Treatment with HIF-1α Antagonist PX-478 Inhibits Progression and Spread of Orthotopic Human Small Cell Lung Cancer and Lung Adenocarcinoma in Mice
Open accessAbstract
Introduction PX-478 is a potent small-molecule inhibitor of hypoxia-inducible factor 1alpha (HIF-1alpha). In prior preclinical studies, it had antitumor activity against various solid tumors in subcutaneous xenografts but had no measurable activity against a non-small cell lung cancer (NSCLC) xenograft. To determine the effectiveness of PX-478 against lung tumors, we investigated HIF-1alpha expression in several lung cancer cell lines, both in vitro and in vivo, and treated orthotopic mouse models of human lung cancer with PX-478. Methods Cells from two human lung adenocarcinoma cell models (PC14-PE6 and NCI-H441) or two human small cell lung cancer (SCLC) models (NCI-H187 and NCI-N417) were injected into the left lungs of nude mice and were randomized 16 to 18 days after injection with daily oral treatment with PX-478 or vehicle for 5 days. Results In the PC14-PE6 NSCLC model, treatment with 20 mg/kg PX-478 significantly reduced the median primary lung tumor volume by 87% (p = 0.005) compared with the vehicle-treated group. PX-478 treatment also markedly reduced mediastinal metastasis and prolonged survival. Similar results were obtained in a second NSCLC model. In SCLC models, PX-478 was even more effective. In the NCI-H187 model, the median primary lung tumor volume was reduced by 99% (p = 0.0001). The median survival duration was increased by 132%. In the NCI-N417 model, the median primary lung tumor volume was reduced by 97% (p = 0.008). Conclusions We demonstrated that the PX-478, HIF-1alpha inhibitor, had significant antitumor activity against two orthotopic models of lung adenocarcinomas and two models of SCLC. These results suggest the inclusion of lung cancer patients in phase I clinical trials of PX-478.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
4 of 21 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured
- Interpretationcitation
Off-target effects may have contributed to tumor inhibition in the orthotopic models.
“In summary, off-target effects, which has also been described recently22 for this drug, may have contributed to tumor inhibition in our model.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [22] Palayoor, 2008, PX-478, an inhibitor of hypoxia-inducible factor-1alpha, enhances radiosensitivity of prostate carcinoma cells, Int J Cancer source
- Findingown data
In the NCI-H187 model, most mice have to be killed because of primary lung tumor burden, possibly before visible metastases develop.
“but most mice have to be killed because of primary lung tumor burden, possibly before they develop visible metastases.”
Quote in the paperSubstantial claim - Findingown data
HIF-1α expression was seen in orthotopic tumor tissue from NCI-H187, NCI-N417, PC14PE6, and NCI-H441 cells in nude mice.
“We observed HIF-1α expression in the tumor tissue of two SCLC cell lines, NCI-H187, and NCI-N417, and in tissue of the adenocarcinoma cell lines PC14PE6 and NCI-H441 (Figure 1C).”
Quote in the paperSubstantial claim - Findingown data
In vitro, PX-478 lowered HIF-1α protein expression in PC14PE6 cells by more than half.
“and reduced HIF-1α protein expression in PC14PE6 cells by more than 50%.”
Quote in the paperSubstantial claim - Findingreasoning
In the NCI-H187 model, combination therapy with paclitaxel did not further improve outcome.
“Combination therapy with paclitaxel did not further improve the outcome, probably because of the high response rate obtained with PX-478 alone.”
Quote in the paperNot a substantial claim
- Findingown data
In the PC14PE6 model, adding paclitaxel did not further improve tumor growth reduction.
“Combination treatment with paclitaxel did not further improve tumor growth reduction in this model.”
Quote in the paperNot a substantial claim - Findingown data
In the NCI-H187 model, three of 13 mice treated with 20 mg/kg PX-478 had no lung tumors on histologic analysis.
“Moreover, in three of the 13 mice treated with 20 mg/kg PX-478, no lung tumors could be found on histologic analysis.”
Quote in the paperNot a substantial claim - Findingown data
In the NCI-H187 SCLC model, PX-478 produced nearly complete tumor growth reduction or cure regardless of schedule.
“In the NCI-H187 SCLC model, we observed nearly complete tumor growth reduction or cure (Table 2 and Figure 2E), regardless of schedule.”
Quote in the paperSubstantial claim - Findingown data
In the PC14PE6 model, 20 mg/kg PX-478 given daily for 5 days, 3 days per week for 1 week, or every third day for 1 week markedly reduced tumor growth.
“treatment with 20 mg/kg oral PX-478 daily for 5 days, 3 days a week for 1 week, or every third day for 1 week led to a marked reduction in tumor growth in the PC14PE6 model.”
Quote in the paperSubstantial claim - Findingown data
NCI-H187 tumors had a high background of apoptotic cells around necrotic areas, even in the vehicle-treated group.
“Furthermore, NCI-H187 tumors had a high background of apoptotic cells around the necrotic areas, even in the vehicle-treated group.”
Quote in the paperSubstantial claim - Findingown data
In vitro, 25 μM PX-478 inhibited hypoxia-induced HIF-1α protein expression in NCI-H187 cells.
“PX-478 inhibited hypoxia-induced HIF-1α expression protein in vitro at a dose of 25 µM in NCI-H187 cells”
Quote in the paperSubstantial claim - Findingown data
In the PC14PE6 orthotopic adenocarcinoma model, 20 mg/kg PX-478 for 5 days reduced median primary lung tumor volume by 87% versus vehicle (p = 0.005).
“In the 20 mg/kg PX-478 group, the median primary lung tumor volume was reduced by 87%”
- Also stated in: § Results · plain
“treatment with 20 mg/kg PX-478 significantly reduced the median primary lung tumor volume by 87% (p = 0.005) compared with the vehicle-treated group.”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
IC50 values for PX-478 under normoxic and hypoxic (1% O2) conditions were similar in all four cell lines used.
“although IC50 values for PX-478 obtained in MTT assays conducted under normoxic and hypoxic (1% O2) conditions were similar in all four cell lines used in this study (data not shown)”
Quote in the paperSubstantial claim - Findingown data
In the NCI-H441 model, PX-478 treatment produced a statistically significant reduction in pleural effusion (p = 0.0055).
“Furthermore, we observed a statistically significant reduction in pleural effusion (p = 0.0055).”
Quote in the paperNot a substantial claim - Findingown data
PX-478 markedly reduced the rate of mediastinal lymph node metastasis.
“It also markedly reduced the rate of mediastinal lymph node metastasis.”
Quote in the paperSubstantial claim - Findingreasoning
In the NCI-H187 model, most mice in the PX-478 treatment group had to be killed because of metastatic disease rather than impairment by the primary tumor.
“Most mice in the treatment group had to be killed because of metastatic disease rather than impairment by the primary tumor.”
Quote in the paperSubstantial claim - Findingown data
PX-478 treatment dramatically increased survival duration in the NCI-H187 model.
“PX-478 treatment also dramatically increased the survival duration in this model.”
Quote in the paperSubstantial claim - Findingnone given
In NCI-H187 and NCI-N417 cells, HIF-1α expression levels were highest in hypoxic and necrotic areas.
“Interestingly, in NCI-H187 and NCI-N417 cells, HIF-1α expression levels were highest in hypoxic and necrotic areas.”
Quote in the paperNot a substantial claim - Findingown data
In mice with NCI-H187 SCLC, PX-478 increased median survival by 132%, from 45.5 days in vehicle-treated mice to 105.5 days in PX-478-treated mice.
“the median survival duration increased by 132% from a median of 45.5 days in the vehicle-treated group to 105.5 days in the PX-478-treated group (Figure 2F).”
- Also stated in: § Results · plain
“The median survival duration was increased by 132%.”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
PC14PE6 vehicle-treated tumors had only a few apoptotic cells in a scattered pattern.
“In contrast, PC14PE6 vehicle-treated tumors had only a few apoptotic cells in a more scattered pattern.”
Quote in the paperSubstantial claim - Findingown data
PX-478 had a more pronounced effect on tumor growth in the NCI-H187 model than in the PC14PE6 model.
“PX-478 had a more pronounced effect on tumor growth in the NCI-H187 model than in the PC14PE6 model”
Quote in the paperNot a substantial claim - Findingown data
PC14PE6 and NCI-H187 cells had high HIF-1α expression under hypoxia-mimicking conditions.
“with the adenocarcinoma cell line PC14PE6 and the SCLC cell line NCI-H187 showing high expression of HIF-1α under hypoxia-mimicking conditions (Figure 1A).”
