| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Tumor Biology |
Department of Radiation Oncology, German Cancer Research Center, INF 280, 69120 Heidelberg, Germany [A. A., J. D., P. E. H.]; SUGEN, Inc., South San Francisco, California 94080-4811 [K. E. L., A. R. H.]; Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02215 [P. H., L. H.]; and Department of Radiation Oncology, University of Heidelberg Medical School, INF 400, 69120 Heidelberg, Germany [A. A., X. H., R. K., T. T., K. J. W., J. D., P. E. H.]
| ABSTRACT |
|---|
|
|
|---|
| INTRODUCTION |
|---|
|
|
|---|
Radiotherapy is the most important nonsurgical treatment for cancer. Interestingly, for many tumors, the standard radiation treatment schedule can, in fact, be considered radiotherapy with low metronomic dosing. For approximately 50 years, radiotherapy has typically consisted of a daily dose of 2 Gy, 5 times weekly, for a total dose of up to 60 Gy over 6 weeks or so. Historically, this schedule is not the result of a theoretical formulation, but rather the empirical result of clinical studies seeking to optimize clinical outcome. Important questions arising from these observations are whether microvascular ECs function as important targets of ionizing radiation and, more generally, how radiation affects communication between a tumor and its microenvironment.
Radiation research has primarily concentrated on the cancer cell compartment. Relatively little attention has been paid to the effect of radiation on the EC compartment and the complex interaction between the tumor and its microenvironment, consisting of extracellular matrix, cytokines, and ECs. Three objectives, therefore, warrant greater focus:
The conventional explanation of the effectiveness of radiotherapy is that tumor cell DNA is the principal target of ionizing radiation. Similarly, the side effects of radiotherapy are presumed to be attributable primarily to radiation damage to normal cell DNA, although this scenario has recently been questioned by the observation that a single large dose of radiation selectively damaged the ECs of the gut microvasculature (9) , leading to the death of epithelial stem cells as a secondary event.
VEGF and bFGF, potent angiogenic cytokines, appear to be important in modulating the effects of radiation on ECs (10, 11, 12, 13) . VEGF is a known survival factor for ECs and selectively induces EC proliferation, migration, and tube formation (14) . In clinical settings, high VEGF levels have been associated with poor prognosis and poor therapeutic outcome in various human cancers, such as malignant gliomas (15) . Interestingly, these types of cancers are often described as highly resistant to radiation treatment. There is also evidence that proangiogenic factors such as bFGF may inhibit radiation-induced damage to normal tissue (9 , 16) .
Recently, several groups have shown in preclinical studies that combining antiangiogenic agents with ionizing radiation improves the antitumor effect of radiation (11 , 17, 18, 19, 20, 21) , in particular, by VEGF signaling inhibitors. The first clinical trial to use an antiangiogenic agent and radiation has been reported recently (22) .
Here we examine the ability of IR to inhibit EC proliferation, tube formation, migration, and clonogenic survival. We also analyze the ability of VEGF and bFGF to act as radioprotectors in ECs. Additionally, we show how the RTK inhibitors SU5416 and SU6668 can reverse these protective effects. In an effort to better mimic in vivo conditions, we use a coculture system to demonstrate how selective IR of the tumor compartment may activate ECs via VEGF and bFGF release. Accordingly, we show that the VEGFR2 is up-regulated in ECs, and SU5416 and SU6668 were able to prevent radiation-dependent tumor-cell induction of EC invasiveness. By combining these findings, we propose a tumor/endothelium communication model for the tumor-survival mechanism in radiotherapy and suggest how concurrent antiangiogenic therapy may ameliorate the process by interfering with this communication.
