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[Therapy with inhibitors of polyamine biosynthesis in refractory prostatic carcinoma. An experimental and clinical

Onkologie
|August 1, 1985
PubMed

Insights

Polyamine inhibitors alpha-difluoromethylornithine (DFMO) and s-methylglyoxal-bisguanylhydrazone (MGBG) showed significant anti-tumor effects in prostate cancer models. Combination therapy completely eradicated tumors in animals, with DFMO mitigating MGBG toxicity.

Area of Science:

  • Oncology
  • Biochemistry
  • Pharmacology

Background:

  • Prostate cancer is characterized by altered polyamine metabolism.
  • Polyamines are crucial for cell growth and proliferation.
  • Inhibiting polyamine biosynthesis is a potential therapeutic strategy.

Purpose of the Study:

  • To evaluate the efficacy of polyamine biosynthetic inhibitors, alpha-difluoromethylornithine (DFMO) and s-methylglyoxal-bisguanylhydrazone (MGBG), in treating prostate adenocarcinoma.
  • To investigate the effects of DFMO and MGBG, alone and in combination, on tumor growth and polyamine levels.
  • To assess the clinical utility of polyamine antimetabolites in patients with metastatic prostate cancer.

Main Methods:

  • Treatment of transplantable prostate adenocarcinoma with DFMO (ornithine decarboxylase inhibitor) and MGBG (s-adenosylmethionine decarboxylase inhibitor).
  • Assessment of tumor growth reduction, tumor eradication, and polyamine content (spermidine, spermine, putrescine) in cancerous tissues.
  • Clinical trials with DFMO in patients with hormone-resistant prostate cancer and metastasis, and a combined DFMO/MGBG therapy in a patient with metastatic anaplastic prostate cancer.

Main Results:

  • DFMO (0.8-1.11 g/kg) reduced tumor growth by 40%.
  • Combination therapy with DFMO and MGBG (10.5 mg/kg) completely destroyed prostate adenocarcinomas in animals.
  • MGBG alone increased ornithine decarboxylase activity and putrescine levels to toxic levels, which was prevented by DFMO.
  • Clinical DFMO therapy (0.2-0.3 g/kg) showed moderate anti-tumor activity but significant side effects.
  • Combined DFMO/MGBG therapy in one patient did not improve survival but showed histological regression.

Conclusions:

  • Polyamine biosynthetic inhibitors demonstrate significant anti-tumor potential in prostate cancer.
  • Combination therapy with DFMO and MGBG offers a promising strategy for complete tumor eradication in preclinical models.
  • DFMO can mitigate MGBG-induced toxicity, allowing for higher therapeutic doses.
  • Clinical application of polyamine antimetabolites warrants further investigation, particularly regarding side effect management and combination strategies.

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