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Characterization of sequence-dependent synergy between ZD1839 ("Iressa") and oxaliplatin
Authors:Xu Jian-Ming  Azzariti Amalia  Severino Montemuro  Lu Bing  Colucci Giuseppe  Paradiso Angelo
Institution:Beijing 307 Hospital Cancer Center, Beijing 100039, China.
Abstract:ZD1839 ("Iressa"), a selective epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), is currently undergoing preclinical and clinical evaluation in several solid tumors. The present study aimed to assess the effect of ZD1839 in combination with oxaliplatin in the colon cancer cell lines HT-29 and LoVo. For in vitro chemosensitivity testing, cells were treated with serial dilutions of each drug sequentially at a fixed ratio of doses that corresponded to 1/20, 1/10, 1/5, 1/2, 1, 1.5 and 2 times the individual IC(50) values. Oxaliplatin followed by ZD1839 produced a synergistic effect. In contrast, oxaliplatin following ZD1839 exhibited an additive effect at best. Mass spectrometry examination revealed that ZD1839 modestly enhanced cellular oxaliplatin accumulation and platinum-DNA (Pt-DNA) adducts (P>0.05). In additional studies, high-performance liquid chromatography revealed that oxaliplatin had no effect on ZD1839 accumulation. In contrast, ZD1839 markedly inhibited removal of Pt-DNA adducts (P<0.05). With oxaliplatin treatment (1 day) followed by ZD1839 (1 day), then incubation with drug-free medium (1 day), 90% of Pt-DNA adducts remained. Apoptosis examination revealed that oxaliplatin-induced apoptosis was prolonged by sequential oxaliplatin followed by ZD1839 treatment compared with oxaliplatin alone. Further experiments revealed that ZD1839 decreased cellular gamma-glutamyltransferase activity.CONCLUSIONS: The above observations provide a mechanistic explanation for the synergy of oxaliplatin followed by ZD1839, and suggest that this treatment combination warrants further preclinical and clinical investigation.
Keywords:EGFR  epidermal growth factor receptor  TKI  tyrosine kinase inhibitor  CI  combination index  Pt  platinum  HPLC  high-performance liquid chromatography  γ-GT  γ-glutamyltransferase  GSH  glutathione  ic50 (ic90)" target="_blank">ic50 (ic90)  dose that reduces 50% (90%) of cell growth  5FU  5-fluorouracil  Topo-II  topoisomerase II  NER  nucleotide excision repair  OD  optical density  mAbs  monoclonal antibodies  DNA-PK  DNA-dependent protein kinase
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