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Experimental Therapeutics |
Oncology Research [F. L., C. M. D., T. A., C. B., S. M., M. H., X. T., C. H., R. H., M. B., L. M. G.] and Chemical Sciences [T. S., G. K., S. A-K., A. Z.], Wyeth Research, Pearl River, New York 10965; The National Cancer Institute Center for Cancer Research, National Cancer Institute, Bethesda, Maryland 20892 [M. S. P., T. F.]; and Department of Chemistry, University of British Columbia, Vancouver, Canada V6T 1Z1 [J. A. N., R. J. A.]
| ABSTRACT |
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| INTRODUCTION |
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Despite the ability of taxanes and Vinca alkaloids to inhibit the progression of some cancers, inherent resistance to antimicrotubule agents is encountered in many tumor types, and acquired resistance usually occurs during multiple cycles of therapy (1 , 3) . Beyond this, side effects are significant and can be attributed to the compound itself and/or the vehicle required for administration. Therefore, there has been great interest in identifying novel antimicrotubule drugs that overcome various modes of resistance and have improved pharmacology profiles. Experimental antimitotic drugs in clinical trials include novel taxanes, epothilones, and peptide-like agents (4) .
This study focuses on a synthetic hemiasterlin analogue, HTI-286 (Fig. 1)
. Originally identified as natural products from marine sponges (Cymbastela sp., Hemiasterella minor, Siphonochalina sp., and Auletta sp.), hemiasterlins comprise a small family of naturally occurring tripeptides containing three highly modified amino acids (5, 6, 7)
. Hemiasterlin is a potent inhibitor of cell growth that, like vinblastine, depolymerizes microtubules and arrests cells in the G2-M phase of the cell cycle (8)
. However, like other peptide-like antimicrotubule agents, such as dolastatin-10 and cryptophycin-1, hemiasterlin noncompetitively inhibits the binding of vinblastine to tubulin (9)
. Because hemiasterlin competitively inhibits the binding of dolastatin-10 to tubulin, it has been proposed that these molecules bind to the Vinca-peptide-binding site of tubulin (9)
.
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| MATERIALS AND METHODS |
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Cell Lines.
Cell lines were obtained from the American Type Culture Collection (Rockville, MD), except as indicated. S1 and S1-M1-3.2 cells have been described previously (13)
. The parental and resistant cell counterparts were generously provided as follows: (a) KB series (Dr. M. Gottesman, National Cancer Institute; Ref. 14)
; and (b) HL60 and HL60/ADR cells (Dr. M. Center, University of Kansas; Ref. 15)
. The PC3MM2 prostate carcinoma cell line was generously provided by Dr. I. J. Fidler (M. D. Andersen Cancer Center). MX-1-Wyeth, designated MX-1W, was a subclone of the breast carcinoma MX-1 that was originally obtained from the National Cancer Institute. MX-1W cells were obtained by adapting the growth of these fragments to tissue culture. For in vivo experiments, MX-1W tumors were maintained by passage of tumor xenograft fragments between athymic mice. Cell lines were maintained in either DMEM or RPMI 1640, supplemented with 10% FCS and 10 units/ml penicillin and 10 µg/ml streptomycin, with the exception of the KB series, where 20% FCS was used. KB-8-5 and KB-V1 were maintained in 25 nM colchicine and 1.1 µM vinblastine, respectively, except during growth assays. Cells were maintained at 37°C in a 5% CO2/humidified incubator.
Tubulin Polymerization Assays.
For in vitro tubulin polymerization assays, bovine MAP-rich4
tubulin, PEM buffer [80 mM Na-PIPES (pH 6.9), 1 mM MgCl2, and 1 mM EGTA], and GTP were purchased from Cytoskeleton (Denver, CO). MAP-rich tubulin (final concentration 1.5 mg/ml) was dissolved in cold PEM buffer containing 1 mM GTP (GPEM) and centrifuged at 12,000 x g for 10 min at 4°C. The tubulin solution (100 µl/well) was added rapidly to wells of a low-volume, 96-well plate already containing duplicate aliquots (10 µl) of test compounds in GPEM. Final compound concentrations were 0.1 or 1 µM. Control wells contained the same final concentration of DMSO (0.3%). After initiation of the reaction, absorbance at 340 nm was measured every minute for 60 min at 24°C using a SpectraMax Plus plate reader (Molecular Devices, Sunnyvale, CA).
