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Patterns of resistance and therapeutic synergism among alkylating agents.

Alkylating anticancer drugs are varied in chemical structure, alkylating moieties, and likely mechanisms of cytotoxic activity for vital normal cells and sensitive tumor cells. This has been objectively documented by numerous examples illustrating: (1) different in vitro and in vivo reaction products; (2) greater than additive, additive, and less than additive cytotoxicity of drug combinations for vital normal cells in the mouse; (3) readily reproducible and often marked therapeutic synergism between a variety of 2-drug combinations of alkylating agents against a wide variety of histologic types of murine tumors, and (4) observed resistance and cross-resistance of a variety of murine tumors, selected for resistance to specific alkylating agents, compatible with recognized chemical and functional differences between these drugs. The most important observations on resistance and cross-resistance reported are: (a) L1210 cells selected for complete resistance to cyclophosphamide (CPA) retain full sensitivity to selected nitrosoureas (BCNU, CCNU, MeCCNU), chlorozotocin), dianhydrogalactitol, and cis-DDPt, while retaining marked but somewhat reduced sensitivity to L-PAM, piperazinedione, and thioTEPA. (B) L1210 cells selected for resistance to BCNU retain full sensitivity to CPA, L-PAM, and dianhydrogalactitol. They show complete cross-resistance to BIC and variable cross-resistance to other selected nitrosoureas and piperazinedione. (c) L1210/L-PAM has incomplete but marked resistance to L-PAM. It is similar to the parent drug-sensitive line (L1210/0) in response to BCNU, CCNU, MeCCNU, and BIC. It is variably (usually moderately) cross-resistant to CPA, chlorozotocin, dianhydrogalactitol, and thioTEPA, but is completely cross-resistant to cis-DDPt. These resistance and cross-resistance patterns, which are consistent with most other biological and chemical principles established with these alkylating agents, may be useful in selecting alkylating drug combinations for inclusion in chemotherapy protocols in man which, on the basis of diverse observations in animal tumor systems, appear to be clearly indicated.

Alkylating Agents↗

Reproductive toxicology of alkylating agents.

Alkylating agents have been used during childhood and in reproductive age groups for the treatment of malignancy or collagen-vascular disease. Because of their mechanism of action, alkylating agents have the ability to interfere with chromosomal structure, ovarian function, spermatogenesis, and embryogenesis. Teratogenic risks have been established in animal studies, although are less clear for humans. Total dose, timing of administration, and age of the patient at the time of therapy are all factors in determining adverse effects. If possible, alkylating agents should be avoided in the first trimester, but can be used during the remainder of pregnancy.

Age Factors↗

In vivo formation and persistence of modified nucleosides resulting from alkylating agents.

Alkylating agents are ubiquitous in the human environment and are continuously synthesized in vivo. Although many classes exist, interest has been focused on the N-nitroso compounds, since many are mutagens for bacteria, phage, and cells, and carcinogens for mammals. In contrast to aromatic amines and polyaromatic hydrocarbons which can react at carbons, simple alkylating agents react with nitrogens and oxygens: 13 sites are possible, including the internucleotide phosphodiester. However, only the N-nitroso compounds react extensively with oxygens. In vivo, most possible derivatives have been found after administration of methyl and ethyl nitroso compounds. The ethylating agents are more reactive toward oxygens than are the methylating agents and are more carcinogenic in terms of total alkylation. This is true regardless of whether or not the compounds require metabolic activation. It has been hypothesized that the level and persistence of specific derivatives in a "target" cell correlates with oncogenesis. However, no single derivative can be solely responsible for this complex process, since correlations cannot be made for even a single carcinogen acting on various species or cell types. Some derivatives are chemically unstable, and the glycosyl bond is broken (3- and 7-alkylpurines), leaving apurinic sites which may be mutagenic. These, as well as most adducts, are recognized by different enzymatic activities which remove/repair at various rates and efficiencies depending on the number of alkyl derivatives, as well as enzyme content in the cell and recognition of the enzyme. Evaluation of human exposure requires early and sensitive methods to detect the initial damage and the extent of repair of each of the many promutagenic adducts.

Alkylating Agents↗

Glutathione-S-transferase activates novel alkylating agents.

