Hill S A, Sampson L E, Chaplin D J
Gray Laboratory Cancer Research Trust, Mount Vernon Hospital, Middlesex, UK.
Int J Cancer. 1995 Sep 27;63(1):119-23. doi: 10.1002/ijc.2910630121.
Several agents have now been identified which exert their anti-tumour effects in large part via the tumour vasculature; these include TNF alpha and flavone acetic acid (FAA). More recently, Vincristine and Vinblastine have also been shown to cause a prolonged and selective decrease in tumour perfusion. Vinblastine, unlike, FAA, causes no increase in plasma TNF alpha levels in mice bearing the CaNT tumour, suggesting 2 distinct mechanisms of anti-vascular activity for these structurally diverse agents. Since FAA and Vinblastine also show quite different normal tissue toxicities, which are separately dose-limiting, we have examined the strategy of combining these 2 agents. When Vinblastine preceded FAA by 24 hr or less, tumour growth delay was significantly enhanced without a concomitant increase in toxicity. The level of enhancement was not significantly reduced by a 5-fold decrease in Vinblastine dose, though any reduction in the dose of FAA caused a rapid reduction in treatment effectiveness. Investigation of the functional vasculature of treated tumours suggested that increased anti-vascular effects may contribute to the enhanced growth inhibition of the combined treatment. Our results demonstrate the potential benefit of combining 2 different classes of anti-vascular agent, using Vinblastine and FAA (or 5,6-MeXAA) as prototype drugs.
现已鉴定出几种主要通过肿瘤血管系统发挥抗肿瘤作用的药物;这些药物包括肿瘤坏死因子α(TNFα)和黄酮乙酸(FAA)。最近,长春新碱和长春碱也已被证明可导致肿瘤灌注持续且选择性地降低。与FAA不同,长春碱不会使携带CaNT肿瘤的小鼠血浆TNFα水平升高,这表明这些结构不同的药物具有两种不同的抗血管活性机制。由于FAA和长春碱还表现出截然不同的正常组织毒性,且这些毒性分别限制了剂量,因此我们研究了联合使用这两种药物的策略。当长春碱在FAA之前24小时或更短时间给药时,肿瘤生长延迟显著增强,且毒性没有相应增加。长春碱剂量降低5倍时,增强水平没有显著降低,不过FAA剂量的任何降低都会导致治疗效果迅速下降。对经治疗肿瘤的功能性血管系统进行研究表明,增强的抗血管作用可能有助于联合治疗对肿瘤生长抑制作用的增强。我们的结果证明了以长春碱和FAA(或5,6-二甲基黄酮乙酸)作为原型药物联合使用两类不同抗血管药物的潜在益处。