Abstract

BackgroundThe tumor-specific microregional effects of the anticancer agent RRx-001, a novel epigenetic-based radio/chemosensitizer with nitrogen oxide-donating properties in phase II clinical trials, were investigated with whole tissue section quantitative immunohistological staining in mouse SCCVII and human U87 tumors.ResultsSCCVII tumors exhibited regions of intermittent perfusion exemplified by co-localization of vessels with the hypoxia marker pimonidazole commonly occurring throughout the tissue. A moderate increase in perfusion (21 to 28 %) was observed after a bolus dose of the perivascular stain DiOC7(3), however, with the absence of an increase in tissue oxygenation. U87 tumors showed an absence of blood flow over large areas of treated tumors after dosing with RRx-001. However, these areas did not become necrotic and returned to near normal levels after 12 h. No significant change in tumor hypoxia was seen at 90 min or 12 h. For both tumor types, RRx-001 treatment resulted in the loss of perfusion in the large regions of the tumor; however, at the 12-h time point, both tumor types showed an increase in vessel perfusion but no significant decrease in hypoxia.ConclusionsThese data suggest a redistribution of blood flow within the tumor for both tumor types akin to vascular normalization. Differences between the tumors were related to tumor architecture and distribution of alpha-smooth muscle actin (α-SMA). RRx-001 shows promise for short-term blood flow redistribution in tumors with a pericyte- and α-SMA-rich vasculature. Expression of α-SMA in tumor vasculature could therefore be useful for predicting tumor response to RRx-001.

Highlights

  • The tumor-specific microregional effects of the anticancer agent RRx-001, a novel epigenetic-based radio/chemosensitizer with nitrogen oxide-donating properties in phase II clinical trials, were investigated with whole tissue section quantitative immunohistological staining in mouse SCCVII and human U87 tumors

  • These data suggest a redistribution of blood flow within the tumor for both tumor types akin to vascular normalization

  • Expression of α-SMA in tumor vasculature could be useful for predicting tumor response to RRx-001

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Summary

Introduction

The tumor-specific microregional effects of the anticancer agent RRx-001, a novel epigenetic-based radio/chemosensitizer with nitrogen oxide-donating properties in phase II clinical trials, were investigated with whole tissue section quantitative immunohistological staining in mouse SCCVII and human U87 tumors. Equating the periphery with high status and centrality with low status is oversimplified given the diversified pattern of “hot spots” of hypoxia and perfusion throughout the core of the tumor due to variations in vasculature development [2]. These “pockets of decay” in the tumor based on the mismatched forces of. The hallmark of the microenvironment is heterogeneity with thinly divided, cheek-byjowl zones of wealth and poverty in terms of blood flow and oxygenation The driver of this heterogeneity is hypoxia-induced neovasculogenesis and metastatic dissemination, which arguably is secondary to the maturity of the vasculature. Two main categories of Oronsky et al Clinical Epigenetics (2016) 8:53 hypoxia are present in tumors: chronic hypoxia, known as diffusion-limited or permanent hypoxia, and acute hypoxia, known as perfusion-limited or transient hypoxia [3]

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