Department of Paediatric Surgery and Paediatric Urology, University Children's Hospital, 72076 Tübingen, Germany.
Oncol Rep. 2013 Feb;29(2):646-52. doi: 10.3892/or.2012.2150. Epub 2012 Nov 27.
The response of standard-risk hepatoblastoma (HB) to neoadjuvant cisplatin (CDDP) chemotherapy is excellent; however, in high-risk HB, drug resistance remains a major challenge. Alternative therapeutic strategies may consider combining cytotoxic drugs with apoptosis sensitizers as this has shown additive effects in various types of malignancies. Analysis of published expression databases have revealed an anti-apoptosis state in HB samples. Herein, we evaluated the synergistic effects of ABT-737 as a modulator of apoptosis in combination with CDDP in HB. To this end, clonogenic assays were performed with HepT1 and HUH6 HB cells to evaluate the synergistic effects of CDDP and ABT-737. Combination treatment with CDDP and ABT-737 reduced the clonogenicity of HB cells more than 5-fold compared to treatment with CDDP alone. Furthermore, the HUH6 mixed-type HB cells showed higher sensitivity to CDDP and combination treatment compared to the HepT1 embryonal-type cells. Subcutaneous HUH6 tumors in NOD/LtSz-scid IL2Rγnull mice were treated with CDDP (1.25 and 3 mg/kg body weight, n=6), ABT-737 (100 mg/kg, n=5) and the combination of both agents (n=5). Combined treatment led to a significantly reduced tumor growth compared to CDDP treatment alone (p<0.02). When using higher doses of CDDP (3 mg/kg) alone or in combination with ABT-737, dose-dependent toxicity was observed in this mouse strain. In conclusion, our results demonstrated the enhancement of chemotherapy efficacy by using modulators of apoptosis together with cytotoxic agents. Additive effects of ABT-737 may allow reduction in CDDP dosages with maintenance of antitumor activity. Sensitizing HB to apoptosis may also render resistant HB susceptible to established chemotherapy regimens.
标准风险型肝母细胞瘤 (HB) 对新辅助顺铂 (CDDP) 化疗的反应极好;然而,在高危 HB 中,耐药性仍然是一个主要挑战。替代治疗策略可能考虑将细胞毒性药物与凋亡敏化剂联合使用,因为这在各种类型的恶性肿瘤中已显示出相加作用。对已发表的表达数据库的分析表明 HB 样本中存在抗凋亡状态。在此,我们评估了 ABT-737 作为凋亡调节剂与 CDDP 联合应用于 HB 的协同作用。为此,用 HepT1 和 HUH6 HB 细胞进行集落形成实验,以评估 CDDP 和 ABT-737 的协同作用。与单独使用 CDDP 相比,联合治疗 CDDP 和 ABT-737 使 HB 细胞的集落形成能力降低了 5 倍以上。此外,与 HepT1 胚胎型细胞相比,HUH6 混合型 HB 细胞对 CDDP 和联合治疗的敏感性更高。将 CDDP(1.25 和 3mg/kg 体重,n=6)、ABT-737(100mg/kg,n=5)和两者联合(n=5)用于治疗 NOD/LtSz-scid IL2Rγnull 小鼠的皮下 HUH6 肿瘤。与单独使用 CDDP 治疗相比(p<0.02),联合治疗导致肿瘤生长明显减少。当单独使用或与 ABT-737 联合使用较高剂量的 CDDP(3mg/kg)时,在这种小鼠品系中观察到剂量依赖性毒性。总之,我们的结果表明,使用凋亡调节剂与细胞毒性药物联合使用可增强化疗疗效。ABT-737 的附加作用可能允许减少 CDDP 剂量,同时保持抗肿瘤活性。使 HB 易于凋亡也可能使耐药性 HB 对现有的化疗方案敏感。