[HTML][HTML] Discontinuation of anti-VEGF cancer therapy promotes metastasis through a liver revascularization mechanism

Y Yang, Y Zhang, H Iwamoto, K Hosaka, T Seki… - Nature …, 2016 - nature.com
Y Yang, Y Zhang, H Iwamoto, K Hosaka, T Seki, P Andersson, S Lim, C Fischer…
Nature communications, 2016nature.com
The impact of discontinuation of anti-VEGF cancer therapy in promoting cancer metastasis is
unknown. Here we show discontinuation of anti-VEGF treatment creates a time-window of
profound structural changes of liver sinusoidal vasculatures, exhibiting hyper-permeability
and enlarged open-pore sizes of the fenestrated endothelium and loss of VE-cadherin. The
drug cessation caused highly leaky hepatic vasculatures permit tumour cell intravasation
and extravasation. Discontinuation of an anti-VEGF antibody-based drug and sunitinib …
Abstract
The impact of discontinuation of anti-VEGF cancer therapy in promoting cancer metastasis is unknown. Here we show discontinuation of anti-VEGF treatment creates a time-window of profound structural changes of liver sinusoidal vasculatures, exhibiting hyper-permeability and enlarged open-pore sizes of the fenestrated endothelium and loss of VE-cadherin. The drug cessation caused highly leaky hepatic vasculatures permit tumour cell intravasation and extravasation. Discontinuation of an anti-VEGF antibody-based drug and sunitinib markedly promotes liver metastasis. Mechanistically, host hepatocyte, but not tumour cell-derived vascular endothelial growth factor (VEGF), is responsible for cancer metastasis. Deletion of hepatocyte VEGF markedly ablates the ‘off-drug’-induced metastasis. These findings provide mechanistic insights on anti-VEGF cessation-induced metastasis and raise a new challenge for uninterrupted and sustained antiangiogenic therapy for treatment of human cancers.
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