Department of Hematology/Oncology, University Medical Center.
Department of Radiology, Medical Physics, University Medical Center; Freiburg, Germany.
Thromb Res. 2016 Apr;140 Suppl 1:S188. doi: 10.1016/S0049-3848(16)30166-9. Epub 2016 Apr 8.
Lung cancer is the leading cause of cancer-related death worldwide. Small cell lung cancer (SCLC) is thereby a highly aggressive neuroendocrine carcinoma representing about 15% of all lung cancer cases. Due to the highly metastatic behavior and multidrug resistance, the long-term survival of patients is very low.
Current clinical studies revealed an increased survival of SCLC patients treated with heparin. Thus, the role of heparin in SCLC progression was analyzed with the focus on cell adhesion, cell survival and metastasis formation.
Heparins were tested for their capacities to alter migration, adhesion and viability of SCLC cells in vitro as well as tumor growth and metastasis formation in vivo.
Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) both strongly inhibited migration as well as adhesion of SCLC cells to fibronectin and stromal cells. In addition, Heparin induced cellular apoptosis and also increased apoptotic effects of conventional chemotherapeutics in vitro. To investigate the role of LMWH on metastasis formation in vivo, an orthotopic xenograft mouse model with spontaneous metastasis formation has been established. The primary tumors in this mouse model show a marked capacity to metastasize to characteristic distant organs, reflecting advanced steps of malignant progression. Treatment of tumor-bearing mice with LMWH suppressed progression of SCLC.
Administration of LMWH in addition to the conventional treatment might reduce metastasis formation and development of chemoresistance, leading to an improved survival rate of patients suffering from SCLC.
肺癌是全球癌症相关死亡的主要原因。小细胞肺癌(SCLC)是一种高度侵袭性的神经内分泌癌,约占所有肺癌病例的 15%。由于其高度转移性和多药耐药性,患者的长期生存率非常低。
目前的临床研究表明,肝素治疗的 SCLC 患者的生存率有所提高。因此,本研究分析了肝素在 SCLC 进展中的作用,重点关注细胞黏附、细胞存活和转移形成。
检测肝素在体外改变 SCLC 细胞迁移、黏附和活力以及体内肿瘤生长和转移形成的能力。
未分级肝素(UFH)和低分子量肝素(LMWH)均强烈抑制 SCLC 细胞向纤维连接蛋白和基质细胞的迁移和黏附。此外,肝素诱导细胞凋亡,并增加体外常规化疗药物的凋亡作用。为了研究 LMWH 在体内转移形成中的作用,建立了一种具有自发转移形成的原位异种移植小鼠模型。该小鼠模型中的原发性肿瘤具有向特征性远处器官转移的显著能力,反映了恶性进展的晚期步骤。用 LMWH 治疗荷瘤小鼠抑制了 SCLC 的进展。
在常规治疗的基础上联合 LMWH 治疗可能会减少转移的形成和耐药的发展,从而提高 SCLC 患者的生存率。