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TNF- α augments intratumoural concentrations of doxorubicin in TNF- α -based isolated limb perfusion in rat sarcoma models and enhances anti-tumour effects
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  • Published: 20 January 2000

TNF- α augments intratumoural concentrations of doxorubicin in TNF- α -based isolated limb perfusion in rat sarcoma models and enhances anti-tumour effects

  • A H van der Veen1,
  • J H W de Wilt1,
  • A M M Eggermont1,
  • S T van Tiel1,
  • A L B Seynhaeve1 &
  • …
  • T L M ten Hagen1 

British Journal of Cancer volume 82, pages 973–980 (2000)Cite this article

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Abstract

We have shown previously that isolated limb perfusion (ILP) in sarcoma-bearing rats results in high response rates when melphalan is used in combination with tumour necrosis factor alpha (TNF-α). This is in line with observations in patients. Here we show that ILP with doxorubicin in combination with TNF-α has comparable effects in two different rat sarcoma tumour models. The addition of TNF-α exhibits a synergistic anti-tumour effect, resulting in regression of the tumour in 54% and 100% of the cases for the BN175-fibrosarcoma and the ROS-1 osteosarcoma respectively. The combination is shown to be mandatory for optimal tumour response. The effect of high dose TNF-α on the activity of cytotoxic agents in ILP is still unclear. We investigated possible modes by which TNF-α could modulate the activity of doxorubicin. In both tumour models increased accumulation of doxorubicin in tumour tissue was found: 3.1-fold in the BN175 and 1.8-fold in the ROS-1 sarcoma after ILP with doxorubicin combined with TNF-α in comparison with an ILP with doxorubicin alone. This increase in local drug concentration may explain the synergistic anti-tumour responses after ILP with the combination. In vitro TNF-α fails to augment drug uptake in tumour cells or to increase cytotoxicity of the drug. These findings make it unlikely that TNF-α directly modulates the activity of doxorubicin in vivo. As TNF-α by itself has no or only minimal effect on tumour growth, an increase in local concentrations of chemotherapeutic drugs might well be the main mechanism for the synergistic anti-tumour effects. © 2000 Cancer Research Campaign

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  • 16 November 2011

    This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication

References

  • Abolhoda A, Brooks A, Nawata S, Kaneda Y, Cheng H and Burt ME (1997) Isolated lung perfusion with doxorubicin prolongs survival in a rodent model of pulmonary metastases. Ann Thorac Surg 64: 181–184

    Article  CAS  PubMed  Google Scholar 

  • Alexander RB, Nelson WG and Coffey DS (1987) Synergistic enhancement by tumor necrosis factor of in vitro cytotoxicity from chemotherapeutic drugs targeted at DNA topoisomerase II. Cancer Res 47: 2403–2406

    CAS  PubMed  Google Scholar 

  • Asher A, Mule JJ, Reichert CM, Shiloni E and Rosenberg SA (1987) Studies on the anti-tumor efficacy of systemically administered recombinant tumor necrosis factor against several murine tumors in vivo. J Immunol 138: 963–974

    CAS  PubMed  Google Scholar 

  • Benckhuijsen C, Kroon BB, Van Geel AN and Wieberdink J (1988) Regional perfusion treatment with melphalan for melanoma in a limb: an evaluation of drug kinetics. Eur J Surg Oncol 14: 157–163

    CAS  PubMed  Google Scholar 

  • Benckhuijsen C, van Dijk WJ and Van’t Hoff SC (1982) High-flow isolation perfusion of the rat hind limb in vivo. J Surg Oncol 21: 249–257

    Article  Google Scholar 

  • Bielack SS, Erttmann R, Kempf-Bielack B and Winkler K (1996) Impact of scheduling on toxicity and clinical efficacy of doxorubicin: what do we know in the mid-nineties?. Eur J Cancer 32A: 1652–1660

    Article  CAS  PubMed  Google Scholar 

  • Bonavida B, Tsuchitani T, Zighelboim J and Berek JS (1990) Synergy is documented in vitro with low-dose recombinant tumor necrosis factor, cisplatin, and doxorubicin in ovarian cancer cells. Gynecol Oncol 38: 333–339

    Article  CAS  PubMed  Google Scholar 

  • Budd GT (1995) Palliative chemotherapy of adult soft tissue sarcomas. Semin Oncol 22: 30–34

    CAS  PubMed  Google Scholar 

  • de Wilt JH, Manusama ER, van Tiel ST, Van Ijken MG, ten Hagen TL and Eggermont AM (1999) Prerequisites for effective isolated limb perfusion using tumour necrosis factor alpha and melphalan in rats. Br J Cancer 80: 161–166

