In vitro testing of drug combinations employing nilotinib and alkylating agents with regard to pretransplant conditioning treatment of advanced-phase chronic myeloid leukemia.

PURPOSE: The prognosis of patients with advanced-phase chronic myeloid leukemia (CML) remains dismal despite the availability of targeted therapies and allogeneic stem cell transplantation (allo-SCT). Increasing the antileukemic efficacy of the pretransplant conditioning regimen may be a strategy to increase remission rates and duration. We therefore investigated the antiproliferative effects of nilotinib in combination with drugs that are usually used for conditioning: the alkylating agents mafosfamide, treosulfan, and busulfan. METHODS: Drug combinations were tested in vitro in different imatinib-sensitive and imatinib-resistant BCR-ABL-positive cell lines. A tetrazolium-based MTT assay was used for the assessment and quantification of growth inhibition after exposure to alkylating agents alone or to combinations with nilotinib. Drug interaction was analyzed using the median-effect method of Chou and Talalay, and combination index (CI) values were calculated according to the classic isobologram equation. RESULTS: Treatment of imatinib-sensitive, BCR-ABL-positive K562 and LAMA84 cells with nilotinib in combination with mafosfamide, treosulfan, or busulfan resulted in synergistic (CI < 1), additive (CI ~ 1), and predominantly antagonistic (CI > 1) effects, respectively. In imatinib-resistant K562-R and LAMA84-R cells, all applied drug combinations were synergistic (CI < 1) at higher growth inhibition levels. CONCLUSIONS: Our in vitro data warrant further investigation and may provide the basis for nilotinib-supplemented conditioning regimens for allo-SCT in advanced-phase CML.

Lentiviral vector integration sites in human NOD/SCID repopulating cells.

BACKGROUND: Recent observations of insertional mutagenesis in preclinical and clinical settings emphasize the relevance of investigating comprehensively the spectrum of integration sites targeted by specific vectors. METHODS: We followed the engraftment of lentivirally transduced human cord blood (CB) progenitor cells after transplantation into NOD/SCID mice using a self-inactivating HIV-1-derived vector expressing the enhanced green fluorescent protein (EGFP). RESULTS: The mean of transduction of CD34(+) CB cells was 41%, as deduced from the percentage of EGFP(+) cells before transplantation. At 3 weeks post-transplantation, the average of EGFP(+) cells in the human cell population was 65 +/- 8%, and increased to 75 +/- 10% at 12 weeks post-transplantation. In order to determine the proviral integration sites in human NOD/SCID repopulating cells (SRCs) we used the ligation-mediated polymerase chain reaction (LM-PCR) technique. Sixty-eight percent of the integrations were found to be located in RefSeq genes, most of them in intron regions. Twenty percent of these integrations occurred within a distance of 10 kb from the transcription start site; a percentage that is significantly lower compared to that observed in cells transduced by gammaretroviral vectors. Sixty-two percent of integrations occurred in genes with a biological function in cell metabolism, and four integrations were located in genes with a role in tumorigenesis. CONCLUSIONS: These investigations indicate that integration of lentiviral vectors in human repopulating cells capable of engrafting NOD/SCID mice preferentially occur in coding regions of the human genome. Nevertheless, the clustering of integrations at the transcriptional start is not as high as that observed for gammaretroviral vectors.

Susceptibility of mesothelioma cell lines to adeno-associated virus 2 vector-based suicide gene therapy.

Although great efforts have been made to improve conventional therapy for diffuse malignant pleural mesothelioma, the median survival time of the patients after appearance of clinical symptoms remains poor. Due to confinement of the primary tumor to the pleural space, locoregional approaches are attractive strategies to improve the clinical outcome. In this context locoregional gene therapy using the recombinant adeno-associated virus 2 (rAAV-2) may be a new approach. Vectors were constructed containing a fusion gene, consisting of the Herpes simplex virus thymidine kinase (HSV-TK) and the green fluorescent protein (GFP) genes; the former serving as suicide gene by converting the prodrug ganciclovir (GCV) into a toxic agent, thereby killing infected cells. Among a number of different tumor cell lines, rAAV-2 achieved high GFP expression levels in three mesothelioma cell lines (H-Meso-1, MSTO-211H, NCI-H28). A variety of rAAV-2-constructs containing different promoters were tested. The vector with the elongation factor-1alpha (EF-1alpha) promoter showed the highest expression rates. Expression could be further increased by addition of the tyrosine kinase inhibitor genistein. Using the rAAV-2-based suicide system, a nearly complete eradication of transduced and GCV-treated mesothelioma cells was observed. rAAV-2-based suicide gene therapy may be a new approach for locoregional treatment of mesothelioma.