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The Journal of Immunology, 2001, 166: 6212-6217.
Copyright © 2001 by The American Association of Immunologists

Combined Treatment of a Murine Breast Cancer Model with Type 5 Adenovirus Vectors Expressing Murine Angiostatin and IL-12: A Role for Combined Anti-Angiogenesis and Immunotherapy1

Steve Gyorffy, Kay Palmer, Thomas J. Podor, Mary Hitt and Jack Gauldie2

Department of Pathology and Molecular Medicine, Centre for Gene Therapeutics, McMaster University, Hamilton, Ontario, Canada


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
In this study, we used intratumor delivery of adenoviral vectors to induce a selective anti-tumor response by combining the potent angiogenesis inhibitor murine angiostatin (adenovirus (Ad)-angiostatin) with the powerful immune simulator and angiostatic cytokine murine IL-12 (Ad-IL-12). In a murine model of breast carcinoma, intratumor injection of Ad-angiostatin delayed mean tumor growth, as compared with control virus with an initial regression of tumor growth, in 65% of treated animals. However, all treated animals eventually succumbed to the tumors. Mice injected with Ad-IL-12 alone responded with an initial regression in 20% of treated animals, with only 13% developing a total regression. Coinjection of the vectors resulted in 96% of the treated animals developing an initial regression, with 54% undergoing a total regression of the tumor. These mice were resistant to tumor rechallenge and developed a strong CTL response. Frozen tumor sections were stained for microvessel density using an Ab against murine CD31, an endothelial cell marker. Automated image analysis revealed the mean microvessel density following the administration of Ad-angiostatin and Ad-IL-12 alone or in combination was significantly reduced compared with the control-treated tumor. In summary, we have shown that a short-term course of antiangiogenic therapy combined with immunotherapy can effectively shrink a solid tumor and vaccinate the animal against rechallenge. The rationale for this therapy is to limit the tumor size by attacking the vasculature with angiostatin, thereby allowing IL-12 to mount a T cell-specific response against the tumor Ag.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
A number of new therapies are being developed in cancer treatment, among which is the delivery of DNA encoding anticancer agents to the tumor site by gene transfer. Adenoviral vectors rendered replication-deficient are ideal delivery systems because they are highly infectious, yield high levels of transgene product, and the expression is transient (1). Prospective genes should induce a selective antitumor response that attacks the primary tumor, inhibits metastasis, prevents recurrence, and does not promote drug resistance. Immunotherapy, stimulation of the immune system with cytokines to invoke a T cell-specific tumor response and the use of angiogenesis inhibitors that cut off the tumor’s blood supply each has the potential to satisfy the criteria listed above.

Angiostatin has been shown to be a potent inhibitor of endothelial cell proliferation and can inhibit primary and metastatic tumor growth (2, 4, 5). Angiostatin inhibits both endothelial cell proliferation and migration through cytotoxic effects that result in cell apoptosis.

IL-12 is a heterodimeric Th1 cytokine that promotes the proliferation of T cells, NK cells, and tumor-infiltrating lymphocytes (6). Numerous studies have demonstrated IL-12’s ability to facilitate tumor regression (7, 8, 9, 10). In addition to developing strong antitumor CTL responses, IL-12 can induce a cascade of other cytokines including IFN-{gamma} and the chemokine IFN-{gamma} inducible protein 10 (IP-10),3 which possesses significant antiangiogenic properties (6, 11).

In this study, we have used a human type 5 adenovirus (Ad) expressing the cDNA for murine angiostatin. The biological activity of this vector had been characterized using the artificial extracellular matrix Matrigel, examining changes in endothelial cell infiltration and cell morphology. Here we demonstrate the local overexpression of angiostatin and murine IL-12 in a mouse mammary carcinoma model (7, 9, 12). Our results indicate that 5- to 10-day expression by intratumoral injection of the vector expressing angiostatin by itself can delay, but cannot eradicate, tumor growth. The direct intratumor administration of IL-12 can delay tumor growth and induce regression in 13% of treated animals. Notably, when used in combination with the angiostatin vector, total regression is seen in 54% of the animals, with cured mice developing a strong CTL protection against tumor rechallenge.

These results are the first to demonstrate the usefulness of the combination of angiostatin and immunotherapy by a gene-therapeutic approach with intratumor administration.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Animals and cell culture

Six- to 8-wk-old female FVB/n mice were purchased from Charles River Breeding Laboratories (Troy, NY) and housed under pathogen-free conditions at the McMaster Central Animal Facilities. All in vivo procedures were approved by the McMaster University animal ethics research board in accordance with the Canadian Council of Animal Care.

Cell lines used include the following: 293, adenoviral E1-transformed human embryonic kidney cells maintained in F-11 medium supplemented with 10% FBS (complete F-11) (13); 293N3S, 293 suspension cells; and primary polyomavirus middle T (PyMidT) Ag-transformed murine mammary epithelial cells maintained in complete F-11 (14, 15). Splenocyte culture was conducted in RPMI 1640 supplemented with 10% FBS, 20 mM HEPES, and 50 µM 2-ME. All cell culture media contained 100 µg/ml penicillin and 100 U/ml streptomycin. Cells were cultured at 37°C with 5% CO2.

All cell culture media and reagents including {alpha}MEM, {alpha}MEM F-11, RPMI 1640, FBS, and penicillin/streptomycin were products of Life Technologies (Burlington, Ontario, Canada).

Statistical significance of differences was tested using Student’s t test.

Adenoviral vectors

Ads were grown on 293 cells and purified by cesium chloride centrifugation (16). The construction and characterization of the Ad vector expressing murine angiostatin has been described previously.4 Briefly, the cDNA for murine angiostatin was constructed by ligating the endogenous signal sequence and the sequence encoding the first 32 amino acids of murine plasminogen to amino acids 98–458, encompassing the four kringle regions of plasminogen (17). This cDNA was cloned into the shuttle plasmid pACCMV and cotransfected with the rescue plasmid pJM-17 in 293 cells (16). Expression of the angiostatin in the viral vector (Ad-angiostatin) is driven by the human CMV immediate early promotor with a terminal SV40 polyadenylation sequence. Construction and characterization of the Ad vector expressing murine IL-12 (Ad-IL-12) has been described earlier (9). The control vector Ad-dl70, without an expressed gene product, was previously described (11).

PyMidT tumor studies

Transgenic mice expressing the PyMidT Ag under the transcriptional control of the mammary tumor virus long terminal repeat spontaneously develop adenocarcinomas of the mammary epithelium in 8–10 wk (12). Tumors were removed and processed to a single-cell suspension with mechanical disruption conducted in 100 ml PBS in the presence of 25 mg collagenase (Life Technologies). The cells were then placed in complete F-11 medium and cultured for 48 h.

The PyMidT tumor cells were harvested, and 5 x 105 cells in 200 µl PBS were injected s.c. into the right flank of a syngeneic female FVB/n host. Approximately 18–21 days later, a palpable tumor (~150 mm3) had developed in all mice that were injected. The tumors were injected with control virus Ad-dl70 (1 x 109 PFU), Ad-angiostatin (5 x 108 PFU), Ad-IL-12 (5 x 108 PFU), and a combination of Ad-angiostatin plus Ad-IL-12 (5 x 108 PFU of each vector). Total viral load was made up to 1 x 109 PFU with the addition Ad-dl70 in a final volume of 50 µl to compensate for the effect of Ad vectors and particles.

Tumors were measured (in millimeters) using Vernier calipers at the time of virus injection and at weekly intervals. Tumor volumes (millimeters3) were calculated from the longest diameter and average width, assuming a prolate spheroid (18). Those mice that underwent a total tumor regression on the right flank were rechallenged with a similar tumor dose in the left flank 8 wk later. Failure of the second tumor challenge to grow was deemed to be a total regression. Mice were sacrificed when any single or combined tumor linear measurement exceeded 20 mm.

CTL assay

A single-cell suspension was made from the spleens of mice that had undergone a total tumor regression and were resistant to rechallenge following the coinjection of Ad-angiostatin and Ad-IL-12. Splenocytes were separated from RBC using a Ficoll gradient (Amersham Pharmacia Biotech, Uppsala, Sweden) and cocultured with irradiated (5000 rad) 516 MT3 cells expressing the PyMidT Ag at an E:T ratio of 50:1. Five days later, the activated CTLs were harvested and tested for activity against 51Cr-labeled (500 µCi) 516 MT3 or control PTO516 cells. The assay was conducted in a volume of 50 µl using a 250-µl V-bottom 96-well plate at E:T ratios of 90:1, 30:1, and 10:1 for 3 h. Maximum release and spontaneous release was determined by adding 1M HCl or medium alone to the target cells. The percentage of specific lysis was calculated as follows: 100 x (experimental cpm - spontaneous release cpm)/(maximal cpm - spontaneous release cpm).

Anti-CD31 immunostaining of tumor vasculature

Palpable PyMidT tumors in the right flanks of FVB/n mice were treated with Ad vectors in a manner identical with that described above. One week following vector administration, the tumors were removed, embedded in OCT compound, and frozen rapidly in isopentane, which was precooled in liquid nitrogen to -180°C and stored at -70°C.

The frozen tumors were cryosectioned to 5 µm at -20°C and were allowed to air-dry overnight. The slides were fixed in cold acetone for 10 min, air-dried for 30 min, and were treated with 1% H2O2 for 10 min at room temperature to remove endogenous peroxidases. Slides were rinsed three times for 5 min with PBS, and nonspecific binding was blocked using Powerblock (Biogenex Laboratories, San Ramon, CA) for 6 min, followed by another PBS wash cycle. The sections were then incubated with anti-CD31 Ab (BD PharMingen, San Diego, CA) at a 1:800 dilution in Ab-diluting fluid (Dako, Carpinteria, CA) for 1 h. Following three washes in PBS, the secondary biotinylated anti-rat IgG (Vector Laboratories, Burlingame, CA) was added at a 1:400 dilution for 1 h. The slides were washed in PBS and incubated in a 1:60 dilution of avidin-biotinylated enzyme complex (ABC; Vector Laboratories) for 1 h followed again by three washes with PBS. The substrate chromogen 3-amino-9-ethylcarbazole (Vector Laboratories) was added to the sections for 30 min. The sections were counterstained in 50% Mayer’s hematoxylin and coverslipped in glycerin gelatin. Corresponding frozen tumor sections were also stained with hematoxylin and eosin (H&E) using standard techniques.

Anti-CD31 vessel quantification

Vessel quantification of CD31-stained tumor sections was conducted using a Leica (Deerfield, IL) Laborlux microscope equipped with a Sony (Tokyo, Japan) CCD digital camera. Five medium-power fields (x200) were examined per section in a blinded manner. Vessels were counted using Northern Exposure V2.9 imaging software (Empix Imaging, Mississauga, Ontario, Canada).


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Intratumoral administration of adenoviral vectors

Our own previous studies have shown that the intratumoral injection of an Ad expressing murine IL-12 at 5 x 108 PFU can cause total regression of the PyMidT tumor in 10–30% of tumor-bearing mice, and these "cured" mice remain tumor free (7). The results in the current study are consistent with our earlier work, as administration of Ad-IL-12 induced a 13% cure rate in tumor-bearing mice that were subsequently resistant to rechallenge with PyMidT tumor (Table IGo).


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Table I. Summary of responses of PyMidT tumors following intratumor injection of Ad-dl70, Ad-angiostatin, Ad-IL-12, and combination of Ad-angiostatin plus Ad-IL-12

 
Mice bearing tumors that were directly injected with an Ad expressing murine angiostatin at 5 x 108 PFU responded with 65% showing partial tumor regression/stasis; however, none of the treated mice showed total regression (Table IGo), and all mice in this group grew tumors and were finally sacrificed. We established criteria for partial regression as stasis or decrease in tumor volume 1 wk after the administration of a vector, as compared with the original tumor volume before treatment.

