Lung cancer is currently the leading cause of cancer deaths worldwide. Primary lung cancers are classified into two main histological groups: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC constitutes approximately 85% of all lung cancers and often shows intrinsic multidrug resistance (MDR), whereas SCLC almost always responds well to various anticancer agents. 1) Cisplatin is an established antitumor agent for the treatment of advanced human NSCLC and is employed in cisplatin-based adjuvant chemotherapy. 2,3) Although the development of resistance to cisplatin is one of the major obstacles in the successful treatment of NSCLC, the molecular mechanisms involved remain poorly understood. In order to overcome the problems related to drug resistance and to improve the clinical outcome of patients with NSCLC, the mechanisms of cancer chemoresistance must be more clearly elucidated.Our previous in vitro study using three NSCLC cell lines has demonstrated that cisplatin has triggered apoptosis more easily in the chemosensitive human NSCLC cell line than the chemoresistant cell line, based on biochemical and morphological findings. 4) We have also reported that an increased transcriptional level of constitutive signal transducer and activator of transcription (STAT) 3 may be related to the suppressive regulation of the apoptotic pathway in intrinsically chemoresistant NSCLC cells.
4)However, multiple factors are involved in the chemoresistance of cancer cells, suggesting that other mechanisms or factors may also contribute to the resistance of the NSCLC cell lines. Therefore, it is needed to further study other cellular mechanisms of chemoresistance, such as ATP-binding cassette transporters and lung resistance-related protein (LRP), important in drug disposition and in the development of MDR, together with measuring the concentration of anticancer agent in cancer cells.During the past decade, there have been many studies linking various transporters to MDR both in cell culture and in the clinical setting. Of these proteins, P-glycoprotein (MDR1), multidrug resistance-associated protein 1 (MRP1), and LRP have attracted considerable attention in studies of cancer chemotherapy. In tumor cell lines, MDR is often associated with overexpression of ATP-dependent drug efflux proteins belonging to the superfamily of ATP-binding cassette transporters: the 170-kDa MDR1 and the 190-kDa MRP1.5) These proteins bind to and transport various structurally unrelated compounds to maintain their intracellular concentrations below cytotoxic levels. In addition to an overall decrease in intracellular drug concentration, redistribution of the drug from the nucleus to the cytoplasm has also been implicated in MDR of cancer cells. 6) Recently, another drug resistance-related protein, referred to as LRP, has been identified.7) LRP has been found to be identical to the human major vault protein, which is the major component of vaults.8) Vaults are mainly located in the cytoplasm, and approximately 5% of cellular va...