Dickens David S, Cripe Timothy P
Division of Pediatric Hematology/Oncology, Cincinnati Children's Hospital Medical Center, Ohio 45229, USA.
J Pediatr Hematol Oncol. 2003 Sep;25(9):709-14. doi: 10.1097/00043426-200309000-00007.
Sarcomas express cyclooxygenase (COX)-2, an inducible enzyme with known tumor-promoting activity. COX-2 inhibition is efficacious against many cancer types but has not been tested for human sarcomas. Matrix metalloproteinase (MMP) inhibitors also possess antiproliferative activity. Because MMP inhibitor therapy induces COX-2 expression, the authors hypothesized that the combination of COX-2 and MMP inhibitors results in a synergistic antitumor effect.
Human osteosarcoma or rhabdomyosarcoma cells were injected into athymic mice. Tumor development and growth were measured following treatment with a COX-2 inhibitor (celecoxib), an MMP inhibitor (doxycycline), or both. The tumors were analyzed for necrosis, apoptosis, cyclooxygenase activity (PGE2 production), and MMP-2 levels.
When treatment was started prior to tumor cell implantation, doxycycline inhibited osteosarcoma tumor growth alone and in combination with celecoxib (30% and 33% reduction, respectively). An effect on osteosarcoma tumor implantation rates was noted in mice receiving doxycycline alone and in combination with celecoxib (12.5% and 6.25% reduction, respectively). Established osteosarcoma and rhabdomyosarcoma tumors were inhibited only by combination therapy (36% and 55%, respectively). A higher proportion of osteosarcoma tumors in the combination therapy group had more than 50% necrosis (3/7) when compared with control tumors (0/8). Antitumor effects did not correlate with PGE2 levels, suggesting the observed interaction with doxycycline was due to previously described non-enzymatic effects of celecoxib.
The authors' preclinical data suggest that the combination of inexpensive, nontoxic, oral COX-2 and MMP inhibitors may be useful for the treatment of some types of solid tumors.
肉瘤表达环氧化酶(COX)-2,这是一种具有已知促肿瘤活性的诱导酶。COX-2抑制对多种癌症类型有效,但尚未在人类肉瘤中进行测试。基质金属蛋白酶(MMP)抑制剂也具有抗增殖活性。由于MMP抑制剂疗法会诱导COX-2表达,作者推测COX-2和MMP抑制剂联合使用会产生协同抗肿瘤作用。
将人骨肉瘤或横纹肌肉瘤细胞注射到无胸腺小鼠体内。在用COX-2抑制剂(塞来昔布)、MMP抑制剂(强力霉素)或两者治疗后,测量肿瘤的发生和生长情况。对肿瘤进行坏死、凋亡、环氧化酶活性(前列腺素E2产生)和MMP-2水平分析。
在肿瘤细胞植入前开始治疗时,强力霉素单独使用以及与塞来昔布联合使用均能抑制骨肉瘤肿瘤生长(分别降低30%和33%)。在单独接受强力霉素以及与塞来昔布联合使用的小鼠中,观察到对骨肉瘤肿瘤植入率有影响(分别降低12.5%和6.25%)。已形成的骨肉瘤和横纹肌肉瘤肿瘤仅通过联合治疗受到抑制(分别为36%和55%)。与对照肿瘤(0/8)相比,联合治疗组中更高比例的骨肉瘤肿瘤坏死超过50%(3/7)。抗肿瘤作用与前列腺素E2水平无关,这表明观察到的与强力霉素的相互作用是由于塞来昔布先前描述的非酶促作用。
作者的临床前数据表明,廉价、无毒的口服COX-2和MMP抑制剂联合使用可能对某些类型的实体瘤治疗有用。