Background: Based primarily on studies concerning early-stage tumours (treated surgically), and locally advanced disease (treated with chemoradiation), the prognosis for women with adenocarcinoma (AC) or adenosquamous (AS) carcinoma has been reported to be poorer than those with squamous cell carcinoma (SCCA) of the cervix. It is unclear whether differences in prognosis also persist in the setting of recurrent or metastatic disease treated using chemotherapy doublets with or without bevacizumab. Methods: Cases were pooled from three Gynaecologic Oncology Group randomised phase III trials of chemotherapy doublets. Pearson's test was used to evaluate response rate (RR) of AC/AS vs SCCA, Kaplan-Meier method to estimate progression-free survival (PFS) and overall survival (OS), and Cox proportional hazards model to estimate the impact of histology on PFS and OS. Results: Of 781 evaluable patients, 77% (N = 599) had SCCA and 23% (N = 182) AC/AS. There were no significant differences in RRs between histologic subgroups. The adjusted hazard ratio (HR) for death for SCCA vs AC/AS was 1.13 (95% CI 0.93, 1.38 P = 0.23). When comparing SC/AS (N = 661, 85%) to AC alone (N = 120, 15%), the adjusted HR for death was 1.23 (95% CI 0.97, 1.57, P = 0.09). Conclusions: AC/AS and SCCA have similar survival in recurrent or metastatic cervical carcinoma when treated with chemotherapy doublets.

Moléculas de origem vegetal foram há muito testadas como fonte de drogas antineoplásicas com sucesso promissor. Este trabalho trata dos efeitos antiangiogênicos do Metil Jasmonato. Este derivado hidrofóbico do ácido jasmônico foi demonstrado anteriormente como um agente de dano seletivo para a mitocôndria de células neoplásicas. In vitro, o Metil Jasmonato 1-10 mM promoveu a morte celular de células endoteliais humanas de cordão umbilical (HUVEC) e de melanoma murino (B16 -F10), enquanto concentrações micromolares foram inócuas. A inclusão do Metil Jasmonato em liposomos de fosfatidilcolina e em um nanocarreador hidrofílico baseado em açúcar mostrou efeitos diferenciais sobre a citotoxicidade. A interrupção do ciclo celular foi observada em concentrações citotóxicas, enquanto a diminuição na produção de VEGF e algum grau de autofagia foram sugeridos em concentrações micromolares. In vivo, Metil Jasmonato 1-10mM foi francamente tóxico, e reduziu a densidade de vasos em membranas corioalantóicas de embrião de galinha (CAM). Entretanto, concentrações entre 1-10 ?M produziram um efeito complexo. Ocorreu aumento no brotamento capilar, mas os novos vasos apresentaram-se frágeis e menos organizados que os controles correspondentes. Sugere-se que, além da toxicidade direta, a ação do Metil Jasmonato sobre a angiogênese seja relevante para seu efeito antineoplásico. / Molecular plant components have long been tested as sources for antineoplasic drugs with promising success. The present work deals with the anti-angiogenic effects of Methyl Jasmonate. This hydrophobic Jasmonate derivative was previously demonstrated to selectively damage the mitochondria of cancer cells. In vitro, 1-10 mM Methyl Jasmonate induced the cell death of the human umbilical vein endothelial cells (HUVEC) and the Murine melanoma cells (B16-F10), while micromolar concentrations were ineffective. Methyl Jasmonate inclusion in phosphatidylcholine liposomes and in an hydrophilic sugar based nanocarrier presented differential effects upon citotoxicity. Cell cycle arrest was observed in citotoxic concentrations, while VEGF withdrawn and some autophagy was suggested in the micromolar range. In vivo, 1-10mM concentrations were explicitly toxic and reduced the vessel density of the Chorioallantoic Membrane of the Chicken Embryo (CAM). However, 1-10 ?M concentrations produced a complex effect. There was increased capillary budding, but the new vessels were leakier and less organized than corresponding controls. It is suggested that not only direct toxicity, but also the drug effects upon angiogenesis are relevant to the antineoplasic effects of Methyl Jasmonate.

