Fakih Marwan, Cao Shousong, Durrani Farukh A, Rustum Youcef M
Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Clin Colorectal Cancer. 2005 Jul;5(2):132-5. doi: 10.3816/ccc.2005.n.026.
Limited therapeutic selectivity and tumor resistance are major obstacles to current chemotherapy. The development of new therapeutic modalities for solid tumor remains a challenge. The use of selenium, 5-methylselenocysteine (MSC), or seleno-L-methionine (SLM) as selective modulators of anticancer drugs is novel and has not been previously investigated. Selenium deficiency is associated with an increased risk of cancer and cancer death. Although low-dose selenium supplementation has been investigated in a large randomized prevention trial, its potential in chemotherapy toxicity prevention and enhancement of antitumor activity of anticancer drugs has not been evaluated. An ideal biomodulator of anticancer drugs would allow escalation of drug dose with the hope of enhancing antitumor activity and possibly reversing drug resistance. Results from this laboratory have demonstrated that MSC and SLM are highly effective modulators of irinotecan cure rates in de novo sensitive and resistant human tumor xenografts. Studies in mice have documented that the minimum effective dose of MSC when combined with irinotecan is 0.01 mg daily. The optimal schedule is to administer MSC orally for 7 days before and concurrently with irinotecan. The observed effects were not drug-specific, as similar results were obtained with taxanes, platinum agents, 5-fluorouracil, and anthracyclines; nor were they species-specific, as selective effects were obtained in mice and rats and are currently being confirmed in ongoing clinical trials.
治疗选择性有限和肿瘤耐药性是当前化疗的主要障碍。开发针对实体瘤的新治疗方式仍然是一项挑战。使用硒、5-甲基硒代半胱氨酸(MSC)或硒代-L-蛋氨酸(SLM)作为抗癌药物的选择性调节剂是新颖的,此前尚未进行过研究。硒缺乏与癌症风险和癌症死亡风险增加有关。尽管在一项大型随机预防试验中对低剂量补充硒进行了研究,但其在预防化疗毒性和增强抗癌药物抗肿瘤活性方面的潜力尚未得到评估。一种理想的抗癌药物生物调节剂将允许提高药物剂量,以期增强抗肿瘤活性并可能逆转耐药性。本实验室的结果表明,MSC和SLM是伊立替康在原发性敏感和耐药人肿瘤异种移植模型中治愈率的高效调节剂。对小鼠的研究表明,MSC与伊立替康联合使用时的最小有效剂量为每日0.01毫克。最佳给药方案是在伊立替康给药前7天及给药期间口服MSC。观察到的效果并非药物特异性的,因为紫杉烷类、铂类药物、5-氟尿嘧啶和蒽环类药物也获得了类似结果;也不是物种特异性的,因为在小鼠和大鼠中都获得了选择性效果,目前正在正在进行的临床试验中得到证实。