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Mol Cancer Ther. 2006;5:732-738
© 2006 American Association for Cancer Research

Modulation of chemotherapy resistance in regional therapy: a novel therapeutic approach to advanced extremity melanoma using intra-arterial temozolomide in combination with systemic O6-benzylguanine

Tomio Ueno1,2, Sae Hee Ko1, Elizabeth Grubbs1, Yasunori Yoshimoto1,2, Christi Augustine1, Zeinab Abdel-Wahab1, Tsung-Yen Cheng1, Omar I. Abdel-Wahab1, Scott K. Pruitt1, Henry S. Friedman1 and Douglas S. Tyler1

1 Department of Surgery, Duke University Medical Center, Durham, North Carolina and 2 Department of Surgery II, Yamaguchi University School of Medicine, Yamaguchi, Japan

Requests for reprints: Douglas S. Tyler, Department of Surgery, Duke University Medical Center, Box 3118, Durham, NC 27710. Phone: 919-684-6858; Fax: 919-684-6044. E-mail: tyler002{at}acpub.duke.edu

This study investigated whether the therapeutic index of regional melanoma therapy using parenteral temozolomide could be improved by chemomodulation with O6-benzylguanine (O6BG), an inhibitor of the DNA repair enzyme O6-alkylguanine-DNA alkyltransferase (AGT). Using a nude rat s.c. human melanoma xenograft model of the extremity, tumors were analyzed for AGT level 2 to 3 hours after the i.p. injection of 3.5 to 70.0 mg/kg O6BG to inhibit AGT activity. Survival studies were conducted using animals that were treated with a 15-minute isolated limb infusion with 10% DMSO in PBS (control), temozolomide alone, or temozolomide in conjunction with single or multiple doses of i.p. O6BG. Tumor volume and toxicity level were monitored every other day. Administration of 3.5 mg/kg O6BG depleted tumor AGT activity by 93.5% (P < 0.01). Groups treated with regional temozolomide alone (350 mg/kg), systemic temozolomide with O6BG, or vehicle combined with O6BG showed no significant tumor responses compared with controls. Whereas use of regional temozolomide alone at a higher dose (750 mg/kg) showed some degree of tumor response, regional temozolomide given in conjunction with multiple dosages of O6BG showed a marked (P < 0.01) reduction in tumor growth with minimal toxicity. Our findings suggest that AGT modulation by the administration of O6BG in combination with temozolomide regional chemotherapy leads to a significant improvement in melanoma antitumor responses. Clinical trials using chemotherapy modulation may improve response rates in future regional infusion and perfusion drug trials. [Mol Cancer Ther 2006;5(3):732–8]


Grant support: Veterans Affairs Merit Review (D.S. Tyler), Veterans Affairs Institute of Medical Research (D.S. Tyler), and Correlative Science Committee of the American College of Surgeons Oncology Group (D.S. Tyler).

The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Received 4/ 4/05; revised 12/ 4/05; accepted 1/11/06.




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