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A unifying model for reconstructing radiosensitivity from micronucleus formation, apoptosis and abnormal morphology.

At present micronucleus data cannot predict cellular radiosensitivity. The inclusion of data from apoptosis and abnormal morphology has not entirely resolved this problem. Here, we assess the probability of cell death arising from events other than micronucleation, apoptosis and abnormal morphology (i.e. lesions not detected by these damage assays) P(oe), for its ability to reflect intrinsic cellular radiosensitivity. Analysis of data from 17 cell lines used in two separate studies, spanning a wide range of radiosensitivity (0.09</=SF2</=0.70), confirmed our previous observation that cell death due to undetected lesions depends on the irradiation dose and is cell type-specific. We further demonstrate that P(oe) accounts for inter-cell line differences in translating irradiation damage into cell death. Data from any two of micronucleus formation, apoptosis and abnormal cell morphology, fitted to the P(oe) model, adequately predict clonogenic survival, and measurement of additional damage endpoints is not required. The P(oe) model may benefit patient selection in situations where colony formation of primary tumour cultures fails to arrive at estimates of radiosensitivity.

Apoptosis↗

Metabolism and radiosensitization of 4,5-dimethylmisonidazole, a ring-substituted analog of misonidazole.

4,5-Dimethylmisonidazole (DMM) is a ring-substituted derivative of the 2-nitroimidazole, misonidazole. 2-Nitroimidazoles are able to sensitize radioresistant hypoxic cells, and to kill them outright through bioreductive metabolism. The toxic process is believed to reflect the consequences of reductively activated drugs forming adducts with cellular (macro)molecules. Both this process and the radiosensitizing activity are thought to correlate with the electron affinity of radiosensitizing agents. In the present study, methyl groups were added to the imidazole ring of misonidazole in order to hinder adduct formation with cellular molecules after reductive-activation of the compound. It was anticipated that this would substantially decrease the hypoxic-cell toxicity of the parent drug. The presence of the two methyl groups reduced the half-wave reduction potential of DMM by about 70 mV, so we expected that its radiosensitizing ability would also decrease. In direct comparison with misonidazole, DMM, at equimolar concentrations, showed dramatically reduced binding to cellular macromolecules under bioreductive conditions, both in vivo, using a liver perfusion system, and in vitro, using tissue culture cells incubated under extreme hypoxia. However, DMM was only moderately less toxic than the parent compound, and showed greatly diminished radiation sensitization capacity. Since the decrease in toxicity was much less than expected, and the decrease in radiosensitization was much more than expected, this compound may be an important drug for continuing studies on the mechanisms of radiation sensitization, binding and cytotoxicity caused by electron affinic drugs.

Animals↗

Assessment of DNA binding of platinum-radiosensitizer complexes by inhibition of restriction enzymes.

A simple and rapid method has been used to compare the binding of platinum complexes to DNA, in a relatively qualitative manner. A compound bound at or near the restriction site inhibits enzymatic cleavage of DNA; inhibition of BamHI and EcoRI activity by complexes was assessed in this study using linearized pSV2-gpt plasmid. Our particular interest was in DNA binding by complexes of platinum (Pt) with known organic radiosensitizers (RS), to determine whether the Pt was able to target the RS to the DNA. Although the Pt-RS complexes investigated themselves have moderate radiosensitizing ability (like the inorganic complexes, cis- or trans-diamminedichloroplatinum(II), c- or t-DDP) none of the Pt-RS inhibit to the same extent as c- or t-DDP. However, there appears to be some correlation between enhanced radiosensitization by Pt-RS over Pt(RS)2, with the degree of Pt binding (as assessed by our assay). Our results using isolated DNA suggest that not all complexes bind well (e.g. Pt with two RS ligands), but that in certain cases (e.g. Pt with only one RS), it is possible to target the drug to the DNA. An ammine or amine ligand may be required in order to target a radiosensitizer to DNA using platinum.

Base Sequence↗

The in vitro interaction with DNA of several hypoxic radiosensitizers.

