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Estramustine resistance
S Sangrajrang1, F Calvo, A Fellous
1Laboratoire de Pharmacologie, Institut de Génétique Moléculaire, Hôpital Saint-Louis, Paris, France.
Abstract:
Estramustine (EM), a conjugate of nornitrogen mustard and estradiol, is a antimicrotubule drug currently in use for the treatment of advanced prostatic carcinoma. Experimental data are accumulating concerning the antitumor effect of EM in other malignancies, and clinical studies in other malignancies are ongoing. This review summarizes the information available to date concerning the effects of EM and the development of drug resistance. EM depolymerizes microtubules by binding to microtubule-associated proteins (MAPs) as well as tubulin. Because of the radiosensitizing effect of this drug there has been a recent increase in interest concerning estramustine and its clinical use. Recently, it was proposed that EM induces an apoptotic cell death in glioma cells in vitro and in a rat model. EM resistance is distinct from MDR phenotype; it has been used in combination with antimitotic agents which are part of the MDR phenotype. Observations made with estramustine-resistant cell lines show the acquisition of estramustine resistance is a function of multiple adaptation by changes at tubulin expression pattern, and is also associated with changes in tau expression and phosphorylation.
Insights
Estramustine (EM), an antimicrotubule drug, shows promise beyond prostate cancer. Drug resistance to EM involves complex cellular adaptations, distinct from multidrug resistance, affecting tubulin and tau expression.
Area of Science:
- Oncology
- Pharmacology
- Cell Biology
Background:
- Estramustine (EM) is an antimicrotubule agent used for advanced prostate cancer.
- Emerging data suggest antitumor effects in other malignancies, with ongoing clinical studies.
- EM's mechanism involves microtubule depolymerization via tubulin and microtubule-associated protein (MAP) binding.
Purpose of the Study:
- To review the current understanding of Estramustine's effects.
- To summarize the development and characteristics of Estramustine drug resistance.
- To highlight the potential of EM in broader oncological applications.
Main Methods:
- Literature review of experimental and clinical data on Estramustine.
- Analysis of studies investigating Estramustine's mechanism of action.
- Examination of research on Estramustine resistance mechanisms in cell lines.
Main Results:
- Estramustine exhibits radiosensitizing properties, increasing clinical interest.
- EM has demonstrated induction of apoptotic cell death in glioma models.
- Estramustine resistance is a distinct phenotype, not linked to the multidrug resistance (MDR) phenotype.
- Resistance acquisition involves adaptive changes in tubulin expression and tau phosphorylation.
Conclusions:
- Estramustine has potential applications beyond prostate cancer treatment.
- Understanding Estramustine resistance is crucial for optimizing its clinical use.
- The distinct resistance mechanisms suggest novel therapeutic strategies may be developed.
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