title: Flunarizine enhancement of melphalan activity against drug-sensitive/resistant rhabdomyosarcoma.
abstract: Flunarizine, a diphenylpiperazine calcium channel blocker, is known to increase tumor blood flow. It also interferes with calmodulin function, repair of DNA damage and drug resistance associated with P-glycoprotein. Flunarizine was tested for its ability to modulate either cyclophosphamide- or melphalan-induced growth delay for a drug-resistant rhabdomyosarcoma xenograft (TE-671 MR) and the drug-sensitive parent line (TE-671), in which P-glycoprotein is not involved in the mechanism of drug resistance. Tumour blood flow was increased by 30% after a flunarizine dose of 4 mg kg-1, but no modification in growth delay was induced by melphalan (12 mg kg-1). In contrast, a 60 mg kg-1 dose of flunarizine had no effect on tumour blood flow, but the same dose created significant enhancement in melphalan-induced tumour regrowth delay in both tumour lines. The dose-modifying factor for flunarizine as an adjuvant to melphalan was approximately 2 for both tumour lines. Although blood flow measurements were not performed with the combination of flunarizine and melphalan, the results from flunarizine alone suggested that augmentation of melphalan cytotoxicity is not mediated by changes in blood flow. In contrast, flunarizine did not affect drug sensitivity to cyclophosphamide in groups of animals bearing the drug-sensitive parent tumour line. These results suggest that the mechanism of drug sensitivity modification by flunarizine is not related to modification of tumour blood flow, but may be mediated by modification of transport mechanisms that are differentially responsible for cellular uptake and retention of melphalan as compared with cyclophosphamide.
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Castellino
authors.forename: H S
authors.initials: HS
authors.lastname: Friedman
authors.forename: G B
authors.initials: GB
authors.lastname: Elion
authors.forename: E T
authors.initials: ET
authors.lastname: Ong
authors.forename: S L
authors.initials: SL
authors.lastname: Marcelli
authors.forename: R
authors.initials: R
authors.lastname: Page
authors.forename: D D
authors.initials: DD
authors.lastname: Bigner
authors.forename: M W
authors.initials: MW
authors.lastname: Dewhirst
mesh_terms: D000818:Animals; D002460:Cell Line; D004347:Drug Interactions; D004351:Drug Resistance; D005260:Female; D005444:Flunarizine / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008558:Melphalan / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D051379:Mice; D008807:Mice, Inbred BALB C; D008819:Mice, Nude; D009132:Muscles / Q000098:blood supply; D012039:Regional Blood Flow / Q000187:drug effects; D012208:Rhabdomyosarcoma / Q000098:blood supply / Q000188:drug therapy*; D014183:Transplantation, Heterologous
chemical_list: D008558:Melphalan; D005444:Flunarizine