Intrapleural targeted therapies (anti-VEGF and anti-EGFR) in the model of malignant pleural effusion
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Milena Marques Pagliarelli Acencio1, Juliana Puka1, Vanessa Adélia Alvarenga1, Vanessa Martins2, Mariana Lombardi Peres de Carvalho3, Evaldo Marchi4, Vera Luiza Capelozzi2 and Lisete Ribeiro Teixeira1
1Laboratorio de Pleura / LIM09 - Divisao de Pneumologia, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo SP, Brazil
2Departmento de Patologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo SP, Brazil
3Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo SP, Brazil
4Faculdade de Medicina de Jundiai, Jundiai SP, Brazil
Lisete Ribeiro Teixeira, email: [email protected]
Keywords: targeted therapies; malignant pleural effusion; VEGF; EGFR; experimental model
Received: May 10, 2017 Accepted: August 28, 2017 Published: September 28, 2017
Rationale: Malignant pleural effusion has few options of treatment and drugs administrated by different routes can lead to a less permissive microenvironment for the development of malignant pleural disease.
Objectives: To analyze therapies administered intrapleurally in malignant pleural disease and to study EGFR and KRAS mutations in adenocarcinoma.
Methods: Mice received LLC cells and were treated intrapleurally with anti-VEGF, anti-EGFR, anti-VEGF+anti-EGFR or saline. Animal survival, weight and mobility, volume, biochemistry and immunology of fluid, gene expression, KRAS and EGFR mutation were evaluated.
Results: All animals developed malignant effusion and presented progressive weight loss without difference between groups; however, groups treated with anti-EGFR were more active. No difference in mortality was observed. Temporal increase of volume and inflammatory markers was observed mainly in the untreated group. Gene expression in tumors was overexpressed in VEGF, EGFR and KRAS compared with normal tissue. Mutation in exon 2 of the KRAS gene was observed.
Conclusions: Intrapleural Anti-VEGF and/or anti-EGFR reduced volume and inflammatory mediators in pleural fluid. Anti-EGFR and anti-VEGF+anti-EGFR decreased morbidity although without impact on survival. LLC tumors presented KRAS mutation, this could have influenced the action of these therapies.
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