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dc.contributor.authorWang, Xiaoen
dc.contributor.authorZhang, Liang
dc.contributor.authorGoldberg, S. Nahum
dc.contributor.authorBhasin, Manoj
dc.contributor.authorBrown, Victoria
dc.contributor.authorAlsop, David C.
dc.contributor.authorSignoretti, Sabina
dc.contributor.authorMier, James W.
dc.contributor.authorAtkins, Michael B.
dc.contributor.authorBhatt, Rupal Satish
dc.date.accessioned2012-08-09T13:26:12Z
dc.date.issued2011
dc.identifier.citationWang, Xiaoen, Liang Zhang, S Nahum Goldberg, Manoj Bhasin, Victoria Brown, David C Alsop, Sabina Signoretti, James W Mier, Michael B Atkins, and Rupal S Bhatt. 2011. High dose intermittent sorafenib shows improved efficacy over conventional continuous dose in renal cell carcinoma. Journal of Translational Medicine 9: 220.en_US
dc.identifier.issn1479-5876en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:9385639
dc.description.abstractBackground: Renal cell carcinoma (RCC) responds to agents that inhibit vascular endothelial growth factor (VEGF) pathway. Sorafenib, a multikinase inhibitor of VEGF receptor, is effective at producing tumor responses and delaying median progression free survival in patients with cytokine refractory RCC. However, resistance to therapy develops at a median of 5 months. In an effort to increase efficacy, we studied the effects of increased sorafenib dose and intermittent scheduling in a murine RCC xenograft model. Methods: Mice bearing xenografts derived from the 786-O RCC cell line were treated with sorafenib according to multiple doses and schedules: 1) Conventional dose (CD) continuous therapy; 2) high dose (HD) intermittent therapy, 3) CD intermittent therapy and 4) HD continuous therapy. Tumor diameter was measured daily. Microvessel density was assessed after 3 days to determine the early effects of therapy, and tumor perfusion was assessed serially by arterial spin labeled (ASL) MRI at day 0, 3, 7 and 10. Results: Tumors that were treated with HD sorafenib exhibited slowed tumor growth as compared to CD using either schedule. HD intermittent therapy was superior to CD continous therapy, even though the total dose of sorafenib was essentially equivalent, and not significantly different than HD continuous therapy. The tumors exposed to HD sorafenib had lower microvessel density than the untreated or the CD groups. ASL MRI showed that tumor perfusion was reduced to a greater extent with the HD sorafenib at day 3 and at all time points thereafter relative to CD therapy. Further the intermittent schedule appeared to maintain RCC sensitivity to sorafenib as determined by changes in tumor perfusion. Conclusions: A modification of the sorafenib dosing schedule involving higher dose intermittent treatment appeared to improve its efficacy in this xenograft model relative to conventional dosing. MRI perfusion imaging and histologic analysis suggest that this benefit is related to enhanced and protracted antiangiogenic activity. Thus, better understanding of dosing and schedule issues may lead to improved therapeutic effectiveness of VEGF directed therapy in RCC and possibly other tumors.en_US
dc.language.isoen_USen_US
dc.publisherBioMed Centralen_US
dc.relation.isversionofdoi:10.1186/1479-5876-9-220en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3258225/pdf/en_US
dash.licenseLAA
dc.subjectrenal cell carcinomaen_US
dc.subjectanti-angiogenic therapyen_US
dc.subjectarterial spin labeled magnetic resonance imagingen_US
dc.titleHigh Dose Intermittent Sorafenib Shows Improved Efficacy Over Conventional Continuous Dose in Renal Cell Carcinomaen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalJournal of Translational Medicineen_US
dash.depositing.authorWang, Xiaoen
dc.date.available2012-08-09T13:26:12Z
dc.identifier.doi10.1186/1479-5876-9-220*
dash.contributor.affiliatedZhang, Liang
dash.contributor.affiliatedWang, Xiaoen
dash.contributor.affiliatedGoldberg, S.
dash.contributor.affiliatedBhatt, Rupal
dash.contributor.affiliatedSignoretti, Sabina
dash.contributor.affiliatedMier, James
dash.contributor.affiliatedAlsop, David


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