Characterization of cellular accumulation and toxicity of illudin S in sensitive and nonsensitive tumor cells

 Illudins are novel low molecular weight natural products cytotoxic to human tumor cells in vitro. Illudin-derived analogs are effective against experimental human cancers nonresponsive to conventional anticancer agents. It is not known why some illudin analogs are more efficacious in vitro and in vivo than other analogs. Therefore, the in vitro cytotoxicity of the parent compound illudin S towards tumor cells was characterized using radiolabeled drug. Two cell lines sensitive at nanomolar concentrations using only a 15-min exposure period displayed a saturable, energydependent accumulation of illudins with relatively low K_m and high V_max values. A nonsensitive cell line, requiring millimolar concentrations to achieve in vitro toxicity, showed minimal illudin uptake with higher K_m and lower V_max values. No release of radioactivity could be demonstrated from tumor cells, indicating that there was no efflux of illudin S (or metabolites) from these cells. The number of intracellular illudin S molecules required to kill 50% of cells of different tumor cell lines varied from 78 000 to 1 114 000 molecules per cell and was correlated with the 2-h IC₅₀ value determined using a colony-forming assay. Illudin S was cytotoxic to a variety of multidrug-resistant tumor cell lines regardless of whether resistance was mediated by gp170/mdrl, gp180/MRP, GSHTR-pi, topoisomerase I,topoisomerase II, increased DNA repair capacity, or alterations in intracellular thiol content. Information obtained in this study could be used to design clinical phase I trials and to develop analogs with improved therapeutic indexes. Received: 26 April 1996 / Accepted: 19 September 1996     

Transferrin modulation of colony stimulating factor elaboration by adherent blood and bone marrow cells

When added to cultured normal, adherent blood and marrow cells at concentrations of 25-100 micrograms/ml (3 X 10(-7) to 1.3 X 10(-6) M), human transferrin enhanced colony-stimulating factor (CSF) elaboration. Fe saturated and relatively unsaturated Tf were equally effective in increasing CSF release, but soluble ferric nitriloacetate was ineffective. Dose-dependent increases in CSF release by adherent blood and marrow cells occurred in serum-free media and the continuous presence of Tf was necessary for this effect. Using a monoclonal anti-Tf receptor antibody, normal blood mononuclear cells contained no detectable Tf receptor positive cells. However, after 5 d culture in serum-free medium, Tf receptor positive cells were identified among normal adherent blood cells, and the per cent receptor positive cells increased with Tf concentration. We conclude Tf modulates CSF production from normal, adherent blood and marrow cells in vitro. These findings indicate a possible role for Tf in intramedullary regulation of normal granulopoiesis.     

Induction of colony-stimulating factor response in myeloid leukaemia cell lines

Untreated, late passage HL60 promyelocytic and KG1 myeloblastic leukaemia cells did not increase proliferation with placenta or Mo T cell conditioned medium containing colony-stimulating factor (CSF) nor with partially purified, recombinant granulocyte/macrophage (GM)-CSF. However, after induction with DMSO or 1,25-dihydroxy-vitamin D3, HL60 cells showed dose-dependent increases in proliferation with crude and purified CSFs. CSF responses and macrophage differentiation were induced in KG1 cells by treatment with tetradecanoylphorbol-acetate (TPA). When cells were exposed to inducing agents for varying periods, washed and exposed to CSF, proliferative responses were related to time of exposure. Cells exposed for 1-4 d showed post-induction CSF-induced proliferation, but cells induced for 5-6 d were inhibited by CSF. Induction of CSF response appeared linked to differentiation, since KG1 cells differentiated with TPA and developed CSF-induced proliferative responses, but showed no differentiation or CSF induced proliferation after treatment with vitamin D3. When HL60 cells were continuously exposed to DMSO or vitamin D3, overall cell production was increased by placenta conditioned medium, but cultures still became senescent and died after several weeks. Cells continuously cultured with DMSO were predominantly macrophages, indicating lineages of DMSO-induced differentiation were modified by continuous culture or the presence of CSF. After treatment with chemical inducers, proliferation of myeloid leukaemia lines is stimulated by CSF, providing a model for post-deterministic regulation of normal and malignant myeloid cell production.     

