Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Pharmacokinetic and pharmacodynamic study of intratumoral injection of an adenovirus encoding endostatin in patients with advanced tumors

Abstract

Angiogenesis plays a pivotal role in tumor growth, tissue invasion and metastasis. Endostatin is an angiogenesis inhibitor and has been shown to reduce tumor growth in animal models. However, therapy with recombinant endostatin protein was hampered by its short half-life and very-low yield of bioactive protein. We performed a phase I dose–escalation clinical trial using intratumoral injection of an adenovirus containing human endostatin gene (Ad-rhE; E10A; 1010–1012 virus particles (vp)) in 15 patients with advanced solid tumors. We observed intratumoral injections of E10A without dose-limiting toxicity. Most frequently reported E10A-related adverse events were transient fever and local response. Distribution studies revealed that the vector was detected in the blood, throat and injection site, but rarely in the urine and stool. An increased endostatin expression was detected using enzyme immunoassay in serum in 13 of 14 treated patients throughout the period of treatment despite the presence of neutralizing antiadenovirus antibody. Median serum basic fibroblast growth factor levels decreased from 32.4 pg ml−1 at baseline to 24.9 pg ml−1 after 28 days of first treatment. Thus, direct intratumoral injection of up to 1012 vp of E10A to patients is well tolerated and further studies are necessary to define and increase clinical efficacy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5

Similar content being viewed by others

References

  1. Bergers G, Benjamin LE . Tumorigenesis and the angiogenic switch. Nat Rev Cancer 2003; 3: 401–410.

    Article  CAS  Google Scholar 

  2. Folkman J, Klagsbrun M . Angiogenic factors. Science 1987; 235: 442–447.

    Article  CAS  Google Scholar 

  3. Folkman J, Weisz PB, Joullie MM, Li WW, Ewing WR . Control of angiogenesis with synthetic heparin substitutes. Science 1989; 243: 1490–1493.

    Article  CAS  Google Scholar 

  4. Zeng Q, Li S, Chepeha DB, Giordano TJ, Li J, Zhang H et al. Crosstalk between tumor and endothelial cells promotes tumor angiogenesis by MAPK activation of Notch signaling. Cancer Cell 2005; 8: 13–23.

    Article  CAS  Google Scholar 

  5. Boehm T, Folkman J, Browder T, O’Reilly MS . Antiangiogenic therapy of experimental cancer does not induce acquired drug resistance. Nature 1997; 390: 404–407.

    Article  CAS  Google Scholar 

  6. Jain RK . Normalization of tumor vasculature: an emerging concept in antiangiogenic therapy. Science 2005; 307: 58–62.

    Article  CAS  Google Scholar 

  7. Folkman J . Antiangiogenesis in cancer therapy—endostatin and its mechanisms of action. Exp Cell Res 2006; 312: 594–607.

    Article  CAS  Google Scholar 

  8. Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004; 350: 2335–2342.

    Article  CAS  Google Scholar 

  9. Eggert A, Ikegaki N, Kwiatkowski J, Zhao H, Brodeur GM, Himelstein BP . High-level expression of angiogenic factors is associated with advanced tumor stage in human neuroblastomas. Clin Cancer Res 2000; 6: 1900–1908.

    CAS  PubMed  Google Scholar 

  10. Relf M, LeJeune S, Scott PA, Fox S, Smith K, Leek R et al. Expression of the angiogenic factors vascular endothelial cell growth factor, acidic and basic fibroblast growth factor, tumor growth factor beta-1, platelet-derived endothelial cell growth factor, placenta growth factor, and pleiotrophin in human primary breast cancer and its relation to angiogenesis. Cancer Res 1997; 57: 963–969.

    CAS  PubMed  Google Scholar 

  11. O’Reilly MS, Boehm T, Shing Y, Fukai N, Vasios G, Lane WS et al. Endostatin: an endogenous inhibitor of angiogenesis and tumor growth. Cell 1997; 88: 277–285.

    Article  Google Scholar 

  12. Dixelius J, Cross MJ, Matsumoto T, Claesson-Welsh L . Endostatin action and intracellular signaling: beta-catenin as a potential target? Cancer Lett 2003; 196: 1–12.

    Article  CAS  Google Scholar 

  13. Abdollahi A, Hahnfeldt P, Maercker C, Grone HJ, Debus J, Ansorge W et al. Endostatin's antiangiogenic signaling network. Mol Cell 2004; 13: 649–663.

    Article  CAS  Google Scholar 

  14. Li L, Liu RY, Huang JL, Liu QC, Li Y, Wu PH et al. Adenovirus-mediated intra-tumoral delivery of the human endostatin gene inhibits tumor growth in nasopharyngeal carcinoma. Int J Cancer 2006; 118: 2064–2071.

    Article  CAS  Google Scholar 

  15. Liang ZH, Wu PH, Li L, Xue G, Zeng YX, Huang WL . Inhibition of tumor growth in xenografted nude mice with adenovirus-mediated endostatin gene comparison with recombinant endostatin protein. Chin Med J (Engl) 2004; 117: 1809–1814.

