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Antiangiogenic agents significantly improve survival in tumor-bearing mice by increasing tolerance to chemotherapy-induced toxicity.

Abstract
Chemotherapy-induced broad toxicities are the leading cause of the drug-induced mortality in cancer patients. Antiangiogenic drugs (ADs) in combination with chemotherapy are widely used as front-line therapy for the treatment of various human cancers. However, the beneficial mechanisms underlying combination therapy are poorly understood. Here we show that, in several murine tumor models, administration of sunitinib markedly reduced chemotherapy-induced bone marrow toxicity. Intriguingly, in a sequential treatment regimen, delivery of ADs followed by chemotherapy demonstrated superior survival benefits compared with simultaneous administration of two drugs. In murine tumor models, we show that VEGF increased chemotoxicity by synergistically suppressing bone marrow hematopoiesis with cytostatic drugs. These findings shed light on molecular mechanisms by which ADs in combination with chemotherapy produce survival benefits in cancer patients and provide conceptual information guiding future designs of clinical trials, current practice, and optimization of ADs for the treatment of cancer.
AuthorsDanfang Zhang, Eva-Maria E Hedlund, Sharon Lim, Fang Chen, Yin Zhang, Baocun Sun, Yihai Cao
JournalProceedings of the National Academy of Sciences of the United States of America (Proc Natl Acad Sci U S A) Vol. 108 Issue 10 Pg. 4117-22 (Mar 08 2011) ISSN: 1091-6490 [Electronic] United States
PMID21367692 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Vascular Endothelial Growth Factor A
  • Cyclophosphamide
  • Carboplatin
Topics
  • Angiogenesis Inhibitors (therapeutic use)
  • Animals
  • Antineoplastic Agents (adverse effects, therapeutic use)
  • Carboplatin (adverse effects, therapeutic use)
  • Cyclophosphamide (adverse effects, therapeutic use)
  • Drug Synergism
  • Hematopoiesis (physiology)
  • Melanoma, Experimental (drug therapy, metabolism, pathology)
  • Mice
  • Vascular Endothelial Growth Factor A (antagonists & inhibitors, physiology)

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