| MATERIALS AND METHODS |
|---|
|
|
|---|
The angiogenesis inhibitors SU5416 and SU6668 were synthesized at SUGEN Inc. (South San Francisco, CA) as described previously (4
, 5)
. SU5416 is an ATP-competitive inhibitor of the Flk-1/KDR/VEGFR2 RTK, with a Ki value of
160 nM. It also inhibits PDGFRß TK with a Ki value of 320 nM, but is significantly less potent for inhibition of FGFR1, with a Ki value of 19.5 µM. SU5416 blocks VEGF stimulated HUVEC proliferation with an IC50 value of 40 nM versus an IC50 value of >50 µM for bFGF stimulated HUVEC proliferation (4)
. SU5416 inhibited tumor metastases, microvessel formation, and cell proliferation. SU6668 is a potent inhibitor of PDGFRß, with a Ki value of 8 nM. It also inhibits the kinases of VEGF receptor 2 (Flk-1/KDR) and FGFR1, with Ki values of 2.1 and 1.2 µM, respectively (5)
.
Endothelial and Tumor Cell Proliferation Assay.
HUVEC and HDMEC passages 69 were grown to confluence in MPM supplemented with 5% FCS, containing 2 ng/ml VEGF and 4 ng/ml bFGF. PC3 cells were cultured in DMEM supplemented with 10% FCS. Cells were harvested by trypsinization at 37°C and neutralized with trypsin-neutralizing solution. A suspension of 50,000 cells in MPM/DMEM was added to 25 cm2 flasks (Becton Dickinson, Heidelberg, Germany). The cells were incubated for 24 h at standard conditions, irradiated with doses of 0, 1, 2, 5, and 10 Gy, and incubated for another 72 h. Cells were then dispersed in trypsin, resuspended, and counted in a Coulter counter.
Clonogenic Assay.
Endothelial cells (HUVECs and HDMECs) and PC3 cells were grown in MPM (ECs) and DMEM (PC3), respectively. To account for radiation mortality, increasing numbers of cells (102 to 5 x 104) were plated in 25-cm2 flasks. Cells were irradiated with doses of 010 Gy using 6 MeV X-rays from a linear accelerator (Primus, Siemens, Erlangen, Germany) at a dose rate of 118 cGy/min. Cultures were returned to the incubator for 1417 days, after which they were stained with crystal violet (Sigma, Germany), colonies were counted and the surviving percentage was determined for clonogenic survival after correcting for PE.
EC Morphogenesis Assay: Tube Formation.
To examine the ability of the ECs to produce tubular structures in vitro, 24-well plates were coated with 300-µl Matrigel (Becton Dickinson). This extract of the Engelbreth-Holm-Swarm murine sarcoma, which contains basement membrane components, is liquid at 4°C and forms a gel when warmed to 37°C. When plated on Matrigel, HUVECs (48,000 cells/well) undergo differentiation into capillary-like tube structures in MPM medium (10% FCS) supplemented with VEGF (2 ng/ml) and bFGF (4 ng/ml). Angiogenesis inhibitors were added before radiation. Six hours after the incubation on the Matrigel at 37°C/5% CO2, the media were aspirated, the cells were fixed and stained with Diff-Quik II reagents (Dade Behring AG, Germany), and the slides examined for EC alignment in pictures taken with a microscope.
Matrigel Invasion Assay.
A Matrigel assay was used to assess the migration/invasion ability of ECs after direct radiation of ECs and combined treatment with SU5416. Transwell inserts with an 8-µm pore size were coated with Matrigel (0.78 mg/ml; Becton Dickinson). HUVEC were trypsinized and 200 µl of cell suspension (3 x 105 cells/ml) per condition were added in triplicate transwells. Chemoattractant medium containing various concentrations of VEGF and bFGF (500 µl) was added to the lower wells.
To assess the effects on ECs after selective radiation of adjacent tumor cells, we developed a modified coculture model of the Matrigel invasion assay. PC3 cells were first seeded in 24-well plates. After IR of the PC3 cells, Matrigel-coated transwells with HDMEC were added in the upper compartment and were allowed to migrate toward the PC3 cell compartment. HDMECs were used in the coculture because these cells are microvascular ECs and, thus, resemble as close to in vivo conditions as possible. After 18 h of incubation, ECs that had invaded to the underside of the membrane were fixed, stained in thiazine and eosin solution using Diff-Quik II solution, and sealed on slides. Migrating cells were counted by microscopy.