Administration of the control virus Ad-dl70 did not delay the growth of the PyMidT tumor. None of the tumors injected with control virus had any response and none of the mice were cured, a result that we had reported previously (7). Tumor volumes for this group expanded at a near-linear rate as determined by weekly measurements, and mice in this control group were sacrificed 20 days after injection due to excessive tumor volumes (Fig. 1GoA; data from a representative experiment). In contrast, the kinetics of PyMidT tumor growth in Ad-IL-12-treated and Ad-angiostatin-treated animals was delayed as compared with the control-treated animals. This delay extended the survival of the mice in the treatment groups by 14 days on average (Fig. 1GoB). However, none of the Ad-angiostatin-treated animals were protected, with all animals succumbing to tumor proliferation. The mechanism for this growth delay is likely a reflection of angiostatin’s inhibitory effects on proliferation of tumor vasculature via apoptosis of endothelial cells. Moreover, the inhibition of tumor growth over this period may be directly related to the transient expression of angiostatin from the Ad vector. Once the virus is cleared from the animal, there is no longer transgene expression and the tumors resume normal and rapid growth.



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FIGURE 1. A, Tumor growth response following intratumoral injection of Ad. PyMidT tumor cells (5 x 105) were injected s.c. into the right flank of female FVB/n mice. Twenty-one days later, palpable tumors were injected with 5 x 108 PFU of Ad-angiostatin ({blacktriangledown}; n = 5), Ad-IL-12 ({circ}; n = 5), or a combination of Ad-angiostatin plus Ad-IL-12 ({triangledown}; n = 5). Final viral load was adjusted to 1 x 109 PFU with control virus Ad-dl70 (•; n = 5). Tumors were measured at the time of injection and then weekly using Vernier calipers. *, Regression obtained with a combination of Ad-angiostatin plus Ad-IL-12 was significant compared with Ad-dl70 (day 21, p < 0.005). B, Long-term survival of FVB/n mice bearing PyMidT tumors following treatment with control virus Ad-dl70 (•; n = 5), Ad-angiostatin ({blacktriangledown}; n = 5), Ad-IL-12 ({circ}; n = 5), and a combination of Ad-angiostatin plus Ad-IL-12 ({triangledown}; n = 5).

 
Unlike angiostatin alone, Ad-IL-12 induced total regression of tumors in some mice (13%) and could protect these mice against rechallenge with PyMidT tumor cells. This illustrates the role for immune stimulation by IL-12 and the generation of T cell-specific responses that have been reported by us and others (7, 15). As seen previously, no toxicity was observed with the use of low level Ad-IL-12 at 5 x 108 PFU (15). Similarly, animals that received Ad-angiostatin in doses as high as 1 x 109 PFU had no noticeable side effects.

Coinjection of Ad-angiostatin with Ad-IL-12 increased the number of mice that showed an initial/partial tumor regression to 96%, and 54% showed total regression and were protected against challenge with further PyMidT tumor cells. In those mice that underwent total tumor regression, the tumors were completely absent 3 wk after the injection of the virus combination. Mice that had a relapse of tumor growth after initial regression had a 2- to 3-wk increase in survival time comparable to the kinetics seen with angiostatin alone (Fig. 1GoB). Our results indicate that injection of the vector expressing angiostatin disrupts the tumor endothelium and, in combination with the immunostimulatory potential of IL-12, produces a synergistic effect that dramatically reduces tumor size and leads to increased total regression.

Anti-tumor immunity in mice injected with a combination of Ad-angiostatin plus Ad-IL-12

Two mice from the cured combination Ad-angiostatin and Ad-IL-12 group were sacrificed and their spleens removed 8 wk after rejecting a second challenge of 5 x 105 PyMidT cells in the contralateral flank. Splenocytes were cocultured with irradiated 516 MT3 cells, which express the PyMidT Ag (15), for 5 days to activate tumor-specific lymphocytes. These activated cells demonstrated a high degree of specific killing against 51Cr-labeled 516 MT3 cells, but not the PyMidT-negative PT516 control cell line (Fig. 2Go). CTL killing was 32% at an E:T ratio of 10:1 and 43% at 30:1, with no measurable background.