The five 5-nitroimidazole derivatives and the four glyoxylic compounds tested in this paper for their interaction with DNA with and without irradiation had previously been reported to act as radiosensitizers at a cellular level. Our aim was to find if the radiosensitizing activity of these products could be due to their interaction with DNA. For this purpose the formation of a complex was tested by comparing the spectrophotometrical absorbances of (DNA-product) solutions with those of DNA and of the products, at the absorption maxima of the products. None of the products formed in vitro a complex with DNA. The irradiation of product solutions with and without DNA induced a molecular degradation of the product which was linearly correlated with the radiation dose. The G values characterizing this radiodegradation showed that the presence of DNA did not modify the radiosensitivity of the products, neither in aerobic nor under hypoxic irradiation conditions. These results proved that the radiosensitizing properties of these compounds cannot be attributed to their chemical interaction with DNA.

DNA↗

Study on the variation in X-ray sensitivity of human diploid skin fibroblasts. Normal radiosensitivity of cells derived from patients with Huntington's disease.

9 cell strains derived from patients with Huntington's disease and 9 from age- and sex-matched controls were investigated for X-ray sensitivity. No differences in radiosensitivity were observed for the two groups. The two groups taken together reveal a dependence of radiosensitivity on intrinsic cloning efficiency which in turn correlates with donor age. A difference in radiosensitivity between males and females is also indicated although at the borderline of significance. As a parameter for radiosensitivity the dose needed to obtain 0.1% survival appears superior to the Do.

Adult↗

Determination of the chromosomal site for the human radiosensitive ataxia telangiectasia gene by chromosome transfer.

The chromosomal localization of the gene which complements radiation hypersensitivity of AT cells was studied by microcell-mediated chromosome transfer. A 6-thioguanine-resistant derivative of an immortalized AT cell line, AT2KYSVTG, was used as a recipient for microcell-mediated chromosome transfer from 4 strains of mouse A9 cells, 3 of which carried a human X/11 recombinant chromosome containing various regions of chromosome 11, while the other carried an intact X chromosome. HAT-resistant microcell hybrids were isolated and examined for their radiosensitivity and chromosome constitution. The microcell hybrid clones obtained from the transfer of an intact X chromosome or an X/11 chromosome bearing the pter----q13 region of chromosome 11 did not show a difference in radiosensitivity from parental AT cells, while those obtained from the transfer of X/11 chromosomes bearing either the p11----qter or the pter----q23 region of chromosome 11 exhibited a marked radioresistance which was comparable to normal human fibroblasts. A HAT-resistant but radiosensitive variant was further obtained from the microcell fusion with an A9 cell strain carrying an X/11 chromosome bearing the 11p11----qter region, in which a deletion at the 11q23 region was found. The results indicate that the gene which complements a radiosensitive phenotype of AT is located at the q23 region of chromosome 11.

Ataxia Telangiectasia↗

Chromosomal radiosensitivity in common variable immune deficiency.

From more than 500 tumours reported in human primary immune deficiencies a majority has been observed in two disorders: ataxia telangiectasia (A-T) and common variable immune deficiency (CVID). Since both diseases have an increased risk of lymphomas/leukaemias and gastrointestinal tumours, suggesting a common risk factor, and the cells derived from A-T patients exhibit an increased chromosomal radiosensitivity we analysed chromosome damage in the G2 lymphocytes of 24 CVID patients and 21 controls after X-irradiation in vitro. There was a significant difference in mean aberration yields between patients and controls. Three CVID patients had yields higher than the mean + 3SD of the controls. Six patients but only one control had yields higher than the mean + 2SD of controls. The patient with the highest chromosomal radiosensitivity subsequently developed a lymphoma. Repeat assays on the same blood sample, with a 24-h delay in setting up the second culture, showed as much variability for control donors as the variation between control donors although for CVID patients inter-individual variation was greater than the difference between results of repeat samples. There was a weak positive correlation between radiosensitivity and age of donor. Chromosomal radiosensitivity of five patients with X-linked hypogammaglobulinaemia was not different from healthy donors. The mean mitotic index (MI) for unirradiated samples from CVID patients was significantly lower than for controls and there was an inverse relationship between MI and aberration yields in the patients, but not in controls. We suggest that the defect in CVID patients that reduces response to mitogenic stimuli may have mechanism(s) in common with those involved in cellular repair processes.