Immunofluorescence Microscopy.
KB-3-1 epidermoid carcinoma cells were plated on coverslips (No. 1 thickness), placed in 6-well dishes, and cultured overnight. Compounds diluted in media were added to the wells. After 20 h of incubation with compounds, cells were washed in PBS, fixed for 10 min in methanol at -20°C, rehydrated in PBS, and incubated for 20 min at 37°C with a 1:500 dilution of anti-
-tubulin antibody (clone DM 1A; Sigma) in PBS. After a PBS wash, cells were incubated with 1:100 dilution of FITC-conjugated F(ab')2 fragment of goat antimouse IgG (Jackson Immunoresearch, West Grove, PA) and 50 µg/ml propidium iodide (Roche, Indianapolis, IN) for 20 min at 37°C in PBS. After extensive washing, cells were rinsed once in water and mounted in one drop of Slowfade Light Antifade (Molecular Probes, Eugene, OR). Cells were examined with an Olympus BX61 microscope (Olympus America, Inc., Melville, NY) and x60 objective using epi-illumination. Images were obtained with a Cooke Sensicam QE cooled CCD camera (Cooke Corp., Auburn Hills, MI) and Slidebook software (Intelligent Imaging Innovations, Inc., Denver, CO).
Proliferation Assays.
Cells were plated in 96-well plates in 100-µl media at densities predetermined to produce 6090% confluence at the time of analysis. Compounds, which were serially diluted into media as 2 x stocks, were added to cells in duplicate. After 3 days of incubation, cell survival was assessed by the SRB assay as described (13)
. For nonadherent cells, proliferation was assayed with the CellTiter 96 Aqueous nonradioactive cell proliferation assay according to the manufacturers directions (Promega, Madison, WI).
Cell Cycle Analyses.
KB-3-1 cells were seeded into 6-well dishes and treatments initiated when cells were 6070% confluent. Drugs were diluted in media as 4 x stocks and added to cells to provide the specified final concentrations. Cells were processed for cell cycle analyses as described previously (16)
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Analysis of P-Glycoprotein (MDR1) Expression.
The level of P-glycoprotein in tumor cell lines was determined by isolating membranes from cells as described previously (13)
, followed by immunoblot analysis using a primary antibody specific for P-glycoprotein (Ab-1; Oncogene Science, Uniondale, NY) and a goat-antirabbit IgG horseradish peroxidase-conjugated secondary antibody (Bio-Rad, Hercules, CA). Detection was done by the enhanced chemiluminescence method (Amersham, Piscataway, NJ).
In Vivo Efficacy Studies.
Athymic nu/nu female mice, 56 weeks of age, were obtained from Charles River Laboratories (Wilmington, MA). Mice were implanted s.c. with 1.5 x 106 Lox melanoma cells, 2.5 x 106 KB-3-1 cells, 7 x 106 KB-8-5 cells, 6 x 106 DLD-1 cells, 5 x 106 HCT-15 cells, or five fragments of MX-1W. When tumors attained a mass of between 80 and 120 mg (day 0), animals were randomized into treatment groups. In some experiments, tumors were allowed to grow
2.5 grams in size before drug treatment was initiated. After randomization, animals were treated i.v. with one or more doses of HTI-286 prepared in saline, 60 mg/kg/dose paclitaxel, or a saline vehicle control (0.2 ml of bolus injection except 0.5 ml for paclitaxel). In some experiments, animals were treated i.p. with 1 mg/kg/dose vincristine prepared in saline. Paclitaxel was formulated by suspension in 100% ethanol, followed by mixing with Cremophor EL (Sigma) to yield a 25 mg/ml stock (50% ethanol/50% Cremophor EL), which was diluted into saline immediately before administration. The final dosing formulation was 6% ethanol/6% Cremophor EL/88% saline. The doses chosen for both paclitaxel and vincristine were between 80 and 95% of the maximum tolerated dose for each drug. Tumor mass [(length x width2)/2] was determined once a week for
35 days. The data were analyzed by a one-sided Student t test. A drug dose was considered toxic if there was >20% lethality or if animals lost
20% of their initial body weight.
| RESULTS |
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-tubulin. Untreated KB-3-1 epidermoid carcinoma cells in interphase contained a dense and complex network of microtubules evident in the cytoplasm, generally originating in the perinuclear region and extending into the cell periphery (Fig. 3A)
50% of cells in metaphase (Fig. 3B)
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1-, 3-, or 10-fold higher than the IC50 needed to inhibit cell growth after 3 days. Because the data for the 48- and 72-h time points were similar, only the 24- and 48-h results are shown in Table 1
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Effect of HTI-286 on Growth of Cells that Have Acquired Overexpression of Drug Efflux Pumps.
Cell lines selected for expression of drug efflux pumps by chronic drug exposure were also used to compare the activity of HTI-286 with other chemotherapeutics (Table 3)
. KB-8-5 cells were selected for low-level resistance to colchicine (14)
and overexpress moderate levels of P-glycoprotein (approximately equivalent to levels observed in DLD-1 cells; data not shown). These cells were moderately resistant to paclitaxel (19-fold), docetaxel (18-fold), vinblastine (37-fold), vinorelbine (52-fold), colchicine (9.8-fold), dolastatin-10 (7.1-fold), and doxorubicin (15-fold) compared with parental cells. In contrast, KB-8-5 cells had only 2.4-fold resistance to HTI-286. Resistance to HTI-286 can be mediated by P-glycoprotein in extreme circumstances, because 81-fold resistance to HTI-286 was found in the KB-V1 cell line that expresses very high levels of MDR1 (14)
. This line had profound resistance to paclitaxel, vinorelbine, and vinblastine (
14001800-fold) and was also highly resistant to docetaxel (669-fold) and colchicine (382-fold). Resistance to paclitaxel and HTI-286 in the KB-V1 cell line was likely attributable to P-glycoprotein itself and not a coselected factor, because resistance to these drugs was completely reversed with an MDR1-specific inhibitor, CL-329,753 (12
, 13)
. In particular, in this experimental series, the IC50 of HTI-286 in KB-V1 cells was 56.6 ± 9.2 nM in the absence of CL-329,753 but 1.3 ± 0.6 nM in the presence of 5 µM CL-329,753. This closely matched the IC50 in the parental KB-3-1 cells, which was 1.2 ± 0.3 or 0.9 ± 0.5 nM in the absence or presence of 5 µM CL-329,753, respectively. Therefore, resistance to HTI-286 in KB-V1 cells was reversed nearly to wild-type levels. In contrast, the IC50 in KB-V1 cells for paclitaxel was >3000 nM and 15 ± 11.3 nM in the absence and presence of 5 µM CL-329,753, respectively.
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In addition to analogues of hemiasterlin, we studied the effectiveness of another peptidic antimicrotubule agent. Dolastatin-10 is a highly potent microtubule-depolymerizing agent, which, like hemiasterlin, interacts at the peptide-binding site of tubulin (9)
. However, two differences between dolastatin-10 and HTI-286 were found: (a) dolastatin-10 was
25-fold more potent than HTI-286; and (b) resistance to dolastatin was 3- and 7-fold higher compared with HTI-286 in KB-8-5 and KB-V1 cells, respectively. These data are consistent with a report that dolastatin-10 is a highly potent molecule that interacts with P-glycoprotein (17)
.