Angiogenesis, the formation of new blood vessels from pre-existing ones, is a crucial step in many pathologies, including tumor growth and metastasis. We developed an adenovirus vector allowing the 16K hPRL expression, an antiangiogenic factor, in situ. We show 16K hPRL inhibits oxygen-induced retinopathy in mice. Then, using the 16K-Ad vector, we investigated the ability of 16K hPRL to prevent metastatic spread through inhibition of angiogenesis. We show that 16K hPRL administered via adenovirus-mediated gene transfer inhibits tumor growth in a subcutaneous B16-F10 mouse melanoma model by reducing the size and width of tumor vessels. We also show, for the first time, that 16K hPRL considerably reduces the establishment of B16-F10 metastases in an experimental lung metastasis model. These results highlight a potential role for 16K hPRL in anticancer therapy for both primary tumors and metastases. In parallel, we have sought to identify in human 16K PRL (16K hPRL) a peptide that might be responsible for its antiangiogenic activity. Although the 16K fragments of the other three human PRL/GH-family members are also potently antiangiogenic, the sequence similarity of these fragments is low (around 35% similarity between all mammalian PRL/GH sequences). This led us to seek a peculiar common structural feature rather than a similar sequence. We demonstrate that all these fragments possess a 14-amino-acid sequence having the characteristics of a tilted peptide. We show for the first time that tilted peptides exert antiangiogenic activity. The tilted peptides of hPRL and hGH induce endothelial cell apoptosis, inhibit endothelial cell proliferation, and inhibit capillary formation both in vitro and in vivo. These antiangiogenic effects are abolished when the peptides hydrophobicity gradient is altered by mutation. We further demonstrate for the first time that the well-known tilted peptides of SIV gp32 and Alzheimers beta-amyloid peptide are also angiogenesis inhibitors. Taken together these results point to a potential new role for tilted peptides in regulating angiogenesis. Langiogenèse, la formation de nouveaux vaisseaux à partir de vaisseaux préexistants, joue un rôle important dans de nombreuses pathologies incluant la croissance tumorale et la dissémination des métastases. Nous avons développé un vecteur adénoviral (16K-Ad) nous permettant de produire le facteur antiangiogène hPRL 16K directement in situ. Une première analyse permettant détudier les effets de la hPRL 16K produite par lapproche adénovirale a été réalisée in vivo. Nous montrons tout dabord que la hPRL 16K produite est capable de prévenir la néovascularisation rétinienne dans un modèle murin de rétinopathie. Par la suite, en utilisant le vecteur 16K-Ad, nous montrons que la hPRL 16K peut inhiber le développement tumoral dans un modèle murin développant des tumeurs formées par les cellules de mélanome B16-F10 dans le tissu sous-cutané. Cette inhibition de la croissance tumorale est corrélée avec une diminution de la taille des vaisseaux. Nous montrons aussi, pour la première fois, que la hPRL 16K peut considérablement réduire létablissement des métastases B16-F10 dans un modèle expérimental de métastases se développant dans le poumon. Ces résultats soulignent le rôle potentiel de la hPRL 16K dans la thérapie anticancéreuse dirigée contre les tumeurs primaires et les métastases. Parallèlement à ces travaux, nous nous sommes attachés à identifier une région responsable de lactivité de la hPRL 16K. Partant du fait que les fragments 16K des trois autres membres de la famille humaine PRL/GH sont aussi de puissants facteurs antiangiogènes, malgré que leur similarité de séquence soit faible (environ 35% de similarité entre les séquences de la PRL et de la GH), nous avons recherché une caractéristique structurale commune partagée par ces différents fragments. Nous avons identifié un domaine susceptible d'adopter une structure en peptide oblique dans les séquences protéiques des fragments de 16 kDa de la famille PRL/GH. Leffet antiangiogène des peptides obliques de la hPRL 16K et de la hGH 16K est montré dans des expériences menées in vitro et in vivo. Nous montrons également leffet antiangiogène des peptides obliques du peptide de fusion gp 32 du virus SIV et du peptide b-amyloïde.

