title: Efficacy of Cotargeting Angiopoietin-2 and the VEGF Pathway in the Adjuvant Postsurgical Setting for Early Breast, Colorectal, and Renal Cancers.
abstract: Antiangiogenic tyrosine kinase inhibitors (TKI) that target VEGF receptor-2 (VEGFR2) have not been effective as adjuvant treatments for micrometastatic disease in phase III clinical trials. Angiopoietin-2 (Ang2) is a proangiogenic and proinflammatory vascular destabilizer that cooperates with VEGF. The purpose of this study was to test whether CVX-060 (an Ang2-specific CovX-body) can be combined with VEGFR2-targeting TKIs (sunitinib or regorafenib) to successfully treat postsurgical metastatic disease in multiple orthotopically implanted human tumor xenograft and syngeneic murine tumor models. In the MDA-MB-231.LM2-4 human breast cancer model, adjuvant sunitinib was ineffective, whereas adjuvant CVX-060 delayed the progression of pulmonary or distant lymphatic metastases; however, overall survival was only improved with the adjuvant use of a VEGF-A/Ang2-bispecific CovX-body (CVX-241) but not when CVX-060 is combined with sunitinib. Adjuvant CVX-241 also showed promise in the EMT-6/CDDP murine breast cancer model, with or without an immune checkpoint inhibitor (anti-PD-L1). In the RENCA model of mouse renal cancer, however, combining CVX-060 with sunitinib in the adjuvant setting was superior to CVX-241 as treatment for postsurgical lung metastases. In the HCT116 and HT29 xenograft models of colorectal cancer, both CVX-060 and regorafenib inhibited liver metastases. Overall, our preclinical findings suggest differential strategies by which Ang2 blockers can be successfully combined with VEGF pathway targeting in the adjuvant setting to treat micrometastatic disease-particularly, in combination with VEGF-A blockers (but not VEGFR2 TKIs) in resected breast cancer; in combination with VEGFR2 TKIs in resected kidney cancer; and as single agents or with VEGFR2 TKIs in resected colorectal cancer. Cancer Res; 76(23); 6988-7000. ©2016 AACR.
authors.affiliation: Department of Medical Biophysics, University of Toronto, Toronto, Canada.|Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Florence T H
authors.initials: FT
authors.lastname: Wu
authors.affiliation: Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Shan
authors.initials: S
authors.lastname: Man
authors.affiliation: Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Ping
authors.initials: P
authors.lastname: Xu
authors.affiliation: Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Annabelle
authors.initials: A
authors.lastname: Chow
authors.affiliation: Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Marta
authors.initials: M
authors.lastname: Paez-Ribes
authors.affiliation: Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Christina R
authors.initials: CR
authors.lastname: Lee
authors.affiliation: Oncology and Rinat Research Unit, Pfizer Worldwide Research and Development, La Jolla, California.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Pirie-Shepherd
authors.affiliation: Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Urban
authors.initials: U
authors.lastname: Emmenegger
authors.affiliation: Department of Medical Biophysics, University of Toronto, Toronto, Canada. robert.kerbel@sri.utoronto.ca.|Biological Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kerbel
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D042702:Angiopoietin-2 / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D000818:Animals; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery; D045744:Cell Line, Tumor; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000601:surgery; D051379:Mice; D008807:Mice, Inbred BALB C; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000627:therapeutic use*
chemical_list: D020533:Angiogenesis Inhibitors; D042702:Angiopoietin-2; D042461:Vascular Endothelial Growth Factor A