Abstract Lung cancer is a significant cause of cancer-related deaths worldwide, with a high incidence rate, poor prognosis, aggressiveness, and a lack of effective treatment options. The present study has brought together two FDA-approved drugs with antineoplastic properties to create a complex that promises to revolutionize the treatment of Non-Small Cell Lung Cancer (NSCLC). By combining C-Phycocyanin extract (PCE), a pigment-protein complex synthesized by blue-green microalgae platensis, with the immunostimulatory doxorubicin (DOX) loaded Bacterial Ghosts (BGs), the present study aims to achieve enhanced dual-chemotherapy and remarkable inhibition of DOX-chemoresistance. The BG delivery system uses purified bacterial cell evacuation and safe confirmed Klebsiella pneumoniae BGs (KPBG) for safe and effective delivery, overcoming issues with resistance and poor delivery. The complex delivery system of KPBG-PCE/DOX was tested on two NSCLC cell lines, wild-P53, A549, and mutant-P53, NCI/H358, respectively. Our data showed that the loaded combined treatment significantly induced morphological changes with signs of apoptosis induction in the tested cell lines compared with the control. The WST-1 assay was used to evaluate cell proliferation. Data indicates that PCE and DOX have a synergistic effect at low concentrations when loaded on KPBGs for a constant count of BGs CFU/ml after 48 h of treatment. The viability inhibition and apoptosis induction of A549 and NCI/H358 cells were amplified in the combined treatment of 48 h compared to the control or either each drug alone. At the protein levels, our data showed activation of caspase-3, upregulation of BAX, and downregulation of Bcl-2, Bcl-XL, m-TOR, S6k, oncogenic β-catenin, and cyclin-D1 protein expression levels after treatment with (KPBG-PCE/DOX) for 48 h, indicating apoptotic induction and modulating oncogenic signaling pathways. In conclusion, the current study presents a promising outcome of a synergistic delivery system of KPBG-PCE/DOX that can inhibit lung cancer cell line proliferation, induce apoptosis, and increase cell sensitivity to DOX. The KPBG delivery system offers an appealing approach for a successful combination of targeted therapy for lung cancer. Citation Format: Basma Adel Elsayed Abdelaziz, Hoda Eid Mahmoud, Omayma Mohamed Sadek, Ahmed Samir Sultan. The novel complex delivery system of C-phycocyanin-loaded klebsiella pneumoniabacterial ghost induces apoptosis and sensitizes non-small cell lung cancer cell lines to doxorubicin [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7589.
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