Inhibition of vascular endothelial growth factor a and hypoxia-inducible factor 1α maximizes the effects of radiation in sarcoma mouse models through destruction of tumor vasculature Journal Article


Authors: Lee, H. J.; Yoon, C.; Park, D. J.; Kim, Y. J.; Schmidt, B.; Lee, Y. J.; Tap, W. D.; Eisinger-Mathason, T. S. K.; Choy, E.; Kirsch, D. G.; Simon, M. C.; Yoon, S. S.
Article Title: Inhibition of vascular endothelial growth factor a and hypoxia-inducible factor 1α maximizes the effects of radiation in sarcoma mouse models through destruction of tumor vasculature
Abstract: Purpose To examine the addition of genetic or pharmacologic inhibition of hypoxia-inducible factor 1α (HIF-1α) to radiation therapy (RT) and vascular endothelial growth factor A (VEGF-A) inhibition (ie trimodality therapy) for soft-tissue sarcoma. Methods and Materials Hypoxia-inducible factor 1α was inhibited using short hairpin RNA or low metronomic doses of doxorubicin, which blocks HIF-1α binding to DNA. Trimodality therapy was examined in a mouse xenograft model and a genetically engineered mouse model of sarcoma, as well as in vitro in tumor endothelial cells (ECs) and 4 sarcoma cell lines. Results In both mouse models, any monotherapy or bimodality therapy resulted in tumor growth beyond 250 mm3 within the 12-day treatment period, but trimodality therapy with RT, VEGF-A inhibition, and HIF-1α inhibition kept tumors at <250 mm3 for up to 30 days. Trimodality therapy on tumors reduced HIF-1α activity as measured by expression of nuclear HIF-1α by 87% to 95% compared with RT alone, and cytoplasmic carbonic anhydrase 9 by 79% to 82%. Trimodality therapy also increased EC-specific apoptosis 2- to 4-fold more than RT alone and reduced microvessel density by 75% to 82%. When tumor ECs were treated in vitro with trimodality therapy under hypoxia, there were significant decreases in proliferation and colony formation and increases in DNA damage (as measured by Comet assay and γH2AX expression) and apoptosis (as measured by cleaved caspase 3 expression). Trimodality therapy had much less pronounced effects when 4 sarcoma cell lines were examined in these same assays. Conclusions Inhibition of HIF-1α is highly effective when combined with RT and VEGF-A inhibition in blocking sarcoma growth by maximizing DNA damage and apoptosis in tumor ECs, leading to loss of tumor vasculature.
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 91
Issue: 3
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2015-03-01
Start Page: 621
End Page: 630
Language: English
DOI: 10.1016/j.ijrobp.2014.10.047
PROVIDER: scopus
PUBMED: 25544668
PMCID: PMC4559849
DOI/URL:
Notes: Export Date: 2 March 2015 -- Source: Scopus
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MSK Authors
  1. Sam Yoon
    108 Yoon
  2. William Douglas Tap
    372 Tap
  3. Do Joong Park
    16 Park
  4. Changhwan Yoon
    41 Yoon