The ABC-transporter MRP1 and ABC half-transporter MXR are members of two other classes of drug transporters known to mediate resistance to chemotherapeutics, although they do not effectively mediate resistance to most antimicrotubule agents (18) . It was unknown whether the hemiasterlin family of peptides interacted with these drug pumps. No resistance to HTI-286 was detected in cells selected for overexpression of MRP1 (IC50 in HL60 and HL-60/ADR cells was 0.21 ± 0.05 and 0.25 ± 0.45 nM, respectively) or MXR (IC50 in S1 and S1-M1-3.2 cells was 3.7 ± 2 and 4.8 ± 2.1 nM, respectively), although these cell lines were highly resistant to both doxorubicin (HL-60/ADR cells: >124-fold; S1-M1-3.2 cells: 52-fold) and mitoxantrone (HL-60/ADR cells: 32-fold; S1-M1-3.2 cells: 535-fold), compared with parental cells.
In Vivo Efficacy in Xenograft Tumor Models of HTI-286 Given i.v.
Initial in vivo studies were performed with tumors known to be sensitive to paclitaxel or vincristine. HTI-286, paclitaxel, or vincristine were given on days 1, 5, and 9 to athymic mice bearing small established tumors (
100 mg) derived from Lox melanoma (Fig. 4A)
or KB-3-1 epidermoid carcinoma (Fig. 4B)
. When given the maximum tolerated dose of HTI-286 (1.6 mg/kg i.v.), paclitaxel (60 mg/kg i.v.), or vincristine (1 mg/kg i.p.), growth of Lox tumors was inhibited by 9698% on day 12 with each agent, compared with vehicle-treated controls. Similar results were obtained with the KB-3-1 tumor model (Fig. 4B)
. The minimum effective dose of HTI-286 in the Lox melanoma model was
0.2 mg/kg (data not shown). Any weight loss attributable to HTI-286, paclitaxel, or vincristine on a 1-, 5-, and 9-day schedule was greatest by the second dose (maximally 12% versus controls) but recovered within 12 days after the completion of treatments. HTI-286 also inhibited the growth of other paclitaxel-sensitive tumors in xenograft assays, e.g., 1 mg/kg HTI-286 given on days 1, 5, and 9 inhibited tumor growth on day 14 by 73 ± 9% (n = 2 independent experiments) in PC3-MM2 prostate carcinomas, 96 ± 5% (n = 3) in SW620 colon carcinomas, 83% in U87 gliomas, 94% in MCF-7 breast carcinomas, and 65% in LoVo colon carcinomas.
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The activity of HTI-286 was also studied in tumors derived from cell lines that either have acquired or inherent resistance to paclitaxel. KB-8-5 tumors, which had acquired
20-fold resistance to paclitaxel in tissue culture (Table 2)
as a result of P-glycoprotein overexpression, were not responsive to 60 mg/kg paclitaxel or 1 mg/kg vincristine (Fig. 4C)
. The response of tumors derived from KB-8-5 cells was in sharp contrast to KB-3-1 parental cells where 60 mg/kg paclitaxel caused >95% inhibition of tumor growth (Fig. 4B)
. HTI-286 given at 1.6 mg/kg on days 1, 5, and 9 significantly inhibited the growth of KB-8-5 tumors by 84% on day 14, compared with the vehicle control group, although growth resumed by day 21.
The ability of HTI-286 to inhibit the growth of tumors that had inherent resistance to paclitaxel or vincristine was tested in MX-1W human breast carcinoma (Fig. 4D)
, DLD-1 human colon carcinoma (Fig. 4E)
, and HCT-15 human colon carcinoma (Fig. 4F)
. These tumors were chosen because they were relatively resistant to paclitaxel in vitro and overexpressed P-glycoprotein (Table 2)
. In tissue culture, compared with the KB-3-1 cell line, which was among the most sensitive cell line to paclitaxel, the MX-1W, DLD-1, and HCT-15 cell lines were
4-, 8-, and 112-fold resistant to paclitaxel, respectively (Table 2)
. Tumors derived from these three cell lines were resistant to paclitaxel or vincristine therapy in vivo when these agents were given at their maximum tolerated dose. However, 97% tumor growth inhibition was achieved in the MX-1W model with 1.6 mg/kg HTI-286. The minimum effective dose for inhibition of MX-1W tumors was found to be
0.7 mg/kg. Although tumor growth resumed on day 28 after HTI-286 therapy was initiated, complete inhibition of tumor growth was maintained for
8 weeks when HTI-286 continued to be administered weekly (data not shown). Furthermore, the tumors derived from DLD-1 and HCT-15 were also significantly inhibited (maximum of 80 and 66%, respectively) by tolerated doses of HTI-286 by day 1314,
5 days after the last dose was administered. However, growth resumed after this period (Figs. 4, E and F)
. In general, higher doses of HTI-286 were needed to achieve efficacy in paclitaxel-resistant tumors, compared with paclitaxel-sensitive tumors, although these doses were still well tolerated.
