Anti-VEGF agents confer survival advantages to tumor-bearing mice by improving cancer-associated systemic syndrome

Proc Natl Acad Sci U S A. 2008 Nov 25;105(47):18513-8. doi: 10.1073/pnas.0807967105. Epub 2008 Nov 18.

Abstract

The underlying mechanism by which anti-VEGF agents prolong cancer patient survival is poorly understood. We show that in a mouse tumor model, VEGF systemically impairs functions of multiple organs including those in the hematopoietic and endocrine systems, leading to early death. Anti-VEGF antibody, bevacizumab, and anti-VEGF receptor 2 (VEGFR-2), but not anti-VEGFR-1, reversed VEGF-induced cancer-associated systemic syndrome (CASS) and prevented death in tumor-bearing mice. Surprisingly, VEGFR2 blockage improved survival by rescuing mice from CASS without significantly compromising tumor growth, suggesting that "off-tumor" VEGF targets are more sensitive than the tumor vasculature to anti-VEGF drugs. Similarly, VEGF-induced CASS occurred in a spontaneous breast cancer mouse model overexpressing neu. Clinically, VEGF expression and CASS severity positively correlated in various human cancers. These findings define novel therapeutic targets of anti-VEGF agents and provide mechanistic insights into the action of this new class of clinically available anti-VEGF cancer drugs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia / physiopathology
  • Angiogenesis Inhibitors / therapeutic use*
  • Animals
  • Antineoplastic Agents / therapeutic use*
  • Capillary Permeability
  • Humans
  • Immunohistochemistry
  • Liver / physiopathology
  • Mice
  • Neoplasms, Experimental / blood supply
  • Neoplasms, Experimental / drug therapy*
  • Neoplasms, Experimental / physiopathology
  • Neoplasms, Experimental / prevention & control
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Vascular Endothelial Growth Factor A