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PubMed1994

Combined immunosuppressive therapy with low dose FK506 and antimetabolites in rat allogeneic heart transplantation.

Following rat heterotopic heart allotransplantation, low to lethal doses of the antimetabolites mizoribine (MIZ), RS-61443 (RS), and AZA were given alone or in combination with subtherapeutic doses of FK506 (0.04 mg/kg/day) for 14 days after transplantation. With the median effect analysis of Chou and Kahan for quantitative drug interactions, substantial therapeutic synergism was demonstrated between FK506 and non-toxic doses of MIZ (2.5, 5, and 10 mg/kg/day) or AZA (5, 30, and 45 mg/kg/day), which was particularly evident with the lowest dose MIZ (2.5 mg/kg/day). When FK506 was used in combination with MIZ or AZA but not with RS, the maximum effect (peak median graft survival) was enhanced significantly from 15 days (MIZ alone) to 26 days (P < 0.05), and from 19 days (AZA alone) to 32 days (P < 0.01). In contrast, RS interacted with FK506 no more than additively. Although RS was the most powerful single antimetabolite, the best overall survival was obtained by combining AZA and FK506. The addition of FK506 did not significantly increase the percent mortality and LD50 of the antimetabolites.

Animals↗
PubMed1976

Antimetabolites produced by microorganisms. XIII. The synthesis and microbiological production of a novel amino acid, L-2-amino-4-(2-aminoethoxy) butanoic acid.

A novel amino acid, L-2-amino-4-(2-aminoethoxy-)-butanoic acid, was isolated from a fermentation broth of Streptomyces sp. X-11,085. It was shown to be identical with the chemical reduction product of an antimetabolite antibiotic, L-2-amino-4-(2-aminoethoxy)-trans-3-butenoic acid, a co-product in the fermentation. Addition of the title compound to the fermentation led to an enhanced yield of the antimetabolite suggesting that the saturated amino acid serves as a precursor for the antimetabolite.

Aminobutyrates↗
PubMed1985

[Anticancer treatment with a combination of antimetabolites of polyamine and pyrimidine].

A combined efficacy of the polyamine antimetabolites, alpha-difluoromethylornithine (DFMO) and methylglyoxal-bis-guanylhydrazone (MGBG) with two fluorinated pyrimidines was studied. DFMO, MGBG, 5-FU and 5'-deoxy-5-fluorouridine (5'-DFUR) were administered intraperitoneally to BALB/c nu/nu mice bearing xenotransplanted human gastric cancer for 5 consecutive days. Similar antitumor efficacies were observed in 3 groups treated with DFMO plus MGBG, DFMO, MGBG plus 5-FU as well as DFMO, MGBG plus 5'-DFUR. The two groups on 5-FU or 5'-DFUR alone did not differ in antitumor effects from the control, although reasonable levels of 5-FU were involved in tumor tissues. Hepatic and splenic 5-FU levels after 5-FU administration were significantly higher than those after 5'-DFUR, and marked decrease in mouse body weight was caused by 5-FU alone as well as 5-FU plus polyamine antimetabolites for 5 consecutive days. DNA biosynthesis and spermine levels in the tumor tissues on day 2 after cessation of the treatments dropped in 3 groups with DFMO plus MGBG, DFMO, MGBG plus 5'-DFUR as well as DFMO, MGBG plus 5-FU, while on day 6 there was little difference between the control and treated groups. These data suggest that combination with 5-FU or 5'-DFUR does not enhance the antitumor activity of polyamine antimetabolites by this experimental regimen.

Animals↗
PubMed1987

[Antitumor effects of polyamine antimetabolites with polyamine-free diet].

To evaluate the antitumor efficacy of polyamine antimetabolites such as methylglyoxal-bis-guanylhydrazone (MGBG), ethylglyoxal-bis-guanylhydrazone (EGBG), and alpha-difluoromethylornithine (DFMO), the combined therapies of polyamine antimetabolites with a polyamine-free diet were studied. The combination of EGBG plus DFMO or MGBG plus DFMO showed a marked suppression of tumor growth with a polyamine-free diet; and, when compared, EGBG was slightly superior to MGBG. The inhibition of DNA biosynthesis was also parallel to the above-mentioned results. Furthermore, from an analysis for polyamine levels in tumor tissues, it was confirmed that the polyamine depletion can be maintained by polyamine antimetabolites in combination with a polyamine-free diet in vivo. Moreover, as EGBG has lesser side effects than MGBG, EGBG might be more suitable for clinical use.