Acidic isoferritins (leukemia-associated inhibitory activity) fail to inhibit blast proliferation in acute myelogenous leukemia

Cell-free extracts of bone marrow and blood cells from patients with leukemia contain an inhibitor of normal granulocyte/macrophage progenitor (CFU-GM) proliferation (leukemia-associated inhibitory activity, LIA) identified as acidic isoferritins. A comparison was made of the action of crude LIA prepared from frozen-thawed leukemic blood cells and purified spleen ferritin from a patient with chronic myelogenous leukemia, on the proliferation of blast progenitors from patients with acute myelogenous leukemia (AML), and on the promyelocytic leukemia cell line, HL-60. Crude LIA showed no inhibition of blast progenitor or HL-60 proliferation at low concentrations, but inhibited the proliferation of CFU-GM. At higher concentrations, crude LIA inhibited both blast cells and CFU-GM. Purified spleen ferritin failed to inhibit blast progenitors or HL-60 cells at any concentration tested, but inhibited both 70-day and 14-day CFU-GM. Using the thymidine "suicide" technique, the action of LIA was confirmed as being on CFU-GM in S-phase, but it failed to affect the proliferation of blast cell in S-phase. It is concluded that acidic isoferritins inhibit normal CFU-GM but not blast cells from patients with AML. Acidic isoferritins could confer a proliferative advantage of the leukemic clone over its normal counterparts.     

Use of nude mouse xenografts as preclinical drug screens. Further studies on in vitro growth of xenograft tumor colony-forming cells

Previous studies suggested tumor colony-forming cells (CFC) grown from xenografts might be useful as a preclinical, in vitro drug screen. To further evaluate this possibility, eight melanoma and six ovarian carcinoma xenografts were established from untreated patients and tested for in vitro CFC growth. For each tumor, linear relationships between cells plated and colony (30 cells or greater than 75 micron diameter) and cluster (10-30 cells or 50-75 micron) growth were observed. All eight melanomas grew sufficient colonies (greater than or equal to 30) for in vitro drug assessment, although four required hypoxic (pO2 = 40) incubation to reliably attain this level of growth. Only one in six of the ovary xenografts consistently grew enough colonies, and growth was not significantly improved by hypoxic incubation, or addition of luteinizing hormone, follicle-stimulating hormone, or steroid hormones. Cloning efficiencies (colonies + clusters/cells plated) for tumors demonstrating adequate growth ranged from 0.01% to 0.3%. For most tumors, no direct relationship was observed between characteristics of xenograft tumors (size) or their resulting cell suspensions (viabilities, cell yield) and CFC growth. Cell suspensions were incubated with a 3 log concentration of nine established chemotherapeutic agents. Resulting dose-effect curves were linear and showed no plateaus of drug effect. Analyzing 447 in vitro drug trials on six melanomas and one ovarian carcinoma, interexperiment variability was high. Cell lines were established from three xenografts using a low concentration of fetal bovine serum (1%), and also examined for in vitro drug sensitivity. Using both liquid culture isotope incorporation and a colony-forming assay, drug sensitivity profiles for the cell lines were nearly identical to those for parent xenograft CFC. However, assays performed using the cell lines were more reproducible than those using xenograft tissue. The authors conclude that tumor CFC can be reliably grown from melanoma xenografts, but in vitro drug assays using these xenografts are poorly reproducible. The xenografts are a resource for establishing cell lines, and drug assays performed using these lines are highly reproducible. Similarities in drug sensitivity profiles for parent xenograft CFC and derived cell lines suggest that, despite poor reproducibility, repetitive assays using melanoma CFC accurately reflect some properties of cells which sustain tumor cell growth.     

Thymidine as a chemotherapeutic agent: sensitivity of normal human marrow, peripheral blood T cells, and acute nonlymphocytic leukemia

Normal marrow granulocyte (CFU-GM) and peripheral blood T-lymphocyte (CFU-TL) colony-forming cells were studied for their sensitivity to high concentrations of thymidine (dThd) and compared to leukemic CFU from patients with acute nonlymphocytic leukemia (ANLL). The sensitivity of two ANLL cell lines was also assessed. dThd was toxic to both CFU-GM and CFU-TL at concentrations above 10(-5) M when cultured under conditions where dThd exposure was analogous to that used in clinical trials. There was little variation in the fractional colony survival between marrow samples, and the sensitivity of CFU-GM closely approximated that of CFU-TL. Thymine was not toxic at up to 10(-3) M. In liquid culture, T cells in G0 at the start of exposure were able to proliferate in the presence of 10(-3) M dThd, whereas T cells already proliferating in response to phytohemagglutinin (PHA) at the start of dThd exposure were killed. Leukemic CFU demonstrated marked variability in dThd sensitivity; blasts from some patients were resistant to dThd, while others were greater than 100-fold more sensitive than normal CFU- GM.     

