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Keynote address: multidrug resistance: a pleiotropic response to cytotoxic drugs

C R Fairchild1, K H Cowan

  • 1Medicine Branch, Division of Cancer Treatment, National Cancer Institute, Bethesda, MD 20892.

Insights

Cancer cells can develop multidrug resistance (MDR) to various chemotherapy drugs. This resistance is linked to P-glycoprotein, an efflux pump, and altered drug metabolism, suggesting a general stress response in cells.

Area of Science:

  • Biochemistry
  • Molecular Biology
  • Cancer Research

Background:

  • Tumor cells can acquire resistance to multiple classes of antineoplastic agents, a phenomenon known as multidrug resistance (MDR).
  • MDR is often associated with decreased drug accumulation and the overexpression of P-glycoprotein, a membrane protein acting as an energy-dependent drug efflux pump.
  • In human MCF-7 breast cancer cells resistant to adriamycin (AdrR MCF-7), MDR is linked to mdr1 gene amplification and overexpression.

Purpose of the Study:

  • To investigate the biochemical changes associated with multidrug resistance in cancer cells.
  • To explore the role of P-glycoprotein and drug metabolizing enzymes in conferring cross-resistance to various cytotoxic agents.
  • To compare resistance mechanisms in a human cancer cell line and a rat model of chemical carcinogenesis.

Main Methods:

  • Exposure of tumor cells in tissue culture to different classes of antineoplastic agents.
  • Analysis of drug accumulation and P-glycoprotein expression in resistant cell lines.
  • Investigation of alterations in Phase I and Phase II drug metabolizing enzymes.
  • Comparison of biochemical changes in resistant MCF-7 cells and a rat hepatocellular carcinogenesis model.

Main Results:

  • Acquired resistance to one antineoplastic agent conferred cross-resistance to other drug classes.
  • Multidrug resistance was associated with decreased intracellular drug levels and P-glycoprotein overexpression.
  • The mdr1 gene, encoding P-glycoprotein, was amplified and overexpressed in adriamycin-resistant MCF-7 cells.
  • Resistant cells also exhibited alterations in drug metabolizing enzymes, similar to changes observed in a rat hepatotoxin resistance model.

Conclusions:

  • Multidrug resistance involves P-glycoprotein acting as a drug efflux pump, reducing intracellular drug concentrations.
  • Alterations in drug metabolizing enzymes accompany P-glycoprotein-mediated resistance.
  • The observed similarities in resistance mechanisms between human cancer cells and a rat carcinogenesis model suggest a conserved cellular response to cytotoxic stress.
  • These findings indicate that cells may possess a coordinated battery of genes that can be activated to confer resistance against a broad spectrum of toxic agents.

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