The growth of solid tumours beyond a threshold size (~1 mm dia) requires angiogenesis, the development of new blood vessels. This has focussed attention on anti-angiogenic agents for the treatment of cancers and particularly to inhibit the growth of secondary tumours (metastases).
Fig. 1. Normal (left) and CA-4P-treated (right) human endothelial cells stained for tubulin, showing the disruption of cytoskeletal structure by the drug.
We have recently shown that combretastatin-4P (CA-4P), a tubulin-binding compound (Fig. 1) currently undergoing Phase I clinical trials, not only retards primary tumour growth but is a potent inhibitor of metastasis in mice (Fig. 2). CA-4P also disrupts neovasculature in mouse goitre, a rapidly proliferating, non-tumour tissue. These observations indicate the potential of CA-4P as an anti-metastatic agent and for the treatment of angio-proliferative diseases (e.g. atherosclerosis, diabetic retinopathy). In a complementary anti-angiogenic approach we are developing adenovirus-based targetted gene therapy strategies.
In a parallel programme focussed on transforming growth factor b (TGFb), we have recently identified four novel mutations in the TGFb type 2 receptor in breast tumours from patients who had become refractory to tamoxifen treatment.
Fig. 2. The lungs of mice treated with CA-4P (left) show few metastases from a subcutaneous primary tumour compared with the lungs of untreated mice (right) and resemble normal lung (centre).
Three of these mutations greatly impair the signalling function of the receptor. These findings establish a rationale for a systematic analysis of components of the TGFb signalling pathway for mutations that may contribute to the development of tamoxifen resistance.
References
Lücke, C.D., Philpott, A., Metcalfe, J.C., Thompson, A.M., Hughes-Davies, L., Kemp, P.R. & Hesketh, R. (2001) Inhibiting mutations in the transforming growth factor b type 2 receptor in recurrent human breast cancer. Cancer Res. 61, 482-485.
Griggs, J., Hesketh, R., Smith, G.A., Brindle, K.M., Metcalfe, J.C., Thomas, G.A. & Williams, E.D. (2001) Combretastatin-A4 disrupts neo-vascular development in non-neoplastic tissue. Brit. J. Cancer 84, 832-835.
Griggs, J., Smith, G.A., Brindle, K.M., Metcalfe, J.C. & Hesketh, R. (2002) Inhibition of proliferative retinopathy by the antivascular agent combretastatin-A4. Amer. J. Pathology 160, 1097-1103.