In Vivo Efficacy of HTI-286 by p.o. Administration.
MDR1 is expressed by gastrointestinal epithelial cells, and this significantly limits p.o. absorption of drugs that interact with MDR1, including paclitaxel (3)
. Because HTI-286 overcomes MDR1-mediated resistance in most cells, this suggested that the drug might be efficacious by p.o. administration. Consistent with this, 3 mg/kg HTI-286 administered by p.o. gavage on days 1, 5, and 9 inhibited growth on day 14 by 97.3 ± 2.5% (n = 3 independent experiments) in Lox melanoma xenografts. Growth inhibition (82%) was also observed on day 22 in the KB-3-1 epidermoid xenograft model when 3 mg/kg HTI-286 was given p.o. on days 1, 8, and 16.
| DISCUSSION |
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-tubulin. Consistent with this, mutations in
-tubulin have been found in cells selected for resistance to HTI-286 (20)
. Interaction with
-tubulin is uncharacteristic of most antimitotic agents examined to date. The initial clinical assessment of novel antimicrotubule drugs, such as HTI-286, will depend on their effectiveness in those patients who have inherent or acquired resistance to existing therapies. Although taxanes and Vinca alkaloids have been widely used in the clinic, it is well documented that certain tumors (e.g., colon) are refractory to these agents, whereas other tumors acquire resistance during the course of repeated therapy (1) . The basis of resistance to antimicrotubule agents is complex (21) . In experimental systems, taxane resistance has been attributed to high expression of MDR1, tubulin mutations, differential expression of tubulin isoforms, and most recently, alterations of proteins that regulate cell death via apoptosis, such as survivin (22) .
From the data in the current report, we conclude that HTI-286 overcomes P-glycoprotein-mediated resistance to paclitaxel or vincristine both in xenograft models and most cell lines that overexpress the protein. The clinical significance of this observation awaits further study. The correlation between MDR1 expression in patients and resistance to substrates of P-glycoprotein (e.g., Vinca alkaloids, paclitaxel, docetaxel, and doxorubicin) is poorly defined in most cancer types. A positive correlation between MDR1 expression and poor survival or response has been established in leukemias and myelomas (3) , but the correlation in solid tumors is controversial. Elevated levels of MDR1 have been found in breast, renal, and colon cancers. However, since there is substantial heterogeneity in expression within tumor types and between individual reports, the association with lack of response to chemotherapy is unclear (3) . On the basis of meta-analysis in breast cancers, Trock et al. (23) concluded that patients whose tumors express MDR1 were three times more likely to fail to respond to chemotherapy than patients who were MDR1 negative.
The data shown here demonstrate that the KB-8-5, MX-1W, and DLD-1 cell lines have 420-fold resistance to paclitaxel in tissue culture and very low to moderate P-glycoprotein levels, compared with parental cells or other paclitaxel-sensitive cells that have no P-glycoprotein detected by immunoblot analysis. Remarkably, tumors derived from all these cell lines are highly resistant to paclitaxel or vincristine in animal xenograft models. These data suggest that even small changes in MDR1, perhaps within the limits of detection in clinical assessment, may mediate paclitaxel resistance in patients. Consistent with this hypothesis, double knockout of mdr1a and mdr1b in murine fibroblasts, which have low P-glycoprotein expression in wild-type cells, caused a 1525-fold increased sensitivity to paclitaxel (3) . Because HTI-286 can overcome paclitaxel resistance in tumors derived from such cell lines, HTI-286 may have utility in taxane-refractory tumors or in patients who have failed paclitaxel therapy caused by MDR1 overexpression.
