
March 08 | PhysOrg.com article
by Washington University School of Medicine
Fugitive
Cancer Cells Can Be Blocked by Stopping Blood Cells That Aid
Them
Cancer cells get a helping hand from platelets,
specialized blood cells involved in clotting. Platelets shelter and
feed tumor cells that stray into the bloodstream, making it easier
for cancer to spread, or metastasize. Research at Washington University
School of Medicine in St. Louis suggests that inactivating platelets
could slow down or prevent metastasis.
In advance of online publication in the Journal
of Cellular Biochemistry, the scientists report that a combination
of two platelet inhibitors reduced the number and size of breast
cancer or melanoma tumors that grew in the bones of laboratory
mice.
One of the drugs was aspirin, a widely used inhibitor
of platelet clotting. The other was an experimental drug, APT102,
which also prevents platelet clotting, but by a different mechanism.
Both drugs were needed to reduce bone tumors.
"Past research has shown that tumor cells
activate platelets and that mice with defective platelets have significantly
fewer metastases," says Katherine Weilbaecher, M.D., assistant
professor of medicine and of cell biology and physiology. "We
also know that platelets have several traits that can aid tumor cells,
and we are working to break up that potentially lethal partnership."
Metastasis of cancer cells to sites away from the
main tumor can cause pain and other symptoms and greatly increases
the likelihood a patient will die of the disease. In fact, more than
90 percent of cancer deaths are the result of metastasis, which is
difficult to control with current therapies.
Cancer cells that leave the primary tumor and circulate
in the bloodstream can readily take advantage of platelets they encounter.
The circulating tumor cells secrete factors that make platelets stick
together, creating a shield of platelets that protects cancer cells
from immune attack. In addition, platelets release growth factors
that help tumor cells survive, and platelets' capacity to stick to
particular sites enables companion tumor cells to settle in and proliferate
in new areas.
Weilbaecher, an oncologist with the Siteman Cancer
Center at Washington University School of Medicine and Barnes-Jewish
Hospital, and colleagues, including Özge Uluçkan, a predoctoral
trainee in molecular genetics, and Mark Eagleton, a research technician,
tested the effect of aspirin and APT102 in mice that received an
injection of either melanoma or breast cancer cells.
The cancer cells establish themselves in bones
in as little as two days and proliferate to produce large bone tumors
in less than two weeks. But the researchers found the bone tumors
were smaller and fewer in mice that got a dose of aspirin and APT102 before inoculation with cancer cells and additional treatments twice
a day for two days after that.
"We only had a small amount of APT102 to test,
so in this set of experiments, we gave only a few doses of the drugs
to the mice," Uluçkan explains. "At this point,
we don't know if additional treatment would have further reduced
the tumor burden, but it's clear that reducing platelet function
had a positive result in this model of metastatic cancer."
By themselves neither aspirin nor APT102 lessened
the amount and size of bone tumors in the mice, possibly because
cancer cells can activate platelets in several different ways, making
a dual approach more effective, according to Weilbaecher.
"Aspirin prevents platelets from making thromboxane,
a substance that facilitates clotting," Weilbaecher says. "APT102
is an especially interesting drug because it gets rid of a compound
called ADP, which tumor cells release and which stimulates platelets
to clump. So APT102 prevents platelet activation in response to tumor
cells."
APT102 is produced by APT Therapeutics Inc., a
St. Louis-based biopharmaceutical company. The company donated the
drug but did not fund the research project. Co-authors Soon Seog
Jeong and Ridong Chen are employees of APT Therapeutics and provided
expertise about the bioactivity and dosing of APT102.
The researchers noted that the drug combination
would likely be well tolerated because it did not cause excessive
bleeding in the mice, as might be expected from platelet inhibitors.
The research group plans to continue to study the process of metastasis
and the role played by platelets.
In collaboration with Michael Naughton, M.D., assistant
professor of medicine, Weilbaecher is also involved in a clinical
trial of women with advanced breast cancer to test aspirin and Plavix®,
another antiplatelet drug, to see if the drug combination affects
the number of tumor cells that circulate in the blood. The trial
is open only to breast cancer patients undergoing treatment at the
Siteman Cancer Center.
© 2008, Washington University School
of Medicine in St. Louis and PhysOrg.com. All rights reserved.
Reprinted with permission.
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