@article{ShannonHein2013, author = {Shannon, Graver and Hein, Melanie}, title = {Tumor cell response to bevacizumab single agent therapy in vitro}, series = {Cancer Cell International}, journal = {Cancer Cell International}, doi = {10.1186/1475-2867-13-94}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-97185}, year = {2013}, abstract = {Background Angiogenesis represents a highly multi-factorial and multi-cellular complex (patho-) physiologic event involving endothelial cells, tumor cells in malignant conditions, as well as bone marrow derived cells and stromal cells. One main driver is vascular endothelial growth factor (VEGFA), which is known to interact with endothelial cells as a survival and mitogenic signal. The role of VEGFA on tumor cells and /or tumor stromal cell interaction is less clear. Condition specific (e.g. hypoxia) or tumor specific expression of VEGFA, VEGF receptors and co-receptors on tumor cells has been reported, in addition to the expression on the endothelium. This suggests a potential paracrine/autocrine loop that could affect changes specific to tumor cells. Methods We used the monoclonal antibody against VEGFA, bevacizumab, in various in vitro experiments using cell lines derived from different tumor entities (non small cell lung cancer (NSCLC), colorectal cancer (CRC), breast cancer (BC) and renal cell carcinoma (RCC)) in order to determine if potential VEGFA signaling could be blocked in tumor cells. The experiments were done under hypoxia, a major inducer of VEGFA and angiogenesis, in an attempt to mimic the physiological tumor condition. Known VEGFA induced endothelial biological responses such as proliferation, migration, survival and gene expression changes were evaluated. Results Our study was able to demonstrate expression of VEGF receptors on tumor cells as well as hypoxia regulated angiogenic gene expression. In addition, there was a cell line specific effect in tumor cells by VEGFA blockade with bevacizumab in terms of proliferation; however overall, there was a limited measurable consequence of bevacizumab therapy detected by migration and survival. Conclusion The present study showed in a variety of in vitro experiments with several tumor cell lines from different tumor origins, that by blocking VEGFA with bevacizumab, there was a limited autocrine or cell-autonomous function of VEGFA signaling in tumor cells, when evaluating VEGFA induced downstream outputs known in endothelial cells.}, language = {en} } @article{LinsenmannMonoranuVinceetal.2014, author = {Linsenmann, Thomas and Monoranu, Camelia M. and Vince, Giles H. and Westermaier, Thomas and Hagemann, Carsten and Kessler, Almuth F. and Ernestus, Ralf-Ingo and L{\"o}hr, Mario}, title = {Long-term tumor control of spinal dissemination of cerebellar glioblastoma multiforme by combined adjuvant bevacizumab antibody therapy: a case report}, doi = {10.1186/1756-0500-7-496}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-110536}, year = {2014}, abstract = {Background Glioblastoma multiforme located in the posterior fossa is extremely rare with a frequency up to 3.4\%. Compared with glioblastoma of the hemispheres the prognosis of infratentorial glioblastoma seems to be slightly better. Absence of brainstem invasion and low expression rates of epidermal growth factor receptor are described as factors for long-time survival due to the higher radiosensitivity of these tumors. Case presentation In this case study, we report a German female patient with an exophytic glioblastoma multiforme arising from the cerebellar tonsil and a secondary spinal manifestation. Furthermore, the tumor showed no O (6)-Methylguanine-DNA methyltransferase promotor-hypermethylation and no isocitrate dehydrogenase 1 mutations. All these signs are accompanied by significantly shorter median overall survival. A long-term tumor control of the spinal metastases was achieved by a combined temozolomide/bevacizumab and irradiation therapy, as part of a standard care administered by the treating physician team. Conclusion To our knowledge this is the first published case of a combined cerebellar exophytic glioblastoma with a subsequent solid spinal manifestation. Furthermore this case demonstrates a benefit undergoing this special adjuvant therapy regime in terms of overall survival. Due to the limited overall prognosis of the disease, spinal manifestations of glioma are rarely clinically relevant. The results of our instructive case, however, with a positive effect on both life quality and survival warrant treating future patients in the frame of a prospective clinical study.}, language = {en} } @article{KunzmannNgyuenStahletal.2019, author = {Kunzmann, S. and Ngyuen, T. and Stahl, A. and Walz, J. M. and Nentwich, M. M. and Speer, C. P. and Ruf, K.}, title = {Necrotizing enterocolitis after intravitreal bevacizumab in an infant with Incontinentia Pigmenti - a case report}, series = {BMC Pediatrics}, volume = {19}, journal = {BMC Pediatrics}, doi = {10.1186/s12887-019-1732-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201024}, pages = {353}, year = {2019}, abstract = {Background Incontinentia Pigmenti is a rare disease affecting multiple organs. Fifty of patients show affection of the eye with retinopathy and possible amaurosis being the worst outcome. Treatment has commonly been panretinal laser coagulation but intravitreal application of bevacizumab as VEGF-inhibitor has shown to effectively suppress retinal neovascularization. Case presentation A six-week-old female infant with Incontinentia Pigmenti developed a foudroyant necrotizing enterocolitis shortly after intravitreal injection of bevazicumab due to