Suppressing neutrophil-dependent angiogenesis abrogates resistance to anti-VEGF antibody in a genetic model of colorectal cancer

Y Itatani, T Yamamoto, C Zhong… - Proceedings of the …, 2020 - National Acad Sciences
Y Itatani, T Yamamoto, C Zhong, AA Molinolo, J Ruppel, P Hegde, MM Taketo, N Ferrara
Proceedings of the National Academy of Sciences, 2020National Acad Sciences
We tested cis-Apc Δ716/Smad4+/− and cis-Apc Δ716/Smad4+/− Kras G12D mice, which
recapitulate key genetic abnormalities accumulating during colorectal cancer (CRC)
tumorigenesis in humans, for responsiveness to anti-VEGF therapy. We found that even
tumors in cis-Apc Δ716/Smad4+/− Kras G12D mice, although highly aggressive, were
suppressed by anti-VEGF treatment. We tested the hypothesis that inflammation, a major risk
factor and trigger for CRC, may affect responsiveness to anti-VEGF. Chemically induced …
We tested cis-ApcΔ716/Smad4+/− and cis-ApcΔ716/Smad4+/− KrasG12D mice, which recapitulate key genetic abnormalities accumulating during colorectal cancer (CRC) tumorigenesis in humans, for responsiveness to anti-VEGF therapy. We found that even tumors in cis-ApcΔ716/Smad4+/− KrasG12D mice, although highly aggressive, were suppressed by anti-VEGF treatment. We tested the hypothesis that inflammation, a major risk factor and trigger for CRC, may affect responsiveness to anti-VEGF. Chemically induced colitis (CIC) in cis-ApcΔ716/Smad4+/− and cis-ApcΔ716/Smad4+/− KrasG12D mice promoted development of colon tumors that were largely resistant to anti-VEGF treatment. The myeloid growth factor G-CSF was markedly increased in the serum after induction of colitis. Antibodies blocking G-CSF, or its target Bv8/PROK2, suppressed tumor progression and myeloid cell infiltration when combined with anti-VEGF in CIC-associated CRC and in anti-VEGF-resistant CRC liver metastasis models. In a series of CRC specimens, tumor-infiltrating neutrophils strongly expressed Bv8/PROK2. CRC patients had significantly higher plasma Bv8/PROK2 levels than healthy volunteers and high plasma Bv8/PROK2 levels were inversely correlated with overall survival. Our findings establish Bv8/PROK2 as a translational target in CRC, in combination with anti-VEGF agents.
National Acad Sciences