Animals↗
PubMed1987

[Antitumor efficacy of polyamine antimetabolites and mitomycin C under polyamine-free diet].

Treatment of nude mice xenografted with human gastric cancer was carried out by polyamine antimetabolites combined with mitomycin C (MMC) and polyamine-free diet. Polyamine antimetabolites, alpha-difluoromethylornithine (DFMO) and ethylglyoxal-bis-guanylhydrazone (EGBG), were given ip in a daily dose of 1,000 mg/kg and 20 mg/kg, respectively, for 6 consecutive days. MMC 2.0 mg/kg was administered every other day. The polyamine-free diet was given from 4 days before start of the treatment through the end of the study. Although the tumor growth rate of the control group given polyamine-free diet was similar to that given normal diet, in the mice treated with EGBG, DFMO plus MMC, the antitumor effect in the polyamine-free diet group was superior to the normal diet group. In comparison with tumor growth suppression due to EGBG plus DFMO or MMC only, the polyamine-free diet group showed better result than the normal diet group to some extent. In mice treated with EGBG, DFMO plus MMC, tumor tissue spermine levels in the polyamine-free diet group were significantly depressed, compared to the normal diet group. Furthermore, marked suppression of DNA biosynthesis was observed in mice given EGBG, DFMO plus MMC together with the polyamine-free diet. These results suggest that combined treatments of polyamine antimetabolites and MMC revealed a marked enhancement of antitumor effects, under conditions of polyamine depletion, which may be responsible for the alteration in DNA structure.

Animals↗
PubMed1984

Interaction of aspartate and aspartate-derived antimetabolites with the enzymes of the threonine biosynthetic pathway of Escherichia coli.

The five enzymes responsible for the conversion of L-aspartate to L-threonine in Escherichia coli were purified to homogeneity and subsequently reconstituted in vitro in ratios approximating those found in vivo. 31P NMR was used to conveniently monitor the rates of consumption of the substrates ATP and NADPH, the accumulation of the intermediates beta-aspartyl phosphate and homoserine phosphate, and the formation of the products ADP, NADP+, and Pi in a single experiment. By this method, the flux of aspartic acid through the enzymes of the pathway was monitored in the absence and in the presence of several alternative substrates and inhibitors. Several known antimetabolites were found to be alternative substrates that ultimately became inhibitors of pathway flux. L-threo-3-Hydroxyaspartic acid was converted to 3-hydroxyhomoserine phosphate by the first four enzymes of the pathway. The antimetabolite L-threo-3-hydroxyhomoserine was found to bind to and inhibit aspartokinase-homoserine dehydrogenase I in a cooperative fashion (I 0.5 = 3 mM, nH = 2.5), similar to the action of the allosteric end product inhibitor L-threonine (I 0.5 = 0.36 mM, nH = 2.4). In the presence of the remaining enzymes of the pathway, however, L-threo-3-hydroxyhomoserine was phosphorylated to the apparent ultimate antimetabolite L-threo-3-hydroxyhomoserine phosphate that was a potent inhibitor of threonine synthase and consequently of L-threonine biosynthesis. When aspartic acid alone was examined as a substrate of the enzymes of the pathway, no accumulation of the beta-aspartyl phosphate and homoserine phosphate intermediates was observed. However, in the presence of either 5 mM L-threo-3-hydroxyhomoserine or 5 mM L-threo-3-hydroxyhomoserine phosphate, homoserine phosphate was found to accumulate. In contrast to the homoserine phosphate and 3-hydroxyhomoserine phosphate intermediates, both of which were very stable, the acylphosphate intermediates beta-aspartyl phosphate and beta-3-hydroxyaspartyl phosphate were highly susceptible to hydrolysis, with first-order rate constants of 4.6 X 10(-3) min-1 and 4.5 X 10(-2) min-1 (pH 7.8, 25 degrees C), respectively.

Aspartate Kinase↗
PubMed1982

Selective expansion of mitochondrial nucleoside triphosphate pools in antimetabolite-treated HeLa cells.