Quantitative Reverse-transcription PCR.
HDMECs and PC3 cells were raised and treated as indicated. Total RNA was extracted (Qiagen, RNeasy) and treated with DNase 1 (DNA-free, Ambion) to remove contaminating genomic DNA. First-strand cDNA was reverse-transcribed from total RNA using the cDNA Archive Kit (ABI) and stored at -20°C at a concentration equivalent to RNA at 20 ng/µl until use. cDNA was used at a final concentration of 0.1 ng/µl. The 18S subunit was used as the endogenous control because of its low variability across all samples. The gene cluster VEGFR2 was profiled against treated HDMECs. The primers used were 5'-GTGTACCGGTTGGCAAAA-3' and 5'-ACGATGCAACTGAGGTGG-3' with the TaqMan probe 5'-CCACAAGGTATTTCAAG-3'. The clusters VEGF-A and bFGF were profiled against treated PC3. The consensus sequences derived from all accession numbers within the UniGene code were used for primer and probe design. The primers used for VEGF-A were 5'-ACGAGGGCCTGGAGTGTGT-3' and 5'-CATCACACCATGCAGATTATGCG-3' with the TaqMan probe 5'-CCCACTGAGGAGTCC-3'. The primers used for bFGF were 5'-CCGACGGCCGAC-3' and 5'-TCAAGCTACAACTTCAAGCAGAAGA-3' with the TaqMan probe 5'-AGAAGAGCGACCCTC-3'. A fluorogenic 5'-nuclease assay and the ABI Prism 7900HAT sequence detection system were used for real time quantitation. Quantitation of relative expression levels is achieved by using standard curves for the threshold cycle amplification reaction of targets and endogenous controls.
Flow Cytometry.
At various times, up to 72 h after therapy, FACS analysis (FACScans; Becton Dickinson, San Jose, CA) was performed. Cells were fixed in Hanks solution and 70% ethanol. After concentrating the cells by centrifugation and removing the supernatant, the cells were washed in PBS. Cells were again pelleted and the supernatant was discarded. Next, the cells were resuspended in the staining solution of PBS, RNase, and propidium iodide, and FACS measurement for apoptotic cells was performed.
Statistical Analysis.
Students t test was used to compare means. For multiple comparisons ANOVA was used with Fishers least-significant difference method. All tests were two-tailed.
| RESULTS |
|---|
|
|
|---|
|
Show in Fig. 1B
is the radiation-dose dependent inhibition of EC proliferation for all combinations of VEGF and bFGF. The maximum inhibition was 60% at 10 Gy radiation if the 72 h incubation media was GF free. IR with 2 Gy resulted in 30% inhibition in the absence of added GFs. Thus, radiation doses used in the clinic have antiproliferative activity on ECs in vitro.
Increasing doses of VEGF and bFGF in the media during the 72-h incubation period after radiation enhanced endothelial proliferation (Fig. 1B)
. When both GFs were combined, protection against radiation-induced proliferation inhibition was higher than with either factor alone. This is demonstrated by the observation that 2 ng/ml VEGF combined with 4 ng/ml bFGF yielded higher cell numbers than 20 ng/ml VEGF or 10 ng/ml bFGF alone. bFGF appeared to be more effective (based on concentration) in protecting against radiation-induced proliferation inhibition than VEGF, but VEGF alone was also able to markedly decrease the antiproliferative effect of radiation compared with media without GF over the entire radiation dosage range (e.g., 20% more cells at 2 Gy; P < 0.01). Thus, both bFGF and VEGF markedly decreased the proliferation radiosensitivity of ECs in vitro.
RTK Inhibitors Enhance the Antiproliferative Effect of Radiation on EC.
