Abstract

BackgroundDrug resistance is one of the major obstacles limiting the activity of anticancer agents. Activation of DNA repair mechanism often accounts for increase resistance to cancer chemotherapy.ResultsWe present evidence that nemorubicin, a doxorubicin derivative currently in clinical evaluation, acts through a mechanism of action different from classical anthracyclines, requiring an intact nucleotide excision repair (NER) system to exert its activity. Cells made resistant to nemorubicin show increased sensitivity to UV damage. We have analysed the mechanism of resistance and discovered a previously unknown mechanism resulting from methylation-dependent silencing of the XPG gene. Restoration of NER activity through XPG gene transfer or treatment with demethylating agents restored sensitivity to nemorubicin. Furthermore, we found that a significant proportion of ovarian tumors present methylation of the XPG promoter.ConclusionsMethylation of a NER gene, as described here, is a completely new mechanism of drug resistance and this is the first evidence that XPG gene expression can be influenced by an epigenetic mechanism. The reported methylation of XPG gene could be an important determinant of the response to platinum based therapy. In addition, the mechanism of resistance reported opens up the possibility of reverting the resistant phenotype using combinations with demethylating agents, molecules already employed in the clinical setting.

Highlights

  • Drug resistance is one of the major obstacles limiting the activity of anticancer agents

  • Exceptions are trabectedin, a marine compound currently under clinical investigation [4,5,6,7] that is less active in cells with deficient nucleotide excision repair (NER) [8,9] and cisplatin and carboplatin, two widely used anticancer agents which display resistance in cells lacking a functional mismatch repair (MMR) system

  • Chinese hamster ovary (CHO)-UV96 cells transfected with the human ERCC1 gene (ERA5) showed a restored NER function [8]; in this cellular system, sensitivity to nemorubicin greatly increased over CHO-UV96 deficient cells, approaching that found in parental CHO cells

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Summary

Introduction

Drug resistance is one of the major obstacles limiting the activity of anticancer agents. Nemorubicin is active in vitro as well as in vivo against murine and human tumor cell lines resistant to doxorubicin, to other P-glycoprotein and multidrug resistance protein (MRP) substrates and to topoisomerase II inhibitors [14,15,16]. It is more potent than the parent drug and retains activity in tumors resistant to alkylating agents and topoisomerase I inhibitors. All these features strongly suggest that nemorubicin, structurally an anthracycline derivative, has a completely different mechanism of action. In Phase I-II trials nemorubicin as single agent was effective against HCC patients; currently, phase I-II studies in combination with cisplatin are ongoing

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