This study asks whether nuclear and mitochondrial DNA replication are supplied by distinct and separately regulated precursor pools. Using improved methodology for extraction and quantitation of deoxyribonucleoside triphosphate pools from HeLa cells, we have confirmed and extended earlier findings of Bogenhagen and Clayton ((1976) J. Biol. Chem. 251, 2938-2944). The four mitochondrial dNTP pools actually expanded following treatment with antimetabolites, even while total cellular pools of dTTP and dGTP are being severely depleted. Ribonucleoside triphosphates also accumulate in mitochondria after antimetabolite treatment. This confirms the idea of distinct regulatory mechanisms affecting precursor supplies for nuclear and mitochondrial DNA. Mitochondrial dNTP pools are larger, in relation to the cellular complement of mitochondrial DNA than are the whole cell pools in relation to the chromosomal DNA complement. Also, of the four dNTPs, the most sensitive to antimetabolite depletion is dGTP. This indicates that dGTP depletion may be more significant than previously realized as an element of the cytotoxic effects of methotrexate and 5-fluorodeoxyuridine.

DNA↗
PubMed1983

Role of polyamines and their antimetabolites in clinical medicine.

Polyamine research, which began with a clinical observation more than 300 years ago, has progressed for several decades as pure basic research, sometimes considered as an academic triviality. The role of polyamines in clinical medicine is coming of age. The fruits of polyamine research are just now entering into the realm of practical application and in a very multidisciplinary manner. Basic research on polyamine metabolism and the elucidation of their physiologic functions has involved many academically interesting, even revolutionary, aspects, but the imagination of biochemists and cell biologists may no longer be sufficient to discover the best ways to translate the results of this basic research into clinical practice. It is almost certain that polyamine antimetabolites will soon find their place among the drug regimens used for the treatment of human malignancies and, possibly, also of hyperproliferative skin diseases. The elucidation of the role of polyamines in cell differentiation may offer fundamental applications regarding the regulation of cell cycle events. The discovery of the antiparasitic properties of polyamine antimetabolites may have a major impact on the well-being of millions of people in the developing world. The potential application of polyamine research in microbial and viral diseases is an area in which investigational insight is just beginning. Finally, the clinical chemistry of extracellular polyamines, although initially disappointing, has not yet been explored in depth and may offer applications useful for the diagnosis or follow-up of a variety of common diseases.

Animals↗
PubMed1985

Dezaguanine mesylate: a new antipurine antimetabolite.

3-Deazaguanine (dezaguanine, USAN; CI-908) is a new antipurine antimetabolite which is entering Phase I studies in the USA. This compound differs from guanine only in the substitution of a carbon for the 3-nitrogen of guanine. Dezaguanine has an unusual spectrum of activity against experimental rodent tumors; its activity against transplantable rodent leukemias is only modest, but it has significant activity against transplantable rodent solid tumors, particularly mammary adenocarcinomas. Mammary adenocarcinoma models against which this compound is active include slow and fast-growing tumors, hormone sensitive and hormone insensitive tumors, and the subrenal capsule implanted human breast cancer xenograft, MX-1. Dezaguanine must be converted to its nucleotides to be active. Dezaguanine nucleotides inhibit synthesis of guanine nucleotides, and can be incorporated into nucleic acids in place of guanine nucleotides; incorporation into DNA may be particularly important in the cytotoxicity of this compound. Addition of certain purines or purine nucleosides can prevent dezaguanine cytotoxicity in vitro. Preclinical studies suggest that dezaguanine does not undergo deamination to 3-deazaxanthine, and is not metabolized by xanthine oxidase. Therefore, this compound may not be subject to metabolic inactivation in vivo, and active metabolites may have a prolonged half-life. This concept is supported by the prolonged half-life of radiolabelled dezaguanine in rats. Finally, dezaguanine can cross the blood-brain barrier. In summary, the novel biochemical and experimental antitumor properties of dezaguanine indicate that this compound could have better activity against some human solid tumors than currently used purine antimetabolites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1994

Antimetabolite-induced increases in the invasive capacity of murine leukaemia L1210 cells.

Pretreatment of murine leukaemia L1210 cells with non-lethal concentrations of various antimetabolites increased the in vitro invasive capacity of these cells into monolayers of rat embryo fibroblasts. The increase in invasive capacity was partly correlated with the induced cell cycle arrest. The concomitant increase in cell surface fucosylation and inhibition of invasion with sulphate indicate a role for glycoproteins in this process. Our results suggest that treatment with antimetabolites may lead to a more aggressive phenotype by altering cell surface properties.

Animals↗
PubMed1985

Potentiation of antimetabolite action by dibromodulcitol in cell culture.

