Optimal treatment scheduling of ionizing radiation and sunitinib improves the antitumor activity and allows dose reduction. 2015

Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands.

The combination of radiotherapy with sunitinib is clinically hampered by rare but severe side effects and varying results with respect to clinical benefit. We studied different scheduling regimes and dose reduction in sunitinib and radiotherapy in preclinical tumor models to improve potential outcome of this combination treatment strategy. The chicken chorioallantoic membrane (CAM) was used as an angiogenesis in vivo model and as a xenograft model with human tumor cells (HT29 colorectal adenocarcinoma, OE19 esophageal adenocarcinoma). Treatment consisted of ionizing radiation (IR) and sunitinib as single therapy or in combination, using different dose-scheduling regimes. Sunitinib potentiated the inhibitory effect of IR (4 Gy) on angiogenesis. In addition, IR (4 Gy) and sunitinib (4 days of 32.5 mg/kg per day) inhibited tumor growth. Ionizing radiation induced tumor cell apoptosis and reduced proliferation, whereas sunitinib decreased tumor angiogenesis and reduced tumor cell proliferation. When IR was applied before sunitinib, this almost completely inhibited tumor growth, whereas concurrent IR was less effective and IR after sunitinib had no additional effect on tumor growth. Moreover, optimal scheduling allowed a 50% dose reduction in sunitinib while maintaining comparable antitumor effects. This study shows that the therapeutic efficacy of combination therapy improves when proper dose-scheduling is applied. More importantly, optimal treatment regimes permit dose reductions in the angiogenesis inhibitor, which will likely reduce the side effects of combination therapy in the clinical setting. Our study provides important leads to optimize combination treatment in the clinical setting.

UI MeSH Term Description Entries
D007211 Indoles Benzopyrroles with the nitrogen at the number one carbon adjacent to the benzyl portion, in contrast to ISOINDOLES which have the nitrogen away from the six-membered ring.
D009389 Neovascularization, Pathologic A pathologic process consisting of the proliferation of blood vessels in abnormal tissues or in abnormal positions. Angiogenesis, Pathologic,Angiogenesis, Pathological,Neovascularization, Pathological,Pathologic Angiogenesis,Pathologic Neovascularization,Pathological Angiogenesis,Pathological Neovascularization
D011758 Pyrroles Azoles of one NITROGEN and two double bonds that have aromatic chemical properties. Pyrrole
D011829 Radiation Dosage The amount of radiation energy that is deposited in a unit mass of material, such as tissues of plants or animal. In RADIOTHERAPY, radiation dosage is expressed in gray units (Gy). In RADIOLOGIC HEALTH, the dosage is expressed by the product of absorbed dose (Gy) and quality factor (a function of linear energy transfer), and is called radiation dose equivalent in sievert units (Sv). Sievert Units,Dosage, Radiation,Gray Units,Gy Radiation,Sv Radiation Dose Equivalent,Dosages, Radiation,Radiation Dosages,Units, Gray,Units, Sievert
D011839 Radiation, Ionizing ELECTROMAGNETIC RADIATION or particle radiation (high energy ELEMENTARY PARTICLES) capable of directly or indirectly producing IONS in its passage through matter. The wavelengths of ionizing electromagnetic radiation are equal to or smaller than those of short (far) ultraviolet radiation and include gamma and X-rays. Ionizing Radiation,Ionizing Radiations,Radiations, Ionizing
D002453 Cell Cycle The complex series of phenomena, occurring between the end of one CELL DIVISION and the end of the next, by which cellular material is duplicated and then divided between two daughter cells. The cell cycle includes INTERPHASE, which includes G0 PHASE; G1 PHASE; S PHASE; and G2 PHASE, and CELL DIVISION PHASE. Cell Division Cycle,Cell Cycles,Cell Division Cycles,Cycle, Cell,Cycle, Cell Division,Cycles, Cell,Cycles, Cell Division,Division Cycle, Cell,Division Cycles, Cell
D002470 Cell Survival The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. Cell Viability,Cell Viabilities,Survival, Cell,Viabilities, Cell,Viability, Cell
D004195 Disease Models, Animal Naturally-occurring or experimentally-induced animal diseases with pathological processes analogous to human diseases. Animal Disease Model,Animal Disease Models,Disease Model, Animal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077210 Sunitinib An indole and pyrrole derivative that inhibits VEGFR-2 and PDGFR BETA RECEPTOR TYROSINE KINASES. It is used as an antineoplastic agent for the treatment of GASTROINTESTINAL STROMAL TUMORS, and for treatment of advanced or metastatic RENAL CELL CARCINOMA. 5-(5-Fluoro-2-oxo-1,2-dihydroindolylidenemethyl)-2,4-dimethyl-1H-pyrrole-3-carboxylic acid (2-diethylaminoethyl)amide,SU 011248,SU 11248,SU-011248,SU-11248,SU011248,SU11248,Sunitinib Malate,Sutent

Related Publications

Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
May 2009, Cancer research,
Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
December 2015, CPT: pharmacometrics & systems pharmacology,
Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
September 2000, Journal of the American Veterinary Medical Association,
Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
May 2019, Internal medicine (Tokyo, Japan),
Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
July 1999, Health management technology,
Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
September 2016, Journal of experimental & clinical cancer research : CR,
Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
August 2017, Angiogenesis,
Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
January 2011, Journal of radiation research,
Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
December 2003, Clinical cancer research : an official journal of the American Association for Cancer Research,
Esther A Kleibeuker, and Matthijs A Ten Hooven, and Kitty C Castricum, and Richard Honeywell, and Arjan W Griffioen, and Henk M Verheul, and Ben J Slotman, and Victor L Thijssen
December 2004, Bulletin of experimental biology and medicine,
Copied contents to your clipboard!