Document Detail


A concomitant ATP-depleting strategy markedly enhances anticancer agent activity.
MedLine Citation:
PMID:  11321035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Most anticancer agents effect DNA damage which initiate the cell death pathways of necrosis and apoptosis, but cancer cells of lesser sensitivity are only sublethally injured, and recover. The two death pathways and their interelationships in the presence of endogenous inhibitors of apoptosis and genetic deletions that facilitates only sublethal damage, are reviewed. Both ATP and pyrimidine levels in the sublethally injured cancer cells are reduced but not to low levels insuffient to sustain cell viability. However, this sublethal damage by the anticancer agent creates a therapeutic opportunity for further reduction of these key metabolites to lower levels that will not support life. Data in tumor-bearing animals is reviewed demonstrating that a combination of ATP-depleting agents plus a de novo pyrimidine inhibitor (PALA) administered concomitantly with each of nine different anticancer agents markedly enhances tumor regression rates,and even produces some cures. It is necessary to deplete tumor ATP levels seveerely (>85%) by a combination of agents that block both synthesis (6-methylmercaptopurine riboside, a purine de novo synthesis inhibitor) and generation of ATP(6-aminonicotinamide, an inhibitor of glycolysis.) Cell viability cannot be sustained if the intracellular ATP level is reduced to 15% of normal or below. In vivo data employing this novel therapeutic strategy with cisplatin is presented. The potential significance of these findings to the improvement of cancer treatment is discussed.
Authors:
D S Martin; D Spriggs; J A Koutcher
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Apoptosis : an international journal on programmed cell death     Volume:  6     ISSN:  1360-8185     ISO Abbreviation:  Apoptosis     Publication Date:    2001 Feb-Apr
Date Detail:
Created Date:  2001-04-25     Completed Date:  2001-09-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9712129     Medline TA:  Apoptosis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  125-31     Citation Subset:  IM    
Affiliation:
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenosine Triphosphate*
Antineoplastic Agents / pharmacology*,  therapeutic use
Apoptosis / drug effects*
Humans
Neoplasms / drug therapy*,  metabolism,  pathology*
Grant Support
ID/Acronym/Agency:
CA 25842/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 56-65-5/Adenosine Triphosphate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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