Document Detail


Initial modulation of the tumor microenvironment accounts for thalidomide activity in prostate cancer.
MedLine Citation:
PMID:  17317833     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Disruption of stromal-epithelial interactions favoring prostate cancer progression may affect the phenotype of the disease. We did a preoperative study to test the hypothesis that thalidomide, an active agent in metastatic disease, is a modulator of the tumor microenvironment. EXPERIMENTAL DESIGN: Eighteen men with high-risk prostate cancer were given thalidomide at doses escalated to 600 mg for 12 weeks, followed by radical prostatectomy. We constructed tissue microarrays from prostatectomy specimens from 15 treated patients and 15 matched untreated control subjects to assess effects of thalidomide on the tumor microenvironment. We compared the immunohistochemical expression of three groups of markers linked to angiogenesis, stromal-epithelial interactions, or the epithelial compartment. Levels of circulating basic fibroblast growth factor, interleukin-6, tumor necrosis factor-alpha, and vascular endothelial growth factor were also assessed. RESULTS: Thalidomide was well tolerated and induced a median reduction in prostate-specific antigen of 41% without affecting testosterone. Tissue microarray analyses indicated modulation of vascular marker expression accompanied by a reduction in microvessel density in the treated group. Comparison of broader stromal-epithelial interaction markers between treated and control groups suggested a transition to a less aggressive phenotype as a result of thalidomide treatment. Hedgehog signaling was attenuated and the ratio of matrix metalloproteinases to E-cadherin shifted to favor E-cadherin. No differences were noted in proliferation or apoptosis in the epithelial compartment. CONCLUSIONS: These findings are the first clinical evidence to support the hypothesis that the reported thalidomide clinical efficacy is attributable to early modulation of the tumor microenvironment and suggest that stromal-targeting therapies will be effective against prostate cancer.
Authors:
Eleni Efstathiou; Patricia Troncoso; Sijin Wen; Kim-Anh Do; Curtis A Pettaway; Louis L Pisters; Timothy J McDonnell; Christopher J Logothetis
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Clinical cancer research : an official journal of the American Association for Cancer Research     Volume:  13     ISSN:  1078-0432     ISO Abbreviation:  Clin. Cancer Res.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-23     Completed Date:  2007-07-18     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  9502500     Medline TA:  Clin Cancer Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1224-31     Citation Subset:  IM    
Affiliation:
Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / drug therapy*,  metabolism,  pathology*,  surgery
Adult
Aged
Cadherins / biosynthesis
Cell Communication / drug effects,  physiology
Combined Modality Therapy
Epithelial Cells / pathology
Fibroblast Growth Factor 2 / blood
Hedgehog Proteins / biosynthesis
Humans
Interleukin-6 / blood
Male
Matrix Metalloproteinases / biosynthesis
Middle Aged
Prospective Studies
Prostate-Specific Antigen / blood
Prostatectomy
Prostatic Neoplasms / drug therapy*,  metabolism,  pathology*,  surgery
Stromal Cells / pathology
Thalidomide / administration & dosage,  adverse effects,  blood,  therapeutic use*
Tumor Necrosis Factor-alpha / blood
Vascular Endothelial Growth Factor A / blood
Grant Support
ID/Acronym/Agency:
CA84964/CA/NCI NIH HHS; CA90270/CA/NCI NIH HHS; ES07784/ES/NIEHS NIH HHS
Chemical
Reg. No./Substance:
0/Cadherins; 0/Hedgehog Proteins; 0/Interleukin-6; 0/SHH protein, human; 0/Tumor Necrosis Factor-alpha; 0/Vascular Endothelial Growth Factor A; 103107-01-3/Fibroblast Growth Factor 2; 50-35-1/Thalidomide; EC 3.4.21.77/Prostate-Specific Antigen; EC 3.4.24.-/Matrix Metalloproteinases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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