Biological ablation of sentinel lymph node metastasis in submucosally invaded early gastrointestinal cancer

Mol Ther. 2015 Mar;23(3):501-9. doi: 10.1038/mt.2014.244. Epub 2014 Dec 19.

Abstract

Currently, early gastrointestinal cancers are treated endoscopically, as long as there are no lymph node metastases. However, once a gastrointestinal cancer invades the submucosal layer, the lymph node metastatic rate rises to higher than 10%. Therefore, surgery is still the gold standard to remove regional lymph nodes containing possible metastases. Here, to avoid prophylactic surgery, we propose a less-invasive biological ablation of lymph node metastasis in submucosally invaded gastrointestinal cancer patients. We have established an orthotopic early rectal cancer xenograft model with spontaneous lymph node metastasis by implantation of green fluorescent protein (GFP)-labeled human colon cancer cells into the submucosal layer of the murine rectum. A solution containing telomerase-specific oncolytic adenovirus was injected into the peritumoral submucosal space, followed by excision of the primary rectal tumors mimicking the endoscopic submucosal dissection (ESD) technique. Seven days after treatment, GFP signals had completely disappeared indicating that sentinel lymph node metastasis was selectively eradicated. Moreover, biologically treated mice were confirmed to be relapse-free even 4 weeks after treatment. These results indicate that virus-mediated biological ablation selectively targets lymph node metastasis and provides a potential alternative to surgery for submucosal invasive gastrointestinal cancer patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoviridae / genetics*
  • Animals
  • Cell Line, Tumor
  • Colonic Neoplasms / genetics
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery
  • Colonic Neoplasms / therapy*
  • Disease Models, Animal
  • Female
  • Gastric Mucosa / metabolism
  • Gastric Mucosa / pathology
  • Gastric Mucosa / surgery
  • Gastrointestinal Neoplasms / genetics
  • Gastrointestinal Neoplasms / pathology
  • Gastrointestinal Neoplasms / surgery
  • Gastrointestinal Neoplasms / therapy*
  • Gene Expression
  • Genes, Reporter
  • Genetic Vectors / administration & dosage
  • Green Fluorescent Proteins / genetics
  • Green Fluorescent Proteins / metabolism
  • Humans
  • Lymph Nodes / metabolism*
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Mice
  • Mice, Nude
  • Mice, Transgenic
  • Neoplasm Recurrence, Local / genetics
  • Neoplasm Recurrence, Local / metabolism
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / prevention & control*
  • Neoplasm Transplantation
  • Oncolytic Virotherapy / methods*
  • Sentinel Lymph Node Biopsy
  • Telomerase / genetics
  • Telomerase / metabolism

Substances

  • Green Fluorescent Proteins
  • Telomerase