title: Zoledronic acid (Zometa) enhances the cytotoxic effect of gemcitabine and fluvastatin: in vitro isobologram studies with conventional and nonconventional cytotoxic agents.
abstract: OBJECTIVE
  To identify synergistic combinations of clinically available agents with zoledronic acid which would enhance antitumor activity as measured by median effect isobologram analysis and apoptosis assays in vitro.
  
  
  METHODS
  The interaction of zoledronic acid as a doublet with either carboplatin, cisplatin, 5'DFUR, docetaxel, epirubicin, fluvastatin, gemcitabine, imatinib, paclitaxel, trastuzumab, or vinorelbine was studied in a 72-hour in vitro system using defined human cancer cell lines grown as a monolayer in exponential phase. Drug effect on growth was measured by a standard MTT assay. Median effect isobologram analysis was applied to the results to determine the presence of synergism, additive effects, or antagonism of drug combinations. Synergistic combinations were also assayed by a cytoplasmic histone-associated DNA fragmentation apoptosis assay to verify that the effect was not cytostatic.
  
  
  RESULTS
  Zoledronic acid with gemcitabine demonstrated global cytotoxic synergy across 7 of 8 cell lines. Clinically achievable concentrations of fluvastatin with zoledronic acid also demonstrated synergy in 7 of 8 cell lines. All the breast cancer cell lines were sensitive. Zoledronic acid and epirubicin were antagonistic in all 4 breast cell lines studied.
  
  
  CONCLUSIONS
  Combinations of zoledronic acid with either gemcitabine or fluvastatin may have a therapeutic role in treatment of bone metastasis of selected malignancies.
authors.affiliation: Section of Experimental Therapeutics, Don Monti Division of Oncology, North Shore University Hospital, New York University, Manhasset, 11030, USA. budman@nshs.edu
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Budman
authors.forename: Anthony
authors.initials: A
authors.lastname: Calabro
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology*; D017209:Apoptosis / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000494:pharmacology*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D045744:Cell Line, Tumor; D003593:Cytoplasm; D053938:DNA Fragmentation / Q000187:drug effects; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000494:pharmacology; D004164:Diphosphonates / Q000494:pharmacology*; D004336:Drug Antagonism; D004357:Drug Synergism; D015251:Epirubicin / Q000494:pharmacology; D005229:Fatty Acids, Monounsaturated / Q000494:pharmacology; D005260:Female; D000077340:Fluvastatin; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology*; D007211:Indoles / Q000494:pharmacology; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology; D000077211:Zoledronic Acid; D000093542:Gemcitabine
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005229:Fatty Acids, Monounsaturated; D007093:Imidazoles; D007211:Indoles; D003841:Deoxycytidine; D015251:Epirubicin; D000077340:Fluvastatin; D000077211:Zoledronic Acid; D000093542:Gemcitabine