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Prevention of gallium toxicity by hyperhydration in treatment of medulloblastoma
H T Whelan1, M B Williams, D M Bajic
1Department of Neurology, Medical College of Wisconsin, Milwaukee 53226.
Abstract:
In vitro and in vivo studies have established gallium nitrate as an effective chemotherapeutic agent against human medulloblastoma. In vitro, gallium nitrate reduced cell proliferation and DNA synthesis of medulloblastoma Daoy. Gallium inhibits the availability of 59Fe to ribonucleotide reductase and has a direct effect on the enzyme itself. In vivo, gallium demonstrated similar effects on the medulloblastoma Daoy cell line in nude mice. Tumor growth rate and actual size were decreased; however, severe nephrotoxicity and mortality were observed. In our study, intradermal injections of medulloblastoma Daoy cells were given to nude mice and then tumors were allowed to grow. Tumor-bearing mice received a 15-day gallium (50 mg/kg/day) regimen, 20-day rest, 7-day gallium (66.5 mg/kg/day) dose escalation regimen beginning when tumor size exceeded 8-10 mm in diameter. All treated and control mice received saline hyperhydration during both treatment sessions. Our study resulted in the prevention of severe toxicity and an inhibition of tumor growth. No toxicity occurred with gallium nitrate at 50 mg/kg/day. Severe morbidity and mortality were observed at the higher gallium dose level (66.5 mg/kg/day), suggesting that the 50 mg/kg/day dose is the appropriate level when investigating gallium nitrate as a chemotherapy agent in nude mice.
Insights
Gallium nitrate effectively inhibits medulloblastoma growth in mice without toxicity at 50 mg/kg/day. Higher doses caused severe side effects, indicating a safe therapeutic window for this chemotherapy agent.
Area of Science:
- Oncology
- Pharmacology
Background:
- Gallium nitrate shows promise as a chemotherapy agent for human medulloblastoma.
- Previous studies indicate gallium nitrate inhibits medulloblastoma cell proliferation and DNA synthesis.
- In vivo studies noted tumor reduction but also severe toxicity and mortality.
Purpose of the Study:
- To evaluate the efficacy and toxicity of gallium nitrate in a nude mouse model of medulloblastoma.
- To determine an appropriate and safe dosage regimen for gallium nitrate chemotherapy.
Main Methods:
- Medulloblastoma Daoy cells were xenografted into nude mice.
- Mice received a 15-day regimen of gallium nitrate (50 mg/kg/day), followed by a rest period.
- A dose escalation regimen (66.5 mg/kg/day) was initiated for 7 days, with saline hyperhydration for all mice.
Main Results:
- Gallium nitrate at 50 mg/kg/day prevented severe toxicity and inhibited tumor growth.
- A higher dose (66.5 mg/kg/day) resulted in significant morbidity and mortality.
- Saline hyperhydration was administered to all mice during treatment.
Conclusions:
- A gallium nitrate dose of 50 mg/kg/day is effective in inhibiting medulloblastoma tumor growth in mice without causing toxicity.
- Higher doses of gallium nitrate are associated with severe adverse effects, suggesting this level is not suitable for further investigation.
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