Document Detail

Inhibition of vascular endothelial growth factor-a signaling induces hypertension: examining the effect of cediranib (recentin; AZD2171) treatment on blood pressure in rat and the use of concomitant antihypertensive therapy.
MedLine Citation:
PMID:  18483380     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Inhibition of vascular endothelial growth factor-A (VEGF) signaling is a key therapeutic approach in oncology given the role of VEGF in angiogenesis and vascular permeability in solid tumors. Clinical trials examining VEGF signaling inhibitors commonly report hypertension. We examined the effect of cediranib, a highly potent VEGF signaling inhibitor, on the blood pressure of rats and the ability of standard antihypertensive agents to modulate the consequences of VEGF signaling inhibition.
EXPERIMENTAL DESIGN: The ability of cediranib to induce hypertensive changes and the effect of giving antihypertensive therapy were investigated in conscious, unrestrained telemetered rats. Two antihypertensive agents were studied: captopril, an angiotensin-converting enzyme inhibitor, and nifedipine, a dihydropyridine calcium channel blocker. The antitumor activity of cediranib, alone and in combination with nifedipine, was also evaluated in a LoVo human colorectal tumor xenograft model in nude rats. All treatments were given orally.
RESULTS: Administration of 0.1 to 1.5 mg/kg/d of cediranib for 4 consecutive days induced a relatively mild hypertensive effect, elevating diastolic blood pressure by 10 to 14 mmHg. Dosing 3 mg/kg/d cediranib for 4 days induced a marked hypertension of 35 to 50 mmHg. Captopril (30 mg/kg, qd) was effective at lowering a 10 mmHg increase in blood pressure but not a 35 to 50 mmHg increase. However, the latter was rapidly reversed by administration of nifedipine (10 mg/kg, bd). Coadministration of nifedipine did not negatively affect the antitumor activity of cediranib (1.5 mg/kg/d).
CONCLUSIONS: Hypertension is a direct consequence of inhibiting VEGF signaling but can be controlled with appropriately selected, standard antihypertensive medication.
Jon O Curwen; Helen L Musgrove; Jane Kendrew; Graham H P Richmond; Donald J Ogilvie; Stephen R Wedge
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cancer research : an official journal of the American Association for Cancer Research     Volume:  14     ISSN:  1078-0432     ISO Abbreviation:  Clin. Cancer Res.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-16     Completed Date:  2008-08-18     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  9502500     Medline TA:  Clin Cancer Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3124-31     Citation Subset:  IM    
Department of Cancer Bioscience, AstraZeneca, Macclesfield, Cheshire, United Kingdom.
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MeSH Terms
Angiogenesis Inhibitors / pharmacology*
Antihypertensive Agents / pharmacology
Antineoplastic Agents / pharmacology
Blood Pressure / drug effects*
Captopril / pharmacology
Cell Line, Tumor
Colorectal Neoplasms / drug therapy
Hypertension / drug therapy*
Nifedipine / pharmacology
Quinazolines / pharmacology*
Signal Transduction / drug effects*
Vascular Endothelial Growth Factor A / antagonists & inhibitors,  drug effects,  metabolism*
Xenograft Model Antitumor Assays
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antihypertensive Agents; 0/Antineoplastic Agents; 0/Quinazolines; 0/Vascular Endothelial Growth Factor A; 21829-25-4/Nifedipine; 62571-86-2/Captopril; NQU9IPY4K9/cediranib

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