Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Clin Colorectal Cancer. 2009 Jul;8(3):155-62. doi: 10.3816/CCC.2009.n.025.
Despite an armamentarium that is wide in range, scope of action, and target, chemotherapy has limited success in colorectal cancer (CRC). Novel approaches are needed to overcome tumor barriers to chemotherapy that includes an abnormal tumor vasculature constituting a poor drug delivery system. We have previously shown that 5-methylselenocysteine (MSC) enhances therapeutic efficacy of irinotecan in various human tumor xenografts. We have recently demonstrated that MSC through vascular normalization leads to better tumor vascular function in vivo. In this study, we examined the role of MSC on tumor vasculature, interstitial fluid pressure (IFP) and drug delivery in 2 histologically distinct CRC xenografts, HCT-8 (uniformly poorly differentiated) and HT-29 (moderately differentiated tumor with avascular glandular regions). The presence of specific histologic structures as a barrier to therapy in these xenografts and their clinical relevance was studied using tissue microarray of human surgical samples of CRC. MSC led to a significant tumor growth inhibition, a reduced microvessel density, and a more normalized vasculature in both colorectal xenografts. While IFP was found to be significantly improved in HCT-8, an improved intratumoral doxorubicin delivery seen in both xenografts could explain the observed increase in therapeutic efficacy. Differentiated, glandular, avascular and hypoxic regions that contribute to tumor heterogeneity in HT-29 were also evident in the majority of surgical samples of CRC. Such regions constitute a physical barrier to chemotherapy and can confer drug resistance. Our results indicate that MSC could enhance chemotherapeutic efficacy in human CRC, especially in CRC with few or no hypoxic regions.
尽管化疗的武器库在范围、作用和目标上都很广泛,但在结直肠癌(CRC)中,其成功的机会有限。需要新的方法来克服肿瘤对化疗的障碍,其中包括构成不良药物输送系统的异常肿瘤血管。我们之前已经表明,5-甲基硒代半胱氨酸(MSC)增强了伊立替康在各种人肿瘤异种移植物中的治疗效果。我们最近的研究表明,MSC 通过血管正常化,导致体内更好的肿瘤血管功能。在这项研究中,我们研究了 MSC 对两种组织学上不同的 CRC 异种移植物(HCT-8(均匀低分化)和 HT-29(血管化腺区中度分化肿瘤))中的肿瘤血管、间质液压力(IFP)和药物输送的作用。使用结直肠癌手术样本的组织微阵列研究了这些异种移植物中特定的组织学结构作为治疗障碍及其临床相关性。MSC 导致肿瘤生长抑制显著,微血管密度降低,两种结直肠异种移植物的血管更正常化。虽然在 HCT-8 中发现 IFP 显著改善,但在两种异种移植物中都观察到的阿霉素的肿瘤内输送改善,可以解释观察到的治疗效果增加。在 HT-29 中,导致肿瘤异质性的分化、腺状、无血管和缺氧区域也在大多数结直肠癌手术样本中明显。这些区域构成了化疗的物理障碍,并可能导致耐药性。我们的研究结果表明,MSC 可以增强人 CRC 的化疗效果,特别是在缺氧区域较少或没有的 CRC 中。