To further characterize the modulatory effect of GF signaling in response to radiation, the RTK inhibitors SU5416 and SU6668 were used. For proliferation assays, the cells were plated in collagen I-coated flasks and allowed to adhere for 24 h in MPM supplemented with 2 ng/ml VEGF and 4 ng/ml bFGF as shown in Fig. 1B
. Then, SU5416 or SU6668 was added in GF-free medium and incubated for 1 h. Cells were then irradiated in GF-free medium with up to 10 Gy. Thereafter, the medium was removed and new medium added with a final concentration of 2 ng/ml of VEGF and 4 ng/ml of bFGF. As shown in Fig. 1B
, radiation inhibited EC proliferation in all groups with a maximum inhibition of 90% at 10 Gy (Fig. 1C)
. Both SU5416 (0.05 and 1 µM) and SU6668 (5 µM, but not 0.25 µM) markedly enhanced the antiproliferative effect of radiation over the entire dose range. This additional effect was diminished toward greater radiation doses with a maximum inhibiting effect of 90% with either 10 Gy alone or 10 Gy with RTK inhibitors (Fig. 1C)
. As expected, the more potent VEGFR2 inhibitor, SU5416, was active at a lower concentration than SU6668 (0.05 µM versus 5 µM, respectively). The shift to the left of the radiation dose proliferation response curve induced by the addition of RTK inhibitors resulted in a therapeutic gain of
1 Gy in a clinically relevant dosage range. The observation that 0.5 Gy with RTK inhibitor were isoeffective to 1.5 Gy without RTK inhibitor is shown in Fig. 1C
. The comparison of Fig. 1B and C
also shows that the presence or absence of GFs during IR itself had also influenced EC proliferation: when GFs were absent during IR, proliferation inhibition was higher (maximum of 90%; Fig. 1C
) than in the presence of GFs (60%; Fig. 1B
), irrespective of GFs in the media during the 72-h incubation period after radiation. Thus, it is conceivable that GFs cannot rescue ECs if given after radiation.
GFs Promote PE of EC Reversed by RTK Inhibition.
PE and clonogenic survival are criteria considered to be the standard determination of cell survival in response to ionizing radiation. Therefore, we first examined the effects of GFs on HUVEC PE without radiation. The combination of VEGF and bFGF, as well as each factor alone, increased PE compared with control cells without GF (P < 0.01; Fig. 2A
). The combination of both factors increased PE compared with VEGF alone (P < 0.02). SU6668 exhibited a modest, but not significant, reduction of PE of cells supplemented with a combination of VEGF and bFGF (P < 0.1). SU5416 significantly reduced the PE of cells supplemented with VEGF only (P < 0.01).
|
That the impact on clonogenic survival by withdrawal of GFs can be imitated by the addition of an RTK inhibitor to control media is shown in Fig. 2D and E
. The addition of SU5416 decreases the surviving fraction compared with radiation alone in a SU5416 dose-dependent manner. At 2 Gy, clonogenic survival decreased from 40% with control media to 25% at 0.1 µM SU5416 and further to 6% at 1 µM SU5416. This result indicates that SU5416 markedly increases the clonogenic radiosensitivity of HUVEC (Fig. 2D)
. The effects seen with SU6668 were milder, demonstrating significantly reduced clonogenic survival at 5 µM, but not at 0.25 µM in the presence of both VEGF and bFGF, compared with radiation only (Fig. 2E)
. If neither VEGF nor bFGF were added to the media, no clonogenic survival could be determined, emphasizing the importance of the GF for EC survival.
GFs Reduce Radiation-induced Apoptosis in EC.
To investigate potential mechanisms of the protective effect of GFs against radiation damage, the apoptosis rate of irradiated HUVECs was analyzed in the presence or absence of GFs. The observation that 6 Gy radiation significantly induced apoptosis compared with untreated control cells (31% apoptotic cells versus 5%, P < 0.01) is demonstrated in Fig. 3
. If the cultures were supplemented with GF immediately after IR, the apoptotic rate decreased to 22% (VEGF), 21% (bFGF), and 15% (VEGF + bFGF), respectively. No significant difference was seen between the addition of VEGF or bFGF (P > 0.5), although the combination protected against radiation-induced apoptosis better than each single factor (P < 0.05). Qualitatively similar results were obtained with Hoechst staining of HUVEC cytospins and counting the apoptotic cells under the microscope (data not shown). These findings indicate that both VEGF and bFGF may protect ECs from radiation-induced cell killing, at least in part, by blocking radiation-induced apoptosis.
|
|
|
|
|
IR Up-regulates VEGF and bFGF in Cancer Cells, As Well As VEGFR2 in ECs.