Adult↗

Radiosensitivity testing of primary cervical carcinoma: evaluation of intra- and inter-tumour heterogeneity.

Biopsies from 89 patients with cervical carcinoma were studied using a clonogenic assay to obtain values for the surviving fraction at 2 Gy (SF2). Heterogeneity in intrinsic radiosensitivity was investigated by independently processing multiple biopsies from 18 tumors. No significant differences between intra-tumour SF2 values were demonstrated (p = 0.30). The results have shown that intra-tumour heterogeneity is not a limitation to radiosensitivity testing using the Courtenay-Mills assay. A wide range of values (0.13-0.97) for SF2 was obtained with a mean value of 0.47 +/- 0.18 (+/- 1 S.D., CV = 38%) for 52 squamous cell carcinomas and 0.59 +/- 0.27 for four adenocarcinomas. There were statistically significant differences between the individual tumours (p less than 0.001). From the analysis-of-variance of all the SF2 results it appears to be the surviving fractions below about 0.40 and those above about 0.7 which show significant differences in radiosensitivity between pairs of tumours (p = 0.05). Also 36% of the values of SF2 show significant differences from the mean SF2 of all tumours. The storage of tumour cell suspensions in liquid nitrogen improved the colony-forming efficiency (CFE) but it did not alter the radiosensitivity.

Analysis of Variance↗

The ESTRO Regaud lecture. Inherent radiosensitivity of tumor and normal tissue cells as a predictor of human tumor response.

This lecture reviews the history and current status of attempts to correlate the outcome of radiation therapy with estimates of tumor cell radiosensitivity, made by either histologic assessment of tumors irradiated in vivo or by assays for the survival of tumor cells irradiated in vitro. Genetically determined variability in the radiosensitivity of normal tissue cells from different individuals is also discussed in terms of its effect on the determination of "tolerance" doses and the possible correlation between tumor cell and normal tissue cell radiosensitivity in a given patient. It is concluded that measurement of both tumor cell and normal tissue cell radiosensitivities, along with other radiobiologically-based assays, will improve our ability to predict treatment outcome and provide the basis for further therapeutic advances in radiation oncology.

Cell Survival↗

In situ tumour radiosensitization induced by clofibrate administration: single dose and fractionated studies.

It is generally accepted that hypoxia is a common occurrence in many experimental and human tumours and that it is a major cause of local failure after radiotherapy. Many attempts have been made over the last years to eliminate this problem. One of the manoeuvres to improve tumour oxygenation is to manipulate the binding affinity of oxygen (O2) and haemoglobin (Hb). Previous studies have shown that some antilipidaemic drugs (clofibrate and its analogues) can reduce the Hb/O2 binding affinity and sensitize various animal tumours to radiation. The present study evaluated the ability of clofibrate to sensitize in situ a mouse carcinoma (CaNT) to radiation. Clofibrate at 1.5 mmol/kg increased the tumour radiosensitivity, when it was administered per os 2-6 h before a single radiation dose or 2 to 4 h before each of 10 fractions in 5 days. In both the single dose and fractionated regimens, the radiosensitizing effect was drug dose-dependent, but was only statistically significant at doses from 1.0 to 2.0 mmol/kg. These results suggest that clofibrate may be an effective radiosensitizer at radiation doses that are clinically relevant. Further experiments need to be carried out to evaluate clofibrate analogues for their radiosensitizing properties. Clofibrate tolerable doses in man have to be determined first in order to know if clofibrate and analogues could play a role in the clinical management of tumours where hypoxia may limit the outcome of radiotherapy.

Animals↗

The effect of the hypoxic cell drug SR-4233 alone or combined with the ionizing radiations on two human tumor cell lines having different radiosensitivity.

