Summary The effect of taxol (TX) and cisplatin (CDDP), singly or in association, was assessed on two human ovarian cancer cell lines, one sensitive (A2780) and one resistant (A2780 cp8) to CDDP. Cell lines showed a similar sensitivity to TX, whereas different cytotoxicity results were obtained in the two cell lines as a function of TX and CDDP sequence. Specifically, TX followed by CDDP induced simply additive effects in both cell lines, whereas the opposite sequence produced antagonistic effects in A2780 cells and synergistic effects in A2780 cp8 cells. TX, with or without CDDP, induced oligonucleosomal DNA fragmentation typical of the apoptotic process, but the biochemical mechanisms undergoing apoptosis were different in the two cell lines. In fact, in A2780 cells, TX (with or without CDDP) treatment markedly increased p53 as well as p2lwafl protein expression. In A2780 cp8 cells, drug treatment enhanced p53 levels, whereas the expression of p21waf1 was always undetectable at mRNA and protein levels. In the latter cell line, a premature activation of p34cdc2 kinase was observed in correspondence with the drug-induced increase in the S-phase cell fraction. Such an activation was not ascribable to an increase in the overall expression of p34cdc2 or cyclin B1 proteins, but to a dephosphorylation of p34cdc2 kinase. Overall, our results indicate that TX-induced apoptosis in human ovarian cancer cells may be sustained by different events at the cell cycle-control level.Keywords: taxol; cisplatin; apoptosis; cell cycle-related proteins; ovarian cancer Taxol (TX), an antimicrotubule agent that stabilizes mitotic spindles, has a well-documented clinical efficacy in a variety of human neoplasms, including ovarian (Einzig et al, 1992), breast cancer (Nabholts et al, 1993) and cutaneous melanoma (Legha et al, 1990). The encouraging responses as a single agent have prompted the activation of trials of TX in association with cisplatin (CDDP) or doxorubicin. The greatest effect of the CDDP-TX combination in experimental systems was observed when TX preceded the alkylator (Jekunen et al, 1994; Leibmann et al, 1994). However, the type of interaction between the two drugs in the different treatment schedules is controversial (Milross et al, 1995;Mohith et al, 1996), and the biochemical mechanisms responsible for such effects have not been clearly identified.Preclinical studies on the mechanisms of CDDP-TX activity have been carried out only on CDDP-sensitive cells. In the present study, we analysed the effect of the two-drug combination in a CDDP-resistant ovarian cancer cell line (A2780 cp8) in comparison with that observed in the parental CDDP-sensitive cell line (A2780) to ascertain whether CDDP resistance interferes with the pattern of the CDDP-TX interaction. Moreover, as previous reports have indicated that cell death induced by TX is sustained by an apoptotic process (Donaldson et al, 1994;Liu et al, 1994;Danesi et al, 1995;Haldar et al, 1996;Wahl et al, 1996), we analysed the occurrence of apoptosis after CDDP-TX expo...