title: Antitumor effects of the proteasome inhibitor bortezomib in medullary and anaplastic thyroid carcinoma cells in vitro.
abstract: BACKGROUND
  The ubiquitin-proteasome pathway is a major pathway for degradation of intracellular proteins. Proteasome inhibitors constitute a novel class of antitumor agents with preclinical and clinical evidence of activity against hematological malignancies and solid tumors. The proteasome inhibitor bortezomib (PS-341, Velcade) has been approved by the Food and Drug Administration for the treatment of multiple myeloma and is being studied intensely in several other malignancies. Its mechanism of action is complex but appears to include the inhibition of inhibitory-kappaB degradation, which leads to inactivation of the transcriptional factor nuclear factor-kappaB (NF-kappaB). NF-kappaB has been implicated in the pathophysiology of the most aggressive forms of thyroid carcinoma, i.e. medullary and anaplastic.
  
  
  OBJECTIVE
  We evaluated the effect of bortezomib on a panel of thyroid carcinoma cell lines, originating from papillary, follicular, anaplastic, and medullary carcinomas.
  
  
  RESULTS
  Bortezomib induced apoptosis in medullary and anaplastic cell lines with IC(50) values well within the range of clinically achievable concentrations and much lower than respective IC(50) values for other solid malignancies. Bortezomib inhibited NF-kappaB activity; increased p53, p21, and jun expression; and induced caspase-dependent apoptosis. Sensitivity of thyroid carcinoma cells to bortezomib was partially decreased by overexpression of Bcl-2 or treatment with IGF-I, whereas the combination of bortezomib with chemotherapy (doxorubicin) was synergistic.
  
  
  CONCLUSIONS
  These data provide both insights into the molecular mechanisms of antitumor activity of proteasome inhibitors and the rationale for future clinical trials of bortezomib, alone or in combination with conventional chemotherapy, to improve patient outcome in medullary and anaplastic thyroid carcinomas.
authors.affiliation: Department of Medical Oncology, Dana Farber Cancer Institute, Mayer Building, Room M555, 44 Binney Street, Boston, MA 02115, USA. constantine_mitsiades@dfci.harvard.edu
authors.forename: Constantine S
authors.initials: CS
authors.lastname: Mitsiades
authors.forename: Douglas
authors.initials: D
authors.lastname: McMillin
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Kotoula
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Poulaki
authors.forename: Ciaran
authors.initials: C
authors.lastname: McMullan
authors.forename: Joseph
authors.initials: J
authors.lastname: Negri
authors.forename: Galinos
authors.initials: G
authors.lastname: Fanourakis
authors.forename: Sophia
authors.initials: S
authors.lastname: Tseleni-Balafouta
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Ain
authors.forename: Nicholas
authors.initials: N
authors.lastname: Mitsiades
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology*; D017209:Apoptosis / Q000187:drug effects; D051023:BH3 Interacting Domain Death Agonist Protein / Q000378:metabolism; D001897:Boronic Acids / Q000494:pharmacology*; D000069286:Bortezomib; D002277:Carcinoma / Q000188:drug therapy*; D018276:Carcinoma, Medullary / Q000188:drug therapy*; D020169:Caspases / Q000502:physiology; D002453:Cell Cycle / Q000187:drug effects; D045744:Cell Line, Tumor; D050759:Cyclin-Dependent Kinase Inhibitor p21 / Q000032:analysis; D004317:Doxorubicin / Q000494:pharmacology; D004791:Enzyme Inhibitors / Q000494:pharmacology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000494:pharmacology; D016328:NF-kappa B / Q000037:antagonists & inhibitors / Q000378:metabolism; D010766:Phosphorylation; D061988:Proteasome Inhibitors; D016755:Proto-Oncogene Proteins c-jun / Q000378:metabolism; D011719:Pyrazines / Q000494:pharmacology*; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D000970:Antineoplastic Agents; D051023:BH3 Interacting Domain Death Agonist Protein; C494814:BID protein, human; D001897:Boronic Acids; C493956:CDKN1A protein, human; D050759:Cyclin-Dependent Kinase Inhibitor p21; D004791:Enzyme Inhibitors; D016328:NF-kappa B; D061988:Proteasome Inhibitors; D016755:Proto-Oncogene Proteins c-jun; D011719:Pyrazines; D016159:Tumor Suppressor Protein p53; D007334:Insulin-Like Growth Factor I; D000069286:Bortezomib; D004317:Doxorubicin; D020169:Caspases