The postulation that the activity of key enzymes that reveal marked increases should be potential targets for anticancer chemotherapy (47) was supported by new evidence on the alterations of CDP reductase, CTP synthetase and OMP decarboxylase in hepatoma 3924A cell cultures. Inhibitors of these enzymes (VF-122, acivicin, pyrazofurin) and that of IMP dehydrogenase (tiazofurin) efficiently killed hepatoma 3924A cells in culture, as demonstrated by the clonogenic assay. Acivicin, pyrazofurin, tiazofurin and VF-122 were lethal against tumor cells in the exponential phase of growth with IC50 of 1.5, 5, 10 and 4.5 microM, respectively. All these antimetabolites exhibited cytotoxicity preponderantly against exponential-phase cultures, indicating that all the four drugs belong to Class II (phase-specific agents) in the Kinetic Classification of Anticancer Agents (38). Dibromodulcitol, a bifunctional alkylating agent, revealed cycle-specific cytotoxicity (Class III agent) against hepatoma 3924A, yielding IC50 values of 2.3 and 5.5 microM for exponentially and stationary growing cells, respectively. Using isobologram analysis on the survival data of 3924A cells, synergistic interaction was observed when DBD in combination with acivicin, pyrazofurin and tiazofurin was examined. DBD in combination with VF-122 exhibited additive lethality against hepatoma cells in culture. The synergistic and additive cytotoxicity in combinations of DBD with these antimetabolites was accompanied by the concurrent depletion of ribonucleotide and/or deoxyribonucleotide pools. The synergistic biological results of drug combinations of acivicin with DBD can be accounted for by the action of acivicin in inhibiting CTP synthetase, resulting in a synergistic decrease in CTP content, and by inhibition of DNA synthesis caused by DBD. The synergistic and additive depletion of UTP, CTP, dTTP and dCTP pools in the combinations of DBD with pyrazofurin may be responsible for the synergistic lethality of these combinations. Synergism, in terms of pool depletion, was observed for GTP and dCTP; summation was detected for dGTP when DBD and tiazofurin were given concurrently. The synergistic cytotoxicity of this drug combination may be a consequence of these alterations. The additive lethality of DBD-VF-122 drug combinations was reflected in the additive elevations of the ribonucleoside diphosphate concentrations. These observations indicate that treatments based on the Kinetic Classification and on the biochemical targeting of the drug should have an impact on the design of in vivo chemotherapy.

Amides↗
PubMed1981

The effect of temperature and antimetabolites on antibody binding to the outer surface of second stage Toxocara canis larvae.

In vitro maintained second stage Toxocara canis larvae do not bind antiserum raised to their excretions and secretions (ES) at 37 degrees C as detected by indirect fluorescence. However, when these larvae were incubated at 2 degrees C under the same conditions intense fluorescence on the whole outer surface was observed. This fluorescence remained as long as the larvae were maintained at 2 degrees C. When these larvae were reincubated at 37 degrees C a gradual loss of fluorescence along their outer surfaces occurred. This loss was complete after 3 h. Larvae which were preincubated in antimetabolites at 37 degrees C exhibited intense fluorescence on their outer surfaces as did those incubated at 2 degrees C with antimetabolites. It is concluded that antigens present in ES occur along the whole length of the larval outer surface and turn over at 37 degrees C. This turnover occurs along the whole outer surface and is metabolically dependent. Should this occur in vivo it could afford the parasite with a mechanism for evasion of the immune response.

2,4-Dinitrophenol↗
PubMed1999

Long-term follow-up of trabeculectomy without antimetabolites in patients with uveitis.

PURPOSE: To determine the long-term success rate after trabeculectomy without antimetabolites in patients with uveitis. METHODS: Review of data from all patients with uveitis who underwent trabeculectomy for uncontrolled intraocular pressure secondary to intraocular inflammation between May 1990 and December 1994. Results were compared with those from a group of patients with primary open-angle glaucoma matched for sex and surgeon. RESULTS: The uveitis group consisted of 32 eyes (20 patients). Maximum control of intraocular inflammation was achieved for a minimum of 2 months before surgery. Mean (+/-SD) age was 40.0 +/- 12.5 years (range, 14 to 67 years), with a median (+/-SE) follow-up of 53.0 +/- 1.8 months (range, 33 to 84 months). The primary open-angle glaucoma group consisted of 33 eyes (23 patients), with a mean age of 62.0 +/- 13.7 years (range, 26 to 81 years) and a median follow-up of 63.0 +/- 12.0 months (range, 34 to 299 months). The overall 5-year success rate (intraocular pressure < or =21 mm Hg with or without topical medication) for the uveitis group was 78% compared with 82% for the primary open-angle glaucoma group (P = .7). The absolute 5-year success rate (intraocular pressure < or =21 mm Hg with no medication) for the uveitis group was 53% compared with 67% for the primary open-angle glaucoma group (P = .87). CONCLUSIONS: In the absence of other risk factors, such as Afro-Caribbean race and previous intraocular surgery, and with adequate preoperative control of inflammation, trabeculectomy without antimetabolites may be considered the primary surgical procedure for increased intraocular pressure in patients with uveitis.