Alkylating agents which are activated by glutathion-S-transferases (GSTs) have been designed and synthesized. The model compound gamma-glutamyl-alpha-amino-beta-[(2-ethyl N,N,N',N'-tetraethylphosphorodiamidate) sulfonyl]propionylglycine (1) and the nitrogen mustards gamma-glutamyl-alpha- amino-beta-[[2-ethyl N,N,N',N'-tetrakis (2-chloroethyl)phosphorodiamidate] sulfonyl]propionylglycine (2) and gamma-glutamyl-alpha-amino-beta-[[2-ethyl-N,N,N',N'-tetrakis(2- chloroethyl)phosphorodiamidate]sulfonyl]-propionyl-(R)-(-)-phenylg lycine (3) were prepared via multistep chemical synthesis. The compounds were tested with recombinant human A1-1, M1a-1a and P1-1 GSTs. HPLC studies showed that the compounds were differentially and catalytically cleaved by biologically relevant concentrations of the GSTs. Mass spectral studies of the cleavage mixture of 2 showed that M1a-1a GST liberated the cytotoxic phosphate moiety needed for efficacy as an alkylating agent. Cell culture studies with MCF-7 breast cancer cells showed that 1 was not toxic at 200 microM, while 2 and 3 showed IC50S of 40.6 and 37.5 microM, respectively, for the same cell line. MCF-7 cells transfected to overexpress P1-1 GST showed enhanced sensitivity with 2 and 3, with IC50S of 20.9 and 9.5 microM, respectively. This result correlates well with the rates of cleavage of 2 and 3 by P1-1 GST observed in vitro and demonstrates that higher levels of cellular P1-1 GST will give increased sensitivity to these drugs.

Alkylating Agents↗

Distribution of methyl and ethyl adducts following alkylation with monofunctional alkylating agents.

Alkylating agents, because of their ability to react directly with DNA either in vitro or in vivo, or following metabolic activation as in the case of the dialkylnitrosamines, have been used extensively in studying the mechanisms of mutagenicity and carcinogenicity. Their occurrence is widespread in the environment and human exposure from natural and pollutant sources is universal. Since most of these chemicals show varying degrees of both carcinogenicity and mutagenicity, and exhibit compound-specific binding patterns, they provide an excellent model for studying molecular dosimetry. Molecular dosimetry defines dose as the number of adducts bound per macromolecule and relates the binding of these adducts to the human mutagenic or carcinogenic response. This review complies DNA alkylation data for both methylating and ethylating agents in a variety of systems and discusses the role these alkylation products plays in molecular mutagenesis.

Alkylating Agents↗

Targeted disruption of the DNA repair methyltransferase gene renders mice hypersensitive to alkylating agent.

Alkylation of DNA at the O(6)-position of guanine is one of the most critical events leading to induction of mutation as well as to cancer. The enzyme O(6)-methylguanine-DNA methyltransferase repairs this and related lesions in DNA. By means of gene targeting, we established mouse lines deficient in the methyltransferase gene and tissues from these mice contained no methyltransferase activity. Administration of methylnitrosourea to these gene-targeted mice led to early death, and normal mice treated in the same manner showed no untoward effects. In mice given methylnitrosourea treatment, the bone marrow became hypocellular and there was a drastic decrease in the number of leukocytes and platelets, thereby indicating an impaired reproductive capacity of hematopoietic stem cells. Methyltransferase apparently protected these mice from the pancytopenia caused by the alkylating agent.

Alkylating Agents↗

Pharmacokinetics of alkylating agents.

Alkylating agents have been used for over 30 years in the treatment of malignant disease. Because of their very reactive nature, studies of their intermediate metabolism have been difficult. However, this is now possible with modern analytical techniques. Further understanding of their metabolism and pharmacokinetics should lead to a more rational use in the clinic.

Alkylating Agents↗

Mechanisms of action of quinone-containing alkylating agents: DNA alkylation by aziridinylquinones.

Aziridinyl quinones can be activated by cellular reductases eg. DT-diaphorase and cytochrome P450 reductase to form highly reactive DNA alkylating agents. The mechanisms by which this activation and alkylation take place are many and varied. Using clinically relevant and experimental agents this review will describe many of these mechanisms. The agents discussed are Mitomycin C, EO9 and analogues, diaziridinylbenzoquinones and the pyrrolo[1, 2-alpha]benzimidazolequinones.

Alkylation↗

Interaction of tubulin with drugs and alkylating agents. 1. Alkylation of tubulin by iodo[14C]acetamide and N,N'-ethylenebis(iodoacetamide).

