Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Chuo-ku, Japan.
Department of Neurological Surgery, Nihon University School of Medicine, Itabashi-ku, Japan.
Cancer Sci. 2021 Nov;112(11):4736-4747. doi: 10.1111/cas.15141. Epub 2021 Oct 2.
Glioblastomas (GBM) often acquire resistance against temozolomide (TMZ) after continuous treatment and recur as TMZ-resistant GBM (TMZ-R-GBM). Lomustine (CCNU) and nimustine (ACNU), which were previously used as standard therapeutic agents against GBM before TMZ, have occasionally been used for the salvage therapy of TMZ-R-GBM; however, their efficacy has not yet been thoroughly examined. Therefore, we investigated the antitumor effects of CCNU and ACNU against TMZ-R-GBM. As a model of TMZ-R-GBM, TMZ resistant clones of human GBM cell lines (U87, U251MG, and U343MG) were established (TMZ-R-cells) by the culture of each GBM cells under continuous TMZ treatment, and the antitumor effects of TMZ, CCNU, or ACNU against these cells were analyzed in vitro and in vivo. As a result, although growth arrest and apoptosis were triggered in all TMZ-R-cells after the administration of each drug, the antitumor effects of TMZ against TMZ-R-cells were significantly reduced compared to those of parental cells, whereas CCNU and ACNU demonstrated efficient antitumor effects on TMZ-R-cells as well as parental cells. It was also demonstrated that TMZ resistance of TMZ-R-cells was regulated at the initiation of DNA damage response. Furthermore, survival in mice was significantly prolonged by systemic treatment with CCNU or ACNU but not TMZ after implantation of TMZ-R-cells. These findings suggest that CCNU or ACNU may serve as a therapeutic agent in salvage treatment against TMZ-R-GBM.
胶质母细胞瘤(GBM)在连续治疗后常对替莫唑胺(TMZ)产生耐药性,并复发为替莫唑胺耐药性 GBM(TMZ-R-GBM)。洛莫司汀(CCNU)和尼莫司汀(ACNU)在 TMZ 之前曾被用作 GBM 的标准治疗药物,偶尔也被用于 TMZ-R-GBM 的挽救治疗;然而,它们的疗效尚未得到彻底研究。因此,我们研究了 CCNU 和 ACNU 对 TMZ-R-GBM 的抗肿瘤作用。作为 TMZ-R-GBM 的模型,我们通过在持续 TMZ 处理下培养每种 GBM 细胞,建立了 TMZ 耐药的人 GBM 细胞系(U87、U251MG 和 U343MG)的 TMZ 耐药克隆(TMZ-R 细胞),并在体外和体内分析了 TMZ、CCNU 或 ACNU 对这些细胞的抗肿瘤作用。结果表明,虽然所有 TMZ-R 细胞在给予每种药物后均发生生长停滞和细胞凋亡,但 TMZ 对 TMZ-R 细胞的抗肿瘤作用明显低于亲本细胞,而 CCNU 和 ACNU 对 TMZ-R 细胞和亲本细胞均表现出有效的抗肿瘤作用。还表明,TMZ-R 细胞的 TMZ 耐药性在 DNA 损伤反应起始时受到调节。此外,在植入 TMZ-R 细胞后,全身给予 CCNU 或 ACNU 而非 TMZ 可显著延长小鼠的存活时间。这些发现表明,CCNU 或 ACNU 可能作为 TMZ-R-GBM 挽救治疗的治疗药物。