    CAS  Google Scholar 

  16. Wu Y, Yang L, Hu B, Liu JY, Su JM, Luo Y et al. Synergistic anti-tumor effect of recombinant human endostatin adenovirus combined with gemcitabine. Anticancer Drugs 2005; 16: 551–557.

    Article  CAS  Google Scholar 

  17. Sauter BV, Martinet O, Zhang WJ, Mandeli J, Woo SL . Adenovirus-mediated gene transfer of endostatin in vivo results in high level of transgene expression and inhibition of tumor growth and metastases. Proc Natl Acad Sci USA 2000; 97: 4802–4807.

    Article  CAS  Google Scholar 

  18. Capillo M, Mancuso P, Gobbi A, Monestiroli S, Pruneri G, Dell’Agnola C et al. Continuous infusion of endostatin inhibits differentiation, mobilization, and clonogenic potential of endothelial cell progenitors. Clin Cancer Res 2003; 9: 377–382.

    CAS  PubMed  Google Scholar 

  19. Kisker O, Becker CM, Prox D, Fannon M, D’Amato R, Flynn E et al. Continuous administration of endostatin by intraperitoneally implanted osmotic pump improves the efficacy and potency of therapy in a mouse xenograft tumor model. Cancer Res 2001; 61: 7669–7674.

    CAS  PubMed  Google Scholar 

  20. Herbst RS, Hess KR, Tran HT, Tseng JE, Mullani NA, Charnsangavej C et al. Phase I study of recombinant human endostatin in patients with advanced solid tumors. J Clin Oncol 2002; 20: 3792–3803.

    Article  CAS  Google Scholar 

  21. Eder Jr JP, Supko JG, Clark JW, Puchalski TA, Garcia-Carbonero R, Ryan DP et al. Phase I clinical trial of recombinant human endostatin administered as a short intravenous infusion repeated daily. J Clin Oncol 2002; 20: 3772–3784.

    Article  CAS  Google Scholar 

  22. Thomas JP, Arzoomanian RZ, Alberti D, Marnocha R, Lee F, Friedl A et al. Phase I pharmacokinetic and pharmacodynamic study of recombinant human endostatin in patients with advanced solid tumors. J Clin Oncol 2003; 21: 223–231.

    Article  CAS  Google Scholar 

  23. Skovseth DK, Veuger MJ, Sorensen DR, De Angelis PM, Haraldsen G . Endostatin dramatically inhibits endothelial cell migration, vascular morphogenesis, and perivascular cell recruitment in vivo. Blood 2005; 105: 1044–1051.

    Article  CAS  Google Scholar 

  24. Hansma AH, Broxterman HJ, van der Horst I, Yuana Y, Boven E, Giaccone G et al. Recombinant human endostatin administered as a 28-day continuous intravenous infusion, followed by daily subcutaneous injections: a phase I and pharmacokinetic study in patients with advanced cancer. Ann Oncol 2005; 16: 1695–1701.

    Article  CAS  Google Scholar 

  25. He GA, Xue G, Xiao L, Wu JX, Xu BL, Huang JL et al. Dynamic distribution and expression in vivo of human endostatin gene delivered by adenoviral vector. Life Sci 2005; 77: 1331–1340.

    Article  CAS  Google Scholar 

  26. Abdollahi A, Hlatky L, Huber PE . Endostatin: the logic of antiangiogenic therapy. Drug Resist Updat 2005; 8: 59–74.

    Article  CAS  Google Scholar 

  27. Hoekstra R, de Vos FY, Eskens FA, Gietema JA, van der Gaast A, Groen HJ et al. Phase I safety, pharmacokinetic, and pharmacodynamic study of the thrombospondin-1-mimetic angiogenesis inhibitor ABT-510 in patients with advanced cancer. J Clin Oncol 2005; 23: 5188–5197.

    Article  CAS  Google Scholar 

  28. Zhang YA, Nemunaitis J, Scanlon KJ, Tong AW . Anti-tumorigenic effect of a K-ras ribozyme against human lung cancer cell line heterotransplants in nude. Gene Therapy 2000; 7: 2041–2050.

    Article  CAS  Google Scholar 

  29. Slos P, De Meyer M, Leroy P, Rousseau C, Acres B . Immunotherapy of established tumors in mice by intratumoral injection of an adenovirus vector harboring the human IL-2 cDNA: induction of CD8 (+) T-cell immunity and NK activity. Cancer Gene Ther 2001; 8: 321–332.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Supported by the National High Technology Research and Development Program of China, Grant no. 2006AA02Z489; the National Basic Research Program of China, Grant no.: 2004CB518801; the Research and Development Grand of Guangdong Province, Grant no.: 2003A10902; and The CMB-SUMS Scholar Program, Grant no.: 98-677.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to W Huang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, HL., Li, S., Shao, JY. et al. Pharmacokinetic and pharmacodynamic study of intratumoral injection of an adenovirus encoding endostatin in patients with advanced tumors. Gene Ther 15, 247–256 (2008). https://doi.org/10.1038/sj.gt.3303038

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.gt.3303038

Keywords

This article is cited by

Search

Quick links