To provide direct evidence that VEGF and bFGF signal transduction are important in IR-induced, tumor cell-mediated modulation of EC behavior, we used real-time PCR to measure RNA expression of VEGF-A and bFGF in the PC3 cell line. A dose- and time-dependent up-regulation of VEGF of up to 2.4-fold and of bFGF of up to 1.7-fold was observed in PC3 cells after 2 Gy radiation, with a peak expression at
12 h after 2 Gy radiation (Fig. 7, AD)
.
|
|
| DISCUSSION |
|---|
|
|
|---|
Our proliferation studies also suggest that the presence or absence of GFs during radiation influence the inhibitory effects of radiation on proliferation. Without GF supplementation during radiation, the inhibitory effects of radiation on proliferation were more pronounced than with GFs. Likewise, there was a heightened protective effect of GF supplementation to the media after IR when VEGF and bFGF were present during radiation. The extent to which these angiogenic factors spare tumor reduction in vivo may be a rough reflection of the component of radiation response that is attributable to vascular targeting.
These present studies have also demonstrated that the abrogation of downstream GF signaling by RTK inhibitors SU5416 and SU6668 reversed the VEGF- and bFGF-induced protective effects. Taken together, the combination of radiation and the RTK inhibitors SU5416 and SU6668 was found to yield greater antiangiogenic effects than each treatment alone. These results support the idea that combined use of radiotherapy and VEGFR inhibitors (or angiogenesis inhibitors in general) may potentially allow a lowering of the radiation doses necessary to achieve local tumor control (17 , 21) .
The radioprotective effects of VEGF and bFGF in other studies have been argued to arise from reduced EC apoptosis (9
, 10
, 12 , 16)
and increased stem cell survival (23)
. The effects of VEGF on EC survival may be mediated through several different pathways. VEGF may up-regulate the antiapoptotic proteins Bcl-2 and A1 and may also prevent apoptosis by activating the antiapoptotic kinase Akt/PKB via a phosphatidyl-inositol-3 kinase dependent pathway (24)
. In addition, VEGF was found to maintain survival signals in ECs by tyrosine phosphorylation of focal adhesion kinase or through direct interaction with extracellular matrix components such as
Vß3 integrin (25)
. Mitotic cell death, rather than apoptosis, is often considered to be the dominant form of cell mortality caused by ionizing radiation (26)
. If apoptosis plays an important role in radiation-induced death in ECs and, subsequently in the vasculature, the radiation effects on the vasculature could account for the major contribution of apoptosis to radiation-induced effects on tumors.
In a coculture invasion model, endothelial invasion was enhanced by selectively irradiating the tumor cell compartment, suggesting that IR has indirect angiogenic properties. This resulted, at least in part, from IR-induced up-regulation of VEGF and bFGF in the PC3 human prostate cancer cell line. This model of elevated paracrine release of VEGF and bFGF may account for the in vivo observations that sublethal doses of tumor IR promote migration and invasiveness of glioblastoma in rats (27 , 28) .
IR also up-regulated the receptor VEGFR2 in EC. VEGFR2 is considered the key VEGF receptor in tumor angiogenesis. The observation that IR increased the expression of VEGFR2 mRNA in human microvascular ECs and VEGF and bFGF in a human tumor cell line suggests that the tumor cells may transmit an angiogenic stimulus to its associated vasculature in response to radiation. Paracrine GF release by the tumor and the corresponding receptor up-regulation in the endothelium may represent a coordinated mechanism by which primary radiation-induced antivascular effects are attenuated. SU5416 and SU6668 were also able to decrease EC invasion in response to tumor radiation in the coculture model, thus decreasing the indirect angiogenic effects of radiation offers another rationale for the combined use of angiogenesis inhibitors and radiation in cancer therapy.
