Irinotecan, a topoismorase1 inhibitor, has been used for the treatment of colorectal cancer. It was shown that mono-therapy alone is largely ineffective. The combination therapy was used for anti-tumor activity. The synergistic anti-cancer effects of oncolytic Reovirus-infected secretome in combination with Irinotecan and Metformin are evaluated in vitro. The aim of research is to assess anti-cancer impacts of ReoT3D, Irinotecan, Metformin in combination, against murine colorectal cancer cells (CT26). The L929 and the CT26 colorectal cancerous cell lines were treated in vitro with Irinotecan, Metformin, the Dearing strain of Reovirus serotype 3 (Reo T3D) (V), and the secretome of intact(S) or Reo-virus infected murine adipose-derived mesenchymal stem cells (SV). The cell viability was measured by MTT and the apoptosis rate was analyzed by Annexin V-FITC staining and flow cytometry 48 and 72 hours after treatment. We found that cells exposed to a combination of SV+Met+I had significantly lower cell viability and higher apoptosis rates as compared to cells exposed to Met+I, 48 and 72 hours. These results suggest that: Metformin in combination with Irinotecan and Reovirus produces a synergistic effect on cell death, and adding Reovirus-infected secretome (SV) to a Met+I regimen induces a higher apoptosis rate compared to Met+I alone. Based on the results, the combination of SV+Met+I has induced more apoptosis than S, SV, SV+I and SV+Met. Also, all of the combined treatments induced apoptosis significantly versus secretome alone. In this in-vitro study we found that the combination of T3D Reovirus (oncolytic virus) and Metformin with the anti-cancer drug Irinotecan resulted in higher rates of growth-inhibition and apoptosis induction in the colorectal cancer cell line. This synergistic effect was even more pronounced when using the combination of secretome derived from Reovirus-infected AD-MSCs, Metformin, and Irinotecan. We highlight that the combination of ReoT3D- derived secretome with Irinotecan and Metformin showed a synergistic anti-cancer effect on the CT26 cell line, and this strategy may be considered as a new approach against colorectal cancer (CRC) in the in vitro and in vivo in future studies.
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