The sulfhydryl groups of tubulin are reported to play a role in regulating microtubule assembly and colchicine binding to tubulin. The alkylating agents iodo[14C]acetamide and its bifunctional analogue N,N'-ethylenebis(iodoacetamide) are used as probes for the sulfhydryl groups of tubulin. In the presence of 8 M urea, alpha- and beta-tubulin have 10-11 and 8 alkylatable sulfhydryls, respectively, and one of the high molecular weight proteins (HMW 2) has 5 sulfhydryls/Mr 271 000. In the absence of urea, the rates of alkylation of alpha- and beta-tubulin are significantly lower but that of HMW 2 is unaffected. The sulfhydryls of tubulin are masked in intact microtubules. N,N'-Ethylenebis(iodoacetamide) reacts with free tubulin to generate a band, designated beta, which migrates ahead of beta on polyacrylamide gels. beta appears to represent a form of beta-tubulin containing at least one intrachain cross-link between sulfhydryl groups. Formation of beta* is inhibited in intact microtubules and is abolished if tubulin is denatured by 8 M urea, 1% sodium dodecyl sulfate, or boiling. N,N'-Ethylenebis(iodoacetamide) may thus be used as a probe for the native conformation of free tubulin.

Alkylating Agents↗

Determining N7-alkylguanine adducts by immunochemical methods and HPLC with electrochemical detection: applications in animal studies and in monitoring human exposure to alkylating agents.

Many xenobiotics exert their toxic effects through interaction with DNA in the cells of the exposed organism. This interaction may lead to the formation DNA adducts. Some of these may give rise to mutations that initiate cell transformation and, ultimately, the formation of tumors. Sensitive methods for determining DNA adducts are indispensable for the study of chemical mutagenesis and carcinogenesis and for biomonitoring human exposure to genotoxic agents. Alkylating agents form an important class of genotoxic compounds. They react preferentially at the N7-position of guanine. Under neutral or acidic conditions, the adducts can be readily released from the DNA backbone as the free base N7-alkylguanine (N7-AlkGua). The imidazole ring of N7-alkyldeoxyguanosine (N7-AlkdGuo) can be opened under alkaline conditions, which results in formation of a more stable adduct in DNA. To develop immunochemical methods for the detection of N7-alkylations, we immunized mice with various alkylguanosines in the ring-opened form (RON7-AlkdGuo). Antibodies were selected to detect adducts in isolated DNA by competitive ELISA and in single cells by immunofluorescence microscopy (IFM). Various monoclonal antibodies were characterized in detail with respect to specificity and sensitivity toward methylated, ethylated, and hydroxyethylated DNAs. The antibodies showed extensive cross-reactivity toward N7-(m)ethyl- and N7-(2-hydroxyethyl)guanine modifications in the ring-opened form. The limits of detection in the direct and competitive ELISA were 5-10 and 1-2 adducts per 10(6) nucleotides, respectively. The detection limit of the IFM method was about 20 adducts per 10(6) nucleotides(ABSTRACT TRUNCATED AT 250 WORDS)

Alkylating Agents↗

Alkylating agents stronger than alkyl triflates.

A new class of potent electrophilic "R(+)" alkylating agents has been developed using weakly nucleophilic carborane anions as leaving groups. These reagents, R(CHB(11)Me(5)X(6)) (R = Me, Et, and i-Pr; X = Cl, Br), are prepared via metathesis reactions with conventional alkylating agents such as alkyl triflates, using the high oxophilicity of silylium ion-like species, Et(3)Si(carborane), as the driving force to obtain increased alkyl electrophilicity. The crystal structure of the isopropyl reagent, i-Pr(CHB(11)Me(5)Br(6)), has been determined, revealing covalence in the alkyl-carborane bonding. This contrasts with the free i-Pr(+) carbocation observed when the anion is less coordinating (e.g. Sb(2)F(11)(-)) or with tertiary alkyl centers, as in [tert-butyl][carborane] salts. In solution, the reagents exist as equilibrating isomers with the alkyl group at the 7-11 or 12 halide positions of the CB(11) icosahedral carborane anion. These alkylating agents are so electrophilic that they (a) react with alkanes at or below room temperature via hydride extraction to produce carbenium ions, (b) alkylate benzene without a Friedel-Crafts catalyst to give arenium ions, and (c) alkylate electron-deficient phosphorus compounds that are otherwise inert to conventional alkylating agents such as methyl triflate.

