Multifaceted Resistance of Gliomas to Temozolomide1
- Dora B. Bocangel,
- Sydney Finkelstein,
- S. Clifford Schold,
- Kishor K. Bhakat,
- Sankar Mitra and
- Demetrius M. Kokkinakis2
- Department of Pathology, The University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania 15261 [S. F., S. C. S., D. M. K.], and The University of Texas Medical Branch at Galveston, Galveston, Texas 77555 [D. B. B., K. K. B., S. M.]
Abstract
Purpose and Experimental Design: The contributions of O6-methylguanine-DNA-methyltransferase(MGMT), p53 status, mismatch repair, and apoptotic response to the resistance of glial tumors to temozolomide (TMZ) were tested using seven established human glial tumor cell lines in culture and xenografts in athymic mice.
Results: Resistance to TMZ was only marginally dependent on MGMT activity, because subtoxic doses of TMZ easily eliminated MGMT reserves for at least 18 h after treatment. Resistance to TMZ varied most notably with the p53 status of the tumor. Tumors with wild-type (wt) p53 and a functional p53 response to DNA damage (SWB40 and SWB61) were most sensitive. The p21-related cell cycle arrest was intimately linked to TMZ toxicity because tumors with wt p53 but lacking a robust increase in p21 protein level (D-54) were resistant to TMZ. In contrast, tumors with a dysfunctional p53 cycle and a weak cell cycle response to DNA damage (SWB39 and SWB77) were extremely unresponsive to treatment even with the aid of MGMT inactivators. Notable exceptions to the above were observed with the p53 mutated tumors SWB33 and SWB95, which were arrested by TMZ in G1-S and consequently underwent apoptosis despite their failure to express p21.
Conclusions: By testing a limited number of glial tumors in cell culture and also as xenografts, we have shown that mobilization of the p53 in response to TMZ damage is likely to induce a cell cycle arrest and apoptosis in glial tumors. Additional pathways linking cell cycle arrest and apoptosis contribute to the efficacy of TMZ against p53 mutated glial tumors. The unusual resistance of tumors, of which the cell cycle was not arrested in response to TMZ treatment, was associated with allelic losses during regrowth of treated tumors. Nevertheless such resistance was not related to dysfunctional mismatch repair.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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↵1 Supported by National Cancer Institute Grants CA 57725, CA84461, and CA 78561.
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↵2 To whom requests for reprints should be addressed, at Department of Pathology, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15261. Phone: (418) 648-9850; Fax: (412) 383-9822; E-mail: Kokkinakisdm{at}msx.upmc.edu
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↵3 The abbreviations used are: BCNU, 1,3-bis(2-chloroethyl)-1-nitrosourea; MGMT, O6-methylguanine-DNA methyltransferase; BG, O6-benzylguanine; dBG, O6-benzyl-2′-deoxyguanosine; MMR, mismatch repair; TMZ, temozolomide; wt, wild type; TUNEL, terminal deoxynucleotidyl transferase (Tdt)-mediated nick end labeling; TG, thioguanine.
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- Accepted April 18, 1902.
- Received October 31, 1901.
- Revision received April 3, 1902.
