Tyrosine kinase proteins play a crucial role in the transduction of intracellular signals, leading to various cellular responses, such as proliferation, apoptosis and differentiation. 1,2 These enzymes are therefore becoming new targets in antitumor therapies designed to block tumor growth, metastasis and neoangiogenesis and to trigger tumor cell apoptosis. 3,4 The tyrosine kinase inhibitor, STI571, belonging to the 2-phenylaminopyrimidine class, formerly known as CGP57148B, selectively inhibits BCR/ABL, 5 platelet-derived growth factor receptor (PDGFR) and c-kit kinase activity. 6 Numerous publications have shown preclinical and clinical efficacy of STI571 on these 3 identified targets: (i) via inhibition of ABL kinase activity in chronic myeloid leukemia (CML) in chronic phase or acute lymphoblastic leukemia with t(9;22)(q34;q11); 7,8 (ii) via PDGFR, CML with PDGFR␣ rearrangement, 9 idiopathic hypereosinophilic syndrome, 10 dermatofibrosarcoma protuberans, [11][12][13] SCLC appears to be an appropriate target for STI571 therapy, as 36% to more than 70% of SCLC tumors and cell lines express c-kit transcript or protein. 29 -38 The growth and viability of a number of SCLC cell lines were inhibited in a dose-dependent fashion by STI571 27,28 and by adenovirus vectors expressing antisense c-kit transcript; 26 in vitro data have shown that STI571 inhibits cell growth and viability via a mechanism involving inactivation of the tyrosine kinase c-kit. 28 This effect appears to be cytostatic because no increase in apoptosis was observed. 27 In contrast with in vitro data reported in CML, STI571 failed to enhance the cytotoxicity of either carboplatin or etoposide when coadministered with these agents. 27 No data are available concerning the efficacy of STI571 in in vivo xenografted human SCLC tumors or on the therapeutic potential of combined administration of chemotherapy and imatinib in these tumors. We therefore investigated the therapeutic efficacy of STI571, alone or combined with chemotherapeutic agents, on various human SCLC cells or tumors xenografted into nude mice. We found that STI571 induced tumor growth inhibition to a variable extent that was not dependent on c-kit expression level, and a synergistic efficacy of concomitant chemotherapy was observed, associated with increased toxicity.
Material and methods
Cell lines, culture conditions and quantification of proliferation and apoptosisThe SCLC6 human small cell lung cancer cell line was obtained from tumor that was previously xenografted into nude mice. 39 Transplanted tumors were dissected and suspended in culture medium. After filtration, cells were grown in DMEM (Sigma, St. Louis, MO) supplemented with 10% FCS (Dutscher, Brumath, France), and Penicillin G (10 2 IU/ml) ϩ streptomycin (50 g/ml; Sigma). Cells were cultured in medium containing stem cell factor (SCF, Amgen, Nevilly sur Seine, France) or medium alone in the presence or absence of STI571 (Novartis, Basel, Switzerland) and/or etoposide (Pierre Fabre, Boulogne, France) or topotecan (GlaxoSmit...