title: An antiendothelial combination therapy strategy to increase survival in experimental pancreatic cancer.
abstract: BACKGROUND
  Combination treatments in addition to gemcitabine have failed to improve outcomes in pancreatic cancer. We tested gemcitabine in combination with the antiendothelial agent endothelial monocyte-activating polypeptide II (EMAP II).
  
  
  METHODS
  Human pancreatic cancer cell line murine xenografts were treated with recombinant EMAP II (80 mug/kg), gemcitabine (100 mg/kg), or a combination, and survival and local tumor outcomes were studied.
  
  
  RESULTS
  Both EMAP II and gemcitabine inhibited tumor growth, but the combination of both was always more effective. EMAP II and gemcitabine also inhibited microvessel density, with the combination being more effective. Apoptotic activity was increased by factors of 3.2-, 2.7-, and 4.2-fold in EMAP II, gemcitabine, or their combination, respectively. There was a significant extension of survival after EMAP II and gemcitabine combination therapy compared with controls in 2 different pancreatic cancer cell line models at P = .0001 and P = .006, respectively. The median EMAP II survival contribution over gemcitabine was 16 days, from 35 to 51 days (P = .017). EMAP II had no impact on gemcitabine-induced antiproliferative effects against pancreatic cancer cells in vitro.
  
  
  CONCLUSIONS
  The antiendothelial agent EMAP II enhanced gemcitabine-mediated tumor inhibition, pointing toward a promising strategy for improved combination treatment of pancreatic cancer.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390-8548, USA. Roderich.Schwarz@utsouthwestern.edu
authors.forename: Roderich E
authors.initials: RE
authors.lastname: Schwarz
authors.forename: Srivani
authors.initials: S
authors.lastname: Konduri
authors.forename: Niranjan
authors.initials: N
authors.lastname: Awasthi
authors.forename: Danielle
authors.initials: D
authors.lastname: Cafasso
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Schwarz
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D045744:Cell Line, Tumor; D049109:Cell Proliferation / Q000187:drug effects; D016207:Cytokines / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D051379:Mice; D008819:Mice, Nude; D009363:Neoplasm Proteins / Q000008:administration & dosage; D009368:Neoplasm Transplantation; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D016601:RNA-Binding Proteins / Q000008:administration & dosage; D023041:Xenograft Model Antitumor Assays; D000093542:Gemcitabine
chemical_list: D020533:Angiogenesis Inhibitors; D016207:Cytokines; D009363:Neoplasm Proteins; D016601:RNA-Binding Proteins; C077219:small inducible cytokine subfamily E, member 1; D003841:Deoxycytidine; D000093542:Gemcitabine