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Exisulind in Combination with Docetaxel Inhibits Growth and Metastasis of Human Lung Cancer and Prolongs Survival in Athymic Nude Rats with Orthotopic Lung Tumors

Daniel C. Chan, Keith A. Earle, Tom L. M. Zhao, Barbara Helfrich, Chan Zeng, Anna Baron, Clark M. Whitehead, Gary Piazza, Rifat Pamukcu, W. Joseph Thompson, Hector Alila, Peter Nelson and Paul A. Bunn Jr.
Daniel C. Chan
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Keith A. Earle
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Tom L. M. Zhao
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Barbara Helfrich
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Chan Zeng
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Anna Baron
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Clark M. Whitehead
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Gary Piazza
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Rifat Pamukcu
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W. Joseph Thompson
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Hector Alila
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Peter Nelson
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Paul A. Bunn Jr.
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DOI:  Published March 2002
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  • Fig. 1.
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    Fig. 1.

    A, the cytotoxicity of exisulind alone on the NSCLC line A549. B, the cytotoxicity of docetaxel alone and paclitaxel alone on the NSCLC line A549. C, the CI isobologram for the NSCLC line A549 adenocarcinoma treated in vitro with exisulind and paclitaxel. CI < 1 indicates synergism, CI = 1 indicates additive effects, and CI > 1 indicates antagonism. All data were obtained from 6-day MTT assays.

  • Fig. 2.
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    Fig. 2.

    First survival study of athymic nude rats with orthotopic A549 tumors. A, the survival curves for animals treated with exisulind and docetaxel alone compared with saline-treated controls (+); exisulind 50 mg/kg alone (▵); exisulind 100 mg/kg alone (▴); docetaxel 5 mg/kg (2×) then 2.5 mg/kg (4×; ○); and docetaxel 10 mg/kg (2×) and 5 mg/kg (4×; •). B, the survival curves for animals treated with the combination of exisulind + docetaxel compared with saline treated controls (+); exisulind 50 mg/kg plus docetaxel 5 mg/kg (2×) then 2.5 mg/kg (4×; ▿); exisulind 100 mg/kg plus docetaxel 5 mg/kg (2×) then 2.5 mg/kg (4×; ▾); exisulind 50 mg/kg plus docetaxel 10 mg/kg (2×) then 5 mg/kg (4×; □); and exisulind 100 mg/kg plus docetaxel 10 mg/kg (2×) then 5 mg/kg (4×; ▪).

  • Fig. 3.
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    Fig. 3.

    Second survival study of athymic nude rats with orthotopic A549 tumors. A, the survival curves for animals treated with exisulind or docetaxel alone compared with saline treated controls (+); exisulind 25 mg/kg alone (▵); exisulind 50 mg/kg alone (▴); docetaxel 2.5 mg/kg (6×; ○); and docetaxel 5 mg/kg (6×; •). B, the survival curves for animals treated with exisulind + docetaxel compared with saline treated controls (+); exisulind 25 mg/kg plus docetaxel 2.5 mg/kg (6×; ▿); exisulind 25 mg/kg plus docetaxel 5 mg/kg (6×; ▾); exisulind 50 mg/kg plus docetaxel 2.5 mg/kg (6×; □); exisulind 50 mg/kg plus docetaxel 5 mg/kg (6×; ▪); and exisulind 50 mg/kg plus docetaxel 5 mg/kg (2×) then 2.5 mg/kg (4×; ♦).

  • Fig. 4.
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    Fig. 4.

    Dissected lungs and mediastinum from athymic nude rats with A549 tumors treated with (A) saline control (day 34), (B) exisulind 50 mg/kg (day 55), (C) docetaxel 5 mg/kg (day 50), and (D) exisulind 50 mg/kg plus docetaxel 5 mg/kg (day 80).

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    Fig. 5.

    Apoptotic rates determined by TUNEL analysis. The levels of apoptosis in the treatment groups were compared with the background apoptosis levels in the control group that received no treatment. Levels of apoptosis relative to controls are shown. The treatment group receiving the combination of 50 mg/kg/day of exisulind and 5 mg/kg/day docetaxel exhibited a significant increase in apoptosis.

Tables

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  • Table 1

    In vitro effects of exisulind and docetaxel alone and in combination on cell cycle distribution and % of apoptotic cells in A549 NSCLC cells

    Treatment% G1a% S% G2-M% Apoptosis
    Control 24 h4638160
    Exi 200 μm6022180.1
    Exi 300 μm6514210
    Doce 0.2 nm4239190
    Doce 0.5 nm3841210.05
    Doce 1 nm4640140.58
    Doce 3 nm32571111
    Control 12 h5133160
    Docetaxel 6 nm30502034
    Docetaxel 10 nm10513964
    Control 24 h4638160
    Exi 200 μm + Doce 0.2 nm5921200.47
    Exi 200 μm + Doce 0.5 nm5428199.4
    Exi 200 μm + Doce 1 nm468465
    Exi 300 μm + Doce 0.2 nm5817255
    Exi 300 μm + Doce 0.5 nm43243339
    Exi 300 μm + Doce 1 nm51361362
    • a Exi, exisulind; Doce, docetaxel; % Apoptosis, percentage of apoptotic cells.

  • Table 2

    Effect of exisulind, docetaxel, and the combination on the number of athymic rats with metastases from orthotopic A549 tumors (first experiment)

    TreatmentDose and scheduleMean survival days (P, log-rank)# rats with mets/# treated (P, Fisher’s exact test)
    Control43 days9/10
    Exisulind50 mg/kg daily52.5 days7/8
    (P = 0.49)(P = 1.0)
    Exisulind100 mg/kg daily57.625 days7/8
    (P = 0.26)(P = 1.0)
    Docetaxela5 mg/kg (2×/wk)63.5 days6/8
    2.5 mg/kg/wk (4×)(P = 0.058)(P = 0.56)
    Docetaxela10 mg/kg (2×/1 wk)63.25 days5/8
    5 mg/kg/wk (4×)(P = 0.038)(P = 0.27)
    Exisulind50 mg/kg daily>80 days1/8
    Docetaxela5 mg/kg (2×/wk)(P < 0.001)(P = 0.003)
    2.5 mg/kg/wk (4×)
    Exisulind50 mg/kg daily62.375 days3/8
    Docetaxela10 mg/kg (2×/wk)(P = 0.12)(P = 0.043)
    5 mg/kg/wk (4×)
    Exisulind100 mg/kg daily43.375 days4/8
    Docetaxela5 mg/kg (2×/wk)(P = 0.99)(P = 0.12)
    2.5 mg/kg/wk (4×)
    Exisulind100 mg/kg daily49 days3/8
    Docetaxela10 mg/kg (2×/wk)(P = 0.40)(P = 0.043)
    5 mg/kg/wk (4×)
    • a Docetaxel was administered at the higher dose twice in the first week and once weekly at the lower dose for the next 4 weeks.

  • Table 3

    Effect of exisulind, docetaxel, and the combination on the number of athymic rats with metastases from orthotopic A549 tumors (second experiment)

    TreatmentDose and scheduleMean survival days (P, log-rank)# rats with mets/# treated (P, Fisher’s exact test)
    Control35.7 days15/15
    Exisulind25 mg/kg daily36 days12/12
    (P = 0.76)(P = 1.0)
    Exisulind50 mg/kg daily41.08 days11/12
    (P = 0.31)(P = 0.41)
    Docetaxel2.5 mg/kg/wk (6×)34.5 days12/12
    (P = 0.66)(P = 1.0)
    Docetaxel5 mg/kg/wk (6×)43.58 days9/12
    (P = 0.17)(P = 0.06)
    Exisulind25 mg/kg daily35.5 days12/12
    Docetaxel2.5 mg/kg/wk (6×)(P = 0.68)(P = 1.0)
    Exisulind25 mg/kg daily49.33 days8/12
    Docetaxel5 mg/kg/wk (6×)(P = 0.04)(P = 0.02)
    Exisulind50 mg/kg daily36 days11/12
    Docetaxel2.5 mg/kg/wk (6×)(P = 0.31)(P = 0.41)
    Exisulind50 mg/kg daily63.17 days2/12
    Docetaxel5 mg/kg/wk (6×)(P < 0.0004)(P < 0.0001)
    Exisulind50 mg/kg daily65.17 days1/12
    Docetaxela5 mg/kg/wk (3×)(P < 0.0001)(P < 0.0001)
    2.5 mg/kg/wk (3×)
    • a Docetaxel was administered at 5 mg/kg/wk for the weeks 1–3 and at the lower dose of 2.5 mg/kg/wk for weeks 4–6.

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March 2002
Volume 8, Issue 3
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Exisulind in Combination with Docetaxel Inhibits Growth and Metastasis of Human Lung Cancer and Prolongs Survival in Athymic Nude Rats with Orthotopic Lung Tumors
Daniel C. Chan, Keith A. Earle, Tom L. M. Zhao, Barbara Helfrich, Chan Zeng, Anna Baron, Clark M. Whitehead, Gary Piazza, Rifat Pamukcu, W. Joseph Thompson, Hector Alila, Peter Nelson and Paul A. Bunn Jr.
Clin Cancer Res March 1 2002 (8) (3) 904-912;

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Exisulind in Combination with Docetaxel Inhibits Growth and Metastasis of Human Lung Cancer and Prolongs Survival in Athymic Nude Rats with Orthotopic Lung Tumors
Daniel C. Chan, Keith A. Earle, Tom L. M. Zhao, Barbara Helfrich, Chan Zeng, Anna Baron, Clark M. Whitehead, Gary Piazza, Rifat Pamukcu, W. Joseph Thompson, Hector Alila, Peter Nelson and Paul A. Bunn Jr.
Clin Cancer Res March 1 2002 (8) (3) 904-912;
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