Alberts D S, Fanta P T, Running K L, Adair L P, Garcia D J, Liu-Stevens R, Salmon S E
Department of Medicine, University of Arizona, College of Medicine, Tucson 85724, USA.
Cancer Chemother Pharmacol. 1997;39(6):493-7. doi: 10.1007/s002800050604.
To compare the in vitro cytotoxicity of nedaplatin, an investigational platinum analog, with that of the standard platinum agents, cisplatin and carboplatin, against fresh human, epithelial ovarian cancers.
The Hamburger-Salmon human tumor colony-forming assay (HTCA) was used to measure the chemosensitivity of 36 fresh tumor samples obtained during initial exploratory laparotomy from patients with newly diagnosed stage III-IV epithelial ovarian cancer who had received no prior chemotherapy or radiation therapy. Tumor samples were exposed to the platinum analogs for 1 h at concentrations of 10 and 100 micrograms/ml of nedaplatin and cisplatin and 100 and 1000 micrograms/ml of carboplatin. The resulting survival data were used to estimate the IC50 (drug concentration associated with 50% inhibition of tumor colony forming units, TCFUs) of each of the platinum analogs for each of the tumor samples, as well as the estimated survival following exposure to clinically achievable drug levels (i.e. the ultrafiltrable platinum area under the plasma disappearance curve, AUC, achieved in cancer patients following administration of standard or phase II doses).
At the lowest concentration tested (i.e. 10 micrograms/ml nedaplatin and cisplatin and 100 micrograms/ml carboplatin) the percentages of tumor samples which were sensitive (as defined by 50% or less survival of TCFUs as compared with controls) were 42, 50, and 40% for nedaplatin, cisplatin and carboplatin, respectively. The median IC50 values were 28.5, 12 and 121 micrograms/ml for nedaplatin, cisplatin and carboplatin, respectively. The estimated percentage of tumors sensitive to clinically achievable dose levels was 42% for nedaplatin and 36% for cisplatin and carboplatin. Nedaplatin and carboplatin proved relatively crossresistant with cisplatin in vitro; of the 18 tumor samples which were resistant to cisplatin, only 5 (28%) were sensitive to nedaplatin and 3 of 17 (18%) were sensitive to carboplatin.
Nedaplatin was associated with cytotoxicity similar to cisplatin and carboplatin in this study. Although nedaplatin appears to be crossresistant with cisplatin, its high rate of in vitro cytotoxicity, relative lack of neurotoxicity and nephrotoxicity, and large in vivo biovailability establish nedaplatin as a promising platinum analog for further clinical development as a salvage and primary chemotherapeutic agent for patients with advanced ovarian cancer.
比较新型铂类药物奈达铂与标准铂类药物顺铂和卡铂对新鲜人上皮性卵巢癌的体外细胞毒性。
采用汉堡-鲑鱼人肿瘤集落形成试验(HTCA),检测36例新诊断的Ⅲ-Ⅳ期上皮性卵巢癌患者在初次探查性剖腹手术时获取的新鲜肿瘤样本的化疗敏感性,这些患者此前未接受过化疗或放疗。将肿瘤样本分别暴露于浓度为10和100微克/毫升的奈达铂和顺铂以及100和1000微克/毫升的卡铂中1小时。所得生存数据用于估算每种铂类药物对每个肿瘤样本的半数抑制浓度(IC50,即与50%抑制肿瘤集落形成单位相关的药物浓度),以及暴露于临床可达到的药物水平(即癌症患者在给予标准或Ⅱ期剂量后血浆清除曲线下的超滤铂面积,AUC)后的估计生存率。
在最低测试浓度(即10微克/毫升的奈达铂和顺铂以及100微克/毫升的卡铂)下,对奈达铂、顺铂和卡铂敏感的肿瘤样本百分比(定义为与对照组相比肿瘤集落形成单位存活率为50%或更低)分别为42%、50%和40%。奈达铂、顺铂和卡铂的中位IC50值分别为28.5、12和121微克/毫升。对临床可达到剂量水平敏感的肿瘤估计百分比,奈达铂为42%,顺铂和卡铂为36%。奈达铂和卡铂在体外对顺铂表现出相对交叉耐药性;在18例对顺铂耐药的肿瘤样本中,仅5例(28%)对奈达铂敏感,17例中的3例(18%)对卡铂敏感。
在本研究中,奈达铂的细胞毒性与顺铂和卡铂相似。尽管奈达铂似乎与顺铂存在交叉耐药性,但其较高的体外细胞毒性、相对缺乏神经毒性和肾毒性以及较大的体内生物利用度,使奈达铂成为一种有前景的铂类药物,有望进一步作为晚期卵巢癌患者的挽救和一线化疗药物进行临床开发。