Continuous Low-Dose (Metronomic) Chemotherapy on Rat Prostate Tumors Evaluated Using MRI In Vivo and Comparison with Histology

• Published in: Neoplasia (New York, N.Y.) N.Y.), 2005-07, Vol.7 (7), p.678-687
• Main Authors: Zhao, Dawen, Jiang, Lan, Hahn, Eric W., Mason, Ralph P.
• Format: Article
• Language: English
• Subjects: Animals; antiangiogenesis; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Apoptosis; Area Under Curve; continuous low-dose (metronomic) chemotherapy; Cyclophosphamide - administration & dosage; Hypoxia; immunohistochemistry; Immunohistochemistry - methods; magnetic resonance imaging (MRI); Magnetic Resonance Imaging - methods; Male; Necrosis; prostate tumor; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - pathology; Rats; Thalidomide - administration & dosage; Time Factors; Vascular Endothelial Growth Factor A - metabolism
• ISSN: 1476-5586; 1522-8002; 1476-5586; 1522-8002
• DOI: 10.1593/neo.04757

Continuous low-dose (metronomic) therapy, based on cyclophosphamide (CTX) combined with thalidomide (Tha), was evaluated on Dunning prostate R3327-AT1 rat tumors. Significantly delayed tumor growth (P < .001) was observed with oral CTX alone at a low dose (metronomic cyclophosphamide or M-CTX; 30 mg/kg per day) or combined with Tha. To investigate dynamic changes in tumor physiology during early stages of treatment, magnetic resonance imaging (MRI) was applied before and during the M-CTX or M-CTX + Tha therapy. Dynamic contrast-enhanced MRI revealed significant changes in the tumor center by day 3 (P < .01); by day 7, only a thin peripheral tumor region showed high signal enhancement. There was a significant correlation between poorly enhancing fraction on day 7 and ultimate tumor growth delay (P < .02). The apparent transverse relaxation rate (R2*) showed similar baseline tumor heterogeneity, but no obvious changes with growth or therapy. Histology confirmed substantial necrosis in the tumor center, leaving a thin live peripheral rim. Immunohistochemistry showed a significant increase in vascular endothelial growth factor, apoptotic tumor and vascular endothelial cells. These results show the efficacy of the metronomic CTX ± Tha for delaying tumor growth and indicate that MRI provides insights into the mode of action and early indication of efficacy.