Abstract

BackgroundDNA topoisomerase I (Top1) is a DNA unwinding protein and the specific target of the camptothecin class of chemotherapeutic drugs. One of these, irinotecan, acting through its active metabolite SN-38, is used in the treatment of metastatic colorectal cancer. However, resistance to irinotecan represents a major clinical problem. Since molecular alterations in Top1 may result in resistance to irinotecan, we characterized Top1 in three human colon cancer cell lines with acquired resistance to SN-38.MethodsThree SN-38 resistant (20–67 fold increased resistance) cell lines were generated and compared to wild-type parental cells with regards to: TOP1 gene copy number and gene sequence, Top1 expression (mRNA and protein), Top1 enzymatic activity in the absence and presence of drug, and Top1-DNA cleavage complexes in drug treated cells. TOP1 mutations were validated by PCR using mutant specific primers. Furthermore, cross-resistance to two indenoisoquinoline Top1-targeting drugs (NSC 725776 and NSC 743400) and two Top2-targeting drugs (epirubicin and etoposide) was investigated.ResultsTwo of three SN-38 resistant cell lines carried TOP1 gene copy number aberrations: A TOP1 gene copy gain and a loss of chromosome 20, respectively. One resistant cell line harbored a pair of yet unreported TOP1 mutations (R364K and G717R) in close proximity to the drug binding site. Mutant TOP1 was expressed at a markedly higher level than wild-type TOP1. None or very small reductions were observed in Top1 expression or Top1 activity in the absence of drug. In all three SN-38 resistant cell lines Top1 activity was maintained in the presence of high concentrations of SN-38. None or only partial cross-resistance were observed for etoposide and epirubicin, respectively. SN-38 resistant cells with wild-type TOP1 remained sensitive to NSC 743400, while cells with mutant TOP1 was fully cross-resistant to both indenoisoquinolines. Top1-DNA cleavage complex formation following drug treatment supported the other findings.ConclusionsThis study adds to the growing knowledge about resistance mechanisms for Top1-targeting chemotherapeutic drugs. Importantly, two yet unreported TOP1 mutations were identified, and it was underlined that cross-resistance to the new indenoisoquinoline drugs depends on the specific underlying molecular mechanism of resistance to SN-38.

Highlights

  • DNA topoisomerase I (Top1) is a DNA unwinding protein and the specific target of the camptothecin class of chemotherapeutic drugs

  • TOP1 gene copy number aberrations in SN-38 resistant cells identified by FISH TOP1 gene copy number was determined using a TOP1/ CEN-20 FISH probe combination, where CEN-20 is used as a reference (TOP1 is located at 20q12-q13.1), in both the parental and resistant cells

  • As Top1 is the sole target of camptothecins [8, 43], Top1 alterations play a critical role in mediating resistance to irinotecan and as a possible predictive biomarker of response to irinotecan in metastatic colorectal cancer (mCRC)

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Summary

Introduction

DNA topoisomerase I (Top1) is a DNA unwinding protein and the specific target of the camptothecin class of chemotherapeutic drugs. Irinotecan, acting through its active metabolite SN-38, is used in the treatment of metastatic colorectal cancer. In metastatic colorectal cancer (mCRC), current chemotherapeutic treatment options consist of either 5fluorouracil and folinic acid with oxaliplatin (FOLFOX) or 5-fluorouracil and folinic acid with irinotecan (FOLFIRI) [1, 2]. Irinotecan belongs to the camptothecin class of chemotherapeutic drugs and is a pro-drug of the active metabolite SN-38. Camptothecins selectively target DNA topoisomerase I (Top1)-DNA cleavage complexes which form in the vicinity of replication and transcription complexes to unwind DNA [8,9,10]. DNA topoisomerase II (Top2) is the target of other classes of chemotherapeutic drugs, including the anthracylines and etoposide [8, 12, 13]

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