G-CSF-initiated myeloid cell mobilization and angiogenesis mediate tumor refractoriness to anti-VEGF therapy in mouse models

Proc Natl Acad Sci U S A. 2009 Apr 21;106(16):6742-7. doi: 10.1073/pnas.0902280106. Epub 2009 Apr 3.

Abstract

Recent studies suggest that tumor-associated CD11b(+)Gr1(+) myeloid cells contribute to refractoriness to antiangiogenic therapy with an anti-VEGF-A antibody. However, the mechanisms of peripheral mobilization and tumor-homing of CD11b(+)Gr1(+) cells are unclear. Here, we show that, compared with other cytokines [granulocyte-macrophage colony stimulating factor (GM-CSF), stromal derived factor 1alpha, and placenta growth factor], G-CSF and the G-CSF-induced Bv8 protein have preferential expression in refractory tumors. Treatment of refractory tumors with the combination of anti-VEGF and anti-G-CSF (or anti-Bv8) reduced tumor growth compared with anti-VEGF-A monotherapy. Anti-G-CSF treatment dramatically suppressed circulating or tumor-associated CD11b(+)Gr1(+) cells, reduced Bv8 levels, and affected the tumor vasculature. Conversely, G-CSF delivery to animals bearing anti-VEGF sensitive tumors resulted in reduced responsiveness to anti-VEGF-A treatment through induction of Bv8-dependent angiogenesis. We conclude that, at least in the models examined, G-CSF expression by tumor or stromal cells is a determinant of refractoriness to anti-VEGF-A treatment.

MeSH terms

  • Animals
  • Antibodies, Neoplasm / therapeutic use*
  • Cell Movement / drug effects*
  • Cell Proliferation / drug effects
  • Disease Models, Animal
  • Drug Resistance, Neoplasm
  • Drug Screening Assays, Antitumor
  • Gastrointestinal Hormones / immunology
  • Granulocyte Colony-Stimulating Factor / pharmacology*
  • Humans
  • Mice
  • Mice, Nude
  • Myeloid Cells / cytology*
  • Myeloid Cells / drug effects
  • Neoplasms / blood supply
  • Neoplasms / drug therapy*
  • Neoplasms / immunology
  • Neovascularization, Pathologic / immunology*
  • Neuropeptides / immunology
  • Vascular Endothelial Growth Factor A / immunology*

Substances

  • Antibodies, Neoplasm
  • Gastrointestinal Hormones
  • Neuropeptides
  • Prok2 protein, mouse
  • Vascular Endothelial Growth Factor A
  • Granulocyte Colony-Stimulating Factor