Alkylating Agents↗

Inactivation of purified human O6-alkylguanine-DNA alkyltransferase by alkylating agents or alkylated DNA.

O6-Alkylguanine-DNA alkyltransferase partially purified from cultured human lymphoblasts (CEM-CCRF line) was inactivated with DNA substrates that had been treated separately with five methylating agents or with five chloroethylnitrosoureas. The extent of depletion of the transferase by alkylated DNA was compared with its inactivation by direct reaction with these ten agents. As expected, DNA substrates treated with methylating agents that efficiently produce O6-methylguanine were most effective in depleting the transferase, as was DNA pretreated with 1-(2-chloroethyl)-1-nitrosourea, 1,3-bis(2-chloroethyl)-1-nitrosourea, and chlorozotocin, agents presumed to form O6-chloroethylguanine as well as O6-hydroxyethylguanine in DNA. Unexpectedly, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea and 1-trans-(2-chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea were relatively ineffective in producing a DNA substrate that would inactivate the transferase, suggesting that both agents produce low steady-state levels of O6-alkylguanine. All of the agents tested were capable of inactivating the transferase by direct alkylation, although the efficiency of this activity ranges widely. We conclude that simple methylating agents and the cross-linking chloroethylnitrosoureas can inactivate O6-alkylguanine-DNA alkyltransferase both directly and indirectly, affording two mechanisms by which such agents could modulate their own cytotoxicity.

Alkylating Agents↗

Mutagenic damage to mammalian cells by therapeutic alkylating agents.

Cytotoxic alkylating agents used as therapeutics include nitrogen mustards, ethyleneimines, alkyl sulfonates, nitrosoureas and triazenes. Their reactivity with DNA, RNA and proteins can cause cell death. Side-effects of treatment include tissue toxicity and secondary malignancies, likely due to the genetic damage induced. The full mutagenic potential of alkylating agents may only be realised after they undergo metabolic activation, principally by cytochromes P450. Mutagenicity is related to the ability of alkylating agents to form crosslinks and/or transfer an alkyl group to form monoadducts in DNA. The most frequent location of adducts in the DNA is at guanines. Expressed mutations involve different base substitutions, including all types of transitions and transversions. The mutational spectra of alkylating agents on mammalian cells is distinct from that induced in bacterial cells, reflecting the different codon usage by bacteria and differences in DNA repair and replication enzymes. Mutations are induced by busulfan, chlorambucil (CAB), cyclophosphamide (CP, or its metabolite), dacarbazine, mechlorethamine, melphalan, mitomycin-C (MMC), nitrosoureas and thiotepa. Although dose-dependent, the relationship is not always linear. The molarities at which alkylating agents induce cell killing and mutations vary over three orders of magnitude. The mutagenic efficiency, of alkylating agents also varies, with some agents inducing three times more mutations for equivalent cell killing. The induction of micronuclei, sister chromatid exchanges, or chromosome aberrations is variable, but has been observed for CP, CAB, MMC, melphalan and triethylenemelamine. There is insufficient information to determine whether any synergistic effects of alkylating agents used in combination will influence the cytotoxic and mutagenic damage equally. Understanding the potential synergy of alkylating agents at the cellular and molecular level should allow improvement of the therapeutic efficacy of alkylating agents without increasing the unwanted mutation induction.

Alkylating Agents↗

Prophage inductive efficiency of alkylating agents and radiations.

The prophage inducing efficiency in E. coli K-12 (lambda) of a number of agents--alkylating agents and radiations--has been compared at a high survival of bacteria. The inducing effectiveness (per alkylation in DNA) and efficiency (compared with mutation frequency in E. coli Sd-4) was found to decrease in the order 2-hydroxyethylating agents (2-hydroxyethyl methanesulphonate and ethylene oxide) greater than isopropyl methanesulphonate approximately equal to methyl methanesulphonate greater than ethylating agents (diethyl sulphate, ethyl methanesulphonate). The low inducing activity of the ethylating agents could not be explained with respect to their reactivity towards targets of differing nucleophilicity, nor could the effectiveness in mutagenicity or the ability to break the chromosomes in the presence of metal ions be invoked. The high inducing efficiency of hydroxyalkylating agents may be related to their ability to break DNA strands.

Alkylating Agents↗