Jaime R. Merchan, M.D., MMSc.
Associate Professor of Medicine
Description of Research
Dr. Merchan’s laboratory focuses on the development of novel biological strategies aimed at targeting angiogenesis and cancer in the laboratory and then translating these findings into clinical trials for patients with advanced cancer.
A major focus of his laboratory is to develop stromal and vascular targeted oncolytic viral vectors for cancer treatment. The Merchan lab has engineered a novel recombinant oncolytic measles virus (MV-uPA) fully retargeted against human (MV-huPA) or murine (MV-muPA) urokinase receptor, a clinically and biologically established tumor and vascular target. Our lab has demonstrated for the first time the ability of MV-muPA to target tumor capillaries after systemic administration. Current studies are characterizing the safety, biodistribution and antitumor effects of MV-uPA in immunocompetent cancer models, as well as the biological implications of targeting tumor stroma as a component of oncolytic viral therapies.
In addition, in collaboration with Glen Barber, we are developing VSV-h-IFNB as an agent for the treatment of patients with advanced head and neck cancer. We have completed preclinical studies and are currently pursuing a phase I clinical trial of this agent for patients with this disease. Future studies will characterize the safety and efficacy of VSV-h-IFNB as a systemic therapy agent for different human malignancies.
As part of Dr. Merchan’s efforts to identify novel angiogenesis targets for cancer treatment and to overcome resistance to antiangiogenic therapies, his team has investigated –in a bench to bedside manner- novel combinations of antiangiogenic agents. Most of the translational studies and trials have derived from their laboratory observations. Examples of these strategies include the use of plasminogen activators as antiangiogenic/antitumor agent, and the combination of metronomic paclitaxel and COX-2 inhibitors for melanoma and prostate cancer. Current efforts include the evaluation of CCI-779 and Bevacizumab in RTKI refractory renal cell cancer (our reported phase I portion led to 2 large First line trials in advanced RCC in Europe and the USA), and a combination of metronomic vs. standard ixabepilone and sunitinib for advanced solid tumors. All of these studies include translational (angiogenesis biomarker studies) to correlate biological and clinical activity/toxicity.
Finally, Dr. Merchan’s laboratory is investigating the antiangiogenic activity of 2-DG. They have discovered that 2-DG potently inhibits angiogenesis in vitro and in vivo, and that the cytotoxic effects occur at concentrations of 2-DG that are below tumor cytotoxic concentrations. Current studies are aimed at understanding the molecular mechanisms of 2-DG antiangiogenic effects, and to explore other agents that target glycosylation and induce endothelial ER stress glucose as a strategy to overcome tumor resistance to anti-VEGF/antiangiogenic therapies.
- Discovered that proteases of the plasminogen activator system induced potent antiangiogenic activity in vitro and in vivo. Dr. Merchan also has demonstrated induction of an antiangiogenic state in patients with cancer, after administration of intravenous tissue plasminogen activator and captopril.
- Discovered that overexpression of urokinase delays tumor growth, metastasis, and survival in a syngeneic, immunocompetent murine model of breast cancer. Also demonstrated that the tumor delaying effects are directly due to the protease activity of urokinase, which induces in vivo antiangiogenic and antiproliferative effects.
- Discovered that the pro-or antitumorigenic effects of urokinase overexpression are dependent, in part, on endogenous tumor PAI-1 expression, and that shifting the balance in favor of uPA delay tumor progression and distant metastases.
- Discovered that endothelial uptake of taxanes is significantly higher than tumor or normal cells. This discovery provides a mechanistic explanation for the exquisite sensitivity of endothelium to low dose taxanes. This provided insight into the clinical finding that low dose, frequent taxane administration is more effective in several tumor types than standard (high) taxane doses.
- Discovered that endothelial expression of COX-2 is increased after exposure to taxanes, and that combining COX-2 inhibitors to low-dose taxanes significantly enhanced the antiangiogenic effects. This discovery led to a clinical trial of metronomic paclitaxel and celecoxib in patients with advanced melanoma.
- Identified novel angiogenesis biomarkers. By using a novel endothelial bioassay (endothelial tube formation) using patient’s plasma as a surrogate marker, Dr. Merchan discovered that pre-eclampsia is an antiangiogenic state, due to placental overexpression of sFLT-1. This important discovery opened a new avenue of research in pre-eclampsia, placing the disorder into the category of angiogenesis-dependent diseases. Relevant to cancer research, this discovery shed light into the understanding of common side effects of FDA-approved antiangiogenic agents (like Avastin), whose side effects (hypertension/proteinuria) mimic the antiangiogenic state of pre-eclampsia. These plasma bioassays are currently being investigated as potential biomarkers to establish surrogate endpoints for benefit in several antiangiogenesis trials.
- Developed the first oncolytic measles virus fully retargeted against a tumor/angiogenesis target (MV-uPA) with the ability to target murine tissues. This significantly contributes to the field of measles virotherapy, by allowing for the first time to perform in vivo studies using non-transgenic, immunocompetent animals, for further development of retargeted oncolytic measles virotherapy for cancer treatment.
- Discovered that the glucose analog, 2-DG is a potent antiangiogenic agent at concentrations that are not cytotoxic for cancer cells, effect mediated by inhibition of endothelial N-linked glycosylation, unfolded protein response (UPR) and UPR mediated endothelial apoptosis.
