Joseph I B, Vukanovic J, Isaacs J T
Johns Hopkins Oncology Center, Baltimore, Maryland 21205, USA.
Cancer Res. 1996 Aug 1;56(15):3404-8.
There are two distinct phases during prostatic carcinogenesis with regard to tumor blood vessel development. During the first or prevascular phase, which may persist for years, cells that have undergone some but not all of the transformation steps undergo a limited amount of net growth, producing premalignant prostatic intraepithelial neoplastic (PIN) lesions. Most of these PIN lesions do not continue net growth and do not progress to produce histologically detectable cancer. Even the PIN lesions that do progress to cancer remain of limited virulence unless they undergo conversion to the second or angiogenic phase. Once this angiogenic phase is reached, new blood vessel development is greatly enhanced within the cancer. It is this enhanced tumor angiogenesis which allows these cancers both to grow continuously and to metastasize. Thus, inhibition of angiogenesis should be an effective chemopreventive approach for prostatic carcinogenesis. Linomide is a low molecular weight, water-soluble agent with excellent p.o. absorption and bioavailability. We have previously demonstrated that daily p.o. treatment with Linomide has antiangiogenic abilities against a series of rat and human prostatic cancer xenografts growing in vivo. In the present studies, we have demonstrated using Matrigel in in vivo angiogenesis assays that daily p.o. Linomide at 25 mg/kg/day inhibits angiogenesis induced by tumor necrosis factor alpha, acidic fibroblast growth factor, basic fibroblast growth factor, and vascular endothelial growth factor. Using an N-methylnitrosourea initiation-androgen promotion model, Linomide was given p.o. at a daily dose as high as 25 mg/kg/day for at least 1 year without major toxicity while inhibiting the development of seminal vesicle/prostate cancers in male rats by >50%. Dose-response analysis demonstrated that a Linomide blood level of 50-100 microM is optimal for such chemoprevention. In addition, Linomide treatment at a dose of 25 mg/kg/day was able to inhibit by approximately 60% the incidence of N-methylnitrosourea and approximately 50% of 7,12-dimethyl-benz(a)anthracine-induced mammary carcinogenesis in female rats.
在前列腺癌发生过程中,肿瘤血管生成存在两个不同阶段。在第一个阶段即血管前期,此阶段可能持续数年,经历了部分而非全部转化步骤的细胞会有有限的净生长,产生癌前前列腺上皮内瘤变(PIN)病变。这些PIN病变大多不会继续净生长,也不会发展为组织学上可检测到的癌症。即使进展为癌症的PIN病变,其毒性也有限,除非它们转化为第二个阶段即血管生成期。一旦进入这个血管生成期,癌症内部的新血管生成会大大增强。正是这种增强的肿瘤血管生成使得这些癌症能够持续生长并发生转移。因此,抑制血管生成应该是预防前列腺癌发生的一种有效化学预防方法。利诺胺是一种低分子量、水溶性药物,口服吸收和生物利用度良好。我们之前已经证明,每天口服利诺胺对一系列在体内生长的大鼠和人前列腺癌异种移植瘤具有抗血管生成能力。在本研究中,我们在体内血管生成试验中使用基质胶证明,每天口服25mg/kg/天的利诺胺可抑制由肿瘤坏死因子α、酸性成纤维细胞生长因子、碱性成纤维细胞生长因子和血管内皮生长因子诱导的血管生成。使用N-甲基亚硝基脲启动-雄激素促进模型,每天口服高达25mg/kg/天的利诺胺至少1年,无明显毒性,同时可抑制雄性大鼠精囊/前列腺癌的发生超过50%。剂量反应分析表明,利诺胺血药浓度为50-100μM时对这种化学预防最为理想。此外,每天25mg/kg/天的利诺胺治疗能够抑制雌性大鼠中约60%的N-甲基亚硝基脲诱导的以及约50%的7,12-二甲基苯并(a)蒽诱导的乳腺癌发生。