The influence of the hypoxic cell drug, SR-4233, alone and/or combined with ionizing radiations on the survival of two human cell lines having very different intrinsic radiosensitivity was analysed. The killing effect of SR-4233 in hypoxia was similar for both cell lines. Twenty microM SR-4233 under hypoxic conditions had a killing effect equivalent to 6.6 Gy for the poorly sensitive cell line (HT29) and equivalent to 3.9 Gy for the highly sensitive cell line (SW48). The effect of SR-4233 and ionizing radiations on these two cell lines was tested in vitro: the cells were incubated for one hour in hypoxia with or without 20 microM SR-4233 and then irradiated in air. The HT29 cells that survived treatment with SR-4233 are more radiosensitive than untreated cells. However, their radiosensitivity is similar to that of cells that have been given a dose of 6.6 Gy. This suggests that SR-4233 acts additively, rather than as a radiosensitiser. As SR-4233 acts selectively in hypoxia, these results appear encouraging for the treatment of poorly-radiosensitive human tumors.

Cell Hypoxia↗

Correlation between the radiosensitivity in vitro of clones and variants derived from a human melanoma cell line and their spontaneous metastatic potential in vivo.

With an experimental model of spontaneous lung metastases of human melanoma in immunosuppressed newborn rats, a large panel of clones and variants with different metastatic potential were derived from a single human melanoma parental cell line (M4Be). Seven clones and variants from M4Be were selected, respectively, for their low (parental, clone 1), intermediate (clones 2 and 3, subvariant 1-) and high (variant 1, subvariant 1+, clone 4) metastatic potential. This paper investigates the relationship between the in vivo metastatic potential of the eight cell lines and their sensitivity to ionizing radiation in vitro (range 0.05-7 Gy). The radiosensitivity was estimated from the mean inactivation dose, a parameter equal to the area under the survival curve plotted in linear coordinates. Examination of the eight survival curves, obtained with cells cultured for no more than five passages after defrost, shows that clone 1, subvariant 1- and the M4be parental line are the most radioresistant cells, clone 4 and subvariant 1+ are the most radiosensitive cells, while clones 2 and 3 and variant 1 showed an intermediate response to radiation. The metastatic potential in vivo of the parental line and the seven sublines is significantly correlated to their radiosensitivity in vitro: the higher the metastatic potential, the higher the radiosensitivity.

Animals↗

Radiosensitizing effect of cisplatin in prostate cancer cell lines.

The radiosensitizing effect of platinum compounds has been demonstrated in a number of tumors. In prostate cancer, clinical and preclinical data concerning an eventual efficacy of the concept of radiosensitization are lacking. In the present study cisplatin and carboplatin have been used as a model to explore radiosensitization in in vitro prostate cancer cell lines. Human (DU-145) and rat (R3327-MATLyLu) prostate tumor cells were irradiated with doses ranging from 0 to 8 Gy in the presence of various concentrations of either cisplatin or carboplatin. For the evaluation of the combined effect of the two treatment modalities, a simple model is presented. Supra-additive treatment effects of combinations of platinum drugs with radiotherapy, both at clinically achievable doses, were shown on the basis of surviving fractions of tumor cells and proved to be significant. These data strongly suggest that radiotherapy may be effectively combined with radiosensitizers such as platinum drugs in prostate cancer therapy, to yield synergism in treatment efficacy.

Animals↗

Radiosensitization by non-nitro compounds.

The effects of 23 non-nitro compounds on the radiosensitivity of hypoxic Chinese hamster V79-379A or E. coli AB 1157 cells in vitro are outlined. Imidazole derivatives substituted with several alternative electron-withdrawing groups are described; the dicyanovinyl function conferred considerable radiosensitizing activity. 2,4,5-Tribromoimidazole and 2,4-dinitrophenol may show unusual radiosensitizing activity because of interference with oxidative phosphorylation. Attempts to influence radiosensitivity by compounds potentially capable of depleting intracellular sulphydryls are also described.

Animals↗

Azomycin riboside: a new radiosensitizer.

Azomycin riboside (2-nitro-1-beta-D-ribofuranosylimidazole) (AR), a nucleoside analogue with the base component replaced by a 2-nitroimidazole was studied to determine its potential as a radiosensitizer. In vitro evidence showed that AR is as good as or slightly better than misonidazole (MISO) as a hypoxic cell radiosensitizer. AR was also found to kill hypoxic cells directly and this cytotoxicity was at least as great as MISO cytotoxicity. However, when tumor regrowth delay was used to assess in vivo radiosensitization, AR was found to be inferior to MISO while the LD50 host toxicity assay indicated that AR might be nearly as toxic as MISO. Unless AR proves to be less toxic than MISO or can be selectively distributed with nucleoside transport inhibitors, these preliminary observations have not shown any advantage of AR over MISO as a potential clinically useful radiosensitizer.