a retinopathy with impending tractional detachment of the left eye. Since the onset of abdominal symptoms occurred immediately after the intravitreal application, a link between the two events seemed likely. Sequential analyses of the VEGF serum concentrations showed a massive suppression of endogenous VEGF with only a very slow recovery over weeks. Such a severe systemic adverse event has not been reported after intravitreal treatment with bevacizumab in an infant. Conclusion This case report shows a relevant systemic uptake of bevacizumab after intravitreal application as suppressed VEGF levels show. There seems to be a connection between suppressed VEGF levels and the onset of necrotizing enterocolitis. Therefore, treatment with bevacizumab should be carefully considered and further research is needed to assess this drug's safety profile.}, language = {en} } @phdthesis{Hein2014, author = {Hein, Melanie}, title = {Functional analysis of angiogenic factors in tumor cells and endothelia}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-93863}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2014}, abstract = {Tumor angiogenesis is essential for the growth of solid tumors as their proliferation and survival is dependent on consistent oxygen and nutrient supply. Anti-angiogenic treatments represent a therapeutic strategy to inhibit tumor growth by preventing the formation of new blood vessels leading to starvation of the tumor. One of the best characterized anti angiogenic therapeutics is the monoclonal antibody bevacizumab (Avastin), which targets and neutralizes VEGF leading to disruption of the VEGF signaling pathway. Until today, bevacizumab has found its way into clinical practice and has gained approval for treatment of different types of cancer including colorectal cancer, non-small cell lung cancer, breast cancer and renal cell carcinoma. Signaling of VEGF is mediated through VEGF receptors, mainly VEGFR2, which are primarily located on the cell surface of endothelial cells. However, there has been evidence that expression of VEGF receptors can also be found on tumor cells themselves raising the possibility of autocrine and/or paracrine signaling loops. Thus, tumor cells could also benefit from VEGF signaling, which would promote tumor growth. The aim of this study was to investigate if bevacizumab has a direct effect on tumor cells in vitro. To this end, tumor cell lines from the NCI-60 panel derived from four different tumor types were treated with bevacizumab and angiogenic gene and protein expression as well as biological outputs including proliferation, migration and apoptosis were investigated. Most of the experiments were performed under hypoxia to mimic the in vivo state of tumors. Overall, there was a limited measurable effect of bevacizumab on treated tumor cell lines according to gene and protein expression changes as well as biological functions when compared to endothelial controls. Minor changes in terms of proliferation or gene regulation were evident in a single tumor cell line after VEGF-A blockade by bevacizumab, which partially demonstrated a direct effect on tumor cells. However, the overall analysis revealed that tumor cell lines are not intrinsically affected in an adverse manner by bevacizumab treatment. Besides the functional analysis of tumor cells, embryonic stem cell derived endothelial cells were characterized to delineate vascular Hey gene functions. Hey and Hes proteins are the best characterized downstream effectors of the evolutionary conserved Notch signaling pathway, which mainly act as transcriptional repressors regulating downstream target genes. Hey proteins play a crucial role in embryonic development as loss of Hey1 and Hey2 in mice in vivo leads to a severe vascular phenotype resulting in early embryonic lethality. The major aim of this part of the thesis was to identify vascular Hey target genes using embryonic stem cell derived endothelial cells utilizing a directed endothelial differentiation approach, as ES cells and their differentiation ability provide a powerful in vitro system to study developmental processes. To this end, Hey deficient and Hey wildtype embryonic stem cells were stably transfected with an antibiotic selection marker driven by an endothelial specific promoter, which allows selection for endothelial cells. ESC-derived endothelial cells exhibited typical endothelial characteristics as shown by marker gene expression, immunofluorescent staining and tube formation ability. In a second step, Hey deficient ES cells were stably transfected with doxycycline inducible Flag-tagged Hey1 and Hey2 transgenes to re-express Hey proteins in the respective cell line. RNA-Sequencing of Hey deficient and Hey overexpressing ES cells as well as ESC-derived endothelial cells revealed many Hey downstream target genes in ES cells and fewer target genes in endothelial cells. Hey1 and Hey2 more or less redundantly regulate target genes in ES cells, but some genes were regulated by Hey2 alone. According to Gene Ontology term analysis, Hey target genes are mainly involved in embryonic development and transcriptional regulation. However, the response of ESC-derived endothelial cells in regulating Hey downstream target genes was rather limited when compared to ES cells, which could be due to lower transgene expression in endothelial cells. The limited response also raises the possibility that target gene regulation in endothelial cells is not only dependent on Hey gene functions alone and thus loss or overexpression of Hey genes in this in vitro setting does not influence target gene regulation.}, subject = {Krebs }, language = {en} }