title: Anti-vascular endothelial growth factor therapies as a novel therapeutic approach to treating neurofibromatosis-related tumors.
abstract: Patients with bilateral vestibular schwannomas associated with neurofibromatosis type 2 (NF2) experience significant morbidity such as complete hearing loss. We have recently shown that treatment with bevacizumab provided tumor stabilization and hearing recovery in a subset of NF2 patients with progressive disease. In the current study, we used two animal models to identify the mechanism of action of anti-vascular endothelial growth factor (VEGF) therapy in schwannomas. The human HEI193 and murine Nf2(-/-) cell lines were implanted between the pia and arachnoid meninges as well as in the sciatic nerve to mimic central and peripheral schwannomas. Mice were treated with bevacizumab (10 mg/kg/wk i.v.) or vandetanib (50 mg/kg/d orally) to block the VEGF pathway. Using intravital and confocal microscopy, together with whole-body imaging, we measured tumor growth delay, survival rate, as well as blood vessel structure and function at regular intervals. In both models, tumor vessel diameter, length/surface area density, and permeability were significantly reduced after treatment. After 2 weeks of treatment, necrosis in HEI193 tumors and apoptosis in Nf2(-/-) tumors were significantly increased, and the tumor growth rate decreased by an average of 50%. The survival of mice bearing intracranial schwannomas was extended by at least 50%. This study shows that anti-VEGF therapy normalizes the vasculature of schwannoma xenografts in nude mice and successfully controls the tumor growth, probably by reestablishing a natural balance between VEGF and semaphorin 3 signaling.
authors.affiliation: Department of Radiation Oncology, Steele Laboratory, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA.
authors.forename: Hon Kit
authors.initials: HK
authors.lastname: Wong
authors.forename: Johanna
authors.initials: J
authors.lastname: Lahdenranta
authors.forename: Walid S
authors.initials: WS
authors.lastname: Kamoun
authors.forename: Annie W
authors.initials: AW
authors.lastname: Chan
authors.forename: Andrea I
authors.initials: AI
authors.lastname: McClatchey
authors.forename: Scott R
authors.initials: SR
authors.lastname: Plotkin
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Jain
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: di Tomaso
mesh_terms: D020533:Angiogenesis Inhibitors / Q000494:pharmacology*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000235:genetics; D048708:Cell Growth Processes / Q000187:drug effects; D045744:Cell Line, Tumor; D006801:Humans; D051379:Mice; D008819:Mice, Nude; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D009442:Neurilemmoma / Q000098:blood supply / Q000188:drug therapy* / Q000235:genetics; D016518:Neurofibromatosis 2 / Q000188:drug therapy / Q000235:genetics; D025581:Neurofibromin 2 / Q000172:deficiency / Q000235:genetics; D010880:Piperidines / Q000494:pharmacology*; D011799:Quinazolines / Q000494:pharmacology*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D025581:Neurofibromin 2; D010880:Piperidines; D011799:Quinazolines; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; C452423:vandetanib
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