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Reverse translation of phase I biomarker findings links the activity of angiotensin-(1--7) to repression of hypoxia inducible factor-1alpha in vascular sarcomas
Authors:W Jeffrey Petty  Mebea Aklilu  Victor A Varela  James Lovato  Paul D Savage  Antonius A Miller
Abstract:ABSTRACT: BACKGROUND: In a phase I study of angiotensin-(1--7) [Ang-(1--7)], clinical benefit was associated with reduction in plasma placental growth factor (PlGF) concentrations. The current study examines Ang-(1--7) induced changes in biomarkers according to cancer type and investigates mechanisms of action engaged in vitro. METHODS: Plasma biomarkers were measured prior to Ang-(1--7) administration as well as 1, 2, 3, 4, and 6 hours after treatment. Tests for interaction were performed to determine the impact of cancer type on angiogenic hormone levels. If a positive interaction was detected, treatment-induced biomarker changes for individual cancer types were assessed. To investigate mechanisms of action, in vitro growth assays were performed using a murine endothelioma cell line (EOMA). PCR arrays were performed to identify and statistically validate genes that were altered by Ang-(1--7) treatment in these cells. RESULTS: Tests for interaction controlled for dose cohort and clinical response indicated a significant impact of cancer type on post-treatment VEGF and PlGF levels. Following treatment, PlGF levels decreased over time in patients with sarcoma (P = .007). Treatment of EOMA cells with increasing doses of Ang-(1--7) led to significant growth suppression at doses as low as 100 nM. PCR arrays identified 18 genes that appeared to have altered expression after Ang-(1--7) treatment. Replicate analyses confirmed significant changes in 8 genes including reduction in PlGF (P = .04) and hypoxia inducible factor 1alpha (HIF-1alpha) expression (P < .001). CONCLUSIONS: Ang-(1--7) has clinical and pre-clinical activity for vascular sarcomas that is linked to reduced HIF-1alpha and PlGF expression.
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