Guminski A D, Harnett P R, deFazio A
Department of Medical Oncology, Westmead Hospital, Faculty of Medicine, University of Sydney at Westmead Hospital, NSW, Australia.
Cancer Chemother Pharmacol. 2001 Sep;48(3):229-34. doi: 10.1007/s002800100279.
Clinical observation has shown that paclitaxel ameliorates the antiplatelet toxicity of carboplatin when the two drugs are combined, although antitumour activity and white cell toxicity are at least additive. We hypothesized that this is due to an interaction between the two drugs at the level of the platelet precursor.
We measured inhibition of growth of the megakaryoblast cell line MEG-01 following exposure to paclitaxel and carboplatin singly or combined. Drug interaction was assessed by median effect analysis.
An antagonistic interaction was observed, and this was most marked at drug concentrations giving a low level of growth inhibition (P < 0.002, sign test). The interaction was not sequence-dependent. There was no significant difference in whole-cell accumulation of platinum or the amount of platinum adducts on DNA following combined treatment in comparison with carboplatin alone.
These results provide the first evidence of an antagonistic interaction between paclitaxel and carboplatin in a platelet precursor and provide an explanation for the platelet-sparing effect of the combination of these chemotherapeutic agents. While the mechanisms underlying the interaction described in this report are yet to be fully elucidated, this study provides evidence that the antagonism between paclitaxel and carboplatin in MEG-01 cells is not due to reduced platination of DNA.
临床观察表明,当两种药物联用时,紫杉醇可改善卡铂的抗血小板毒性,尽管抗肿瘤活性和白细胞毒性至少具有相加作用。我们推测这是由于两种药物在血小板前体水平上相互作用所致。
我们测定了巨核母细胞系MEG-01单独或联合暴露于紫杉醇和卡铂后其生长的抑制情况。通过中位效应分析评估药物相互作用。
观察到一种拮抗相互作用,且在产生低水平生长抑制的药物浓度下最为明显(P < 0.002,符号检验)。这种相互作用不依赖给药顺序。与单独使用卡铂相比,联合治疗后铂在全细胞中的蓄积或DNA上铂加合物的量没有显著差异。
这些结果首次证明了紫杉醇和卡铂在血小板前体中存在拮抗相互作用,并为这两种化疗药物联合使用时的血小板保护作用提供了解释。虽然本报告中描述的相互作用的潜在机制尚未完全阐明,但本研究提供了证据表明紫杉醇和卡铂在MEG-01细胞中的拮抗作用并非由于DNA的铂化减少所致。