Quote in the paperSubstantial claim - Findingown data
In the PC14PE6 model, 20 mg/kg PX-478 reduced median left lung weight by 80% versus vehicle (p = 0.006).
“the median left lung weight was reduced by 80% (Table 1 and Figure 2A) compared with those in the vehicle group; these results were statistically significant (p = 0.005 and 0.006, respectively).”
Quote in the paperSubstantial claim - Findingown data
Microvessel density did not significantly differ between tumors harvested after 5 days of PX-478 treatment and vehicle-treated tumors.
“Microvessel density, as determined by CD31 staining, did not significantly differ between PX-478-treated tumors harvested after 5 days and vehicle-treated tumors.”
Quote in the paperNot a substantial claim - Findingown data
In the NCI-H187 model, mediastinal lymph node metastasis occurred in 8 of 11 (73%) vehicle-treated mice versus 1 of 13 (8%) mice treated with 20 mg/kg PX-478.
“Mediastinal lymph node metastasis was found in eight mice (73%) in the vehicle-treated group, whereas only one mouse (8%) had mediastinal lymph node metastasis in the group treated with 20 mg/kg PX-478”
Quote in the paperSubstantial claim - Findingown data
In the PC14PE6 model, no statistically significant differences in tumor growth reduction were found between the different PX-478 schedules.
“However, we observed no statistically significant differences between the different schedules.”
Quote in the paperNot a substantial claim - Findingown data
After 5 days of PX-478 treatment, no statistically significant reduction in HIF-1α expression was found in the three analyzed orthotopic tumor models.
“we found no statistically significant reduction in HIF-1α expression after 5 days of treatment with the inhibitor in the 3 analyzed models (Figure 3A).”
Quote in the paperNot a substantial claim - Findingown data
In mice with PC14PE6 adenocarcinoma, PX-478 (20 mg/kg orally for 5 days) significantly increased median survival to 41 days versus 30.5 days in vehicle-treated mice (p = 0.01).
“PX-478 treatment significantly (p = 0.01) increased the survival duration of mice with human adenocarcinoma (PC14PE6) to a median of 41 days compared with 30.5 days in the vehicle-treated group (Figure 2C).”
Quote in the paperSubstantial claim - Findingown data
In a time-course experiment in PC14PE6 tumors, no significant reduction in HIF-1α expression was observed after a single 20 mg/kg PX-478 treatment.
“As shown in Figure 3B, we observed no significant reduction in HIF-1α expression.”
Quote in the paperNot a substantial claim - Findingown data
Distant metastasis is frequently observed in the NCI-H187 model.
“we frequently observe distant metastasis in our NCI-H187 model”
Quote in the paperSubstantial claim - Premisecitation
PX-478 is a strong small-molecule inhibitor of HIF-1α.
“PX-478 is a potent small-molecule inhibitor of HIF-1α.”
- Also stated in: § Conclusions · plain
“PX-478, a potent small-molecule inhibitor of HIF-1α, inhibits the subcutaneous growth of a wide variety of tumors, including SCLC”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Welsh, 2004, Antitumor activity and pharmacodynamic properties of PX-478, an inhibitor of hypoxia-inducible factor-1alpha, Mol Cancer Ther source
- Also stated in: § Conclusions · plain
- Premisecitation
In preclinical work, PX-478 had antitumor activity against several solid tumors grown as subcutaneous xenografts.
“In preclinical studies, it had antitumor activity against various solid tumors in subcutaneous xenografts”
- Also stated in: § DISCUSSION · plain
“PX-478 is a small-molecule inhibitor of HIF-1α that has antitumor activity against various human cancer cell lines in subcutaneous xenograft models.17”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Welsh, 2004, Antitumor activity and pharmacodynamic properties of PX-478, an inhibitor of hypoxia-inducible factor-1alpha, Mol Cancer Ther source
- Also stated in: § DISCUSSION · plain
- Premisecitation
HIF-1 is the main transcription factor controlling the cellular response to hypoxia.
“The key regulator of the cellular response to hypoxia is the transcription factor hypoxiainducible factor-1 (HIF-1)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [6] Semenza, 2007, Evaluation of HIF-1 inhibitors as anticancer agents, Drug Discov Today source
- Interpretationown data
PX-478 was particularly effective against two orthotopic models of SCLC.
“PX-478 was particularly effective against two orthotopic models of SCLC.”
Quote in the paperSubstantial claim - Interpretationreasoning
Because PX-478 is effective in both PC14PE6 and NCI-H441, the nonresponsiveness of A-549 tumors to PX-478 is not specific to the NSCLC histologic type.
“Because PX-478 treatment is effective in both this cell line and the NCI-H441 cell line, the nonresponsiveness of A-549 tumors to PX-478 is not specific to the NSCLC histologic type”
Quote in the paperSubstantial claim - Interpretationown data
PX-478 is effective against NSCLC in in vivo models of human adenocarcinoma.
“Together, our results showed, for the first time, that PX-478 is effective against NSCLC in in vivo models of human adenocarcinoma.”
Quote in the paperSubstantial claim - Interpretationown data
Paclitaxel targets the same cell population in the tumor as PX-478.
“Different schedules and the addition of paclitaxel did not lead to further tumor growth inhibition, indicating that paclitaxel targets the same cell population in the tumor.”
Quote in the paperNot a substantial claim - Interpretationown data
PX-478 was particularly effective in the SCLC models.
“PX-478 was particularly effective in our SCLC models.”
Quote in the paperSubstantial claim - Interpretationown data
Preclinical data indicate that PX-478 is active against HIF-1α-expressing human NSCLC and SCLC tumors.
“Our preclinical data indicate that PX-478 is active against HIF-1α-expressing human NSCLC and SCLC tumors”
Quote in the paperSubstantial claim- Rests on an assumption: Orthotopic mouse models of human lung cancer predict how human lung cancer patients will respond to PX-478.
- Rests on an assumption: The human lung cancer cell lines used in this study represent the biology of human NSCLC and SCLC.
- Premisecitation
PX-478 inhibits the subcutaneous growth of many tumor types, including SCLC.
“PX-478, a potent small-molecule inhibitor of HIF-1α, inhibits the subcutaneous growth of a wide variety of tumors, including SCLC”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [17] Welsh, 2004, Antitumor activity and pharmacodynamic properties of PX-478, an inhibitor of hypoxia-inducible factor-1alpha, Mol Cancer Ther source
- Interpretationown data
PX-478 is highly active against orthotopic models of human lung cancer.
“In summary, we showed that PX-478 is highly active against orthotopic models of human lung cancer.”
Quote in the paperSubstantial claim - Interpretationreasoning
Sensitivity to PX-478 differs between in vitro and in vivo settings.
“suggesting that sensitivity to the drug differs in vitro and in vivo.”
Quote in the paperSubstantial claim - Interpretationown data
PX-478 was effective in orthotopic mouse models of human NSCLC and SCLC.
“We found that PX-478 was effective in our models.”
Quote in the paperSubstantial claim - Premisecitation
PX-478 had no measurable activity against an NSCLC xenograft.
“but had no measurable activity against a non-small cell lung cancer (NSCLC) xenograft.”
- Also stated in: § DISCUSSION · plain
“the drug was not effective against the NSCLC cell line A-549 in the panel used by Welsh et al.,17”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Welsh, 2004, Antitumor activity and pharmacodynamic properties of PX-478, an inhibitor of hypoxia-inducible factor-1alpha, Mol Cancer Ther source
- Also stated in: § DISCUSSION · plain
- Interpretationown data
NCI-H187 tumors are more sensitive to apoptosis than PC14PE6 adenocarcinoma cells, at least during earlier tumor growth, even when untreated.
“This observation and the profound effect of PX-478 on tumor growth suggest that NCI-H187 tumors are more sensitive, at least during an earlier stage of tumor growth, to apoptosis than the adenocarcinoma cell line PC14PE6, even in untreated tumors.”
Quote in the paperSubstantial claim
- May combine two claims. 24
- Classified as probably not a substantial claim. 12
May combine two claims.
PremisecitationHIF-1 is overexpressed in 30-62% of NSCLC and 43-46% of SCLC cases, and this overexpression has been linked to worse overall survival.
“HIF-1 is overexpressed in 30 to 62% of NSCLC and 43 to 46% of SCLC cases, and its overexpression has been associated with poorer overall survival.10 –15”
Quote in the paperSubstantial claim3 of 6 sources checked- cites [10] Giatromanolaki, 2001, Relation of hypoxia inducible factor 1 alpha and 2 alpha in operable non-small cell lung cancer to angiogenic/molecular profile of tumours and survival, Br J Cancer source
The paper reports HIF-1 expression in 68 of 108 operable NSCLC cases (62%; p. 881), supporting the upper end of the NSCLC range, but it does not establish the 30% lower end or report the claimed SCLC percentages. Its survival analysis found only a marginal association between HIF-1 expression and poorer prognosis (P = 0.08; p. 886); the stronger association with poor survival was for HIF-2. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites [11] Giatromanolaki, 2003, DEC1 (STRA13) protein expression relates to hypoxia- inducible factor 1-alpha and carbonic anhydrase-9 overexpression in non-small cell lung cancer, J Pathol source
- cites [12] Enatsu, 2006, Expression of hypoxia-inducible factor-1 alpha and its prognostic significance in small-sized adenocarcinomas of the lung, Eur J Cardiothorac Surg source
The Results report that strong HIF-1α expression was associated with reduced overall survival in patients with small-sized lung adenocarcinomas. The Discussion reports strong expression in 23 of 78 cases (29%), but the paper does not establish the claimed 30–62% range for NSCLC or 43–46% range for SCLC. Page numbers are unavailable in our copy. (LLM, conf=0.90)
Experimental — accuracy not yet measured - cites [13] Hung, 2009, Prognostic significance of hypoxia-inducible factor-1alpha, TWIST1 and Snail expression in resectable non-small cell lung cancer, Thorax source
The resectable-NSCLC results report HIF-1α overexpression in 32.2% of 87 tumours, within the claimed NSCLC range, and associate it with shorter overall survival (p = 0.005). The paper does not establish the full 30–62% NSCLC range or address the claimed 43–46% prevalence in SCLC. Page numbers were not provided for these passages. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites [14] Ioannou, 2009, Hypoxia inducible factor-1 alpha and vascular endothelial growth factor in biopsies of small cell lung carcinoma, Lung source
- cites [15] Karetsi E, Kerenidi T, Ioannou M, et al. Clinical significance of hypoxia inducible factor-1 alpha and VEGF expression in lung cancer. European Respiratory Society (ERS) Annual Meeting, Vienna, 2009; Abstract 283.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataNCI-H441 tumors were too small after 5 days of treatment to allow objective evaluation of apoptosis, microvessel density, or HIF-1α expression.
“Tumors from the slow-growing NCI-H441 cell line were too small after 5 days of treatment (day 20 after tumor implantation) to allow an objective evaluation of apoptosis, microvessel density, or HIF-1α expression.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn the NCI-H187 orthotopic SCLC model, 20 mg/kg PX-478 led to near complete tumor growth suppression, with median tumor volume reduced by 99% (p = 0.0001) and median left lung weight reduced by 91% (p = 0.0003) versus vehicle.
“The high dose of PX-478 (20 mg/kg) led to near complete suppression of tumor growth, with a median tumor volume reduction of 99% (p = 0.0001) and a median left lung weight reduction of 91% (p = 0.0003, Table 2 and Figure 2D) compared with the vehicle control group.”
- Also stated in: § Results · plain
“In the NCI-H187 model, the median primary lung tumor volume was reduced by 99% (p = 0.0001).”
Quote in the paperSubstantial claim- Also stated in: § Results · plain
May combine two claims.
Findingown dataIn the NCI-H441 orthotopic adenocarcinoma model, 20 mg/kg PX-478 for 5 days decreased tumor volume by 90% (p = 0.0001) and left lung weight by 79% (p = 0.0004).
“treatment with 20 mg/kg PX-478 for 5 days decreased tumor volume by 90% (p = 0.0001) and left lung weight by 79% (p = 0.0004) in this tumor model.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataPX-478 was highly effective in the NCI-N417 SCLC model, although curative effects were not observed.
“PX-478 was highly effective in the other SCLC model (NCI-N417), although curative effects were not observed.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn the NCI-N417 orthotopic SCLC model, 20 mg/kg PX-478 daily for 5 days decreased median tumor volume by 97% (p = 0.008) and left lung weight by 87% (p = 0.002).
“Treatment with the higher dose of PX-478 (20 mg/kg) daily for 5 days decreased the median tumor volume by 97% (p = 0.008) and left lung weight by 87% (p = 0.002)”
- Also stated in: § Results · plain
“In the NCI-N417 model, the median primary lung tumor volume was reduced by 97% (p = 0.008).”
Quote in the paperSubstantial claim- Also stated in: § Results · plain
May combine two claims.
Findingown dataIn vitro, HIF-1α expression differed among lung cancer cell lines and did not track with histologic type.
“HIF-1α expression levels varied between cell lines and were independent of cell histologic type”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataNCI-N417 and NCI-H187 tumors had extended areas of necrosis and hypoxia, whereas PC14PE6 tumors had only small necrotic and hypoxic areas.
“We killed several mice before the start of treatment and 5 days later and found extended areas of necrosis and hypoxia in NCI-N417 and NCI-H187 tumors, whereas PC14PE6 tumors had only small necrotic and hypoxic areas (as measured by pimonidazole binding, data not shown).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn the NCI-H187 survival experiment, all seven PX-478-treated mice killed before the end of the experiment had metastatic disease, some in multiple organs including lymph nodes, bone, brain, and liver.
“All seven mice that were killed before the end of the experiment had metastatic disease, some in multiple organs, including the lymph nodes (four mice), bone (3), brain (2), and liver (1).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn the NCI-H187 model, a 5-day course of PX-478 was curative in some mice and caused dramatic tumor regression in others.
“In the model using NCI-H187 cells, a 5-day course of PX-478 was curative in some mice, and in other mice, it led to dramatic tumor regression.”
Quote in the paperSubstantial claimMay combine two claims.
Findingnone givenIn PC14-PE6 tumors, HIF-1α levels were higher and randomly distributed, and the tumors were not necrotic and less hypoxic.
“In PC14-PE6 tumors, HIF-1α levels were higher and random, and the tumors were not necrotic and less hypoxic.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn NCI-H187 tumors, vehicle-treated cells had a high background of apoptotic cells, accompanied by necrotic areas.
“In NCI-H187 tumors, a high background of apoptotic cells was visible in vehicle-treated cells; this was accompanied by necrotic areas.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn the NCI-H187 survival experiment, two of 10 PX-478-treated mice were healthy at day 140, and three others had no primary lung tumors when killed.
“two of 10 mice in the PX-478-treated group were healthy at the end of the experiment (day 140 after injection); three others had no primary lung tumors on the day they were killed.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFive days of PX-478 treatment induced profound apoptosis in tumor cells, statistically significant in PC14PE6 and NCI-N417 tumors.
“treatment with PX-478 for 5 days induced profound apoptosis in tumor cells, as determined by cleaved caspase-3 staining and the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay (data not shown); this was statistically significant in PC14PE6 and NCI-N417 tumors.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn the NCI-N417 SCLC model, PX-478 produced a marked reduction in tumor growth but no curative effects.
“In the second SCLC model, based on NCI-N417 cells, we again observed a marked reduction in tumor growth; however, we observed no curative effects in the mice.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn the NCI-H187 model, PX-478 had a curative effect in some mice and radically inhibited tumor growth in others.
“In the NCI-H187 model, it had a curative effect in some mice and radically inhibited tumor growth in others.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn the PX-478-treated group, primary tumor growth was controlled, and the mice developed metastases later.
“However, in the PX-478-treated group, primary tumor growth was controlled, and the mice developed metastases later.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn the PC14PE6 model, PX-478 treatment reduced mediastinal lymph node metastasis and pleural effusion.
“Treatment with PX-478 also markedly reduced the occurrence of mediastinal lymph node metastasis and the production of pleural effusion.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataPX-478 decreased tumor growth in a dose-dependent manner in the lung adenocarcinoma model and slightly but significantly improved survival when given as monotherapy for 5 days.
“PX-478 treatment decreased tumor growth in a dose-dependent manner in the lung adenocarcinoma model and slightly but significantly improved survival when given as monotherapy for just 5 days.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningThe nonresponsiveness of A-549 tumors to PX-478 may be due to yet unknown genetic alterations in this cell line.
“and may be due to yet unknown genetic alterations in this cell line.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataMice were randomized before treatment in the orthotopic lung tumor experiments.
“mice (7–13 per group) were randomized and treated with 10 or 20 mg/kg oral PX-478 daily for 5 days”
- Also stated in: § Orthotopic Lung Tumor Model · plain
“mice were randomly treated with 20 mg/kg oral PX-478 daily for 5 days or vehicle.”
Quote in the paperNot a substantial claim- Also stated in: § Orthotopic Lung Tumor Model · plain
May combine two claims.
PremisecitationPX-478 was ineffective against A549 lung adenocarcinoma xenografts, which had only low HIF-1α expression in vitro and in vivo.
“however, it was ineffective against A549 lung adenocarcinoma xenografts that showed only low expression of HIF-1α in vitro and in vivo.17”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Welsh, 2004, Antitumor activity and pharmacodynamic properties of PX-478, an inhibitor of hypoxia-inducible factor-1alpha, Mol Cancer Ther source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenAll experiments met current regulations and standards of the USDA, HHS, NIH, and MD Anderson Cancer Center.
“All experiments met the current regulations and standards of the U.S. Department of Agriculture, the U.S. Department of Health and Human Services, the National Institutes of Health, and The University of Texas MD Anderson Cancer Center.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationHIF-1 consists of an oxygen-regulated HIF-1α subunit and a constitutively expressed HIF-1β subunit.
“which is composed of an oxygen-regulated HIF-1α subunit and a constitutively expressed HIF-1β subunit.6”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] Semenza, 2007, Evaluation of HIF-1 inhibitors as anticancer agents, Drug Discov Today source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe NCI-H187, NCI-N417, and NCI-H441 cell lines were molecularly characterized.
“NCI-H187, NCI-N417, and NCI-H441 cells were purchased from American Type Culture Collection (Manassas, VA) and molecularly characterized by the University of Texas MD Anderson Cancer Center Cell Line Characterization Shared Resource.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationThe effectiveness of PX-478 is positively correlated with HIF-1α expression in tumors.
“Welsh et al.17 suggested that the effectiveness of PX-478 is positively correlated with HIF-1α expression in tumors.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Welsh, 2004, Antitumor activity and pharmacodynamic properties of PX-478, an inhibitor of hypoxia-inducible factor-1alpha, Mol Cancer Ther source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn addition to hypoxia, cytokines, growth factors, oncogenes, and mutations can raise HIF-1α expression and stability, mainly via PI3K/Akt, Ras/Raf/MAPK, and Smad signaling.
“Besides hypoxia, several cytokines, growth factors, oncogenes, and gene mutations can increase the expression and stability of HIF-1α, mostly through activation of the phosphoinositide 3-kinase/Akt, Ras/Raf/mitogen-activated protein kinase, and Smad pathways.9”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [9] Chan, 2007, HIF gene expression in cancer therapy, Methods Enzymol source
Probably not a substantial claim: may not pass S3 (load-bearing).
Interpretationnone givenOral PX-478 might be converted in the GI tract into metabolites with cytotoxic or off-target effects.
“It is possible that oral administration of PX-478 might lead to conversion of the drug into metabolites in the GI tract, which have cytotoxic effects or off-target effects”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataHIF-1α is expressed at varying levels in lung cancer cells in vitro under hypoxic conditions and in SCLC and NSCLC xenograft tumor tissue in vivo.
“Together, these data demonstrate that HIF-1α is expressed at various levels in lung cancer cells in vitro under hypoxic conditions and in vivo in tumor tissues obtained from SCLC and NSCLC xenografts.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationHypoxia is common in solid tumors, and how cells adapt to low oxygen is important for tumor progression and survival.
“Hypoxia is a common feature in solid tumors, and cellular adaptation to hypoxia is critical to tumor progression and survival.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [6] Semenza, 2007, Evaluation of HIF-1 inhibitors as anticancer agents, Drug Discov Today source
May combine two claims.
PremisecitationUnder hypoxia, oxygen-dependent hydroxylases are inhibited, HIF-1α is stabilized, and it partners with HIF-1β and other cofactors to induce genes for metabolic adaptation, apoptosis resistance, angiogenesis, and tumor invasion and metastasis.
“However, Under hypoxic conditions, oxygen-dependent hydroxylases are inhibited and the HIF-1α subunit is stabilized and then it interacts with the HIF-1β subunit and other cofactors and induces the transcription of many genes involved in metabolic adaptation, apoptosis resistance, angiogenesis, and tumor invasion and metastasis.8”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] Semenza, 2003, Targeting HIF-1 for cancer therapy, Nat Rev Cancer source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationUnder normal oxygen, HIF-1α is hydroxylated at two proline residues and then ubiquitinated by von Hippel-Lindau factor for proteosomal degradation.
“Under normoxic conditions, the α subunit is rapidly hydroxylated at two proline residues and targeted for proteosomal degradation after ubiquitination by the von Hippel-Lindau factor.”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationHIF-1α mRNA expression was identified as one of three prognostic factors for overall survival in early-stage NSCLC.
“HIF-1α mRNA expression was identified as one of three prognostic factors for overall survival in early-stage NSCLC.16”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Lau, 2007, Three-gene prognostic classifier for early-stage non small-cell lung cancer, J Clin Oncol source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationreasoningThe lung microenvironment or different pharmacokinetics may influence how effectively PX-478 inhibits HIF-1α.
“It is also likely that the microenvironment of the lung or different pharmacokinetics influences the effectiveness of PX-478 on HIF-1α inhibition”
Quote in the paperNot a substantial claim
The paper relies on this without support.
The best ways to treat lung cancer and the biological basis of resistance to radiation and chemotherapy are not known.
“the optimal treatment modalities in lung cancer and the biologic mechanism of resistance to radiation therapy and chemotherapy are not understood.”
The paper relies on this without support.
No prior scientific study has shown that PX-478 is active when tumors are grown in an orthotopic tissue environment.
“However, no scientific studies have demonstrated the activity of the compound in an orthotopic tissue environment.”
The paper relies on this without support.
Orthotopic mouse models of human lung cancer predict how human lung cancer patients will respond to PX-478.
“These results suggest the inclusion of lung cancer patients in phase I clinical trials of PX-478.”
The paper relies on this without support.
The human lung cancer cell lines used in this study represent the biology of human NSCLC and SCLC.
“Cells from two human lung adenocarcinoma cell models (PC14-PE6 and NCI-H441) or two human small cell lung cancer (SCLC) models (NCI-H187 and NCI-N417) were injected into the left lungs of nude mice”
The paper relies on this without support.
SCLC commonly spreads to distant organs early in the disease course.
“SCLC is known for spreading early to distant organs”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Treatment schedules are described as lasting both one week and until study end
MajorThe methods say the three-days-per-week and every-third-day PX-478 schedules continued until the end of the experiment. The results instead describe both schedules as lasting one week.
“20 mg/kg PX-478 3 days a week (Monday, Wednesday, and Friday) until the end of the experiment, with or without paclitaxel weekly; 20 mg/kg PX-478 every third day until the end of the experiment, with or without paclitaxel weekly”
“treatment with 20 mg/kg oral PX-478 daily for 5 days, 3 days a week for 1 week, or every third day for 1 week led to a marked reduction in tumor growth in the PC14PE6 model.”
Cites
Jemal, A., Siegel, R. L., Ward, E., Hao, Y., Xu, J., Murray, T., & Thun, M. J. (2008) · CA A Cancer Journal for Clinicians · doi:10.3322/ca.2007.0010 · Cited by 10,184 · see citing works
Targeting HIF-1 for cancer therapy
Semenza, G. L. (2003) · Nature Reviews Cancer · doi:10.1038/nrc1187 · Cited by 6,717 · see citing works
Paclitaxel–Carboplatin Alone or with Bevacizumab for Non–Small-Cell Lung Cancer
Sandler, A., Gray, R., Perry, M. C., Brahmer, J., Schiller, J. H., Dowlati, A., Lilenbaum, R., & Johnson, D. H. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa061884 · Cited by 5,761 · see citing works
Erlotinib in Previously Treated Non–Small-Cell Lung Cancer
Shepherd, F. A., Rodrigues Pereira, J., Ciuleanu, T., Tan, E. H., Hirsh, V., Thongprasert, S., Campos, D., Maoleekoonpiroj, S., Smylie, M., Martins, R., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa050753 · Cited by 5,419 · cited 1× · see citing works
“All seven mice that were killed before the end of the experiment had metastatic disease, some in multiple organs, including the lymph nodes (four mice), bone (3), brain (2), and liver (1).”
BackgroundThatcher, N., Chang, A., Parikh, P., Rodrigues Pereira, J., Ciuleanu, T., von Pawel, J., Thongprasert, S., Tan, E. H., Pemberton, K., Archer, V., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67625-8 · Cited by 2,079 · see citing works
Herbst, R. S., Prager, D., Hermann, R., Fehrenbacher, L., Johnson, B. E., Sandler, A., Kris, M. G., Tran, H. T., Klein, P., Li, X., et al. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.02.840 · Cited by 1,490 · cited 1× · see citing works
“All seven mice that were killed before the end of the experiment had metastatic disease, some in multiple organs, including the lymph nodes (four mice), bone (3), brain (2), and liver (1).”
BackgroundGeneral involvement of hypoxia-inducible factor 1 in transcriptional response to hypoxia.
Wang, G. L., & Semenza, G. L. (1993) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.90.9.4304 · Cited by 1,468 · see citing works
Giatromanolaki, A., Koukourakis, M. I., Sivridis, E., Turley, H., Talks, K., Pezzella, F., Gatter, K. C., & Harris, A. L. (2001) · British Journal of Cancer · doi:10.1054/bjoc.2001.2018 · Cited by 478 · see citing works
Evaluation of HIF-1 inhibitors as anticancer agents
Semenza, G. L. (2007) · Drug Discovery Today · doi:10.1016/j.drudis.2007.08.006 · Cited by 363 · see citing works
HIF-1 regulation: not so easy come, easy go
Koh, M. Y., Spivak-Kroizman, T. R., & Powis, G. (2008) · Trends in Biochemical Sciences · doi:10.1016/j.tibs.2008.08.002 · Cited by 339 · see citing works
Self-citationWelsh, S. J., Williams, R. R., Kirkpatrick, L., Paine-Murrieta, G. D., & Powis, G. (2004) · PubMed · Cited by 280 · see citing works
Self-citationThree-gene prognostic classifier for early-stage non small-cell lung cancer
Lau, S. K., Boutros, P. C., Pintilie, M., Blackhall, F. H., Zhu, C.-Q., Strumpf, D., Johnston, M. R., Darling, G., Keshavjee, S., Waddell, T. K., et al. (2007) · Journal of Clinical Oncology · doi:10.1200/jco.2007.12.0352 · Cited by 255 · see citing works
Welsh, S., Williams, R., Kirkpatrick, L., Paine-Murrieta, G., & Powis, G. (2004) · Molecular Cancer Therapeutics · doi:10.1158/1535-7163.233.3.3 · Cited by 240 · see citing works
Self-citationHung, J.-J., Yang, M.-H., Hsu, H.-S., Hsu, W.-H., Liu, J.-S., & Wu, K.-J. (2009) · Thorax · doi:10.1136/thx.2009.115691 · Cited by 207 · see citing works
Onn, A., Isobe, T., Itasaka, S., Wu, W., O’Reilly, M. S., Hong, W. K., Fidler, I. J., & Herbst, R. S. (2003) · PubMed · Cited by 162 · see citing works
Self-citationPalayoor, S. T., Mitchell, J. B., Cerna, D., DeGraff, W., John‐Aryankalayil, M., & Coleman, C. N. (2008) · International Journal of Cancer · doi:10.1002/ijc.23807 · Cited by 132 · see citing works
Giatromanolaki, A., Koukourakis, M. I., Sivridis, E., Turley, H., Wykoff, C. C., Gatter, K. C., & Harris, A. L. (2003) · The Journal of Pathology · doi:10.1002/path.1330 · Cited by 100 · see citing works
Wu, W., Onn, A., Isobe, T., Itasaka, S., Langley, R. R., Shitani, T., Shibuya, K., Komaki, R. U., Ryan, A. J., Fidler, I. J., et al. (2007) · Molecular Cancer Therapeutics · doi:10.1158/1535-7163.mct-06-0416 · Cited by 88 · see citing works
Self-citationIoannou, M., Papamichali, R., Kouvaras, E., Mylonis, I., Vageli, D., Kerenidou, T., Barbanis, S., Daponte, A., Simos, G., Gourgoulianis, K., et al. (2009) · Lung · doi:10.1007/s00408-009-9169-z · Cited by 57 · see citing works
Enatsu, S., Iwasaki, A., Shirakusa, T., Hamasaki, M., Nabeshima, K., Iwasaki, H., Kuroki, M., & Kuroki, M. (2006) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/j.ejcts.2006.03.027 · Cited by 42 · see citing works
Model of malignant pleural effusion of human lung adenocarcinoma in SCID mice.
Yano, S., Nokihara, H., Hanibuchi, M., Parajuli, P., Shinohara, T., Kawano, T., & Sone, S. (1997) · PubMed · Cited by 36 · see citing works
HIF gene expression in cancer therapy
Chan, D. A., Krieg, A. J., Turcotte, S., & Giaccia, A. J. (2007) · Methods in Enzymology · doi:10.1016/s0076-6879(07)35016-7 · Cited by 26 · see citing works
Flagged first, then by citations
2 of the 24 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
van Meerbeeck, J. P., Fennell, D. A., & Ruysscher, D. D. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60165-7 · Cited by 1,239 · see citing works
Kalemkerian, G. P., Akerley, W., Bogner, P., Borghaei, H., Chow, L. Q., Downey, R. J., Gandhi, L., Ganti, A. K. P., Govindan, R., Grecula, J. C., et al. (2013) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2013.0011 · Cited by 440 · see citing works
HIF and the Lung: Role of Hypoxia-inducible Factors in Pulmonary Development and Disease
Shimoda, L. A., & Semenza, G. L. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201009-1393pp · Cited by 272 · see citing works
Targeting hypoxia-inducible factors: therapeutic opportunities and challenges
Yuan, X., Ruan, W., Bobrow, B., Carmeliet, P., & Eltzschig, H. K. (2024) · Nature Reviews Drug Discovery · doi:10.1038/s41573-023-00848-6 · Cited by 245 · see citing works
“N , N ,-bis(chloroethyl)amino]phenyl propionic acid N -oxide dihydrochloride) is another chemical agent that inhibits HIF1α and decreases tumour growth in murine models 146,147 .”
Mechanisms of small cell lung cancer metastasis
Ko, J. H., Winslow, M. M., & Sage, J. (2020) · EMBO Molecular Medicine · doi:10.15252/emmm.202013122 · Cited by 232 · see citing works
Selective Inhibition of Hypoxia-Inducible Factor 1α Ameliorates Adipose Tissue Dysfunction
Sun, K., Halberg, N., Khan, M., Magalang, U. J., & Scherer, P. E. (2013) · Molecular and Cellular Biology · doi:10.1128/mcb.00951-12 · Cited by 231 · see citing works
Inhibition of Hif1α prevents both trauma-induced and genetic heterotopic ossification
Agarwal, S., Loder, S. J., Brownley, C., Cholok, D. J., Mangiavini, L., Li, J., Breuler, C. J., Hsieh, H. H. S., Li, S., Ranganathan, K., et al. (2015) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1515397113 · Cited by 224 · see citing works
Hypoxia inducible factor as a therapeutic target for atherosclerosis
Jain, T., Nikolopoulou, E. A., Xu, Q., & Qu, A. (2017) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2017.09.003 · Cited by 214 · see citing works
“The N terminus is a bHLH that allows for DNA binding, and the C terminus recruits transcriptional regulatory proteins. were more prominent in SCLC (Jacoby et al., 2010; Jordan et al., 2005) A”
BackgroundSmall molecule inhibitors targeting the cancers
Liu, G., Chen, T., Zhang, X., Ma, X., & Shi, H. (2022) · MedComm · doi:10.1002/mco2.181 · Cited by 198 · see citing works
Cascone, T., Herynk, M. H., Xu, L., Du, Z., Kadara, H. N., Nilsson, M. B., Oborn, C. J., Park, Y., Erez, B., Jacoby, J. J., et al. (2011) · Journal of Clinical Investigation · doi:10.1172/jci42405 · Cited by 160 · see citing works
Self-citationUnraveling tumor microenvironment of small-cell lung cancer: Implications for immunotherapy
Li, T. X., & Qiao, T. (2022) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2022.09.005 · Cited by 130 · see citing works
Zhang, J., Hu, Z., Horta, C. A., & Yang, J. (2022) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2022.12.002 · Cited by 103 · see citing works
“PX-478 treatment efficiently suppressed tumor metastasis in HIF-1α-expressing lung cancer cells[350].”
Six Degrees of Separation: The Oxygen Effect in the Development of Radiosensitizers
Oronsky, B. T., Knox, S. J., & Scicinski, J. J. (2011) · Translational Oncology · doi:10.1593/tlo.11166 · Cited by 89 · see citing works
“PX-478, an orally administered compound with radiosensitizing properties, derived from the clinical alkylating agent melphalan [81], is an inhibitor of HIF-1α expression [81–83].”
BackgroundJan, Y., Lai, T., Yang, C., Lin, Y., Huang, M.-S., & Hsiao, M. (2019) · Journal of Hematology & Oncology · doi:10.1186/s13045-019-0698-5 · Cited by 87 · see citing works
“In an orthotopic xenograft model of lung cancer, the HIF-1α antagonist PX-478 effectively inhibits tumor progression [21].”
Silva, V. L., & Al-Jamal, W. T. (2017) · Journal of Controlled Release · doi:10.1016/j.jconrel.2017.03.013 · Cited by 77 · see citing works
Modulation of macrophage metabolism as an emerging immunotherapy strategy for cancer
Dussold, C., Zilinger, K., Turunen, J. R., Heimberger, A. B., & Miska, J. M. (2024) · Journal of Clinical Investigation · doi:10.1172/jci175445 · Cited by 78 · see citing works
Takahashi, O., Komaki, R. R., Smith, P. D., et al. (2012) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-11-2324 · Cited by 63 · see citing works
“Sections of formalin-fixed, paraffin-embedded tissue specimens were used to assess cleaved caspase-3 (Cell Signaling Technology, Danvers, MA), Ki67 (rabbit a-human, Thermo Scientific), VEGF (goat anti-rat/human, R&D), VEGFR2 (rabbit a-human, Santa Cruz), and phosphorylated MAPK 44/42 (Erk1/2) (Thr202/Tyr204) (antihuma…”
Self-citationMimicking Tumor Hypoxia in Non-Small Cell Lung Cancer Employing Three-Dimensional In Vitro Models
Ziółkowska‐Suchanek, I. (2021) · Cells · doi:10.3390/cells10010141 · Cited by 60 · see citing works
“In an orthotopic mouse model of human NSCLC, treatment with a small molecule inhibitor of HIF-1α, PX-478, significantly reduced the median primary lung tumor volume [46].”
BackgroundFlannigan, K. L., Agbor, T. A., Motta, J., Ferraz, J. G., Wang, R., Buret, A. G., & Wallace, J. L. (2014) · The FASEB Journal · doi:10.1096/fj.14-266015 · Cited by 57 · see citing works
Retinoic Acid Signalling Is Activated in the Postischemic Heart and May Influence Remodelling
Bilbija, D., Haugen, F., Sagave, J., Baysa, A., Bastani, N. E., Levy, F. O., Sirsjö, A., Blomhoff, R., & Valen, G. (2012) · PLoS ONE · doi:10.1371/journal.pone.0044740 · Cited by 56 · see citing works
“The concentration of PX478 was chosen based on experiments performed in similar in vivo models [16,17].”
Methodel Maaty, M. A. A., Terzic, J., Keime, C., Rovito, D., Lutzing, R., Yanushko, D., Parisotto, M., Grelet, É., Namer, I. J., Lindner, V., et al. (2022) · Science Advances · doi:10.1126/sciadv.abo2295 · Cited by 52 · see citing works
“This molecule has been previously shown to have anti-tumor activities in a number of mouse models of cancer ( 19 , 46 ) and was well tolerated by patients with cancer in a phase 1 clinical trial ( 18 ).”
Small molecules targeting HIF-1α pathway for cancer therapy in recent years.
Tang, W., & Zhao, G. (2020) · Bioorganic & Medicinal Chemistry · doi:10.1016/j.bmc.2019.115235 · Cited by 50 · see citing works
Mordant, P., Loriot, Y., Lahon, B., Castier, Y., Lesèche, G., Soria, J., Vozenin, M., Decraene, C., & Deutsch, É. (2011) · PLoS ONE · doi:10.1371/journal.pone.0026073 · Cited by 50 · see citing works
“SC xenografts, but inhibited progression and spread of orthotopic human small cell lung cancer and lung adenocarcinoma in mice, and is finally tested in phase 1 trial [30].”
BackgroundTherapeutic Potential of Perineural Invasion, Hypoxia and Desmoplasia in Pancreatic Cancer
Liu, H., Ma, Q., Xu, Q., Lei, J., Li, X., Wang, Z., & Wu, E. (2012) · Current Pharmaceutical Design · doi:10.2174/13816128112092395 · Cited by 49 · see citing works
Long-term exposure to hypoxia inhibits tumor progression of lung cancer in rats and mice
Yu, L., & Hales, C. A. (2011) · BMC Cancer · doi:10.1186/1471-2407-11-331 · Cited by 43 · see citing works
Hypoxia-inducible factor-1 alpha as a therapeutic target for primary effusion lymphoma
Shrestha, P., Davis, D. A., Veeranna, R. P., Carey, R. F., Viollet, C., & Yarchoan, R. (2017) · PLoS Pathogens · doi:10.1371/journal.ppat.1006628 · Cited by 42 · see citing works
Liu, T., Mu, L.-Q., Dai, W., et al. (2016) · International Journal of Nanomedicine · doi:10.2147/ijn.s101918 · Cited by 37 · see citing works
Hypoxia inducible factor 1α inhibitor PX-478 reduces atherosclerosis in mice
Villa-Roel, N., Ryu, K., Gu, L., Esmerats, J. F., Kang, D. W., Kumar, S., & Jo, H. (2022) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2022.01.002 · Cited by 39 · see citing works
Feng, D., Xu, Y., Hu, J., Zhang, S., Li, M., & Xu, L. (2019) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2019.10.134 · Cited by 36 · see citing works
Song, C. W., Kim, H., Cho, H., Kim, M., Paek, S.-H., Park, H. J., Griffin, R. J., Terezakis, S. A., & Cho, L. C. (2022) · Cancers · doi:10.3390/cancers14133273 · Cited by 35 · see citing works
New metastatic model of human small‐cell lung cancer by orthotopic transplantation in mice
Sakamoto, S., Inoue, H., Ohba, S., et al. (2015) · Cancer Science · doi:10.1111/cas.12624 · Cited by 36 · see citing works
Metabolic Roles of HIF1, c-Myc, and p53 in Glioma Cells
Trejo‐Solís, C., Castillo‐Rodríguez, R. A., Serrano-García, N., Silva‐Adaya, D., Vargas-Cruz, S., Chávez-Cortéz, E. G., Gallardo‐Pérez, J. C., Zavala-Vega, S., Cruz-Salgado, A., & Magaña-Maldonado, R. (2024) · Metabolites · doi:10.3390/metabo14050249 · Cited by 40 · see citing works
“PX-478 showed an antitumoral effect, either alone or combined with agents such as arsenic trioxide and gemcitabine, in mouse xenograft models, reducing tumor growth [349–351].”
BackgroundPrognostic Impact of Hypoxia-InduciblemiRNA-210in Patients with Lung Adenocarcinoma
Osugi, J., Kimura, Y., Owada, Y., Inoue, T., Watanabe, Y., Yamaura, T., Fukuhara, M., Muto, S., Okabe, N., Matsumura, Y., et al. (2015) · Journal of Oncology · doi:10.1155/2015/316745 · Cited by 34 · see citing works
“We showed that miR-210 may be a prognostic biomarker for patients with NSCLC, especially for those with lung adenocarcinoma.”
BackgroundCurrent and future therapies for small cell lung carcinoma
Zhai, X., Zhang, Z., Chen, Y., Wu, Y., Zhen, C., Liu, Y., Lin, Y., & Chen, C. (2025) · Journal of Hematology & Oncology · doi:10.1186/s13045-025-01690-6 · Cited by 35 · see citing works
“Researchers have successfully inhibited the progression and spread of in situ human small-cell lung cancer in mice via the use of HIF-1α antagonists [71].”
The Role of Imaging Biomarkers to Guide Pharmacological Interventions Targeting Tumor Hypoxia
Gallez, B. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.853568 · Cited by 34 · see citing works
“PX478, a compound derived from melphalan by oxidation of the nitrogen mustard moiety, reduced the expression of HIF-1α mRNA and protein in human tumor xenografts, reduced the expression of HIF-1α target genes, and consequently decreased tumor progression and sensitized tumors to radiation therapy (Welsh et al., 2004;…”
BackgroundJalouli, M. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26041752 · Cited by 30 · see citing works
Epitranscriptomic regulation of HIF-1: bidirectional regulatory pathways
Benák, D., Alánová, P., Holzerová, K., Chalupova, M., Opletalová, B., Kolář, F., Pavlínková, G., & Hlaváčková, M. (2025) · Molecular Medicine · doi:10.1186/s10020-025-01149-x · Cited by 28 · see citing works
“Inhibitors such as topotecan (Parmakhtiar et al. 2019) or PX-478 (Jacoby et al. 2010) and activators of PHDs like KRH102053 (Choi et al. 2008) or KRH102140 (Nepal et al. 2011) have shown efficacy in tumor cells.”
Li, D., Jiang, Y., He, P., Li, Y., Wu, Y., Lei, W., Liu, N., de Bruijn, J. D., Zhang, H., Zhang, H., et al. (2023) · Advanced Science · doi:10.1002/advs.202207224 · Cited by 27 · see citing works
Qian, J., Bai, H., Gao, Z., DONG, Y., Pei, J., Ma, M., & Han, B. (2016) · Oncology Letters · doi:10.3892/ol.2016.4150 · Cited by 27 · see citing works
HIF inhibitors for ischemic retinopathies and cancers: options beyond anti-VEGF therapies
Subhani, S., Vavilala, D. T., & Mukherji, M. (2016) · Angiogenesis · doi:10.1007/s10456-016-9510-0 · Cited by 26 · see citing works
Garza, M. M. D. L., Cumpian, A. M., Daliri, S., Castro-Pando, S., Umer, M., Gong, L., Khosravi, N., Caetano, M. S., Ramos-Castaneda, M. A., Flores, A. G., et al. (2018) · Oncotarget · doi:10.18632/oncotarget.26030 · Cited by 27 · see citing works
“It has been shown that treatment with a small molecule inhibitor of HIF-1α, PX-478, inhibited progression and spread of orthotopic human small cell lung cancer and lung adenocarcinoma in mice [38].”
BackgroundLiang, J., Qian, Y., Xu, D., et al. (2013) · Asian Pacific Journal of Cancer Prevention · doi:10.7314/apjcp.2013.14.6.3851 · Cited by 24 · see citing works
“The high expression level of HIF-1α in patients with NSCLC was associated with clinical differentiation and metastasis, but there ass no expression in healthy pulmonary tissue 15-20 cm away from tumor tissue, indicating that HIF-1α plays an important role in the occurrence, development, distal metastasis and local inf…”
BackgroundRegulating the Expression of HIF-1α or lncRNA: Potential Directions for Cancer Therapy
Zhang, M., Zhang, Y., Ding, Y., Huang, J., Yao, J., Xie, Z., Lv, Y., & Zuo, J. (2022) · Cells · doi:10.3390/cells11182811 · Cited by 24 · see citing works
Cao, W., Yuan, F., Liu, T., & Yin, R. H. (2024) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2024.117900 · Cited by 23 · see citing works
Xu, Y.-R., Wang, A.-L., & Li, Y. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.984525 · Cited by 22 · see citing works
Isthmin-1 alleviates cardiac ischaemia/reperfusion injury through cGMP-PKG signalling pathway
Hu, M. S., Zhang, X., Hu, C., Ma, Z., Wang, S., Teng, T., Zeng, X., & Tang, Q. (2024) · Cardiovascular Research · doi:10.1093/cvr/cvae077 · Cited by 24 · see citing works
Positive feedback between oncogenic KRAS and HIF-1α confers drug resistance in colorectal cancer
Sun, W.-B., Wang, Y., Lei, F., Rong, W., & Zeng, Q. (2015) · OncoTargets and Therapy · doi:10.2147/ott.s80017 · Cited by 20 · see citing works
“One study suggested that PX-478 could enhance radiosensitivity of prostate carcinoma cells.(24) Here, we examined the inhibition of PX-478 on the proliferation of CRC cells harboring KRAS G12V mutation.”
RetractedHigh expression of HIF-2α and its anti-radiotherapy effect in lung cancer stem cells
Sun, J. C., He, F., Yi, W., Wan, M., Li, R., Wei, X., Wu, R., & Niu, D.-L. (2015) · Genetics and Molecular Research · doi:10.4238/2015.december.22.37 · Cited by 19 · see citing works
“HIF-1α expression is significantly upregulated after surgery or radiotherapy (Zhang et al., 2009); therefore, HIF-1α may serve as a biomarker to evaluate prognosis (Luan et al., 2013; Wang et al., 2014b), or serve as a target for treatment (Jacoby et al., 2010; Zhang et al., 2012).”
BackgroundXu, Z., Zhu, Y., Su, L., et al. (2021) · Mediators of Inflammation · doi:10.1155/2021/8856326 · Cited by 18 · see citing works
“In addition, literatures have shown that the false positive rate of drug e ffi cacy in subcutaneous tumors is much higher than that in 16 Mediators of In fl ammation orthotopic tumors [28, 29].”
Lee, J., Kim, J. O., Jung, C. K., Kim, Y. S., Yoo, I. R., Choi, W. H., Jeon, E. K., Hong, S. H., Chun, S. H., Kim, S. J., et al. (2013) · Clinical Lung Cancer · doi:10.1016/j.cllc.2013.09.005 · Cited by 19 · see citing works
Prognostic value of hypoxia-inducible factor-1 alpha in nasopharyngeal carcinoma: a meta-analysis
Xie, W., Liu, L., He, H., et al. (2018) · The International Journal of Biological Markers · doi:10.1177/1724600818778756 · Cited by 16 · see citing works
Yang, H., Guo, Q., Wu, J., Zhong, L., Sun, L., Liu, W., Wang, J., & Lin, L. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.851554 · Cited by 15 · see citing works
“It is also found that some TCM botanical drugs are effective in orthotopic transplantation of lung cancer model mice, but there is poor or no effect in subcutaneous transplantation model mice (Jacoby et al., 2010), which indicates that the orthotopic cancer model and the subcutaneous cancer model are almost totally di…”
BackgroundTumor angiogenesis in 75 cases of pleomorphic carcinoma of the lung.
Tsubata, Y., Sutani, A., Okimoto, T., et al. (2012) · PubMed · Cited by 14 · see citing works
Gao, F., You, X., Yang, L., Zou, X., & Sui, B. (2024) · International Reviews of Immunology · doi:10.1080/08830185.2024.2333275 · Cited by 14 · see citing works
“The preclinical examinations have shown that the blockade of HIF-1α enhances the response of lung tumors to therapy [257].”
Lower expression of LINC00092 in lung adenocarcinoma might mean poorer prognosis
Wang, X., Wang, X., Huang, G., & Chen, Y. (2020) · Medicine · doi:10.1097/md.0000000000023012 · Cited by 10 · see citing works
“[26,27] HIF-1alpha antagonist can inhibit progression and spread of LUAD.”
BackgroundInfluentialLi, K., Niu, H., Wang, Y., et al. (2021) · International Journal of Immunopathology and Pharmacology · doi:10.1177/20587384211048265 · Cited by 10 · see citing works
“We herein found that upregulation of TUG1 or downregulation of miR-138-5p was associated with lymph node metastasis and indicated a worse prognosis in LAC.”
BackgroundInfluentialHao, Z., Wang, Y., Li, J., et al. (2023) · Medicine · doi:10.1097/md.0000000000033232 · Cited by 8 · see citing works
“[27] In an orthotopic xenograft model of lung cancer, the HIF-1α antagonist PX-478 effectively inhibits tumor progression.[28] Similarly, we identified a high HIF-1α protein expression in PTC tissues, the expression of HIF-1α was also related to tumor size, capsular invasion and lymph node metastasis, revealing an imp…”
BackgroundTargeting Tumor Hypoxia in Radiotherapy: A Brief Review of Historical Background and Recent Progress
(2016) · Exploratory Research and Hypothesis in Medicine · doi:10.14218/erhm.2015.00004 · Cited by 8 · see citing works
“[113] It was reported that PX-478 inhibited HIF-1α protein levels and HIF-1 transactivating activity in a variety of cancer cell lines in both normoxic and hypoxic conditions.[114,115] PX-478 enhanced radiosensitivity of prostate carcinoma cells.”
BackgroundExploring the prognostic and therapeutic value of HIF1A in lung adenocarcinoma
Lu, Z., Bi, Y.-T., Jiang, J.-L., Yao, X., & Hou, G. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e37739 · Cited by 8 · see citing works
“Although the therapeutic significance of HIF1A in LUAD and LUSC has been partially revealed by in vivo antagonist administration [25], the correlation between HIF1A expression and the prognosis of LUAD and LUSC patients with various clinical features remains elusive.”
BackgroundThe role and mechanisms of the HIF-1 signaling pathway in LC-COPD
Zheng, Y., & Qian, J. (2025) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s00432-025-06373-w · Cited by 6 · see citing works
“Furthermore, HIF-1α inhibition shrank tumor volume and reduced lymph node metastasis in mouse models of lung adenocarcinoma and small cell lung cancer (Jacoby et al. 2010).”
Yu, J., Guo, T., Gupta, A. K. D., Llano, E. M., Salisbury, T., Wajahat, N., Zhao, D., Slater, S., Deng, Q., Akbay, E. A., et al. (2026) · Nature Communications · doi:10.1038/s41467-026-68702-y · Cited by 9 · see citing works
Lu, D., Yuan, L., Ma, X., et al. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e31452 · Cited by 6 · see citing works
“We also used 6 hub genes for molecular docking with their targeted inhibitors ( PDGFRB and Ripretinib [23], KIT and Imatinib [24], FGF1 and PD161570 [25], GLI1 and GANT61 [26], F2R and Vorapaxar [27], HIF1A and PX478 [28], Supplementary Material Fig.”
MethodXu, L., Ishikawa, H., Zhou, Y., Kobayashi, T., & Shozu, M. (2022) · F&S Science · doi:10.1016/j.xfss.2022.01.005 · Cited by 6 · see citing works
The HIF-1α/PKM2 Feedback Loop in Relation to EGFR Mutational Status in Lung Adenocarcinoma
Wang, Y., Lian, H., Li, J., et al. (2024) · Journal of Investigative Surgery · doi:10.1080/08941939.2023.2301081 · Cited by 5 · see citing works
“27 And in our present study, we also found an increased expression of HIF-1α in LUAD tissues, the higher expression of HIF-1α was correlated with higher pTNM stage, suggesting a major role of HIF-1α in the pathogenesis of LUAD.”
Singh, J., Yadav, S., Sonkar, A. B., Kumar, A., Shrivastava, N. K., Kumar, R., Kumar, D., Ansari, M. N., Saeedan, A. S., & Kaithwas, G. (2024) · International Journal of Biological Macromolecules · doi:10.1016/j.ijbiomac.2024.136943 · Cited by 4 · see citing works
HIF-1alpha in lung carcinoma: Histopathological evidence of hypoxia targets in patient biopsies
Ιωάννου, Μ., Simos, G., & Koukoulis, G. Κ. (2013) · Journal of Solid Tumors · doi:10.5430/jst.v3n2p35 · Cited by 4 · see citing works
Nervous system contributions to small cell lung cancer: Lessons from diverse oncological studies
Liao, S., Kang, K., Yao, Z., & Lü, Y. (2024) · Biochimica et Biophysica Acta (BBA) - Reviews on Cancer · doi:10.1016/j.bbcan.2024.189252 · Cited by 2 · see citing works
The implied dysregulated RKIP-hypoxia axis in cancer and immune evasion: Clinical implications
McWhorter, R., Chouaı̈b, S., & Bonavida, B. (2025) · Drug Resistance Updates · doi:10.1016/j.drup.2025.101328 · Cited by 2 · see citing works
Chen, Z., Qiang, M., Dong, J., Gong, K., Zhang, X., Huo, P., Zhu, J., Shao, Y., Ma, J., Zhang, B., et al. (2026) · Annals of Medicine · doi:10.1080/07853890.2025.2601401 · Cited by 3 · see citing works
“Targeting HIF-1α with the inhibitor PX-478 significantly suppresses tumour growth and prolongs survival in multiple SCLC xenograft models, confirming HIF-1α as a viable therapeutic target [51].”
[Advances in the research of glycolysis and lung cancer].
Liu, B., Luo, M., Zhou, Q., & Xu, K. (2012) · Europe PMC (PubMed Central) · doi:10.3779/j.issn.1009-3419.2012.04.07 · Cited by 2 · see citing works
[Advances of hypoxia and lung cancer].
Li, X., You, J., & Zhou, Q. (2013) · Europe PMC (PubMed Central) · doi:10.3779/j.issn.1009-3419.2013.04.08 · Cited by 2 · see citing works
Adenylate kinase-4 modulates oxidative stress and stabilizes HIF-1α to drive lung cancer metastasisPreprint
Jan, Y., Lai, T., Yang, C., Lin, Y., Huang, M., & Hsiao, M. (2017) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/196857 · Cited by 2 · see citing works
“In orthotopic xenograft model of lung cancer, HIF-1α antagonist PX-478 effectively inhibits tumor progression (21).”
BackgroundSimayi, N., Li, J., Hu, J., Jia, N., Wan, R., Xie, J., & Huang, W. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1613368 · Cited by 3 · see citing works
Advancing small cell lung cancer metastasis research: innovations in preclinical mouse models
Zhao, Q., Hu, L., & Ji, H. (2025) · Cancer and Metastasis Reviews · doi:10.1007/s10555-025-10301-2 · Cited by 1 · see citing works
“In contrast, orthotopic implantation improves metastatic outcomes in human-derived xenografts [38, 42–44].”
Guan, R., Zhang, C., Zhang, J., Du, S., Wang, H., Zhang, Y., Abdi, A. A. M., & Wang, H. (2026) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2026.105411 · Cited by 1 · see citing works
Regulation of Cancer Cell Metabolism by Hypoxia
Pulkoski‐Gross, A., Evensen, N. A., & Cao, J. P. (2014) · Cancer drug discovery and develogment/Cancer drug discovery and development · doi:10.1007/978-1-4614-9545-1_4 · Cited by 1 · see citing works
Tsubata, Y., Sutani, A., Kosaka, S., et al. (2012) · Institutional Repositories DataBase (IRDB)
Hypoxic Adaptation and Arsenic Trioxide Treatment in Small Cell Lung Carcinoma
Thorén, M. M. (2013) · Lund University Publications (Lund University)
Bilbija, D. (2013) · NORA - Norwegian Open Research Archives
Emerging strategies for therapeutic targeting of the tumour microenvironment
Quah, X. M., Conway, R., Madigan, M. C., & Epstein, R. J. (2014) · Cancer Forum
Review of Evaluation Methods of Tumor Pharmacodynamics
Shi, T. (2020) · IOP Conference Series Earth and Environmental Science · doi:10.1088/1755-1315/512/1/012104
(2013) · Elsevier eBooks · doi:10.1016/b978-0-12-416570-0.00043-3
Dual phase modeling of Chrysotile carcinogenesis from 3D cell transformation to orthotopic tumors
Gao, Y., Yu, W., Li, R., Wang, Q., Zhang, M., Zhong, Y., Xia, H., Zhang, F., & Zhu, L. (2026) · Scientific Reports · doi:10.1038/s41598-025-08158-0
Ma, Z., Sun, J. Y., Wu, X., Shang, C., & Li, B. (2026) · Oncogenesis · doi:10.1038/s41389-026-00603-7
“Tissue morphology was examined and imaged using an Olympus BX50 optical microscope (Olympus, Tokyo) [48].”
- Authors
- Jacoby, J. J., Erez, B., Korshunova, M. V., Williams, R. R., Furutani, K., Takahashi, O., Kirkpatrick, L., Lippman, S. M., Powis, G., O'Reilly, M. S., & Herbst, R. S.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Corresponding author
- Herbst, Roy S.
- ORCID
- Venue
- Journal of Thoracic Oncology
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 5
- Issue
- 7
- Pages
- 940-949
- ISSN
- 1556-0864 (ISSN-L)
- PMC
- PMC3782111
- OpenAlex
- W2028916882
- Cited by
- 84
- References
- 24
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 10 · 2023: 3 · 2022: 11 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 5 · 2014: 3 · 2013: 8 · 2012: 7
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic Oncology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Foundation for the National Institutes of Health
- Lung Cancer Research Foundation
- National Cancer Research Institute
- National Research Foundation
- National Institutes of Health
- National Cancer Institute (P01CA017094, R01CA098920)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Angiogenesis and VEGF in Cancer
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Keywords
- PX-478, HIF-1α inhibitors, hypoxia-inducible factor-1α, small cell lung cancer, lung adenocarcinoma, orthotopic mouse model, anticancer activity, mediastinal metastasis, tumor progression, survival
- MeSH terms
- Adenocarcinoma, Animals, Carcinoma, Non-Small-Cell Lung, Humans, Immunoenzyme Techniques, Lung Neoplasms, Lymphatic Metastasis, Male, Mice, Nude, Mustard Compounds, Phenylpropionates, Tumor Cells, Cultured, Blotting, Western, Survival Rate, Treatment Outcome, Apoptosis, Disease Progression, Mice, Hypoxia-Inducible Factor 1, alpha Subunit, Small Cell Lung Carcinoma
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review