逃避性耐药的生物标志物可预测接受抗血管生成治疗的癌症患者的疾病进展。

Biomarkers of evasive resistance predict disease progression in cancer patients treated with antiangiogenic therapies.

作者信息

Pircher Andreas, Jöhrer Karin, Kocher Florian, Steiner Normann, Graziadei Ivo, Heidegger Isabel, Pichler Renate, Leonhartsberger Nicolai, Kremser Christian, Kern Johann, Untergasser Gerold, Gunsilius Eberhard, Hilbe Wolfgang

机构信息

Department of Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Innsbruck, Austria.

Tyrolean Cancer Research Institute, Innsbruck, Austria.

出版信息

Oncotarget. 2016 Apr 12;7(15):20109-23. doi: 10.18632/oncotarget.7915.

Abstract

Numerous antiangiogenic agents are approved for the treatment of oncological diseases. However, almost all patients develop evasive resistance mechanisms against antiangiogenic therapies. Currently no predictive biomarker for therapy resistance or response has been established. Therefore, the aim of our study was to identify biomarkers predicting the development of therapy resistance in patients with hepatocellular cancer (n = 11), renal cell cancer (n = 7) and non-small cell lung cancer (n = 2). Thereby we measured levels of angiogenic growth factors, tumor perfusion, circulating endothelial cells (CEC), circulating endothelial progenitor cells (CEP) and tumor endothelial markers (TEM) in patients during the course of therapy with antiangiogenic agents, and correlated them with the time to antiangiogenic progression (aTTP). Importantly, at disease progression, we observed an increase of proangiogenic factors, upregulation of CEC/CEP levels and downregulation of TEMs, such as Robo4 and endothelial cell-specific chemotaxis regulator (ECSCR), reflecting the formation of torturous tumor vessels. Increased TEM expression levels tended to correlate with prolonged aTTP (ECSCR high = 275 days vs. ECSCR low = 92.5 days; p = 0.07 and for Robo4 high = 387 days vs. Robo4 low = 90.0 days; p = 0.08). This indicates that loss of vascular stabilization factors aggravates the development of antiangiogenic resistance. Thus, our observations confirm that CEP/CEC populations, proangiogenic cytokines and TEMs contribute to evasive resistance in antiangiogenic treated patients. Higher TEM expression during disease progression may have clinical and pathophysiological implications, however, validation of our results is warranted for further biomarker development.

摘要

许多抗血管生成药物已被批准用于治疗肿瘤疾病。然而,几乎所有患者都会对抗血管生成疗法产生逃避性耐药机制。目前尚未建立用于预测治疗耐药性或反应的生物标志物。因此,我们研究的目的是确定预测肝细胞癌(n = 11)、肾细胞癌(n = 7)和非小细胞肺癌(n = 2)患者治疗耐药性发展的生物标志物。在此过程中,我们在患者接受抗血管生成药物治疗期间测量了血管生成生长因子水平、肿瘤灌注、循环内皮细胞(CEC)、循环内皮祖细胞(CEP)和肿瘤内皮标志物(TEM),并将它们与抗血管生成进展时间(aTTP)相关联。重要的是,在疾病进展时,我们观察到促血管生成因子增加、CEC/CEP水平上调以及TEMs(如Robo4和内皮细胞特异性趋化调节因子(ECSCR))下调,这反映了迂曲肿瘤血管的形成。TEM表达水平升高往往与延长的aTTP相关(ECSCR高 = 275天 vs. ECSCR低 = 92.5天;p = 0.07,Robo4高 = 387天 vs. Robo4低 = 90.0天;p = 0.08)。这表明血管稳定因子的丧失会加剧抗血管生成耐药性的发展。因此,我们的观察结果证实,CEP/CEC群体、促血管生成细胞因子和TEMs在接受抗血管生成治疗的患者中促成了逃避性耐药。然而,疾病进展期间较高的TEM表达可能具有临床和病理生理学意义,不过,我们的结果需要验证以进一步开发生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b514/4991441/f5ad42e9d30e/oncotarget-07-20109-g001.jpg

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