Moléculas de origem vegetal foram há muito testadas como fonte de drogas antineoplásicas com sucesso promissor. Este trabalho trata dos efeitos antiangiogênicos do Metil Jasmonato. Este derivado hidrofóbico do ácido jasmônico foi demonstrado anteriormente como um agente de dano seletivo para a mitocôndria de células neoplásicas. In vitro, o Metil Jasmonato 1-10 mM promoveu a morte celular de células endoteliais humanas de cordão umbilical (HUVEC) e de melanoma murino (B16 -F10), enquanto concentrações micromolares foram inócuas. A inclusão do Metil Jasmonato em liposomos de fosfatidilcolina e em um nanocarreador hidrofílico baseado em açúcar mostrou efeitos diferenciais sobre a citotoxicidade. A interrupção do ciclo celular foi observada em concentrações citotóxicas, enquanto a diminuição na produção de VEGF e algum grau de autofagia foram sugeridos em concentrações micromolares. In vivo, Metil Jasmonato 1-10mM foi francamente tóxico, e reduziu a densidade de vasos em membranas corioalantóicas de embrião de galinha (CAM). Entretanto, concentrações entre 1-10 ?M produziram um efeito complexo. Ocorreu aumento no brotamento capilar, mas os novos vasos apresentaram-se frágeis e menos organizados que os controles correspondentes. Sugere-se que, além da toxicidade direta, a ação do Metil Jasmonato sobre a angiogênese seja relevante para seu efeito antineoplásico. / Molecular plant components have long been tested as sources for antineoplasic drugs with promising success. The present work deals with the anti-angiogenic effects of Methyl Jasmonate. This hydrophobic Jasmonate derivative was previously demonstrated to selectively damage the mitochondria of cancer cells. In vitro, 1-10 mM Methyl Jasmonate induced the cell death of the human umbilical vein endothelial cells (HUVEC) and the Murine melanoma cells (B16-F10), while micromolar concentrations were ineffective. Methyl Jasmonate inclusion in phosphatidylcholine liposomes and in an hydrophilic sugar based nanocarrier presented differential effects upon citotoxicity. Cell cycle arrest was observed in citotoxic concentrations, while VEGF withdrawn and some autophagy was suggested in the micromolar range. In vivo, 1-10mM concentrations were explicitly toxic and reduced the vessel density of the Chorioallantoic Membrane of the Chicken Embryo (CAM). However, 1-10 ?M concentrations produced a complex effect. There was increased capillary budding, but the new vessels were leakier and less organized than corresponding controls. It is suggested that not only direct toxicity, but also the drug effects upon angiogenesis are relevant to the antineoplasic effects of Methyl Jasmonate.

Die antiangioneogenetischen Effekte in-vitro und in-vivo in Kombination mit der selektiven Inhibition der TNFalpha Produktion durch Thalidomid läßt dieses Medikament als geeignete Therapie für Krankheitszustände erscheinen, bei denen die TNFalpha Toxizität eine pathogenetische Rolle spielt, die Immunität jedoch intakt bleiben muß. Ziel dieser Monographie waren Untersuchungen der Wirkungen von Thalidomid in vitro, in vivo und klinische Studien. In einer prospektiv-randomisierten, doppel-blind Studie an 70 Patienten mit kleinzelligem Bronchialkarzinom konnte die Verlängerung der Überlebenszeit durch die additive Therapie mit Thalidomid in Kombination mit einer Standardpolychemotherapie und Strahlentherapie nachgewiesen werden. Vor dem additiven Einsatz des Angioneogenesehemmers Thalidomid in der Chirurgie muß unbedingt sichergestellt sein, daß die Therapie mit Thalidomid nicht zu einer erhöhten postoperativen Morbidität und Letalität führt. Durch in-vitro Untersuchungen konnte eine Proliferationshemmung von Kaninchenendothelzellen durch metabolisiertes Thalidomid bewiesen werden. In einer randomisierten Studie an New Zealand White Kaninchen konnte gezeigt werden, daß die intraperitoneale Gabe von Thalidomid den Berstungsdruck von Kolonanastomosen im Kaninchenmodell im Vergleich zu einer Kontrollgruppe nicht erniedrigt. Darüberhinaus zeigte sich in diesem Tiermodell, daß die Rate an postoperativen Verwachsungen durch die intraperitoneale Gabe von Thalidomid signifikant vermindert wird. Das Medikament könnte eine Rolle in der additiven Therapie von Patienten mit einem kleinzelligen Bronchialkarzinom spielen. Darüberhinaus wird die Heilung von Kolonanastomosen nicht durch die intraperitoneale Gabe von Thalidomid negativ beeinflusst. Somit könnte ein Einsatz in der perioperativen Therapie bei der Resektion gastrointestinaler Karzinome in der Zukunft erwogen werden. / The proven antiangiogenic effects in vivo and in vitro in combination with a selective inhibition of the tnf alpha production seem to predestine thalidomide as an agens for diseases with a pathological elevated tnf alpha level. The theses of this monography were in vitro, in vivo and clinical effects of thalidomide. In a prospective randomized placebo controlled study on 70 patients with proven small cell lung cancer the additive treatment with oral thalidomide lead to a significant prolonged survival in combination with radio chemotherapy. Considering the treatment of thalidomide in combination with surgical therapy of patients it is essential to prove that this treatment does not lead to a higher postoperative morbidity of the patients. In an in vitro assay we could prove the antiproliferative effect of metabolized thalidomide in rabbit endothelial cells. We were than able to demonstrate that intraperitoneal administered thalidomide does not impair anastomotic healing of colonic anastomoses in a New Zealand white rabbit model compared to a control group. In addition to this significant less postoperative adhesions were found in the thalidomide group. In conclusion did the additive treatment with thalidomide in patients with small cell lung cancer lead to a prolonged survival. The antiangiogenic treatment with thalidomide in a perioperative setting does not impair the healing of colonic anastomoses in a rabbit model and may be possible in patients undergoing gastrointestinal resections in the future.