Antiangiogenic agents significantly improve survival in tumor-bearing mice by increasing tolerance to chemotherapy-induced toxicity

D Zhang, EME Hedlund, S Lim… - Proceedings of the …, 2011 - National Acad Sciences
D Zhang, EME Hedlund, S Lim, F Chen, Y Zhang, B Sun, Y Cao
Proceedings of the National Academy of Sciences, 2011National Acad Sciences
Chemotherapy-induced broad toxicities are the leading cause of the drug-induced mortality
in cancer patients. Antiangiogenic drugs (ADs) in combination with chemotherapy are widely
used as front-line therapy for the treatment of various human cancers. However, the
beneficial mechanisms underlying combination therapy are poorly understood. Here we
show that, in several murine tumor models, administration of sunitinib markedly reduced
chemotherapy-induced bone marrow toxicity. Intriguingly, in a sequential treatment regimen …
Chemotherapy-induced broad toxicities are the leading cause of the drug-induced mortality in cancer patients. Antiangiogenic drugs (ADs) in combination with chemotherapy are widely used as front-line therapy for the treatment of various human cancers. However, the beneficial mechanisms underlying combination therapy are poorly understood. Here we show that, in several murine tumor models, administration of sunitinib markedly reduced chemotherapy-induced bone marrow toxicity. Intriguingly, in a sequential treatment regimen, delivery of ADs followed by chemotherapy demonstrated superior survival benefits compared with simultaneous administration of two drugs. In murine tumor models, we show that VEGF increased chemotoxicity by synergistically suppressing bone marrow hematopoiesis with cytostatic drugs. These findings shed light on molecular mechanisms by which ADs in combination with chemotherapy produce survival benefits in cancer patients and provide conceptual information guiding future designs of clinical trials, current practice, and optimization of ADs for the treatment of cancer.
National Acad Sciences