A novel phospholipid gemcitabine conjugate is able to bypass three drug-resistance mechanisms

We have previously synthesized a phospholipid-gemcitabine conjugate and a phospholipid-cytosine arabinoside conjugate that we tested in different human cancer cell lines. The gemcitabine conjugate was more cytotoxic to the cancer cells tested than the cytosine arabinoside (ara-C) conjugate. The focus here was to elucidate the mechanism of action of the conjugate molecule and its ability to bypass certain drug-resistance mechanisms. In contrast to gemcitabine, the gemcitabine conjugate did not enter the cell via the human equilibrative nucleoside transporter (hENT1). Additionally, the gemcitabine conjugate was not a substrate for the multidrug resistance efflux pump, MDR-1, even though the molecule is more lipophilic. Finally, we showed that deoxycytidine kinase (dCK) was not required for the activation of the gemcitabine conjugate. As expected, cells overexpressing dCK were more sensitive to gemcitabine whereas cells overexpressing dCK were not more sensitive to the gemcitabine conjugate. Taken together, these results suggest that the gemcitabine conjugate may be therapeutically superior to gemcitabine due to the conjugate's ability to bypass three resistance mechanisms that often render gemcitabine ineffective as an anticancer agent.