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FIGURE 2. Generation of specific anti-tumor CTL response by a combination of Ad-angiostatin plus Ad-IL-12. 51Cr release from 516 MT3 target cells (MT3) and PTO 516 non-middle T-expressing cells (516) was measured after incubation with in vitro stimulated splenocytes from mice that had undergone a complete regression and were resistant to a second tumor challenge. None of the Ad-angiostatin alone-treated animals showed complete regression, and all succumbed to tumor growth.

 
Immunohistochemistry of PyMidT tumor vasculature with anti-CD31 Ab following treatments with Ad vectors

The effects of angiostatin, IL-12, and the coinjection of the two Ad vectors on the tumor vasculature was determined by immunohistochemical staining. The vessels within the tumor were stained with an Ab against CD31, a mouse endothelial cell marker that is involved in endothelial cell-to-cell adhesion and leukocyte transmigration (19, 20).

The photomicrograph of the PyMid T tumor section injected with control Ad-dl70 shows very extensive CD31 staining of vessels (Fig. 3Go, A and C). Examination of the tumor tissue shows robust tumor growth with no indication of necrotic or apoptotic regions in either the CD31- or corresponding H&E-stained section (Fig. 3Go, B and D).



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FIGURE 3. Effects on tumor vascularization with direct injection of adenoviral vectors. Palpable PyMidT tumors were injected with Ad-dl70, Ad-angiostatin, Ad-IL-12, or a combination of Ad-Angoistatin and IL-12. One week after injection, the tumors were removed, frozen in OCT compound, and sections were stained with anti-murine CD31 Ab as described in Materials and Methods. Sections were also H&E stained to visualize tumor disruption indicative of necrosis and/or apoptosis. A–D, PyMidT tumor injected with Ad-dl70. Extensive CD31 staining (brown) indicating vascularization is evident. Corresponding H&E staining reveals robust tumor cell growth with minimal necrosis and/or apoptosis. Magnification was x200 (A and B) and x400 (C and D), respectively. E, Ad-angiostatin-injected tumor shows reduced CD31 staining, indicating a reduction in tumor vasculature. Tumor necrosis and/or apoptosis is increased with the addition of Ad-angiostatin. Magnification, x200. F, The injection of Ad-IL-12 also has an angiostatic effect on tumor vasculature. CD31 staining is reduced compared with controls. Magnification, x200. G–H, Combination of Ad-angiostatin and Ad-IL-12 shows little CD31 staining, whereas tumor necrosis and/or apoptosis is evident in the H&E-stained sections. Magnification, x200.

 
Sections from tumors injected with Ad vectors expressing angiostatin, IL-12, or a combination show a marked decrease in the CD31-staining pattern compared with that seen with the control vector (Fig. 3Go, E–G). Disruption of the tumor as a result of probable tumor necrosis and/or apoptosis are markedly evident in the tumors treated with angiostatin and IL-12 alone or in combination in both the CD31- and H&E-stained section (Fig. 3Go, E–H).

Vessel quantification of the CD31-stained sections is shown in Fig. 4Go. In the tumors injected with the control virus, 1.8% (±0.65) of the total surface area within the randomly selected fields stained positive for endothelial cells. In contrast, the Ad-angiostatin and Ad-IL-12 alone or in combination significantly (p > 0.005) reduced the tumor vasculature compared with the control, as measured by CD31 staining (Fig. 4Go). Within the treatment groups that can affect angiogenesis, no significant difference was found between the number of CD31-stained regions by treatment with angiostatin or IL-12 alone or in combination.



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FIGURE 4. Tumor-vessel density is affected by angiostatic vectors. Frozen tumor sections were stained with anti-murine CD31 Ab, and vessel quantification was calculated by counting five fields in each tumor with two tumors in each group. Quantification was conducted in a blinded manner using a Leica Laborlux microscope at x200 magnification and Northern Exposure V2.9 software. *, The reduction in vessels counted in each of the treatment groups as compared with the Ad-dl70 was significant (p < 0.005).

