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Inhibition of Protein Kinase Cß by Enzastaurin Enhances Radiation Cytotoxicity in Pancreatic Cancer

Authors' Affiliations: ¹ Department of Radiation Oncology and ² Cellular and Molecular Biology Training Program, The University of Michigan Medical School, Ann Arbor, Michigan

Requests for reprints: Aaron C. Spalding, Department of Radiation Oncology, The University of Michigan Medical School, UH B2C490, Box 0010, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0010. Phone: 734-936-8207; Fax: 734-763-7370; E-mail: spalda{at}med.umich.edu.

Purpose: Aberrant activation of protein kinase Cß (PKCß) by pancreatic cancer cells facilitates angiogenesis and tumor cell survival. Targeting PKCß with enzastaurin, a well-tolerated drug in clinical trials, would be expected to radiosensitize pancreatic tumors through direct antitumor and antivascular effects.

Experimental Design: We tested the hypothesis that enzastaurin radiosensitizes pancreatic cancer cells in culture and in vivo through inhibition of PKCß. We analyzed pancreatic cancer xenografts for growth delay and microvessel density after treatment with enzastaurin, radiation, or both. We determined the effect of radiation and enzastaurin on glycogen synthase kinase 3ß, a mediator of cell death in culture and in vivo.

Results: At concentrations attained in patients, enzastaurin reduced levels of active PKCß measured by phosphorylation at Thr⁵⁰⁰ in culture and in xenografts. Enzastaurin alone did not affect pancreatic cancer cell survival, proliferation, or xenograft growth. However, enzastaurin radiosensitized pancreatic cancer cells in culture by colony formation assay. Enzastaurin alone decreased microvessel density of pancreatic cancer xenografts without appreciable effects on tumor size. When combined with radiation, enzastaurin increased radiation-induced tumor growth delay with a corresponding decrease in microvessel density. Enzastaurin inhibited radiation-induced phosphorylation of glycogen synthase kinase 3ß at Ser⁹ in pancreatic cancer cells in culture and in tumor xenografts, suggesting a possible mechanism for the observed radiosensitization.

Conclusions: Enzastaurin inhibits PKCß in pancreatic cancer cells in culture, enhancing radiation cytotoxicity. Additional antivascular effects of enzastaurin were observed in vivo, resulting in greater radiosensitization. These results provide the rationale for a clinical trial in locally advanced pancreatic cancer combining enzastaurin with radiation.

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