COTI-2
is a novel anticancer thiosemicarbazone in phase I clinical
trial. However, the effects of metal complexation (a main characteristic
of thiosemicarbazones) and acquired resistance mechanisms are widely
unknown. Therefore, in this study, the copper and iron complexes of
COTI-2 were synthesized and evaluated for their anticancer activity
and impact on drug resistance in comparison to metal-free thiosemicarbazones.
Investigations using Triapine-resistant SW480/Tria and newly established
COTI-2-resistant SW480/Coti cells revealed distinct structure–activity
relationships. SW480/Coti cells were found to overexpress ABCC1, and
COTI-2 being a substrate for this efflux pump. This was unexpected,
as ABCC1 has strong selectivity for glutathione adducts. The recognition
by ABCC1 could be explained by the reduction kinetics of a ternary
Cu-COTI-2 complex with glutathione. Thus, only thiosemicarbazones
forming stable, nonreducible copper(II)-glutathione adducts are recognized
and, in turn, effluxed by ABCC1. This reveals a crucial connection
between copper complex chemistry, glutathione interaction, and the
resistance profile of clinically relevant thiosemicarbazones.