Biochemical basis of resistance to chemotherapy

Vincristine- and cisplatin-induced apoptosis in human retinoblastoma. Potentiation by sodium butyrate

Chemotherapy alone has largely been unsuccessful in controlling retinoblastoma growth, and has traditionally been limited in use as an alternative to irradiation for the treatment of retinoblastoma. Recently, clinical studies combining chemotherapy with local therapies, including radiotherapy, laser therapy or cryotherapy and in some cases, cyclosporine A, have been effective in treating retinoblastoma. Differentiating agents may also be combined with chemotherapy to enhance the action of cytotoxic drugs on tumor cell growth, although this approach has not been fully investigated in retinoblastoma. In this study, we evaluated the cytotoxic response of human retinoblastoma cell lines (Y79 and WERI-Rb1) to two chemotherapy agents commonly used in treating retinoblastoma, vincristine (VCR) and cisplatin (CDDP). Retinoblastoma cells have been shown to be sensitive to the differentiating agent sodium butyrate, and cell lines were also treated with a combination of VCR or CDDP with sodium butyrate, and the effects on retinoblastoma viability assessed. Both VCR and CDDP induced dose-dependent death of Y79 and WERI-Rb1 cells, accompanied by nuclear and cytoplasmic condensation and DNA laddering, features characteristic of apoptosis. Inhibitors of macromolecular synthesis, cycloheximide and actinomycin-D, significantly reduced VCR- and CDDP-induced apoptosis, although putative endonuclease inhibitors zinc sulphate and aurintricarboxylic acid had no apparent effect. Treatment with 0.5 mM or 1 mM sodium butyrate combined with VCR or CDDP significantly increased induction of apoptosis by these agents. This augmentation of chemotherapy-induced apoptosis may have implications for retinoblastoma therapy.

Enhanced glutathione S-transferase activity and glutathione content in human bladder cancer. Followup study: influence of smoking

Glutathione content and glutathione S-transferase activity have been studied in human bladder specimens obtained from controls and from patients with superficial transitional cell carcinoma (tumor samples and peri-tumor normal tissues from the same patient). After combining an earlier study from our laboratory with the additional material presented (9 healthy controls and 25 transitional cell carcinoma patients), it can be observed that glutathione S-transferase activity was significantly greater in tumor than in peri-tumor normal tissue (34 patients, p < 1 x 10(-7)) or in normal mucosa (17 controls, p < 1 x 10(-3)). Glutathione content was significantly greater in tumor than in peri-tumor normal tissue (p < 5 x 10(-3)) or in normal mucosa (p < 2 x 10(-2)), with this increase being evident only in smokers. When comparing normal mucosa and peri-tumor samples no significant differences were found either for glutathione S-transferase activity or for glutathione content. Results demonstrate the relationship between the glutathione S-transferase/glutathione system and development of transitional cell carcinoma, as well as its role in cellular resistance to chemotherapy.

Acquired multicellular-mediated resistance to alkylating agents in cancer

EMT-6 murine mammary tumor sublines highly resistant to cyclophosphamide, cis-diamminedichloro-platinum(II), or N,N',N"-triethylenethiophosphoramide were generated in vivo by sequential treatment of tumor-bearing mice with the respective drugs. Previous studies demonstrated the drug-resistant phenotypes of the sublines were not expressed in vitro when the cells were grown as monolayer cultures. We now show that expression of drug resistance--including patterns of cross-drug resistance observed in vivo--can be fully recapitulated in vitro when the cells are grown under in vivo-like, three-dimensional conditions--namely, as multicellular tumor spheroids. Moreover, the spheroids generated from all of the drug-resistant sublines manifested a much more compact structure. Immediate drug-sensitivity testing of single cells released by trypsin treatment from compact drug-resistant spheroids revealed that such cells lost much of their drug-resistant properties. The results suggest a possible mechanism of acquired drug resistance in tumors based on the response of a cell population (i.e., multicellular or tissue resistance) as opposed to classic (uni)cellular resistance mechanisms.