Selected Cancer-Related Publications
- Kurisetty VV, Heiber J, Myers R, Pereira GS, Goodwin JW, Federspiel MJ, Russell SJ, Peng KW, Barber G, Merchan JR. Preclinical safety and activity of recombinant VSV-IFN-? in an immunocompetent model of squamous cell carcinoma of the head and neck. Head Neck :,2013 Read more »
- Motzer RJ, Hutson TE, Cella D, Reeves J, Hawkins R, Guo J, Nathan P, Staehler M, de Souza P, Merchan JR, Boleti E, Fife K, Jin J, Jones R, Uemura H, De Giorgi U, Harmenberg U, Wang J, Sternberg CN, Deen K, McCann L, Hackshaw MD, Crescenzo R, Pandite LN, Choueiri TK. Pazopanib versus sunitinib in metastatic renal-cell carcinoma. N Engl J Med 369:722-31,2013 Read more »
- Xi H, Barredo JC, Merchan JR, Lampidis TJ. Endoplasmic reticulum stress induced by 2-deoxyglucose but not glucose starvation activates AMPK through CaMKK? leading to autophagy. Biochem Pharmacol 85:1463-77,2013 Read more »
- Jing Y, Kovacs K, Kurisetty V, Jiang Z, Tsinoremas N, Merchan JR. Role of Plasminogen Activator Inhibitor-1 in Urokinase's Paradoxical In Vivo Tumor Suppressing or Promoting Effects. Mol Cancer Res :,2012 Read more »
- Talebi TN, Stefanovic A, Merchan J, Lian E, Silva O. Sunitinib-induced microangiopathic hemolytic anemia with fatal outcome. Am J Ther 19:e143-5, 2012. Read more »
- Hosein PJ, de Lima Lopes G Jr, Pastorini VH, Gomez C, Macintyre J, Zayas G, Reis I, Montero AJ, Merchan JR, Rocha Lima CM. A Phase II Trial of nab-Paclitaxel as Second-line Therapy in Patients With Advanced Pancreatic Cancer. Am J Clin Oncol :,2012 Read more »
- Hosein PJ, Macintyre J, Kawamura C, Maldonado JC, Ernani V, Loaiza-Bonilla A, Narayanan G, Ribeiro A, Portelance L, Merchan JR, Levi JU, Rocha-Lima CM. A retrospective study of neoadjuvant FOLFIRINOX in unresectable or borderline-resectable locally advanced pancreatic adenocarcinoma. BMC Cancer 12:199,2012 Read more »
- Ascunce G, Ribeiro A, Reis I, Rocha-Lima C, Sleeman D, Merchan J, Levi J. EUS visualization and direct celiac ganglia neurolysis predicts better pain relief in patients with pancreatic malignancy (with video). Gastrointest Endosc 73:267-74, 2011. Read more »
- Houston SK, Piña Y, Murray TG, Boutrid H, Cebulla C, Schefler AC, Shi W, Celdran M, Feuer W, Merchan J, Lampidis TJ. Novel retinoblastoma treatment avoids chemotherapy: the effect of optimally timed combination therapy with angiogenic and glycolytic inhibitors on LH(BETA)T(AG) retinoblastoma tumors. Clin Ophthalmol 5:129-37,2011 Read more »
- Kubiliun N, Ribeiro A, Fan YS, Rocha-Lima CM, Sleeman D, Merchan J, Barkin J, Levi J. EUS-FNA with rescue fluorescence in situ hybridization for the diagnosis of pancreatic carcinoma in patients with inconclusive on-site cytopathology results. Gastrointest Endosc 74:541-7,2011 Read more »
- Merchan JR, Ferrell A, Macintyre J, Ciombor KK, Levi J, Ribeiro A, Sleeman D, Flores A, Lopes G, Rocha-Lima CM. Phase II Study of Gemcitabine,Oxaliplatin,and Cetuximab in Advanced Pancreatic Cancer. Am J Clin Oncol :,2011 Read more »
- Wang X, Li G, Wang A, Zhang Z, Merchan JR, Halmos B. Combined histone deacetylase and cyclooxygenase inhibition achieves enhanced antiangiogenic effects in lung cancer cells. Mol Carcinog :,2011 Read more »
- Bhatt RS, Merchan J, Parker R, Wu HK, Zhang L, Seery V, Heymach JV, Atkins MB, McDermott D, Sukhatme VP. A phase 2 pilot trial of low-dose,continuous infusion,or "metronomic" paclitaxel and oral celecoxib in patients with metastatic melanoma. Cancer 116:1751-6, 2010. Read more »
- Merchan JR, Kovács K, Railsback JW, Kurtoglu M, Jing Y, Piña Y, Gao N, Murray TG, Lehrman MA, Lampidis TJ. Antiangiogenic activity of 2-deoxy-d-glucose. PLoS One 5:e13699,2010 Read more »
- Ascunce G, Ribeiro A, Rocha-Lima C, Larsen M, Sleeman D, Merchan J, Szabo D, Levi JU. Single-session endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography for evaluation of pancreaticobiliary disorders. Surg Endosc 24:1447-50, 2010. Read more »