    Article  CAS  PubMed  Google Scholar 

  • Di Filippo F, Vaglini M, Azzarelli A, Anza M, Garinei R, Cavaliere F, Deraco M, Giannarelli D, Vecchiato A, Quagliolo V and Cavaliere R (1998) Hyperthermic antiblastic perfusion with tumor necrosis factor and doxorubicin for the treatment of soft tissue limb sarcoma in candidates for amputation: results of a phase I–II study. Eur J Surg Oncol 24: 323 (abstract)

    Google Scholar 

  • Eggermont AMM, Lienard D and Schraffordt Koops H (1993) Treatment of irresectable soft tissue sarcomas of the limbs by isolation perfusion with high dose TNF-alpha in combination with interferon-gamma and melphalan. Tumor Necrosis Factor: Molecular and Cellular Biology and Clinical Relevance, Fiers W, Buurman WA (eds), pp. 239–243, Karger: Basel

    Google Scholar 

  • Eggermont AMM, Schraffordt Koops H, Klausner JM, Kroon BBR, Schlag PM, Lienard D, Van Geel AN, Hoekstra HJ, Meller I, Nieweg OE, Kettelhack C, Ben-Ari G, Pector J-C and Lejeune FJ (1996 a) Isolated limb perfusion with tumor necrosis factor and melphalan for limb salvage in 186 patients with locally advanced soft tissue extremity sarcomas. The cumulative multicenter European experience. Ann Surg 224: 764–765

    Article  Google Scholar 

  • Eggermont AMM, Schraffordt Koops H, Lienard D, Kroon BBR, Van Geel AN, Hoekstra HJ and Lejeune FJ (1996 b) Isolated limb perfusion with high-dose tumor necrosis factor-alpha in combination with interferon-gamma and melphalan for non-resectable extremity soft tissue sarcomas: a multicenter trial. J Clin Oncol 14: 2653–2665

    Article  CAS  PubMed  Google Scholar 

  • Fajardo LF, Kwan HH, Kowalski J, Prionas SD and Allison AC (1992) Dual role of tumor necrosis factor-alpha in angiogenesis. Am J Pathol 140: 539–544

    CAS  PubMed  PubMed Central  Google Scholar 

  • Folli S, Pelegrin A, Chalandon Y, Yao X, Buchegger F, Lienard DX, Lejeune F and Mach JP (1993) Tumor-necrosis factor can enhance radio-antibody uptake in human colon carcinoma xenografts by increasing vascular permeability. Int J Cancer 53: 829–836

    Article  CAS  PubMed  Google Scholar 

  • Fruehauf JP, Mimnaugh EG and Sinha BK (1991) Doxorubicin-induced cross-resistance to tumor necrosis factor (TNF) related to differential TNF processing. J Immunother 10: 165–173

    Article  CAS  PubMed  Google Scholar 

  • Keepers YP, Pizao PE, Peters GJ, van Ark-Otte J, Winograd B and Pinedo HM (1991) Comparison of the sulforhodamine B protein and tetrazolium (MTT) assays for in vitro chemosensitivity testing. Eur J Cancer 27: 8 97–900

    Article  CAS  Google Scholar 

  • Klaase JM, Kroon BB, Benckhuijsen C, Van Geel AN, Albus-Lutter CE and Wieberdink J (1989) Results of regional isolation perfusion with cytostatics in patients with soft tissue tumors of the extremities. Cancer 64: 616–621

    Article  CAS  PubMed  Google Scholar 

  • Kristensen CA, Nozue M, Boucher Y and Jain RK (1996) Reduction of interstitial fluid pressure after TNF-alpha treatment of three human melanoma xenografts. Br J Cancer 74: 533–536

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lee YT, Chan KK, Harris PA and Cohen JL (1980) Distribution of adriamycin in cancer patients: tissue uptakes, plasma concentration after IV and hepatic IA administration. Cancer 45: 2231–2239

    Article  CAS  PubMed  Google Scholar 

  • Lejeune FJ, Lienard D, Leyvraz S and Mirimanoff RO (1993) Regional therapy of melanoma. Eur J Cancer 29A: 606–612

    Article  CAS  PubMed  Google Scholar 

  • Lienard D, Eggermont AMM, Schraffordt Koops H, Kroon BBR, Rosenkaimer F, Autier P and Lejeune FJ (1994) Isolated perfusion of the limb with high-dose tumour necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma) and melphalan for melanoma stage III. Results of a multi-centre pilot study. Melanoma Res 4: 21–26

