Abstract

Brain metastases are common in patients with non-small-cell lung cancer (NSCLC). The efficacy of bevacizumab, an anti-vascular endothelial growth factor (VEGF) humanized antibody, has been demonstrated in patients with nonsquamous NSCLC. We established a transplantable NSCLC cell line (Nluc-H1915) that stably expresses NanoLuc® reporter and confirmed the correlation between total Nluc activity in tumor and tumor volume in vivo. SCID mice inoculated with these cells through the internal carotid artery formed reproducible brain metastases, in which human VEGF was detected. Next, after metastases were established in the model mice (15–17 days), they were intraperitoneally administered weekly doses of human immunoglobulin G (HuIgG) or bevacizumab. Nluc activity in the brain was significantly lower in bevacizumab-treated mice than in HuIgG-treated mice. Additionally, bevacizumab concentration in the brain was higher in mice with brain metastasis than in normal mice, and bevacizumab was primarily observed in brain metastasis lesions. The microvessel density in brain metastasis was lower in bevacizumab-treated mice than in HuIgG-treated mice. We believe bevacizumab’s anti-proliferative effect on brain metastasis is due to anti-angiogenic activity achieved by its penetration into brain metastases; this suggests that a bevacizumab-containing regimen may be a promising treatment option for patients with NSCLC brain metastasis.

Highlights

  • Patients with advanced non-small-cell lung cancer (NSCLC) commonly develop brain metastases; this occurs in 30–64% of the patients [1] and results in very poor prognosis

  • To develop a useful method of determining the total amount of brain metastases and the antitumor activity of a drug on established brain metastases, we first assessed the correlation between tumor volume (TV) and Nluc activity in a subcutaneous xenograft mouse model using Nluc-H1915 cells

  • We demonstrated the anti-proliferative effect of bevacizumab on established brain metastases in a hematogenous brain metastasis xenograft model using the human NSCLC cell line, Nluc-H1915

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Summary

Introduction

Patients with advanced non-small-cell lung cancer (NSCLC) commonly develop brain metastases; this occurs in 30–64% of the patients [1] and results in very poor prognosis. Following this research on GBM, the studies BRAIN and EOLE, which investigated the use of bevacizumab in patients with nonsquamous NSCLC, demonstrated encouraging efficacy and an acceptable safety profile for chemotherapy that included bevacizumab as a first-line treatment for asymptomatic and untreated brain metastases [10, 11]. These results indicate that bevacizumab may be useful in patients with NSCLC with brain metastases. Results of clinical studies need to be fully elucidated, by showing that bevacizumab can penetrate the BBB, and by articulating a detailed mechanism for its antitumor effect on metastatic lesions

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