It should be noted that 80-fold resistance to HTI-286 was detected in KB-V1 cells that have been selected for very high levels of P-glycoprotein and are
5701800-fold resistant to dolastatin-10, docetaxel, paclitaxel, vinorelbine, and vinblastine. However, the expression of P-glycoprotein in these cells is higher than what is typically found in clinical samples from a variety of tumors (24)
. Therefore, we predict that identifying molecules having the least interaction with P-glycoprotein, as assessed by lack of resistance in KB-V1 cells, will have the best chance of avoiding detoxification and excretion by P-glycoprotein-mediated mechanisms in the liver and small intestine, as well as penetrating tumors that have high expression of P-glycoprotein in patients. A similar argument has been made with the epothilones, which also have low interaction with P-glycoprotein (25)
.
Hemiasterlin competes with the binding of dolastatin-10 to purified tubulin (9)
. Hence, these molecules may be expected to act in cells by similar mechanisms. However, this may not be true because dolastatin-10 is a better substrate for P-glycoprotein and was
20-fold more potent (IC50 = 50 pmol) than HTI-286 in cytotoxicity assays reported here and elsewhere (17
, 26)
. To date, the clinical experience with dolastatin-10 (4)
and a dolastatin-15 analogue, cemadotin (27
, 28)
, has not been favorable; granulocytopenia or cardiovascular toxicities have been observed with little evidence of antitumor efficacy. Clinical trials with HTI-286 are required to determine the utility of this molecule for the treatment of cancer.
In tissue culture, resistance to paclitaxel or another polymerizing agent, epothilone B, has been associated with point mutations in ß-tubulin (29 , 30) . These studies, along with crystallographic methods (31) , have helped define the binding sites of taxanes within tubulin. We have examined if ovarian carcinoma cells selected for paclitaxel or epothilone resistance (29) or an A549 lung carcinoma line selected for epothilone resistance (30) were cross-resistant to HTI-286. These cell lines have five distinct point mutations in ß-tubulin and do not express MDR1. No resistance to HTI-286 was found.5 These data are consistent with the prediction that HTI-286 does not bind to the taxane/epothilone binding site within tubulin. Because mutations in tubulin have not been reliably detected in cancer patients (32) , the clinical significance of this observation remains undefined.
In conclusion, the data suggest that the synthetic analogue of hemiasterlin, HTI-286, is an antimicrotubule agent that is highly effective at inhibiting the growth of tumors, including those where resistance to paclitaxel and vincristine is associated with P-glycoprotein overexpression. Because HTI-286 is a synthetic molecule, numerous analogues can be made that may further the understanding of the interaction of peptide-like molecules with tubulin. On the basis of the efficacy and safety assessment of HTI-286 in animals, HTI-286 is currently undergoing Phase I clinical evaluation in cancer patients.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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1 Supported by NIH Grant CA-67786-07 (to R. J. A.). Presented at the annual meeting of the AACR (San Francisco), April 2002, Abstract 1316. ![]()
2 To whom requests for reprints should be addressed, at Wyeth Research, Oncology Research, 401 North Middletown Road, 200/4709, Pearl River, NY 10965. E-mail: loganzf{at}wyeth.com ![]()
3 A. Zask et al., Synthesis and biological activity of analogs of the antimicrotubule agent HTI-286, manuscript in preparation. ![]()
4 The abbreviations used are: MAP, microtubule-associated protein; SRB, sulforhodamine B; MDR1, multidrug resistance protein-1. ![]()
5 M. Poruchynsky and F. Loganzo, unpublished observations. ![]()
Received 7/23/02. Accepted 2/19/03.
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