Abstract. Chemotherapy is one of the commonly used strategies in gastric cancer, especially for unresectable patients, but it becomes insensitive to repeated administration of even the most effective chemotherapeutic agents, such as cisplatin. Given this, there is an urgent need for developing chemosensitizers to overcome acquired resistance to chemotherapeutic agents. Interleukin-24 (IL-24), a cytokine-tumor suppressor, shows broad-spectrum and tumor-specific antitumor properties, and studies have demonstrated that IL-24 could conspicuously restore the chemosensitivity of MDR cancer cells. Herein, we developed a human MDR gastric cancer cell subline, SGC7901/ CDDP, by repeated selection of resistant clones of parental sensitive cells, and further investigated the chemosensitizing effects and the underlying mechanisms of adenovirus-medi-
IntroductionGastric cancer is the fourth leading cause of cancer-related death in the world (1). To date, chemotherapy is the most frequently used fundamental treatment for gastric cancer. However, the main barrier to successful chemotherapy is MDR caused by insensitivity to multiple chemotherapeutic agents after exposure to a single chemotherapeutic drug (2). For decades, the most representative consensus is the overexpression of drug efflux pumps (such as P-gp) occupying a critical position in development of MDR. Consequently, several innovative chemosensitizers against P-gp, such as verapamil, trifluoperazine and cyclosporine, have been found to enhance chemosensitivity of MDR phenotype cancer cells (3). However, the clinical application of these chemosensitizers showed disappointing results (4,5), indicating that there are some unknown molecules and mechanisms also responsible for MDR. Recent studies have verified that some novel factors including defective apoptosis pathway, enhanced DNA repair activity, or altered metabolism of drugs play a critical role in promoting formation of MDR (6). Though the underlying mechanisms have been deeply studied in vitro and in vivo (6-9), the precise mechanisms involved in MDR have not been Abbreviations: MDR, multidrug resistance; P-gp, P-glycoprotein;RT-PCR, reverse transcriptase polymerase chain reaction; IC 50 , 50% inhibitory concentration