Chemotherapy using cytotoxic drugs is presently the most commonly used weapon in the treatment of advanced cancer. However, the therapeutic efficacy of cancer chemotherapeutic agents is limited by factors such as tumor heterogeneity, host toxicity and drug resistance. Recent advances in drug development have provided new opportunities to improve cancer therapy using drugs that target the tumor vasculature and inhibit tumor angiogenesis. To date, however, the survival benefit of these angiogenesis inhibitors has been rather modest and efforts to improve activity by combination with conventional chemotherapeutic drugs have been only partially successful. The overall goal of this project is to develop novel, more effective approaches to combining angiogenesis inhibitors with traditional cancer chemotherapeutics, building on progress made in the last project period in studies using the VEGF receptor-selective tyrosine kinase inhibitor axitinib and the liver cytochrome P450-activated anti-cancer prodrug cyclophosphamide. The major aims of this proposal are: 1) to elucidate the mechanism whereby anti-angiogenic drug treatment blocks tumor regression induced by metronomic cyclophosphamide treatment and then devise alternative therapeutic approaches that circumvent this block;2) to investigate the use of provascular strategies to enhance tumor delivery of cancer chemotherapeutic drugs given in conjunction with anti-angiogenesis;3) to harness the anti-vascular effects of anti-angiogenic drugs so as to increase tumor cell exposure to cytotoxic drugs administered intratumorally via an intratumoral 'trapping'(enhanced drug retention) mechanism;and 4) to investigate the impact of changes in tumor microvessel density, neovascularization and vascular maturity on responsiveness to the combination of anti-angiogenic drug treatment with chemotherapy. Together, these studies will elucidate ways to increase responsiveness to anti-angiogenic drugs by combination with conventional chemotherapeutic agents in a way that improves overall therapeutic activity, and will thereby advance the development of anti-cancer therapies.

Public Health Relevance

This project investigates ways to increase responsiveness to anti-angiogenic drugs by combination with conventional cancer chemotherapeutic agents. These studies may identify strategies that can be used to improve the therapeutic effectiveness of anti-angiogenic drugs in the clinic, and thereby advance the development of anti-cancer therapies.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Developmental Therapeutics Study Section (DT)
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Forry, Suzanne L
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Boston University
Schools of Arts and Sciences
United States
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Sulheim, Einar; Kim, Jana; van Wamel, Annemieke et al. (2018) Multi-modal characterization of vasculature and nanoparticle accumulation in five tumor xenograft models. J Control Release 279:292-305
Wu, Junjie; Waxman, David J (2018) Immunogenic chemotherapy: Dose and schedule dependence and combination with immunotherapy. Cancer Lett 419:210-221
Wu, Junjie; Jordan, Marie; Waxman, David J (2016) Metronomic cyclophosphamide activation of anti-tumor immunity: tumor model, mouse host, and drug schedule dependence of gene responses and their upstream regulators. BMC Cancer 16:623
Jordan, Marie; Waxman, David J (2016) CpG-1826 immunotherapy potentiates chemotherapeutic and anti-tumor immune responses to metronomic cyclophosphamide in a preclinical glioma model. Cancer Lett 373:88-96
Pantziarka, Pan; Hutchinson, Lisa; André, Nicolas et al. (2016) Next generation metronomic chemotherapy-report from the Fifth Biennial International Metronomic and Anti-angiogenic Therapy Meeting, 6-8 May 2016, Mumbai. Ecancermedicalscience 10:689
Haery, Leila; Mussakhan, Sultan; Waxman, David J et al. (2016) Evidence for an oncogenic modifier role for mutant histone acetyltransferases in diffuse large B-cell lymphoma. Leuk Lymphoma 57:2661-71
Diep, Phuong; Pannem, Sanjana; Sweer, Jordan et al. (2015) Three-dimensional printed optical phantoms with customized absorption and scattering properties. Biomed Opt Express 6:4212-20
Kareva, Irina; Waxman, David J; Lakka Klement, Giannoula (2015) Metronomic chemotherapy: an attractive alternative to maximum tolerated dose therapy that can activate anti-tumor immunity and minimize therapeutic resistance. Cancer Lett 358:100-106
Wu, Junjie; Waxman, David J (2015) Metronomic cyclophosphamide eradicates large implanted GL261 gliomas by activating antitumor Cd8(+) T-cell responses and immune memory. Oncoimmunology 4:e1005521
Doloff, Joshua C; Waxman, David J (2015) Transcriptional profiling provides insights into metronomic cyclophosphamide-activated, innate immune-dependent regression of brain tumor xenografts. BMC Cancer 15:375

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