Marmé D
Klinik für Tumorbiologie, Freiburg i.Br.
Onkologie. 2001 Feb;24 Suppl 1:1-5. doi: 10.1159/000055156.
Growth and metastasis of solid tumors depend on the formation of new blood vessels which originate from the existing vascular system. These blood vessels grow into the tumor and thus provide the necessary nutrients and growth factors for tumor progression. At the same time, the newly formed blood vessels allow tumor cells to disseminate and form metastases in distant organs. Normally, vascular homeostasis is regulated by a balance of angiogenic and antiangiogenic mechanisms. Tumor-induced angiogenesis is mainly sustained by the production and secretion of angiogenic factors originating from tumor and stroma cells. The most prominent angiogenic factor is the vascular endothelial growth factor (VEGF). Recently, additional angiogenic factors and their respective receptors have been identified and related to tumor angiogenesis. Among these, the angiopoietins and their receptor TIE-2 have been investigated to some detail. Angiopoietin-1 which binds to and activates TIE-2 is obviously responsible for the stabilization of vessels under homeostatic conditions. Angiopoietin-2 binds to the same receptor as angiopoietin-1 but is antagonistic with respect to angiopoietin-1. It destabilizes blood vessels and, under appropriate conditions, induces complete regression. In the similar situation angiopoietin-2 induces the destabilization of blood vessels, and the angiogenic factor VEGF produced by the tumor induces the massive formation of new vessels. When human melanoma cells A375 are stably transfected to produce the soluble variant of the angiopoietin receptor TIE-2 (sTIE-2), they show a substantial inhibition of tumor growth on nude mice. Similar effects have been seen with the soluble variant of the VEGF receptor FLT-1 (sFLT-1). In both cases, the vessel density of the tumors is significantly reduced. These experiments show that the inhibition of the angiopoietin/TIE-2 system, similar to the inhibition of the VEGF/VEGF receptor system, has an antitumoral effect, most probably due to the inhibition of tumor angiogenesis. Thus, inhibition of both signalling systems seem to be a valid strategy for the development of novel antiangiogenic therapies. Recently, the inhibition of the VEGF receptor tyrosine kinase by the compound PTK787/ZK222584 has been shown to substantially inhibit tumor growth and metastases formation. This compound has now entered clinical trials at the Tumor Biology Center in Freiburg i.Br. A preliminary evaluation of phase I study shows a very promising clinical outcome.
实体瘤的生长和转移依赖于源自现有血管系统的新血管形成。这些血管长入肿瘤,从而为肿瘤进展提供必要的营养物质和生长因子。同时,新形成的血管使肿瘤细胞得以扩散并在远处器官形成转移灶。正常情况下,血管稳态由血管生成和抗血管生成机制的平衡来调节。肿瘤诱导的血管生成主要由肿瘤细胞和基质细胞产生并分泌的血管生成因子维持。最突出的血管生成因子是血管内皮生长因子(VEGF)。最近,已鉴定出其他血管生成因子及其各自的受体,并与肿瘤血管生成相关。其中,血管生成素及其受体TIE-2已得到一定程度的详细研究。与TIE-2结合并激活TIE-2的血管生成素-1显然负责稳态条件下血管的稳定。血管生成素-2与血管生成素-1结合相同的受体,但对血管生成素-1具有拮抗作用。它使血管不稳定,并在适当条件下诱导血管完全消退。在类似情况下,血管生成素-2诱导血管不稳定,而肿瘤产生的血管生成因子VEGF诱导大量新血管形成。当人黑色素瘤细胞A375被稳定转染以产生血管生成素受体TIE-2的可溶性变体(sTIE-2)时,它们在裸鼠上显示出对肿瘤生长的显著抑制。血管内皮生长因子受体FLT-1的可溶性变体(sFLT-1)也观察到类似效果。在这两种情况下,肿瘤的血管密度均显著降低。这些实验表明,与抑制VEGF/VEGF受体系统类似,抑制血管生成素/TIE-2系统具有抗肿瘤作用,很可能是由于抑制了肿瘤血管生成。因此,抑制这两种信号系统似乎是开发新型抗血管生成疗法的有效策略。最近,化合物PTK787/ZK222584对VEGF受体酪氨酸激酶的抑制已显示出能显著抑制肿瘤生长和转移形成。该化合物现已在弗赖堡肿瘤生物学中心进入临床试验。I期研究的初步评估显示出非常有前景的临床结果。