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
This report is the first to demonstrate the anti-cancer potential of a combined antiangiogenesis and immunotherapy treatment regime for cancer. We have demonstrated the efficacy of combining the potent angiogenesis inhibitor angiostatin with the powerful immune system activator IL-12. In addition, our study is the first to combine this type of therapy in a gene-based delivery system using adenoviral vectors to transiently express angiostatin and IL-12 locally within the tumor itself.

Our previous studies have used Ad expressing IL-12 alone (9) or in combination with other immune-stimulating molecules such as IL-2 (15) and/or B7-1 (21) to obtain regression in the transgenic breast cancer model. Viral targeting of human and murine angiostatin has been shown to be effective in delaying the growth of glioblastoma and human breast cancer cell lines in athymic mice (22, 23) for the duration of viral expression.

Although many cytokines, including IL-12, IP-10, monokine induced by IFN-{gamma} (MIG), and TNF-{alpha}, have strong antiangiogenic properties that can inhibit tumor growth, the mechanisms by which endothelial cell inhibition occurs is not completely known and is complex (24, 25). Recent evidence has shown that IP-10 and MIG exert angiostatic activity through binding to the CXC chemokine receptor 3 on endothelial cells (26). TNF-{alpha} has been demonstrated to inhibit endothelial cell growth in vitro (27) and can promote intravascular thrombosis within tumors (28). However, the immune-activating component of TNF-{alpha} results in macrophage- or leukocyte-induced angiogensis (27, 29). Moreover, we have previously reported that the toxicity associated with TNF-{alpha} (28) may also be a limiting factor in using this cytokine at high enough doses to achieve a successful attack on tumor vasculature.

The use of the angiogenesis-specific inhibitor angiostatin has the advantage over a cytokine-based approach in that no toxicity has been associated with administration of this protein (2, 4). Angiostatin, an internal fragment of the plasma protein plasminogen, does not appear to possess any immunological function or enzymatic activity. The results in our study agree with previous findings. No mice receiving Ad-angiostatin had any noticeable gross side effects, and there was no mortality associated with the administration of this vector at concentrations as high as 1 x 109 PFU (data not shown).

The use of Ad-angiostatin in the transgenic PyMidT breast cancer model demonstrates the ability of this vector to limit tumor growth by attacking tumor vasculature. Tumor growth was substantially reduced in mice treated with angiostatin as compared with the control-treated group. The kinetics of tumor growth over the first 3 wk in the Ad-angiostatin-treated mice was similar to that of the Ad-IL-12 group (Fig. 1GoA). This reduction in the rate at which tumors expanded increased the survival of the angiostatin-treated mice by 14 days in most cases, as compared with control-treated animals.

These data illustrate the limitations of first-generation adenoviral vectors and the transient nature of protein expression. The reduction in tumor growth appears to coincide with the kinetics of clearance of the Ad from the animal. Once the vector is gone, transgene expression of angiostatin is also lost and the tumor again progresses at a high growth rate. Similar findings were report by Griscelli (22) and Tanaka (23) using Ad expressing human and murine angiostatin, respectively, in glioma and breast cancer models. A major advantage to using adenoviral-delivered angiostatin over recombinant material produced from Pichia pastoris or Escherichia coli has recently been reported (30). Angiostatin from the later sources may be sensitive to physical manipulation, leading to a rapid loss of activity. In addition, recombinant protein may not be correctly glycosylated, resulting in a shorter circulating half-life (2). In contrast, angiostatin derived from the Ad is produced directly in the infected cell, is properly glycosylated, and is not subject to any physical treatment or purification procedures.

