To: Steven Rachbach who wrote (245 ) 2/22/1999 1:07:00 PM From: Steven Rachbach Read Replies (1) | Respond to
I would like to clarify some of the confusing and misleading aspects of VEGF testing. VEGF (vascular endothelial growth factor) is being tested in peripheral vascular disease and coronary artery disease as a way to restore blood flow to tissues being deprived of oxygen and nutrients. Confusion has arisen because there are several companies working on different VEGFs. On January 26th, Reuters reported that Dr. James Symes, at St.Elizabeth's Hospital at Tufts University, had injected VEGF directly into the hearts of 20 seriously ill cardiac patients. Resulting from the procedure, 19 out of 20 had less chest pain. At the end of the article, it states that, "Human Genome Sciences Inc. <HGSI.O> has licensed the right to develop VEGF to Vascular Genetics Inc., a company that HGSI formed with St.Elizabeth's." That last statement is partially false. The VEGF that Dr. Symes was using was not HGSI's VEGF. HGSI's VEGF is named VEGF-2 and it stimulates lymphatic vessel formation as well as blood vessel formation. The HGSI product is now in clinical trials for peripheral vessel disease (i.e. the leg) although the company expects to ask the FDA for permission to start human trials for the cardiac indication by the end of the year. The statement in the article should have said that HGSI has licensed the right to develop VEGF-2 to Vascular Genetics, a company HGSI formed with St. Elizabeth's. The VEGF that Dr. Symes used was the gene that expresses the protein (VEGF or VEGF-1) that Genentech last week reported a failed Phase 2 trial. In that trial, the protein (not the gene) was administered by intravenous line (not into the heart) and patients failed to show an improvement. That's not a surprise to me at all. I think the medication must be injected into the target area directly. I don't think a protein floating around the body has a real chance to "grow" blood vessels in the heart. Further, there is a rational for using the gene rather than the protein. If the gene if injected directly into heart muscle tissue, it can get integrated into the cell and then crank out protein. After some time, the genes degrades and its effects cease. The gene may last longer than the protein it produces and so the gene treatment may be superior to the protein treatment. In conclusion, the encouraging results of injecting the VEGF-1 gene directly into the heart bodes well for HGSI's VEGF-2 and the fact that systemically administered VEGF-1 protein failed to improve cardiac patients was almost a forgone conclusion.
Regards,
Steve Rachbach