    PubMed  Google Scholar 

  • Lienard D, Ewalenko P, Delmotte JJ, Renard N and Lejeune FJ (1992) High-dose recombinant tumor necrosis factor alpha in combination with interferon gamma and melphalan in isolation perfusion of the limbs for melanoma and sarcoma. J Clin Oncol 10: 52–60

    Article  CAS  PubMed  Google Scholar 

  • Luk CK and Tannock IF (1989) Flow cytometric analysis of doxorubicin accumulation in cells from human and rodent cell lines. J Natl Cancer Inst 81: 55–59

    Article  CAS  PubMed  Google Scholar 

  • Manusama ER, Nooijen PT, Stavast J, de Wilt JH, Marquet RL and Eggermont AM (1998) Assessment of the role of neutrophils on the antitumor effect of TNF-alpha in an in vivo isolated limb perfusion model in sarcoma-bearing brown Norway rats. J Surg Res 78: 169–175

    Article  CAS  PubMed  Google Scholar 

  • Manusama ER, Nooijen PTGA, Stavast J, Durante NMC, Marquet RL and Eggermont AMM (1996 a) Synergistic antitumour effect of recombinant human tumour necrosis factor alpha with melphalan in isolated limb perfusion in the rat. Br J Surg 83: 551–555

    Article  CAS  PubMed  Google Scholar 

  • Manusama ER, Stavast J, Durante NMC, Marquet RL and Eggermont AMM (1996 b) Isolated limb perfusion with TNF alpha and melphalan in a rat osteosarcoma model: a new anti-tumour approach. Eur J Surg Oncol 22: 152–157

    Article  CAS  PubMed  Google Scholar 

  • Mayer LD, Tai LCL, Ko DSC, Masin D, Ginsberg RS, Cullis PR and Bally MB (1989) Influence of vesicle size, lipid composition, and drug-to-lipid ratio on the biological activity of liposomal doxorubicin in mice. Cancer Res 49: 5922–5930

    CAS  PubMed  Google Scholar 

  • Murdter TE, Sperker B, Kivisto KT, McClellan M, Fritz P, Friedel G, Linder A, Bosslet K, Toomes H, Dierkesmann R and Kroemer HK (1997) Enhanced uptake of doxorubicin into bronchial carcinoma: beta-glucuronidase mediates release of doxorubicin from a glucuronide prodrug (HMR 1826) at the tumor site. Cancer Res 57: 2440–2445

    CAS  PubMed  Google Scholar 

  • Nooijen PTGA, Manusama ER, Eggermont AMM, Schalkwijk L, Stavast J, Marquet RL, De Waal RM and Ruiter DJ (1996) Synergistic effects of TNF-alpha and melphalan in an isolated limb perfusion model of rat sarcoma: a histopathological, immunohistochemical and electron microscopical study. Br J Cancer 74: 1908–1915

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Olieman AFT, van Ginkel RJ, Hoekstra HJ, Mooyaart EL, Molenaar WM and Koops HS (1997) Angiographic response of locally advanced soft-tissue sarcoma following hyperthermic isolated limb perfusion with tumor necrosis factor. Ann Surg Oncol 4: 64–69

    Article  CAS  PubMed  Google Scholar 

  • Posner MC, Lienard D, Lejeune FJ, Rosenfelder D and Kirkwood JM (1994) Hyperthermic isolated limb perfusion (HILP) with tumor necrosis factor (TNF) alone for metastatic intransit melanoma. Proc Am Soc Clin Oncol 13: 1351 (abstract)

    Google Scholar 

  • Prewitt TW, Matthews W, Chaudhri G, Pogrebniak HW and Pass HI (1994) Tumor necrosis factor induces doxorubicin resistance to lung cancer cells in vitro. J Thorac Cardiovasc Surg 107: 43–49

    CAS  PubMed  Google Scholar 

  • Renard N, Nooijen PT, Schalkwijk L, De Waal RM, Eggermont AM, Lienar D, Kroon BB, Lejeune FJ and Ruiter DJ (1995) VWF release and platelet aggregation in human melanoma after perfusion with TNF alpha. J Pathol 176: 279–287

    Article  CAS  PubMed  Google Scholar 

  • Ridge JA, Collin C, Bading JR, Hancock C, Conti PS, Daly JM and Raaf JH (1988) Increased adriamycin levels in hepatic implants of rabbit Vx-2 carcinoma from regional infusion. Cancer Res 48: 4584–4587

