MedicalResearch.com Interview with:
Timothy P. Padera, PhD
Edwin L. Steele Laboratories
Department of Radiation Oncology
MGH Cancer Center, Massachusetts General Hospital and Harvard Medical School
Boston, Massachusetts 02114
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Padera: Systemic therapy benefits cancer patients with lymph node metastases; however all phase III clinical trials to date of antiangiogenic therapy have failed in the adjuvant setting. We have previously reported the lack of efficacy of antiangiogenic therapies in pre-clinical models of spontaneous lymphatic metastasis, however there were no mechanistic data to explain these observations. Here, we developed a novel chronic lymph node window model to facilitate new discoveries in the mechanisms of growth and spread of lymph node metastases. Our new data provide pre-clinical evidence along with supporting clinical evidence that angiogenesis does not occur in the growth of metastatic lesions in the lymph node. These results reveal a mechanism of treatment resistance to antiangiogenic therapy in adjuvant setting, particularly those involving lymph node metastases.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Padera: In the adjuvant setting, anti-angiogenic therapy has failed to show a benefit for cancer patients in all Phase III trials. Our new data provide one potential mechanism for the lack of efficacy of anti-angiogenic therapy in the adjuvant setting. The primary implication of our findings is that, since lymph node metastases do not require the growth of new blood vessels, antiangiogenic therapy will not inhibit lymphatic metastases. Other therapies are needed for the treatment of patients at risk for lymph node metastasis.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Padera: We need to continue to learn about the biology of small metastases in lymph nodes in order to design effective adjuvant therapy for patients at risk of developing lymph node metastases.
Han-Sin Jeong, Dennis Jones, Shan Liao, Daniel A. Wattson, Cheryl H. Cui, Dan G. Duda, Christopher G. Willett, Rakesh K. Jain, and Timothy P. Padera
JNCI J Natl Cancer Inst (2015) 107 (9): djv155 doi:10.1093/jnci/djv155
Timothy P. Padera, PhD, Edwin L. Steele Laboratories, & Department of Radiation Oncology (2015). Lymph Node Cancer Metastases Do Not Require Growth of New Blood Vessels