Intratumoral injection of Ad-IL-12 into the PyMidT breast cancer model has been previously described by us and others (7, 31, 32). These reports concentrated on the immunological properties of IL-12 to activate IFN-{gamma}, CD8+ T cells, and NK cells for the rejection of the tumor. Data from this current study indicate that in the first 3 wk after vector administration, vascular disruption within the tumor by IL-12 may be as significant in delaying initial tumor growth as the development of a T cell-mediated antitumor immune response. However, this does not diminish the role of the immune system in the delay in growth. On the contrary, if the mechanism of IL-12-induced inhibition of angiogenesis is taken into account, then NK cells, IFN-{gamma}, and IP-10 may account for this phenomenon because they attack the endothelial cells within the tumor (11). Indeed, in a recent study using a combination of IL-12 with the IP-10 and MIG vectors, we see synergistic activity on tumor regression (33). Therefore, the initial response of the tumor to the administration of Ad-IL-12 may include inhibition of vascular growth followed by a cell (NK or CD4/CD8)-mediated response to tumor-associated Ags (TAA). Conceivably, the necrosis and or apoptosis seen in the CD31-stained tumor sections may enhance the availability of TAA and make it more accessible to the surveillance of the immune system. The cell-mediated cytotoxic response is necessary for inducing long-term protection and is responsible for the 13% total cures seen with the IL-12 treatment alone (7).

The direct injection of a combination of angiostatin and IL-12 gene therapy vectors appears to have synergistic benefits in this tumor model with an intial/partial tumor regression, with 96 and 54% of the mice showing total regression. These mice developed a strong CTL response and were resistant to rechallenge with the tumor.

The combination therapy was well tolerated by all of the mice injected. The relatively safe nature of Ad-angiostatin allows for the addition of Ad-IL-12 at its optimal efficacious and toxicity-limiting dose of 5 x 108 PFU (7), such that the total virus injected did not exceed 1 x 109 PFU.

The proposed mechanism of the combination therapy may be a reduction of tumor vasculature, leading to tumor necrosis and apoptosis and followed by an immune response to released TAA. The process may be initiated following administration of Ad-angiostatin, leading to a decrease in tumor vasculature and resulting in disruption of the tumor environment to a necrotic or apoptotic state. This action may not only serve to reduce the number of viable tumor cells, but at the same time may enhance the availability of TAA for presentation by scavenging APCs. The inclusion of the Ad-IL-12 activates immune effector cells, including dendritic, NK, and T cells, and also initiates an IFN-{gamma}-induced cytokine cascade, resulting in antiangiogenic and pro-T cell chemotactic chemokines being generated. Moreover, the amount of remaining viable tumor may be reduced sufficiently by the initial vascular disruption such that the immune system can mount a response to a much smaller viable tumor burden.

In conclusion, our study has demonstrated that a short-term course of local antiangiogenic therapy combined with immunotherapy can effectively shrink a solid tumor and vaccinate the animal against rechallenge. The approach is novel in that it uses the intratumoral delivery of the genes encoding both the angiogenesis inhibitor angiostatin and the immune stimulatory cytokine IL-12 via adenoviral vectors. The combination Ad-angiostatin with cytokine-expressing vectors is attractive because of the lack of toxicity associated with angiostatin. This approach may be useful in the treatment of many other solid tumors.


    Acknowledgments
 
We thank Duncan Chong and Xueya Feng for their expert technical assistance in propagating and purifying all adenoviral vectors used in this study.


    Footnotes
 
1 This work was supported by the Medical Research Council of Canada with grants to T.J.P. and J.G., The Hamilton Health Sciences Corporation, and St. Joseph’s Hospital. Back

2 Address correspondence and reprint requests to Dr. Jack Gauldie, Department of Pathology and Molecular Medicine, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5. Back

3 Abbreviations used in this paper: IP-10, IFN-{gamma} inducible protein 10; Ad, adenovirus; PyMidT, primary polyomavirus middle T; H&E, hematoxylin and eosin; MIG, monokine induced by IFN-{gamma}; TAA, tumor-associated Ags. Back

4 S. Gyorffy, K. Palmer, and J. Gauldie. 2001. Adenoviral vector expressing murine angiostatin inhibits a model of breast cancer metastatic growth in the lungs of mice. Submitted for publication. Back

Received for publication October 18, 2000. Accepted for publication March 12, 2001.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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