    CAS  PubMed  Google Scholar 

  • Rossi CR, Vecchiato A, Da Pian PP, Nitti D, Lise M, Melanotte PL, Turra S and Vigliani F (1992) Adriamycin in hyperthermic perfusion for advanced limb sarcomas. Ann Oncol 3: S111–113

    Article  PubMed  Google Scholar 

  • Ruegg C, Yilmaz A, Bieler G, Bamat J, Chaubert P and Lejeune FJ (1998) Evidence for the involvement of endothelial cell integrin alphaVbeta3 in the disruption of the tumor vasculature induced by TNF and IFN-gamma. Nat Med 4: 408–414

    Article  CAS  PubMed  Google Scholar 

  • Safrit JT, Berek JS and Bonavida B (1993) Sensitivity of drug-resistant human ovarian tumor cell lines to combined effects of tumor necrosis factor (TNF-alpha) and doxorubicin: failure of the combination to modulate the MDR phenotype. Gynecol Oncol 48: 214–220

    Article  CAS  PubMed  Google Scholar 

  • Sato N, Goto T, Haranaka K, Satomi N, Nariuchi H, Mano-Hirano YX and Sawasaki Y (1986) Actions of tumor necrosis factor on cultured vascular endothelial cells: morphologic modulation, growth inhibition, and cytotoxicity. J Natl Cancer Inst 76: 1113–1121

    CAS  PubMed  Google Scholar 

  • Shimomura K, Manda T, Mukumoto S, Kobayashi K, Nakano K and Mori J (1988) Recombinant human tumor necrosis factor-alpha: thrombus formation is a cause of anti-tumor activity. Int J Cancer 41: 243–247

    Article  CAS  PubMed  Google Scholar 

  • Smyth MJ, Pietersz GA and McKenzie IF (1988) Increased antitumor effect of immunoconjugates and tumor necrosis factor in vivo. Cancer Res 48: 3607–3612

    CAS  PubMed  Google Scholar 

  • Soranzo C, Perego P and Zunino F (1990) Effect of tumor necrosis factor on human tumor cell lines sensitive and resistant to cytotoxic drugs, and its interaction with chemotherapeutic agents. Anticancer Drugs 1: 157–163

    Article  CAS  PubMed  Google Scholar 

  • Suzuki S, Ohta S, Takashio K, Nitanai H and Hashimoto Y (1990) Augmentation for intratumoral accumulation and anti-tumor activity of liposome-encapsulated adriamycin by tumor necrosis factor-alpha in mice. Int J Cancer 46: 1095–1100

    Article  CAS  PubMed  Google Scholar 

  • Tonak J, Hermanek P, Banz H and Groitl H (1979) Cytotoxics and hyperthermic perfusion: a preliminary study. Cancer Treat Rev 6: 135–141

    Article  PubMed  Google Scholar 

  • Watanabe N, Niitsu Y, Umeno H, Kuriyama H, Neda H, Yamauchi N, Maeda M and Urushizaki I (1988) Toxic effect of tumor necrosis factor on tumor vasculature in mice. Cancer Res 48: 2179–2183

    CAS  PubMed  Google Scholar 

  • Weksler B, Lenert J, Ng B and Burt M (1994) Isolated single lung perfusion with doxorubicin is effective in eradicating soft tissue sarcoma lung metastases in a rat model. J Thorac Cardiovasc Surg 107: 50–54

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgical Oncology, University Hospital Rotterdam/Daniel den Hoed Cancer Center, PO Box 5201, Rotterdam, 3008, AE, The Netherlands

    A H van der Veen, J H W de Wilt, A M M Eggermont, S T van Tiel, A L B Seynhaeve & T L M ten Hagen

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From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/

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van der Veen, A., de Wilt, J., Eggermont, A. et al. TNF- α augments intratumoural concentrations of doxorubicin in TNF- α -based isolated limb perfusion in rat sarcoma models and enhances anti-tumour effects. Br J Cancer 82, 973–980 (2000). https://doi.org/10.1054/bjoc.1999.1027

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  • Received: 07 July 1999

  • Revised: 27 September 1999

  • Accepted: 28 September 1999

  • Published: 20 January 2000

  • Issue date: 01 February 2000

  • DOI: https://doi.org/10.1054/bjoc.1999.1027

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Keywords

  • doxorubicin
  • isolated limb perfusion
  • rat
  • sarcoma
  • tumour necrosis factor-alpha

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