title: Antiangiogenic Therapy Induces Hepatic Tumor Vascular Network Rearrangement to Receive Perfusion via the Portal Vein and Hepatic Artery.
abstract: OBJECTIVE
  Hepatic malignancies can easily develop resistance to antiangiogenic therapy, but the underlying mechanism remains poorly understood. This study explores whether antiangiogenic therapy influences the tumor vascular network and/or the vessels feeding the hepatic tumor.
  
  
  METHODS
  Mice implanted with Lewis lung carcinoma (LLC) cells were subcutaneously injected 3 times (once every other day starting 1 week after LLC implantation) with either an antiangiogenic agent [vascular endothelial growth factor (VEGF)-Trap] or control agent (bovine serum albumin) at a dose of 25 mg/kg before performing angiography. Hepatic arteriography and portography were performed using a vascular cast method with vascular latex.
  
  
  RESULTS
  Arteriography of the control-treated LLC-implanted mice showed marked staining of the mass with a prominent feeding artery, suggesting that the tumor is supplied by arterial perfusion. No significant staining was observed on portography. By contrast, 33% (n = 3/9) of the LLC-implanted mice treated with the antiangiogenic agent VEGF-Trap showed intratumoral staining during portography, indicating that these tumors received perfusion via the portal vein.
  
  
  CONCLUSIONS
  Antiangiogenic treatment can induce rearrangement of the hepatic tumor vascular network to establish communication with the portal vein. This implies that hepatic tumors can develop resistance to antiangiogenic therapy by maintaining perfusion through portal venous perfusion.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Wonseok
authors.initials: W
authors.lastname: Kang
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Lim
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Park
authors.forename: Gou Young
authors.initials: GY
authors.lastname: Koh
authors.forename: Honsoul
authors.initials: H
authors.lastname: Kim
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000818:Animals; D018827:Carcinoma, Lewis Lung / Q000098:blood supply / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D045744:Cell Line, Tumor; D019008:Drug Resistance, Neoplasm; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008114:Liver Neoplasms, Experimental / Q000098:blood supply / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008810:Mice, Inbred C57BL; D009389:Neovascularization, Pathologic; D011169:Portal Vein / Q000000981:diagnostic imaging; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor