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Sequence-dependent inhibition of human colon cancer cell growth and of prosurvival pathways by oxaliplatin in combination with ZD6474 (Zactima), an inhibitor of VEGFR and EGFR tyrosine kinases.

Abstract
To date, clinical studies combining the new generation of targeted therapies and chemotherapy have had mixed results. Preclinical studies can be used to identify potential antagonism/synergy between certain agents, with the potential to predict the most efficacious combinations for further investigation in the clinical setting. In this study, we investigated the sequence-dependent interactions of ZD6474 with oxaliplatin in two human colon cell lines in vitro. We evaluated the in vitro antitumor activity of ZD6474, an inhibitor of vascular endothelial growth factor receptor (VEGFR), epidermal growth factor receptor (EGFR) and RET tyrosine kinase activity, and oxaliplatin using three combination schedules: ZD6474 before oxaliplatin, oxaliplatin before ZD6474, and concurrent exposure. Cell proliferation studies showed that treatment with oxaliplatin followed by ZD6474 was highly synergistic, whereas the reverse sequence was clearly antagonistic as was concurrent exposure. Oxaliplatin induced a G(2)-M arrest, which was antagonized if the cells were previously or concurrently treated with ZD6474. ZD6474 enhanced oxaliplatin-induced apoptosis but only when added after oxaliplatin. The sequence-dependent antitumor effects appeared, in part, to be based on modulation of compensatory prosurvival pathways. Thus, expression of total and active phosphorylated EGFR, as well as AKT and extracellular signal-regulated kinase, was markedly increased by oxaliplatin. This increase was blocked by subsequent treatment with ZD6474. Furthermore, the synergistic sequence resulted in reduced expression of insulin-like growth factor-I receptor and a marked reduction in secretion of vascular endothelial growth factor protein. ZD6474 in combination with oxaliplatin has synergistic antiproliferative properties in human colorectal cancer cell lines in vitro when oxaliplatin is administered before ZD6474.
AuthorsTeresa Troiani, Owen Lockerbie, Mark Morrow, Fortunato Ciardiello, S Gail Eckhardt
JournalMolecular cancer therapeutics (Mol Cancer Ther) Vol. 5 Issue 7 Pg. 1883-94 (Jul 2006) ISSN: 1535-7163 [Print] United States
PMID16891475 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Organoplatinum Compounds
  • Piperidines
  • Quinazolines
  • Oxaliplatin
  • ErbB Receptors
  • Receptors, Vascular Endothelial Growth Factor
  • vandetanib
Topics
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
  • Cell Line, Tumor
  • Colonic Neoplasms (drug therapy, enzymology)
  • Drug Synergism
  • ErbB Receptors (antagonists & inhibitors)
  • G2 Phase (drug effects)
  • Humans
  • Organoplatinum Compounds (administration & dosage)
  • Oxaliplatin
  • Piperidines (administration & dosage)
  • Quinazolines (administration & dosage)
  • Receptors, Vascular Endothelial Growth Factor (antagonists & inhibitors)

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