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J Thorac Cardiovasc Surg 1996;112:1372-1377
© 1996 Mosby, Inc.


GENERAL THORACIC SURGERY

GENE THERAPY FOR LUNG CANCER: ENHANCEMENT OF TUMOR SUPPRESSION BY A COMBINATION OF SEQUENTIAL SYSTEMIC CISPLATIN AND ADENOVIRUS-MEDIATED p53 GENE TRANSFER

Dao M. Nguyen, MD, MSc, FRCSCa, Francis R. Spitz, MDb, Nancy Yen, MSca, Richard J. Cristiano, PhDa, Jack A. Roth, MD, FACSa

This study was partially supported by grants from the National Cancer Institute and National Institutes of Health (R01 CA45187 [J.A.R.]; R29 CA66037 [R.J.C.]); by gifts to the Division of Surgery from Tenneco and Exxon for the Core Lab Facility; by the M.D. Anderson Cancer Center Core Support Grant (CA16672); by a grant from the Mathers Foundation; and by a sponsored research agreement from Introgen Therapeutics, Inc., Houston, Tex.

Received for publication May 6, 1996 Revisions requested June 10, 1996; revisions received July 11, 1996 Accepted for publication July 15, 1996 Address for reprints: Jack A. Roth, MD, The University of Texas M. D. Anderson Cancer Center, Department of Thoracic and Cardiovascular Surgery, Box 109, 1515 Holcombe Blvd., Houston, TX 77030.

Abstract

A more effective gene therapy strategy for lung cancer using sequential cisplatin administration and adenovirus-mediated p53 gene transfer was developed on the basis of our previous observation of enhanced expression of a reporter gene in malignant cells exposed to cisplatin before gene transfer. Transfer of the normal (wildtype) p53 gene into cisplatin-treated H1299 cells, in which p53 is homozygously deleted, resulted in up to a 60% further inhibition of cell proliferation in vitro than p53 transfer into untreated H1299 cells. The cisplatin plus p53 gene transfer strategy yielded significantly greater apoptosis and tumor growth suppression in an animal model of subcutaneous H1299 tumor nodules than wildtype p53 gene transfer alone. The timing of cisplatin administration and p53 gene transfer was shown to be critical: cisplatin administration simultaneous with or subsequent to p53 gene transfer was less effective than cisplatin-first sequential treatment. Moreover, the in vivo inhibition of tumor growth was maintained by repeated cycles of treatment. This gene therapy strategy has been incorporated into a phase I clinical trial for the treatment of lung cancer and provides a basis for the development of improved therapeutic protocols. (J THORAC CARDIOVASC SURG 1996;112:1372-7)




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