Induction therapy in a multiple myeloma mouse model using a combination of AS101 and melphalan, and the activity of AS101 in a tumor microenvironment model.

OBJECTIVE: We previously showed that the organotellurium compound, ammonium trichloro (dioxyethylene-0-0') tellurate (AS101), has antitumoral activity in multiple myeloma (MM) cell lines. Here, we evaluated the antimyeloma activity of AS101 combined with low-dose melphalan, and also examined the activity of AS101 in the myeloma tumor microenvironment. MATERIALS AND METHODS: Isobologram analysis was performed to determine the interactions of AS101 and melphalan as a combination therapy. Growth arrest, apoptosis, and CD81 antigen were detected by flow cytometry. Using the 5T33MM mouse model, we evaluated mouse survival and serum levels of vascular endothelial growth factor (VEGF) and IgG(2b) paraprotein. We established cocultures of MS-5 bone marrow stromal cells and 5T33 MM cells in order to examine AS101 activity in a myeloma microenvironment model. RESULTS: Combined treatment of AS101 with melphalan in vitro resulted in a synergistic inhibitory effect on growth, G(2)/M phase growth arrest, reduced IgG(2b) secretion, apoptotic cell death, and reduced fibronectin-mediated adhesion of MM cells. AS101 reduced VEGF secretion and protein expression in myeloma and cocultured cells, downregulated production of the matrix metalloproteinases (MMPs), MMP-9 and MMP-2, and also inhibited growth of the treated myeloma coculture. Combined treatment using AS101 and low dose of melphalan in vivo resulted in modest survival improvement of myeloma-bearing mice and in reduced IgG(2b) and VEGF serum levels. CONCLUSIONS: AS101 in combination with a subtherapeutic dose of melphalan had increased beneficial effect relative to each agent alone in a mouse MM model. In addition, AS101 might be useful for targeting interactions between myeloma cells and the bone marrow microenvironment.

The immunomodulator AS101 induces growth arrest and apoptosis in multiple myeloma: association with the Akt/survivin pathway.

Multiple Myeloma (MM) is a clonal B-cell malignancy affecting both the immune and the skeletal systems, and accounts for 10% of all hematological cancers. The immunomodulator ammonium trichloro (dioxoethylene-O,O') tellurate (AS101) is a non-toxic compound which has direct anti-tumoral properties in several tumor models. The present study examined the anti-tumoral activity of AS101 in MM by targeting the Akt/Survivin signaling pathway, crucial for survival. We showed that AS101 inhibites cell proliferation and colonies formation of MM cell lines, in a dose-dependent manner. AS101 induced G(2)/M growth arrest and increased both cyclin-dependent kinase inhibitor p21(waf1) protein levels and Cdk1 (p34(cdc2))-inhibitory phosphorylation. Longer incubation of MM cells with AS101 resulted in accumulation of apoptotic cell population and in increased caspase 9, 3 and 7 activities. We also showed that AS101 down-regulated Akt phosphorylation and decreased expression of the inhibitor of apoptosis, survivin. Since Akt and survivin are potentials targets for MM therapy, we suggest that AS101, currently being used in clinical studies, may have therapeutic implications in myeloma and other hematopoietic malignancies.