Animals↗

Thermal enhancement of radiosensitivity in normal and ataxia telangiectasia human cells.

Normal human and ataxia telangiectasia (AT) fibroblasts were tested for enhancement of radiosensitivity by hyperthermia. In normal fibroblasts, thermal enhancement of radiosensitivity occurred at 42.0 degrees C and 45.0 degrees C and was greatest for simultaneous treatments of heat and radiation. This thermal enhancement decreased, as an incubation time at 37.0 degrees C was introduced either between heat and X-ray, or X-ray and heat, treatments. AT cells were more radiosensitive (D0 = 0.67 Gy) than normal cells (D0 = 1.4 Gy). Heating at 42.0 degrees or 45.0 degrees C resulted in enhanced radiosensitivity, which was equal for heating before, during or after irradiation. These data show that normal human fibroblasts can recover from heat and radiation treatments, while AT fibroblasts lack this ability.

Ataxia Telangiectasia↗

Intrinsic radiosensitivity of human cell lines is correlated with radioresponsiveness of human tumors: analysis of 101 published survival curves.

One hundred and one published survival curves for 92 human cell lines (including 64 tumor lines) have been analyzed in terms of several parameters that are supposed to characterize cell radiosensitivity. Values for n, Do, alpha and beta (from the linear quadratic model), D (Mean Inactivation Dose), and survivals at 2 Gy and 8 Gy have been obtained for each curve. It was found that: I. the initial part of the survival curve is specific to the corresponding cell line; II. this initial part is well characterized by the parameters alpha and D, the values of which can be used to compare intrinsic radiosensitivity among human cell lines; III. human tumor cell line radiosensitivity (expressed in terms of alpha, D and survival at 2 Gy) reflects the clinical radioresponsiveness of the tumors from which the cell lines are derived. Thus, cells from tumors with low radioresponsiveness (melanomas and glioblastomas) are the less radiosensitive. Furthermore, the range of survival at a dose of 2 Gy is broad enough to account, in large measure, for observed differences in clinical tumor radioresponsiveness.

Cell Line↗

A new ruthenium radiosensitizer: RuCl2(DMSO)2(4-nitroimidazole)2.

Earlier studies on Ru complexes, such as, cis-RuCl2(DMSO)4, as antineoplastic agents, have suggested a DNA binding mechanism similar to that of the clinically successful platinum complex, cis-diammine(dichloro)platinum(II), (cis-DDP). As part of our study on metal-radiosensitizer complexes, cis-RuCl2(DMSO)4 is used as a precursor for synthesis of Ru(II)-nitroimidazole complexes. These complexes were identified and characterized and their toxicity and radiosensitizing abilities were examined in vitro. In the series of Ru(II)-nitroimidazole complexes synthesized, RuCl2(DMSO)2(4-nitroimidazole)2, "Ru-(4-nitro)," was the most effective radiosensitizer. At 200 microM, Ru-(4-nitro) produced a sensitizer enhancement ratio (SER) of 1.6 in hypoxic Chinese hamster ovary (CHO) cells, but did not sensitize oxic CHO cells. Other Ru-nitroimidazole complexes gave SER values of 1.2-1.4 at 200 microM. These Ru(II)-nitroimidazole complexes also showed lower toxicity than the free nitroimidazoles alone at equimolar concentration. The enhanced radiosensitizing effect of Ru-(4-nitro) may be due to the metal's ability to target the sensitizer to DNA, or may be related to changes in reduction potential: from -685 mV for the free ligand to -355 mV and -615 mV for the complex. This complex did not deplete non-protein sulfhydryls (NPSH) at the time intervals and concentrations used. DNA binding was studied using inhibition of restriction enzyme activity on plasmid DNA.

Animals↗