Anti-Vascular Endothelial Growth Factor Treatment in Combination with Chemotherapy Delays Hematopoietic Recovery Due to Decreased Proliferation of Bone.

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Anti-Vascular Endothelial Growth Factor Treatment in Combination with Chemotherapy Delays Hematopoietic Recovery Due to Decreased Proliferation of Bone Marrow Hematopoietic Progenitor Cells Sergey V. Novitskiy, MD, PhD, Ildiko Csiki, MD, PhD, Yuhui Huang, PhD, David H. Johnson, MD, Eva M. Harth, PhD, David P. Carbone, MD, PhD, Mikhail M. Dikov, PhD Journal of Thoracic Oncology Volume 5, Issue 9, Pages 1410-1415 (September 2010) DOI: 10.1097/JTO.0b013e3181e59c24 Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Genetic deletion of vascular endothelial growth factor receptor 1 (VEGFR1) tyrosine kinase domain or administration of VEGF receptor-selective multitargeted TKI SU5416 impair WBC recovery in mice after cytotoxic chemotherapy. WBC counts in wild-type (WT) or VEGFR1(TK−/−) mice after a single dose of 300 mg/kg 5-fluorouracil (5-FU) with or without treatment with 6.5 mg/kg SU5416 coinjected intraperitoneally at the same day and then every third day. In both groups received 5-FU with SU5416, mortality was 80% at day 14. Data are expressed as mean ± SE. Journal of Thoracic Oncology 2010 5, 1410-1415DOI: (10.1097/JTO.0b013e3181e59c24) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Delayed repopulation of bone marrow in mice with genetic deletion of vascular endothelial growth factor receptor 1 (VEGFR1) tyrosine kinase domain or received SU5416 treatment after cytotoxic chemotherapy. The number of cells in bone marrow (BM, tibia, and femurs) in wild-type or VEGFR1(TK−/−) mutant mice on day 14 after receiving a single dose of 5-fluorouracil (5-FU) with or without treatment with SU5416, as described in the legend for Figure 1. Data are expressed as mean ± SE; *p < 0.01; **p < 0.005. Journal of Thoracic Oncology 2010 5, 1410-1415DOI: (10.1097/JTO.0b013e3181e59c24) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Inhibition of vascular endothelial growth factor signaling in vivo significantly attenuates repopulation of myeloid, hematopoietic precursor, and erythroid cellular subsets after cytotoxic chemotherapy. Mice were treated as described in the legend for Figure 1, and proportions of cell populations in bone marrow were assessed by flow cytometry on day 14. A, CD11b+Gr1+. B,ScaI+c-kit+ cells. C, Ter119+CD45− cells. Data are expressed as mean ± SE; *p < 0.01. Journal of Thoracic Oncology 2010 5, 1410-1415DOI: (10.1097/JTO.0b013e3181e59c24) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 Inhibition of vascular endothelial growth factor (VEGF) signaling by receptor TKI, antireceptor blocking antibodies, or s vascular endothelial growth factor receptor 1 (VEGFR1)-Fc fusion protein decreases proliferation of mouse Lin− hematopoietic progenitor cell (HPC). Mouse Lin− HPC were cultured in the presence of supportive cytokines for 3 days without or with escalating doses of SU5416, mixture of anti-VEGFR1-, and anti-VEGFR2-blocking antibodies or sVEGFR1-Fc fusion protein. Cell proliferation was assessed by [3H]-thymidine incorporation. Data are expressed as mean ± SE; *p < 0.01; **p < 0.005. Journal of Thoracic Oncology 2010 5, 1410-1415DOI: (10.1097/JTO.0b013e3181e59c24) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 5 Combination of multitargeted vascular endothelial growth factor (VEGF) receptor TKI SU5416 with chemotherapeutic reagents has additive inhibitory effect on hematopoietic progenitor cell (HPC) proliferation. Mouse Lin− HPC were cultured without or with 100 nm SU5416, 20 nm 5-fluorouracil (5-FU), 1.5 μg/ml carboplatin (CP), 5 ng/ml adriamicyn or combination of SU5416, and chemotherapeutic agents at the same concentrations. Cell proliferation was assessed by [3H]-thymidine incorporation. Data are expressed as mean ± SE; *p < 0.01; **p < 0.005. Journal of Thoracic Oncology 2010 5, 1410-1415DOI: (10.1097/JTO.0b013e3181e59c24) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions