title: In vitro anti-mesothelioma activity of cisplatin-gemcitabine combinations: evidence for sequence-dependent effects.
abstract: OBJECTIVE
  The present study addresses the optimization of gemcitabine-cisplatin protocols currently adopted in the clinical management of malignant pleural mesothelioma (MPM), using cell lines derived from different histological subtypes of MPM as an in vitro model.
  
  
  METHODS
  MPM cell lines were exposed either to single drugs or to their combinations, using a fixed dose ratio. Possible mechanisms for synergistic interactions were investigated by cell cycle analysis, western blot analysis of p53 phosphorylation status, and neutral comet assay to detect double strand breaks.
  
  
  RESULTS
  Four-hour pre-treatment with gemcitabine followed by 68-h exposure to cisplatin was found to exert synergistic activity in both epithelioid and sarcomatoid MPM subtypes, inducing a strong S-phase arrest that correlated with accumulation of double-strand breaks (DSBs).
  
  
  CONCLUSIONS
  The antiproliferative effects of the gemcitabine/cisplatin combination in mesothelioma cells can be maximized by pre-treatment with gemcitabine, suggesting that this drug increases cisplatin-induced DSBs by inhibiting DNA adduct repair.
authors.affiliation: Department of Environmental and Life Sciences, Università del Piemonte Orientale Amedeo Avogadro, Via T. Michel, 11, 15121 Alessandria, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Zanellato
authors.forename: Carla Doriana
authors.initials: CD
authors.lastname: Boidi
authors.forename: Guido
authors.initials: G
authors.lastname: Lingua
authors.forename: Pier-Giacomo
authors.initials: PG
authors.lastname: Betta
authors.forename: Sara
authors.initials: S
authors.lastname: Orecchia
authors.forename: Elena
authors.initials: E
authors.lastname: Monti
authors.forename: Domenico
authors.initials: D
authors.lastname: Osella
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000494:pharmacology; D017209:Apoptosis / Q000187:drug effects; D002453:Cell Cycle / Q000187:drug effects; D045744:Cell Line, Tumor; D002470:Cell Survival / Q000187:drug effects; D002945:Cisplatin / Q000008:administration & dosage* / Q000494:pharmacology*; D053903:DNA Breaks, Double-Stranded / Q000187:drug effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D019008:Drug Resistance, Neoplasm; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006801:Humans; D020128:Inhibitory Concentration 50; D008654:Mesothelioma / Q000188:drug therapy*; D010997:Pleural Neoplasms / Q000188:drug therapy*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine