Abstract

The leaky, heterogeneous vasculature of human tumors prevents the even distribution of systemic drugs within cancer tissues. However, techniques for studying vascular delivery systems in vivo often require complex mammalian models and time-consuming, surgical protocols. The developing chicken embryo is a well-established model for human cancer that is easily accessible for tumor imaging. To assess this model for the in vivo analysis of tumor permeability, human tumors were grown on the chorioallantoic membrane (CAM), a thin vascular membrane which overlays the growing chick embryo. The real-time movement of small fluorescent dextrans through the tumor vasculature and surrounding tissues were used to measure vascular leak within tumor xenografts. Dextran extravasation within tumor sites was selectively enhanced an interleukin-2 (IL-2) peptide fragment or vascular endothelial growth factor (VEGF). VEGF treatment increased vascular leak in the tumor core relative to surrounding normal tissue and increased doxorubicin uptake in human tumor xenografts. This new system easily visualizes vascular permeability changes in vivo and suggests that vascular permeability may be manipulated to improve chemotherapeutic targeting to tumors.

Highlights

  • Tumors develop a chaotic vascular network characterized by variable blood pressure and vascular permeability that inhibits effective drug delivery [1]

  • vascular endothelial growth factor (VEGF), PEP or phosphate buffered saline (PBS) control was injected into a chorioallantoic membrane (CAM) vein distal to the site of analysis or applied topically to a defined area of the CAM and the embryo was incubated for 2 hours

  • The relative vascular leak in PBS, VEGF or PEP-treated vessels was determined in CAMs of day 15 chicken embryos (n$15 in all cases)

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Summary

Introduction

Tumors develop a chaotic vascular network characterized by variable blood pressure and vascular permeability that inhibits effective drug delivery [1]. Sporadic high cell density within the tumor prevents normal tissue drainage [2] This promotes the accumulation of cellular and blood proteins in the interstitial space, leading to high interstitial oncotic pressure, which inhibits the extravasation of systemic drugs [3]. By transiently altering tumor blood vessel physiology during systemic anti-cancer treatment, tissue perfusion and drainage can be enhanced, thereby relieving interstitial hypertension [7,8]. Prolonged treatment with anti-angiogenic drugs, such as Sunitinib or DC101, normalizes blood flow through the remaining stabilized vasculature These treatments can improve tumor micro-hemodynamics and effectively lower the interstitial pressure. Inhibition of the PI3K pathway increases tumor perfusion and simultaneously enhances doxorubicin delivery [13] These findings indicate that the strategic use of adjuvants to transiently modify tumor blood flow and hemodynamics can facilitate drug delivery to cancer sites

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