title: Reversal of chemoresistance in malignant gliomas by calcium antagonists: correlation with the expression of multidrug-resistant p-glycoprotein.
abstract: Resistance to multiple drugs is often observed in malignant gliomas. The authors used a microtiter tetrazolium test to analyze primary in vitro chemoresistance and chemosensitivity of 15 early cultures of human malignant glioma exposed to 50 micrograms/ml (1,4-amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)-3-nitrosoure a (ACNU), 50 micrograms/ml cisplatin, 1 microgram/ml vincristine, or combinations of these chemotherapeutic agents. Primary chemoresistance was observed in 87% of tumors for ACNU, in 87% for cisplatin, and in 83% for vincristine. All tumors were examined for expression of multidrug-resistant p-glycoprotein, a transport protein of 170,000 D, by means of immunohistochemical staining with the JSB-1 antibody on paraffinized tumor sections. Eight of 15 specimens (53%) showed positive staining for the monoclonal antibody. Primary chemoresistance was overcome by addition of the calcium antagonists verapamil or nimodipine to the cultures if the original tumor expressed p-glycoprotein (p < 0.01 for verapamil, p < 0.05 for nimodipine). In tumors not expressing p-glycoprotein, addition of calcium antagonists to the cell cultures did not influence primary chemoresistance. It is concluded from these data that addition of calcium antagonists to the adjuvant chemotherapy of malignant gliomas might overcome primary chemoresistance in tumors expressing the multidrug-resistant phenotype.
authors.affiliation: Department of Neurosurgery, Heinrich Heine University Düsseldorf, Germany.
authors.forename: J C
authors.initials: JC
authors.lastname: Kiwit
authors.forename: A
authors.initials: A
authors.lastname: Hertel
authors.forename: A E
authors.initials: AE
authors.lastname: Matuschek
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000032:analysis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004351:Drug Resistance; D005909:Glioblastoma / Q000737:chemistry / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007124:Immunoenzyme Techniques; D009553:Nimodipine / Q000008:administration & dosage / Q000494:pharmacology*; D015376:Nimustine / Q000008:administration & dosage; D010641:Phenotype; D014407:Tumor Cells, Cultured; D014700:Verapamil / Q000008:administration & dosage / Q000494:pharmacology*; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D015376:Nimustine; D009553:Nimodipine; D014750:Vincristine; D014700:Verapamil; D002945:Cisplatin