Evelhoch Jeffrey L, LoRusso Patricia M, He Zhanquan, DelProposto Zachary, Polin Lisa, Corbett Thomas H, Langmuir Peter, Wheeler Catherine, Stone Andrew, Leadbetter Joanna, Ryan Anderson J, Blakey David C, Waterton John C
Karmanos Cancer Institute, Wayne State University, Harper Hospital MR Center, Detroit, Michigan 48201, USA.
Clin Cancer Res. 2004 Jun 1;10(11):3650-7. doi: 10.1158/1078-0432.CCR-03-0417.
ZD6126 is a novel vascular targeting agent currently undergoing clinical evaluation. It acts by destabilizing the microtubulin of fragile and proliferating neoendothelial cells in tumors. The drug leads to blood vessel congestion, the selective destruction of the vasculature, and extensive necrosis in experimental tumors. The aim of the study reported here was to assess the ability of dynamic contrast enhanced magnetic resonance imaging (MRI) to measure the antivascular effects of ZD6126 in tumors.
The work was carried out in mice bearing C38 colon adenocarcinoma and in patients with advanced cancers. MRI was performed before and 6 h (human tumors) or 24 h (C38 tumors) after i.v. drug administration. Contrast agent (gadolinium diethylenetriaminepentaacetate) enhancement was characterized by the initial area under the gadolinium diethylenetriaminepentaacetate uptake versus time curve (IAUC). IAUC reflects blood flow, vascular permeability, and the fraction of interstitial space.
The median IAUC was reduced in all C38 tumors after ZD6126 administration [by 6-48% at 50 mg/kg (n = 3)], 58-91% at 100 mg/kg (n = 4), and 11-93% at 200 mg/kg (n = 6). In contrast, the administration of vehicle only led to no consistent change in median IAUC (n = 4). The ZD6126-induced changes in median IAUC appeared to be dose dependent (P = 0.045). No ZD6126-induced changes were apparent in murine muscle. Similar effects were seen in preliminary data from human tumors (11 tumors studied, 9 patients). At doses of 80 mg/m(2) and higher, the median IAUC post-ZD6126 treatment was reduced in all of the tumors studied (8 tumors, 6 patients) to 36-72% from the baseline value. There was a significant trend of increasing reductions with increasing exposure (P < 0.01). No drug-induced changes in human muscle or spleen IAUC were apparent. The reproducibility of the median IAUC parameter was investigated in patients. In 19 human tumors (measured in 19 patients) inter- and intratumor coefficients of variation were 64 and 18%.
The contrast enhanced-MRI measured median IAUC is a useful end point for quantifying ZD6126 antivascular effects in human tumors.
ZD6126是一种新型血管靶向药物,目前正在进行临床评估。它通过破坏肿瘤中脆弱且增殖的新生内皮细胞的微管蛋白起作用。该药物会导致血管充血、脉管系统的选择性破坏以及实验性肿瘤中的广泛坏死。本文报道的研究目的是评估动态对比增强磁共振成像(MRI)测量ZD6126对肿瘤抗血管作用的能力。
该研究在携带C38结肠腺癌的小鼠和晚期癌症患者中进行。在静脉注射药物前以及注射后6小时(人类肿瘤)或24小时(C38肿瘤)进行MRI检查。通过钆二乙烯三胺五乙酸摄取量与时间曲线下的初始面积(IAUC)来表征造影剂(钆二乙烯三胺五乙酸)增强情况。IAUC反映血流量、血管通透性以及间质间隙分数。
给予ZD6126后,所有C38肿瘤的IAUC中位数均降低[50 mg/kg时降低6 - 48%(n = 3)],100 mg/kg时降低58 - 91%(n = 4),200 mg/kg时降低11 - 93%(n = 6)。相比之下,仅给予赋形剂时,IAUC中位数无一致变化(n = 4)。ZD6126引起的IAUC中位数变化似乎呈剂量依赖性(P = 0.045)。在鼠类肌肉中未观察到ZD6126引起的变化。在人类肿瘤的初步数据中也观察到了类似效果(研究了11个肿瘤,9名患者)。在80 mg/m²及更高剂量下,所有研究的肿瘤(8个肿瘤,6名患者)在ZD6126治疗后的IAUC中位数从基线值降至36 - 72%。随着暴露增加,降低程度有显著增加趋势(P < 0.01)。在人类肌肉或脾脏的IAUC中未观察到药物引起的变化。对患者的IAUC中位数参数的可重复性进行了研究。在19个人类肿瘤(19名患者测量)中,肿瘤间和肿瘤内变异系数分别为64%和18%。
对比增强MRI测量的IAUC中位数是量化ZD6126对人类肿瘤抗血管作用的有用终点指标。