Tissue culture in the study of the effects of drugs

Could a revision of the current guidelines for cancer drug use improve the quality of cancer treatment?

Clinical practice guidelines are indispensable for such a variable disease as malignant solid tumors, with the complex possibilities of drug treatment. The current guidelines may be criticized on several points, however. First, there is a lack of information on the outcome of treatment, such as the expected success and failure rates. Treating not only drug responders but also nonresponders, that is, patients with drug resistance, must result in failures. There is no mention of the possibility of excluding the drug nonresponders, identifiable by special laboratory tests and no consideration is given to the different side effects of the recommended drug regimens. Nor are there any instructions concerning tumor cases for which anticancer drug treatment is futile. In such cases, early palliative care may lead to significant improvements in both life quality and life expectancy. Not least, there is no transparency concerning the preparation of the guidelines: persons cannot be identified who could give a statement of conflicts of interest, and responsibility is assumed only by anonymous medical associations. A revision of the current guidelines could considerably improve cancer treatment.

Resistance in malignant tumors: can resistance assays optimize cytostatic chemotherapy?

The frequent resistance of malignant tumors to chemotherapy documents the fact that numerous patients are uselessly traumatized by highly toxic drugs. Investigations into this resistance have shown that many different mechanisms exist which can abolish the antitumor action of chemotherapeutics. So far, no safe method has been found to counteract this resistance. To date, the only way to avoid harm by an ineffective chemotherapeutic is to refrain from its use when resistance to it is detected. The present survey reports on the available assays that diagnose resistance reliably; sensitivity tests are excluded as being unreliable. Resistance assays are still not fully recognized in hospitals, despite the fact that they are able to optimize chemotherapy by eliminating treatment that is ineffective and merely harmful. Since the number of chemotherapeutics will increase enormously in the future, pharmacological cancer treatment cannot dispense with resistance assays.

Cytotoxicity of caffeine in cultured heart cells

The cytotoxic effect of caffeine on myocardial cells was evaluated in primary cultures of rat heart muscle (M) and endothelioid (E) cells. The cells were exposed to 5, 10, or 20 mM caffeine for 6, 12, or 24 h. As an index of cell injury produced by the treatments, in situ changes in lysosomal membrane permeability were measured by a sensitive cytochemical technique. The highest concentration of caffeine (20 mM) produced such toxic signs as reduced cell viability, increased vacuolization, and pseudopod formation. At the lower concentrations, caffeine labilized lysosomal membranes of M cells more easily than those of E cells. Pretreatment with hydrocortisone prior to exposure to caffeine protected E and M cell lysosomes from the labilizing effects of caffeine.