Effect of host age on microenvironmental heterogeneity and efficacy of combined modality therapy in solid tumors.

The implications of microenvironmental heterogeneity in solid tumors for combined modality therapy were assessed by comparing the microenvironmental profiles and therapeutic responses of EMT6 tumors implanted into young and aging mice. The radiobiological hypoxic fraction of tumors in aging mice was shown to be 41% (95% CL, 28-60%), while that in young adult hosts is 19% (95% CL, 14-25%). These microenvironmental differences were also seen in perfusion studies and in studies of the intratumoral pH and pO2 in young and aging mice. The therapeutic importance of microenvironmental factors can be examined in this system, as the tumor cells per se are identical, but the proportions of tumor cells in adverse microenvironments are different. Studies described here show that mitomycin C, an agent with selective toxicity to hypoxic cells, produced greater antineoplastic effects in tumors in aging mice when used alone or as an adjunct to radiation. Combined-modality regimens incorporating agents selectively toxic to hypoxic cells may be especially valuable in improving the results of radiotherapy in tumors in which the tumor-host interactions have resulted in unusually large hypoxic fractions.