TY - JOUR T1 - Alterations of Hypoxia-Induced Factor Signaling Pathway Due to Mammalian Target of Rapamycin (mTOR) Suppression in Ovarian Clear Cell Adenocarcinoma: In Vivo and in Vitro Explorations for Clinical Trial JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1210 LP - 1218 DO - 10.1097/IGC.0b013e31829d2d51 VL - 23 IS - 7 AU - Takeshi Hirasawa AU - Masaki Miyazawa AU - Masanori Yasuda AU - Masako Shida AU - Masae Ikeda AU - Hiroshi Kajiwara AU - Naruaki Matsui AU - Mariko Fujita AU - Toshinari Muramatsu AU - Mikio Mikami Y1 - 2013/09/01 UR - http://ijgc.bmj.com/content/23/7/1210.abstract N2 - Objectives Before setting into the clinical trial using a combination of mammalian target of rapamycin (mTOR) inhibitors (rapamycin and everolimus) and other anticancer drugs, this study was conducted to confirm the efficacy of the new therapeutic strategy for ovarian clear cell adenocarcinoma (CCA), which targeted mTOR–hypoxia-induced factor (HIF) signal transduction system.Materials and Methods Using the cultured cells of CCA and animal models, alteration of mTOR-HIF cofactors and cell proliferation under the mTOR inhibitor–treated condition were analyzed.Results Mammalian target of rapamycin–HIF cofactors were inhibited dependent on concentration by mTOR inhibitor, resulting in suppression of the cultured CCA proliferation. However, von Hippel-Lindau was up-regulated at the messenger RNA level. In the nude mice with subcutaneously implanted CCA cells, apoptosis and necrosis were detected especially around the center of the tumors in the mTOR inhibitor–treated group more conspicuously than in the nontreated group. In the assessment of combination therapy with other antitumor agents, a combined treatment with mTOR inhibitor and chemotherapeutic agents caused a significant decrease in tumor size compared to the chemotherapeutic agents–only group.Conclusions Treatment by mTOR inhibitor is expected to down-regulate the cell proliferation of the CCA as a new therapeutic strategy. ER -