These results enable us to speculate about the well-known discrepancy between tumor radiosensitivity in vitro and tumor response in vivo (13) . For example, sets of cell lines from the clinically radiosensitive Hodgkins lymphoma and the clinically radioresistant glioblastoma have similar or overlapping in vitro radiosensitivities (29) . This would suggest that the clinical radioresistance could result from the fact that, unlike the in vitro situation, where the tumor cells are the only radiation targets, different types of supporting cells, including ECs, interact with the tumor compartment in vivo. Perhaps certain ECs are more sensitive to ionizing radiation than cancer cells in agreement with our in vitro findings in HDMEC endothelial and PC3 prostate cancer cells and as reported by others (9) . Likewise, it has been reported that ECs are more susceptible to the chemotherapeutic agent vinblastine than cancer cells (6) . Furthermore, our tumor-endothelium communication data suggest that the tumor compartment can produce survival factors for ECs by paracrine signaling from radiation damage. The implication is that clinically radioresistant and radiosensitive tumors may differ, at least in part, because of differences in their ability to protect their vasculature. With respect to the consequences of clinical radiotherapy, the coculture data may also suggest that radiation effects may not necessarily be restricted to the site of physical radiation dose distribution, but can enhance tumor angiogenesis and tumor promotion outside the directly irradiated fields. The effects of radiotherapy can extend beyond the death of the target tumor cells, in that factor production by such cells has been observed to influence the local environment for some time thereafter (30) .
In summary, our results have established the basis for a salvage model of how tumors protect their vasculature from radiation-induced damage. It simultaneously rationalizes the use of angiogenesis inhibitors that interrupt VEGF and bFGF signaling concomitantly with radiotherapy in cancer treatment. Our data support the idea of additive effects being obtained when radiotherapy is combined with antiangiogenic therapy. Further experimentation is necessary to determine whether systemic application of VEGF or bFGF (to protect normal tissue) will produce more radioresistant tumor phenotypes that will then require higher radiation doses.
| ACKNOWLEDGMENTS |
|---|
| FOOTNOTES |
|---|
1 To whom requests for reprints should be addressed, at German Cancer Research Center, Department of Radiation Oncology, 280 Im Neuenheimer Feld, Heidelberg 69120, Germany. Phone: 49-6221-42-2448; Fax: 49-6221-42-2514; E-mail: p.huber{at}dkfz.de ![]()
2 The abbreviations used are: RTK, receptor tyrosine kinase; EC, endothelial cell; VEGF, vascular endothelial growth factor; bFGF, basic fibroblast growth factor; IR, ionizing radiation; HUVEC, human umbilical vein endothelial cell; HDMEC, human dermal microvascular endothelial cell; MPM, modified Promocell medium; TK, tyrosine kinase; FACS, fluorescence-activated cell sorting; PE, plating efficiency; GF, growth factor. ![]()
Received 6/12/02. Accepted 4/24/03.
