Contacts:
Sarah Goodwin

Kathi Ovnic
Holly Korschun
January 14, 1999


ANGIOGENESIS UPDATE:

  • To Grow or Not to Grow Vessels: Yes! for Heart Disease; No! for Cancer
  • Emory Gears up for Phase II of Its Chiron Trial
    • Gene Therapy for Angiogenesis Begins Soon


    TO GROW OR NOT TO GROW NEW VESSELS: YES! FOR HEART DISEASE; NO! FOR CANCER

    Tiny blood vessels are making medical headlines. When they nourish damaged heart muscle with oxygenated blood, that's a good thing. But the same types of vessels also nourish deadly tumors ­ and that's not such a good thing. It seems that as cardiology researchers are working hard to grow microvessels (angiogenesis), their cancer colleagues are working just as hard to inhibit vessel growth (anti-angiogenesis). Are these cross purposes?

    "Actually, our experimental cardiac treatments are localized to the heart muscle," says Nicolas Chronos, M.D., director of research for the Andreas Gruentzig Cardiovascular Research Center in the division of cardiology, department of medicine, Emory University School of Medicine. "Still, we are careful not to experiment with angiogenesis in heart patients who also have cancer."

    According to Dr. Chronos, the "encouraging" results being seen at Emory and the handful of other institutions conducting clinical trials of angiogenesis for heart disease are based on advances made by oncology researchers attempting to starve tumors. Cancer researchers discovered that tumor cells secrete vascular endothelial growth factor (VEGF) to spur vessel formation. Oncologists now are developing anti-angiogenesis compounds known as statins to inhibit that formation. In Spring 1998, news of the success of angiostatin and endostatin to kill cancerous tumors in mice was hailed as the cure for cancer. Optimistic but cautious, cancer researchers maintained that the drugs must be evaluated in humans. The Winship Cancer Center of Emory University is expected to participate in statin clinical trials.

    EMORY HEART DOCS BEGIN PHASE II OF THEIR CHIRON ANGIOGENESIS TRIAL

    Cardiology researchers have been evaluating new vessel growth in patients with ischemic heart disease given VEGF and recombinant basic fibroblast growth factor (bFGF).

    A portion of the heart muscle can become damaged and develop ischemia when the coronary arteries supplying it become so narrowed with atherosclerotic plaque the muscle literally is starved for nourishment. Angiogenesis researchers theorize that a network of new microvessels could feed and thus heal the damaged tissue.

    During Phase I of the CHIRON trial, led by Principal Investigators Dr. Chronos and Spencer King, M.D., professor of cardiology and director of the Gruentzig Center, 36 patients received bFGF. In a similar trial, Dr. Chronos and Emory colleague Jeffrey Marshall, M.D., evaluated administration of VEGF in two subjects. The angiogenic growth factor was infused into the coronary artery via catheter. Preliminary Phase I data from the two study sites, Emory and Beth Israel Hospital in Boston, will be presented at the upcoming American College of Cardiology meeting.

    The Emory team has begun Phase II of CHIRON, which will compare bFGF vs. placebo in 30-60 subjects. Qualified participants should have advanced, multivessel coronary artery disease and not be candidates for angioplasty or bypass surgery.

    GENE THERAPY FOR HEART DISEASE TO BEGIN AT EMORY THIS SPRING

    The cardiology team led by Douglas Morris, M.D., director of Emory Heart Center, and Dr. Chronos, plans to begin a new trial in Spring 1999 in which the gene that expresses an angiogenic growth factor is injected into the heart muscle rather than the growth factor. To administer the gene for acidic fibroblast growth factor (aFGF), doctors will be guided by the new Biosense Noga electromechanical mapping system. They hope to enroll persons with advanced coronary artery disease into the study.

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