Adolescent↗
PubMed1999

Role of antimetabolites of purine and pyrimidine nucleotide metabolism in tumor cell differentiation.

Transformed cells are characterized by imbalances in metabolic routes. In particular, different key enzymes of nucleotide metabolism and DNA biosynthesis, such as CTP synthetase, thymidylate synthase, dihydrofolate reductase, IMP dehydrogenase, ribonucleotide reductase, DNA polymerase, and DNA methyltransferase, are markedly up-regulated in certain tumor cells. Together with the concomitant down-modulation of the purine and pyrimidine degradation enzymes, the increased anabolic propensity supports the excessive proliferation of transformed cells. However, many types of cancer cells have maintained the ability to differentiate terminally into mature, non-proliferating cells not only in response to physiological receptor ligands, such as retinoic acid, vitamin D metabolites, and cytokines, but also following exposure to a wide variety of non-physiological agents such as antimetabolites. Interestingly, induction of tumor cell differentiation is often associated with reversal of the transformation-related enzyme deregulations. An important class of differentiating compounds comprises the antimetabolites of purine and pyrimidine nucleotide metabolism and nucleic acid synthesis, the majority being structural analogs of natural nucleosides. The CTP synthetase inhibitors cyclopentenylcytosine and 3-deazauridine, the thymidylate synthase inhibitor 5-fluoro-2'-deoxyuridine, the dihydrofolate reductase inhibitor methotrexate, the IMP dehydrogenase inhibitors tiazofurin, ribavirin, 5-ethynyl-1-beta-D-ribofuranosylimidazole-4-carboxamide (EICAR) and mycophenolic acid, the ribonucleotide reductase inhibitors hydroxyurea and deferoxamine, and the DNA polymerase inhibitors ara-C, 9-(2-phosphonylmethoxyethyl)adenine (PMEA), and aphidicolin, as well as several nucleoside analogs perturbing the DNA methylation pattern, have been found to induce tumor cell differentiation through impairment of DNA synthesis and/or function. Thus, by selectively targeting those anabolic enzymes that contribute to the neoplastic behavior of cancer cells, the normal cellular differentiation program may be reactivated and the malignant phenotype suppressed.

Animals↗
PubMed2001

Slow release of the antimetabolite 5-fluorouracil (5-FU) from modified Baerveldt glaucoma drains to prolong drain function.

Drainage devices are routinely placed in the eyes of patients with glaucoma to reduce intraocular pressure (IOP) by providing controlled outflow of fluid (aqueous humor) via a filtering bleb. However, the natural wound healing response often interferes with fluid outflow by thickening the walls of the bleb over time, so that these devices rarely remain functional for more than 5 years. We investigated the use of controlled release of an antimetabolite, 5-fluorouracil (5-FU), within glaucoma drains to determine if the wound healing response could be reduced and the useful life span of the device increased. Collagen plugs containing 1.125 mg of 5-FU were placed in the silicone tubes of modified Baerveldt glaucoma drains. Eight drains with 5-FU and eight drains without 5-FU were implanted in one eye each of 16 New Zealand white rabbits: the contralateral eyes served as unoperated controls. Results were evaluated in terms of IOP, fibrous capsule thickness, macrophage density. and presence of type III collagen surrounding the drain plate, 3 and 6 months after implantation. In general, eyes implanted with antimetabolite-containing drains demonstrated significantly lower values for all evaluated parameters at 3 months and lower or equal values at 6 months, compared with the eyes not receiving 5-FU and the unoperated controls, indicating improved IOP-lowering function, reduced bleb wall thickness, and earlier achievement of a steady-state wound healing response. All eyes remained healthy throughout the 6-month duration of the study with no cytotoxicity complications in any of the eyes. Thus, biodegradable plugs placed within the silicone tubes of glaucoma drains can safely deliver 5-FU to filtering blebs over time, which could prolong the functional life of the bleb by decreasing the thickness of the anterior fibrous capsule and permitting sufficient fluid outflow to reduce IOP to physiological levels.