| REFERENCES |
|---|
|
|
|---|
This article has been cited by other articles:
![]() |
C. Timke, H. Zieher, A. Roth, K. Hauser, K. E. Lipson, K. J. Weber, J. Debus, A. Abdollahi, and P. E. Huber Combination of Vascular Endothelial Growth Factor Receptor/Platelet-Derived Growth Factor Receptor Inhibition Markedly Improves Radiation Tumor Therapy Clin. Cancer Res., April 1, 2008; 14(7): 2210 - 2219. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. C. Manegold, C. Paringer, U. Kulka, K. Krimmel, M. E. Eichhorn, R. Wilkowski, K.-W. Jauch, M. Guba, and C. J. Bruns Antiangiogenic Therapy with Mammalian Target of Rapamycin Inhibitor RAD001 (Everolimus) Increases Radiosensitivity in Solid Cancer Clin. Cancer Res., February 1, 2008; 14(3): 892 - 900. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Abdollahi, C. Schwager, J. Kleeff, I. Esposito, S. Domhan, P. Peschke, K. Hauser, P. Hahnfeldt, L. Hlatky, J. Debus, et al. Transcriptional network governing the angiogenic switch in human pancreatic cancer PNAS, July 31, 2007; 104(31): 12890 - 12895. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Senan and E. F. Smit Design of Clinical Trials of Radiation Combined with Antiangiogenic Therapy Oncologist, April 1, 2007; 12(4): 465 - 477. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. J. Williams, B. A. Telfer, A. M. Shannon, M. Babur, I. J. Stratford, and S. R. Wedge Combining radiotherapy with AZD2171, a potent inhibitor of vascular endothelial growth factor signaling: pathophysiologic effects and therapeutic benefit Mol. Cancer Ther., February 1, 2007; 6(2): 599 - 606. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. R. Horsman and D. W. Siemann Pathophysiologic Effects of Vascular-Targeting Agents and the Implications for Combination with Conventional Therapies Cancer Res., December 15, 2006; 66(24): 11520 - 11539. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Cao, J. M. Albert, L. Geng, P. S. Ivy, A. Sandler, D. H. Johnson, and B. Lu Vascular Endothelial Growth Factor Tyrosine Kinase Inhibitor AZD2171 and Fractionated Radiotherapy in Mouse Models of Lung Cancer Cancer Res., December 1, 2006; 66(23): 11409 - 11415. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. M. Erovic, M. Pelzmann, M. Ch. Grasl, J. Pammer, G. Kornek, W. Brannath, E. Selzer, and D. Thurnher Mcl-1, Vascular Endothelial Growth Factor-R2, and 14-3-3{sigma} Expression Might Predict Primary Response against Radiotherapy and Chemotherapy in Patients with Locally Advanced Squamous Cell Carcinomas of the Head and Neck Clin. Cancer Res., December 15, 2005; 11(24): 8632 - 8636. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Bozec, P. Formento, J. Ciccolini, R. Fanciullino, L. Padovani, X. Murraciole, J.-L. Fischel, and G. Milano Response of endothelial cells to a dual tyrosine kinase receptor inhibition combined with irradiation Mol. Cancer Ther., December 1, 2005; 4(12): 1962 - 1971. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Abdollahi, D. W. Griggs, H. Zieher, A. Roth, K. E. Lipson, R. Saffrich, H.-J. Grone, D. E. Hallahan, R. A. Reisfeld, J. Debus, et al. Inhibition of {alpha}v{beta}3 Integrin Survival Signaling Enhances Antiangiogenic and Antitumor Effects of Radiotherapy Clin. Cancer Res., September 1, 2005; 11(17): 6270 - 6279. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Zips, W. Eicheler, P. Geyer, F. Hessel, A. Dorfler, H. D. Thames, M. Haberey, and M. Baumann Enhanced Susceptibility of Irradiated Tumor Vessels to Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibition Cancer Res., June 15, 2005; 65(12): 5374 - 5379. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. E. Huber, M. Bischof, J. Jenne, S. Heiland, P. Peschke, R. Saffrich, H.-J. Grone, J. Debus, K. E. Lipson, and A. Abdollahi Trimodal Cancer Treatment: Beneficial Effects of Combined Antiangiogenesis, Radiation, and Chemotherapy Cancer Res., May 1, 2005; 65(9): 3643 - 3655. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Abdollahi, M. Li, G. Ping, C. Plathow, S. Domhan, F. Kiessling, L. B. Lee, G. McMahon, H.-J. Grone, K. E. Lipson, et al. Inhibition of platelet-derived growth factor signaling attenuates pulmonary fibrosis J. Exp. Med., March 21, 2005; 201(6): 925 - 935. [Abstract] [Full Text] [PDF] |
||||
![]() |
B Kwabi-Addo, M Ozen, and M Ittmann The role of fibroblast growth factors and their receptors in prostate cancer Endocr. Relat. Cancer, December 1, 2004; 11(4): 709 - 724. [Abstract] [Full Text] [PDF] |