Tranilast-induced stress alleviation in solid tumors improves the efficacy of chemo- and nanotherapeutics in a size-independent manner

Sci Rep. 2017 Apr 10:7:46140. doi: 10.1038/srep46140.

Abstract

Accumulation of mechanical stresses during cancer progression can induce blood and lymphatic vessel compression, creating hypo-perfusion, hypoxia and interstitial hypertension which decrease the efficacy of chemo- and nanotherapies. Stress alleviation treatment has been recently proposed to reduce mechanical stresses in order to decompress tumor vessels and improve perfusion and chemotherapy. However, it remains unclear if it improves the efficacy of nanomedicines, which present numerous advantages over traditional chemotherapeutic drugs. Furthermore, we need to identify safe and well-tolerated pharmaceutical agents that reduce stress levels and may be added to cancer patients' treatment regimen. Here, we show mathematically and with a series of in vivo experiments that stress alleviation improves the delivery of drugs in a size-independent manner. Importantly, we propose the repurposing of tranilast, a clinically approved anti-fibrotic drug as stress-alleviating agent. Using two orthotopic mammary tumor models, we demonstrate that tranilast reduces mechanical stresses, decreases interstitial fluid pressure (IFP), improves tumor perfusion and significantly enhances the efficacy of different-sized drugs, doxorubicin, Abraxane and Doxil, by suppressing TGFβ signaling and expression of extracellular matrix components. Our findings strongly suggest that repurposing tranilast could be directly used as a promising strategy to enhance, not only chemotherapy, but also the efficacy of cancer nanomedicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Cell Line, Tumor
  • Collagen / metabolism
  • Down-Regulation / drug effects
  • Doxorubicin / pharmacology
  • Doxorubicin / therapeutic use
  • Drug Delivery Systems
  • Extracellular Fluid / metabolism
  • Extracellular Matrix / drug effects
  • Extracellular Matrix / metabolism
  • Gene Expression Regulation, Neoplastic / drug effects
  • Humans
  • Hyaluronic Acid / metabolism
  • Mice, Nude
  • Models, Biological
  • Nanomedicine*
  • Neoplasms / blood supply
  • Neoplasms / drug therapy*
  • Neoplasms / genetics
  • Neoplasms / pathology
  • Particle Size*
  • Perfusion
  • Signal Transduction / drug effects
  • Stress, Mechanical*
  • Transforming Growth Factor beta / metabolism
  • Treatment Outcome
  • Tumor Microenvironment / drug effects
  • ortho-Aminobenzoates / pharmacology
  • ortho-Aminobenzoates / therapeutic use*

Substances

  • Antineoplastic Agents
  • Transforming Growth Factor beta
  • ortho-Aminobenzoates
  • Doxorubicin
  • Hyaluronic Acid
  • Collagen
  • tranilast