liver E-II and this antibody (Ab2) to small HBsAg, suggesting that Ab2 mimics a specific E-II epitope that interacts with small HBsAg. In addition, it was demonstrated that anti-HBs antibodies developed in rabbits after immunization with intact human liver E-II or in chickens after immunization with F(ab')2 fragments of rabbit anti-human liver E-II immunoglobulin G recognize the same epitopes on small HBsAg. These findings strongly indicate that human liver E-II is a very specific small HBsAg-binding protein and support the assumption that human liver E-II is the hepatitis B virus receptor protein.

In vitro binding properties of the hepatitis delta antigens to the hepatitis B virus envelope proteins: potential significance for the formation of delta particles

To investigate the possible existence of (a) reactive binding site(s) on the hepatitis B surface antigen (HBsAg) for the hepatitis delta antigen (delta Ag) in the hepatitis delta virus (HDV), we performed binding studies using recombinant (rec)Small, recMiddle, recLarge HBsAg and recombinant small (S) and large (L) hepatitis delta antigen (recS delta Ag, recL delta Ag). Rec delta Ag was immobilized onto microtiter plates and incubated with recSmall, recMiddle and recLarge HBsAg. Of the three HBsAg proteins only the recMiddle HBsAg was found to bind to recS delta Ag. This binding was inhibited by the addition of synthetic PreS2 peptide but not by small HBsAg, indicating that the S delta Ag exhibits a PreS2 binding site. RecL delta Ag bound to all three forms of HBsAg. The binding of the HBsAg to recL delta Ag was saturable and could be blocked with an excess of HBsAg, but not with BSA. The region of the additional 19 amino acids of the L delta Ag is therefore responsible for the creation of the small HBsAg binding site on the L delta Ag. We therefore suggest that all HBsAg proteins but particularly the small HBsAg in the HDV coat seem to be involved in the interaction with the HDV core particle and that the PreS2 region of the middle HBsAg plays a crucial role in binding to small delta Ag during HDV particle formation, probably to increase the stability of the HDV particle.