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Effects of combined inhibition of STAT3 and VEGFR2 pathways on the radiosensitivity of non-small-cell lung cancer cells

Authors Hu C, Zhuang W, Qiao Y, Liu B, Liu L, Hui K, Jiang X

Received 5 September 2018

Accepted for publication 17 December 2018

Published 29 January 2019 Volume 2019:12 Pages 933—944

DOI https://doi.org/10.2147/OTT.S186559

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 3

Editor who approved publication: Dr Arseniy Yuzhalin


Chenxi Hu,1,* Wei Zhuang,2,* Yun Qiao,2,* Bin Liu,2 Liang Liu,2 Kaiyuan Hui,1 Xiaodong Jiang1,2

1Tumor Laboratory, Department of Oncology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang City 222002, China; 2Department of Oncology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang City 222002, China

*These authors contributed equally to this work

Purpose: The goals of this study were to determine the effects of combined inhibition of STAT3 and vascular endothelial growth factor receptor 2 (VEGFR2) pathways on the radiosensitivity of non-small-cell lung cancer (NSCLC) cells, and to assess the underlying mechanisms.
Methods: The expressions of VEGFR2, STAT3, related signaling molecules, hypoxia-inducible factor 1-alpha (HIF-1α), and cyclin D1 were determined by Western blotting. Radiosensitivity was assessed using the colony-forming assay, and cell cycle and cell death were analyzed by flow cytometry. A nude mouse xenograft tumor model of Calu-1 cells was established. The hepatorenal toxicity of the above-mentioned treatment on tumor-bearing mice was observed by H&E staining. The expression of STAT3, VEGFR2, HIF-1α, and cyclin D1 of the transplanted tumor tissues was detected by immunohistochemistry. Apoptosis of tumor tissues was evaluated by TUNEL staining.
Results: In vitro, we selected two cell lines with high expression levels of STAT3, including Calu-1 cells that exhibit high VEGFR2 expression and A549 cells that exhibit low VEGFR2 expression. When apatinib treatment was combined with S3I-201, the expression of VEGFR2, STAT3, and their downstream signaling molecules was significantly decreased (P<0.01). There was an increase in cell death and G2/M phase arrest after treatments, with the most significant changes occurring upon dual inhibition of STAT3 and VEGFR2 (P<0.01). In vivo, combined treatment of radiotherapy and dual inhibition of VEGFR2 and STAT3 was well tolerated and did not deliver additional toxicity. Compared with the control group and the radiation treatment (RT) + apatinib or RT + S3I-201 duplex group, the expression level of STAT3, p-STAT3, VEGFR2, HIF-1α, and cyclin D1 in the triple group (RT + apatinib + S3I-201) was the lowest, and the proportion of apoptotic cells was the highest (P<0.05).
Conclusion: The combined inhibition of VEGFR2 and STAT3 is effective in enhancing radiosensitizing effects in NSCLC cells.

Keywords: STAT3, VEGFR2, non-small-cell lung cancer, radiosensitivity

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