Abstract | BACKGROUND AND PURPOSE:
Esophageal cancer incidence is increasing and is rarely curable. Hypoxic tumor areas cause resistance to conventional therapies, making them susceptible for treatment with hypoxia-activated prodrugs (HAPs). We investigated in vivo whether the HAP evofosfamide (TH-302) could increase the therapeutic ratio by sensitizing esophageal carcinomas to radiotherapy without increasing normal tissue toxicity. MATERIALS AND METHODS: To assess therapeutic efficacy, growth of xenografted esophageal squamous cell (OE21) or adeno (OE19) carcinomas was monitored after treatment with TH-302 (50 mg/kg, QD5) and irradiation ( sham or 10 Gy). Short- and long-term toxicity was assessed in a gut mucosa and lung fibrosis irradiation model, sensitive to acute and late radiation injury respectively. Mice were injected with TH-302 (50 mg/kg, QD5) and the abdominal area ( sham, 8 or 10 Gy) or the upper part of the right lung ( sham, 20 Gy) was irradiated. Damage to normal tissues was assessed 84 hours later by histology and blood plasma citrulline levels (gut) and for up to 1 year by non-invasive micro CT imaging (lung). RESULTS: The combination treatment of TH-302 with radiotherapy resulted in significant tumor growth delay in OE19 (P = 0.02) and OE21 (P = 0.03) carcinomas, compared to radiotherapy only. Irradiation resulted in a dose-dependent decrease of crypt survival (P < 0.001), mucosal surface area (P < 0.01) and citrulline levels (P < 0.001) in both tumor and non- tumor bearing animals. On the long-term, irradiation increased CT density in the lung, indicating fibrosis, over time. TH-302 did not influence the radiation-induced short-term and long-term toxicity, confirmed by histological evaluation. CONCLUSION:
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Authors | Linda Spiegelberg, Stefan J van Hoof, Rianne Biemans, Natasja G Lieuwes, Damiënne Marcus, Raymon Niemans, Jan Theys, Ala Yaromina, Philippe Lambin, Frank Verhaegen, Ludwig J Dubois |
Journal | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
(Radiother Oncol)
Vol. 141
Pg. 247-255
(12 2019)
ISSN: 1879-0887 [Electronic] Ireland |
PMID | 31431383
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2019 The Author(s). Published by Elsevier B.V. All rights reserved. |
Chemical References |
- Nitroimidazoles
- Phosphoramide Mustards
- Radiation-Sensitizing Agents
- TH 302
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Topics |
- Adenocarcinoma
(radiotherapy)
- Animals
- Cell Line, Tumor
- Esophageal Neoplasms
(radiotherapy)
- Female
- Humans
- Male
- Mice
- Nitroimidazoles
(adverse effects, pharmacology)
- Phosphoramide Mustards
(adverse effects, pharmacology)
- Radiation-Sensitizing Agents
(pharmacology)
- Squamous Cell Carcinoma of Head and Neck
(radiotherapy)
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