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Antitumor Effect of 2-Methoxyestradiol in a Rat Orthotopic Brain Tumor Model

Departments of ¹ Hematology/Oncology, ² Neurosurgery, ³ Radiology, and ⁴ Pathology and ⁵ Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Georgia; ⁶ Department of Hematology/Oncology, Weill Cornell Medical College of Cornell University, New York, New York; ⁷ Department of Radiation Oncology, Ajou University Hospital, Suwon, Korea; and ⁸ EntreMed, Inc., Rockville, Maryland

Requests for reprints: Hyunsuk Shim, Winship Cancer Institute, 1701 Uppergate Drive, C5008, Atlanta, GA 30322. Phone: 404-778-4564; Fax: 404-778-5550; E-mail: hyunsuk.shim{at}emory.org.

Grade 4 malignant glioma (GBM) is a fatal disease despite aggressive surgical and adjuvant therapies. The hallmark of GBM tumors is the presence of pseudopalisading necrosis and microvascular proliferation. These tumor cells are hypoxic and express hypoxia-inducible factor-1 (HIF-1), a prosurvival transcription factor that promotes formation of neovasculature through activation of target genes, such as vascular endothelial growth factor. Here, we evaluated whether 2-methoxyestradiol, a microtubule and HIF-1 inhibitor, would have therapeutic potential for this disease in a 9L rat orthotopic gliosarcoma model using a combination of noninvasive imaging methods: magnetic resonance imaging to measure the tumor volume and bioluminescence imaging for HIF-1 activity. After imaging, histologic data were subsequently evaluated to elucidate the drug action mechanism in vivo. Treatment with 2-methoxyestradiol (60–600 mg/kg/d) resulted in a dose-dependent inhibition of tumor growth. This effect was also associated with improved tumor oxygenation as assessed by pimonidazole staining, decreased HIF-1 protein levels, and microtubule destabilization as assessed by deacetylation. Our results indicate that 2-methoxyestradiol may be a promising chemotherapeutic agent for the treatment of malignant gliomas, with significant growth inhibition. Further studies are needed to assess the effect of low or intermediate doses of 2-methoxyestradiol in combination with chemotherapeutic agents in clinical studies focused on malignant gliomas. In addition to showing tumor growth inhibition, we identified three potential surrogate biomarkers to determine the efficacy of 2-methoxyestradiol therapy: decreased HIF-1 levels, -tubulin acetylation, and degree of hypoxia as determined by pimonidazole staining. (Cancer Res 2006; 66(24): 11991-7)

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