Animals↗
PubMed1976

Studies of 1-deoxy-D-fructose, 1-deoxy-D-glucitol, and 1-deoxy-D-minnitol as antimetabolites.

1-Deoxy-D-fructose was synthesized in 27% yield from D-glucosamine in a three-step procedure involving Raney nickel desulfurization and oxidative deamination with 3,5-di-tert-butyl- 1,2-benzoquinone applied to appropriate intermediates. 1-Deoxyfructose and its reduction products, 1-deoxyglucitol and 1-deoxymannitol, were tested as substrates and antimetabolites. For sheep liver glucitol dehydrogenase, the Km is 53 mM for 1-deoxymannitol, were tested as substrates and antimetabolites. For sheep liver glucitol dehydrogenase, the Km is 53 mM for 1-deoxyglucitol and 89 mM for 1-deoxymannitol with maximal velocities 33 and 18%, respectively, of that with glucitol as substrate. These results require substantial revision of the long-accepted polyol substrate structural requirements for this enzyme which have been reported to include a 1-hydroxy group and a cis-2,4-dihydroxy configuration. Km is 614 and 280 mM for yeast and muscle hexokinases, respectively, acting on 1-deoxyfructose; maximal velocities are 2 and 5% of those obtained with fructose. 1-Deoxyfructose 6-phosphate is a competitive inhibitor of phosphoglucose isomerase with a Ki of 1.1 mM; this is about the same as Km for the natural substrates. It is also an effective inhibitor of phosphofructokinase but does not alter the cooperativity of the enzyme interaction with fructose 6-phosphate nor exhibit cooperativity in its own interaction therewith. These results suggest that the 1-hydroxy group is not crucial for binding but does play a role in the cooperative interactions of this allosteric protein. At equivalent concentrations, 1-deoxyfructose is somewhat better than 2-deoxyglucose as an inhibitor of erythrocyte glycolysis; the 1-deoxypolyols are ineffective. All three 1-deoxy compounds are readily, though incompletely, absorbed from the intestine of mice; most of the absorbed dose appears in the urine unchanged within 24 h. Whether given by oral or intraperitoneal routes, 2 to 6% of administered deoxypolyol or deoxyketose appears in the urine as ketose or polyol, respectively. No acute toxic effects or growth retardation are noted for any of the 1-deoxy analogues when given to mice at levels where 2-deoxyglucose has such effects. The properties of these 1-deoxy sugar analogues recommend them for further studies of enzyme mechanisms, for metabolic studies, and for testing as therapeutic agents against such organisms as certain mammalian parasites with heavy reliance on glycolysis.

Animals↗
PubMed1997

Resistance to chemotherapeutic antimetabolites: a function of salvage pathway involvement and cellular response to DNA damage.

The inherent or acquired (induced) resistance of certain tumours to cytotoxic drug therapy is a major clinical problem. There are many categories of cytotoxic agent: the antimetabolites, e.g. methotrexate (MTX), N-phosphonacetyl-L-aspartate (PALA), 5-fluorouracil (5-FU), 6-mercaptopurine (6-TG), hydroxyurea (HU) and 1-beta-D-arabinofuranosylcytosine (AraC); the alkylating agents, e.g. the nitrogen mustards and nitrosoureas; the antibiotics, e.g. doxorubicin and mitomycin C; the plant alkaloids, e.g. vincristine and vinblastine; and miscellaneous compounds, such as cisplatin. There are also many mechanisms of drug resistance elucidated principally from in vitro studies. These include mutation of target genes, amplification of target and mutated genes, differences in repair capacity, altered drug transport and differences in nucleoside and nucleobase salvage pathways (Fox et al, 1991). The aim of the present review is to evaluate in detail the mechanisms of response of both normal and tumour cells to three chemotherapeutic antimetabolites, MTX, PALA and 5-FU, which are routinely used in the clinic either alone or in combination to treat some of the commonest solid tumours, e.g. breast, colon, gastric and head and neck. The normal and tumour cell response to these agents will be discussed in relation to the operation of the known alternative 'salvage pathways' of DNA synthesis and current theories of DNA damage response.

Animals↗