title: Direct evidence that bevacizumab, an anti-VEGF antibody, up-regulates SDF1alpha, CXCR4, CXCL6, and neuropilin 1 in tumors from patients with rectal cancer.
abstract: Clinical studies converge on the observation that circulating cytokines are elevated in most cancer patients by anti-vascular endothelial growth factor (VEGF) therapy. However, the source of these molecules and their relevance in tumor escape remain unknown. We examined the gene expression profiles of cancer cells and tumor-associated macrophages in tumor biopsies before and 12 days after monotherapy with the anti-VEGF antibody bevacizumab in patients with rectal carcinoma. Bevacizumab up-regulated stromal cell-derived factor 1alpha (SDF1alpha), its receptor CXCR4, and CXCL6, and down-regulated PlGF, Ang1, and Ang2 in cancer cells. In addition, bevacizumab decreased Ang1 and induced neuropilin 1 (NRP1) expression in tumor-associated macrophages. Higher SDF1alpha plasma levels during bevacizumab treatment significantly associated with distant metastasis at three years. These data show that VEGF blockade up-regulates inflammatory pathways and NRP1, which should be evaluated as potential targets for improving anti-VEGF therapy.
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Xu
authors.forename: Dan G
authors.initials: DG
authors.lastname: Duda
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: di Tomaso
authors.forename: Marek
authors.initials: M
authors.lastname: Ancukiewicz
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Chung
authors.forename: Gregory Y
authors.initials: GY
authors.lastname: Lauwers
authors.forename: Rekha
authors.initials: R
authors.lastname: Samuel
authors.forename: Paul
authors.initials: P
authors.lastname: Shellito
authors.forename: Brian G
authors.initials: BG
authors.lastname: Czito
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Lin
authors.forename: Martin
authors.initials: M
authors.lastname: Poleski
authors.forename: Rex
authors.initials: R
authors.lastname: Bentley
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Clark
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Willett
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Jain
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D054377:Chemokine CXCL12 / Q000235:genetics* / Q000378:metabolism; D054427:Chemokine CXCL6 / Q000235:genetics* / Q000378:metabolism; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007124:Immunoenzyme Techniques; D008113:Liver Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D008207:Lymphatic Metastasis; D009389:Neovascularization, Pathologic / Q000517:prevention & control; D039942:Neuropilin-1 / Q000235:genetics* / Q000378:metabolism; D020411:Oligonucleotide Array Sequence Analysis; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D019718:Receptors, CXCR4 / Q000235:genetics* / Q000378:metabolism; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015854:Up-Regulation; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000378:metabolism
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014408:Biomarkers, Tumor; C515255:CXCL12 protein, human; C515503:CXCL6 protein, human; C527276:CXCR4 protein, human; D054377:Chemokine CXCL12; D054427:Chemokine CXCL6; D012333:RNA, Messenger; D019718:Receptors, CXCR4; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D039942:Neuropilin-1; D000068258:Bevacizumab