A Combination of Radiation and the Hypoxia-Activated Prodrug Evofosfamide (TH-302) is Efficacious against a Human Orthotopic Pancreatic Tumor Model |
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Authors: | Carla Hajj James Russell Charles P Hart Karyn A Goodman Maeve A Lowery Adriana Haimovitz-Friedman Joseph O Deasy John L Humm |
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Institution: | 2. Department of Medical Physics, MSKCC, 1275 York Avenue, New York, NY, 10065;3. Threshold Pharmaceuticals, South San Francisco, CA 94080, USA;4. Department of Radiation Oncology, University of Colorado Denver School of Medicine, 13001 E 17th Pl, Aurora, CO 80045;5. Department of Medicine, MSKCC, 1275 York Avenue, New York, NY, 10065 |
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Abstract: | This study was designed to investigate the effect of single-dose radiation therapy (RT) in combination with evofosfamide (TH-302), a hypoxia-activated prodrug, in a pre-clinical model of pancreatic cancer. AsPC1 tumors were implanted orthotopically in the pancreas of nude mice. Tumors were treated with 15 Gy of RT, using a 1 cm diameter field, and delivered as a continuous arc. Image-guidance to center the field on the tumor was based on CT imaging with intraperitoneal contrast. Evofosfamide (100 mg/kg, i.p.) was administered 3 hours before RT. Tumor volumes were measured using ultrasound, and regrowth curves were plotted. Tumor hypoxia and cell proliferation were measured using pimonidazole and the thymidine analog EdU, respectively. In vitro clonogenic assays were performed. Tumors were shown to contain substantial areas of hypoxia, as calculated by percent pimonidazole staining. Evofosfamide was active in these tumors, as demonstrated by a significant reduction in uptake of the thymidine analog EdU. This effect was visible in oxygenated tissue, consistent with the previously reported bystander effects of evofosfamide. RT produced significant regrowth delay, as did evofosfamide. The combination of both agents produced a growth delay that was at least equal to the sum of the two treatments given separately. The improvement in tumor response when evofosfamide is combined with RT supports the hypothesis that hypoxia is a cause of radioresistance in high dose RT for pancreatic cancer. Assessing the efficacy and safety of stereotactic radiation treatment and evofosfamide is warranted in patients with locally advanced pancreatic cancer. |
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Keywords: | Address all correspondence to: James Russell Department of Medical Physics MSKCC 1275 York Avenue New York NY 10065 |
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