Continuously growing cell cultures, testing positive for tyrosinase activity, were derived from two brain and three lymph-node metastases of five patients with malignant melanoma. These cell cultures were analyzed regarding their proliferation fate with continuous bromodeoxyuridine (BrdUrd) labeling followed by bivariate Hoechst 33258/ethidium bromide flow cytometry. Melanoma cell cultures are more sensitive toward BrdUrd in comparison to human diploid fibroblast cultures: 50% growth inhibition at 360 f 130 p M BrdUrd (range:130-520; n = 11) vs. 650 f 50 pM BrdUrd (n = 3) for fibroblasts. Moreover, BrdUrd sensitivity in melanoma cells is oxygen dependent: 50% growth inhibition at 200 2 55 pM (range: 65-400 FM) for 20% oxygen vs. 360 f 130 p M BrdUrd for 5% oxygen. The cell cycle kinetic mechanism of BrdUrd-induced growth inhibition is accumulation of cells in the G2 phase. Cultures from a single metastasis showed up to a 3-fold variation in BrdUrd sensitivity. I n one of the brain metastases two populations of different ploidy level (pseudotriploid vs. pseudotetraploid) and BrdUrd sensitivity could be resolved. Thus, continuous BrdUrd labeling followed by bivariate Hoechst 3325Wethidium bromide flow cytometry is a powerful tool to detect heterogeneity in proliferative capacity and drug sensitivity of cell populations within one tumor biopsy. Key terms: Bromodeoxyuridine labeling, melanoma cells, metastasis, Hoechst 33258 dye, ethidium bromide, bivariate flow cytometry, G2 phase, tyrosinaseThe growing incidence of malignant melanoma is becoming a major public health concern ( 11,17,20). Notwithstanding efficient surgical treatment of primary skin tumors, the propensity of malignant melanoma to form metastases contributes to a considerable extent to melanoma morbidity (5). Melanoma metastases present with considerable heterogeneity, which makes them a difficult target for radio-and chemotherapy (1,3,6).We use a highly sensitive cell cycle kinetic assay which allows the systematic study of activated tumor cells with respect to sensitivities toward chemotherapeutic agents ( 13). The assay involves exposure of cell cultures to 50-100 pM concentrations of bromodeoxyuridine (RrdIJrd) for 72 h. Multiple rounds of DNA replication are subsequently detected by staining cells with Hoechst 33258 and ethidium bromide and analysis in a flow cytometer equipped with ultraviolet (UV) excitation ( 1 5,16). In contrast to most other types of cells, melanoma cells were found to be very sensitive to BrdUrd. The availability of several growing cell cultures from each tumor biopsy permitted the study within a single tumor of putative heterogeneity of response toward a cytotoxic drug.
MATERIALS AND METHODS Establishment of Melanoma CulturesTwo brain and three lymph-node melanoma metastases were obtained from five different patients undergoing surgical resection. Tumors were transported in sterile culture media and maintained at room temperature. After rinsing with culture media, consisting of an equal mixture of Dulbecco's modificatio...