Study on lung cancer cells expressing VEGFR2 and the impact on the effect of RHES combined with radiotherapy in the treatment of brain metastases

Clin Lung Cancer. 2014 Mar;15(2):e23-9. doi: 10.1016/j.cllc.2013.11.012. Epub 2013 Nov 20.

Abstract

Introduction: Brain metastases are often accompanied by edema. Endostatin therapy can prevent tumor tissue edema. Therefore, we investigated the therapeutic effects of endostatin combined with radiotherapy in the treatment of brain metastases of non-small cell lung cancer (NSCLC) and assessed the relations between the effect and vascular endothelial growth factor receptor 2 (VEGFR2) expression.

Patients and methods: Eighty patients with brain metastases of NSCLC were randomly divided into a combination therapy group and a radiotherapy-alone group, each group with 40 patients. The short-term effective rate, overall survival time, cerebral edema index, and adverse reactions were observed, and the expressions of VEGFR2 protein and KDR gene in primary lesions were detected via immunohistochemical methods and fluorescence in-situ hybridization (FISH) in all patients.

Results: Compared with the radiotherapy-alone group, brain edema was significantly relieved (P = .003) and there were no marked adverse reactions in the combination therapy group. Regarding the short-term effective rate, there was no statistical significance in the total population (n = 80, 90% vs. 75%, P = .07), but there was statistical significance in cases of positive VEGFR2 (93% vs. 67.7%, P = .012) or positive KDR gene (94.4% vs. 47.3%, P = .002) in both groups. For overall survival time, there was no statistical significance in total population (n = 80, P = .35), positive VEGFR2 patients (P = .109), and positive KDR gene patients (P = .147).

Conclusion: Compared with radiotherapy alone, endostatin combined with radiotherapy can relieve brain edema in patients with brain metastases of NSCLC and can obtain a better short-term effective rate in patients with positive VEGFR2 or positive KDR gene, but endostatin therapy does not significantly improve overall survival time.

Keywords: Brain metastases; Lung cancer; Radiotherapy; Recombinant human endostatin; Vascular endothelial growth factor receptor 2.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use
  • Brain Edema / diagnosis
  • Brain Edema / etiology
  • Brain Edema / prevention & control
  • Brain Neoplasms / metabolism
  • Brain Neoplasms / mortality
  • Brain Neoplasms / secondary
  • Brain Neoplasms / therapy*
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / therapy*
  • Combined Modality Therapy
  • Endostatins / therapeutic use*
  • Female
  • Follow-Up Studies
  • Gene Amplification
  • Humans
  • Immunoenzyme Techniques
  • In Situ Hybridization, Fluorescence
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / therapy*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy*
  • Survival Rate
  • Vascular Endothelial Growth Factor Receptor-2 / genetics
  • Vascular Endothelial Growth Factor Receptor-2 / metabolism*

Substances

  • Antineoplastic Agents
  • Endostatins
  • KDR protein, human
  • Vascular Endothelial Growth Factor Receptor-2