Colony-forming assay for circulating chronic lymphocytic leukemia cells

In these studies, we report adaptation of a colony-forming assay to chronic lymphocytic leukemia (CLL) peripheral blood cells. T-lymphocyte-depleted CLL peripheral blood cells were cultured with irradiated, normal T cells and media conditioned by normal, mitogen-stimulated T cells in methylcellulose. Colonies containing small and transformed lymphocytes appeared after 5–7 days incubation. The plating efficiency of CLL colonies was 0.15 ± 0.08% ($\text{x}\text{±}\text{S.D.}$), similar to that of other colony-forming systems. The majority of CLL colony-forming cells were in S phase (50 ± 4%, $\text{x}\text{±}\text{S.E.}$) as determined by thymidine suicide and the fraction of colony-forming cells in S phase was inversely related to the WBC. Cells harvested from CLL colonies lacked surface markers for T lymphocytes and stained positively for monoclonal surface and/or cytoplasmic immunoglobulin light chains. A 1-h incubation was used to study the in vitro response of CLL colony-forming cells to adriamycin and melphalan. Preliminary studies suggest differences in patterns of in vitro sensitivity to melphalan between patients previously treated with alkylating agents and those who had not received treatment. This system can be used to study regulation of CLL cell proliferation, and may have utility in predicting response to chemotherapeutic agents.     

Extensive disease small cell carcinoma of the lung: trial of non-cross resistant chemotherapy and consolidation radiotherapy

Twenty-nine patients with extensive disease, small-cell carcinoma of the lung, were treated with two cycles of intensive combination chemotherapy: HexaVAC (hexamethylmelamine, vincristine, Adriamycin, cyclophosphamide). Responders received prophylactic cranial radiation (2000 rad/10 fractions) and non cross resistant chemotherapy via a schedule of alternating cycles of CMV (cyclophosphamide, methotrexate, VP-16-213) and AMV (Adriamycin, methotrexate, VP-16-213). Whenever a complete response was achieved, consolidation radiotherapy was given to the lung primary (4000 rad/20 fractions, split dose) and abdominal metastases (2000 rad/10 fractions) synchronous with CMV therapy. The complete response rate was 14% with HexaVAC, but increased to 38% during CMV/AMV. Total response rate (complete and partial) was 59% and median survival was 42 weeks. Prophylactic brain radiation prevented clinical relapse in the brain in all 14 patients who received it. However, consolidation radiotherapy failed to prevent clinical relapse in the lung and/or liver, and therapeutic brain radiation (3000 rad) failed to prevent relapse in that site. The simultaneous administration of radiotherapy and chemotherapy was well-tolerated although two patients with poor performance status died of infectious complications while leukopenic. In spite of the high response rate, durable remissions with prolonged disease free survival were rare. Further evaluation of induction, consolidation, and maintenance modes of therapy are indicated.     

In vitro sensitivity to steroid hormones and cytotoxic agents of normal and malignant lymphocyte colony-forming cells

In vitro assays were used to assess the sensitivity of normal T-cells and malignant, chronic lymphocytic leukemia (CLL) lymphocyte colony-forming cells (CFC) to a panel of cytotoxic drugs and steroid hormones. Normal T-CFC were remarkably resistant to hydrocortisone, progesterone, estradiol, and testosterone at concentrations less than or equal to 10(-5) M. Variable inhibition was seen at concentrations of 10(-4) M, and prior exposure to phytohemagglutinin increased sensitivity only to sex steroid hormones. In contrast to T-CFC, which showed little variation in patterns of steroid hormone inhibition in vitro, CLL-CFC from individual patients displayed widely varying sensitivity to all hormones tested; 50% inhibitory dose varied by as much as 2 logs. T-CFC were fairly resistant to a 1-hr exposure to achievable concentrations of 1-beta-D-arabinofuranosyl-cytosine, 5-fluorouracil, chlorambucil, melphalan, cisplatin, methotrexate, Adriamycin, and bleomycin. Prior exposure to phytohemagglutinin resulted in increased sensitivity only to low concentrations of Adriamycin, a phenomenon that appeared related to prior or concurrent lectin exposure and not to changes in cell cycle status. CLL-CFC showed variable sensitivity to Adriamycin and cisplatin, and concurrent exposure to lectin and Adriamycin did not increase sensitivity to that drug. CLL cells displayed much greater sensitivity to a 1-hr exposure to antimetabolites and bleomycin than to continuous exposure to the same drugs. In contrast to normal T-CFC, CLL-CFC exposed to methotrexate were not "rescued" by subsequent culture in media and fetal bovine serum. Incubation of T-CFC or CLL-CFC with melphalan and a source of protein (fetal bovine serum or bovine serum albumin) resulted in decreased cell kill. Differences in in vitro sensitivity of normal and malignant lymphocyte CFC to steroids and cytotoxic agents can be demonstrated using these culture systems. CLL-CFC showed variable sensitivity to hydrocortisone, and much greater sensitivity to antimetabolites than normal T-CFC. Differences in conditions of drug exposure, such as concurrent exposure to lectin or inclusion of protein, may alter the in vitro sensitivity of lymphocyte CFC to some drugs.