A novel quinoline derivative, TAS-103 ( Fig. 1), has many attractive biological functions: i) it inhibits both topoisomerase (topo) I and topo II; ii) it stabilizes both topo I-and topo II-DNA cleavable complexes; iii) it shows potent cytotoxic effects in vitro; iv) it shows high antitumor activities against subcutaneously-implanted murine and human tumors in vivo, as well as various lung-metastatic murine tumors.
1)However, it is unclear whether TAS-103 will show the similar level of activity against tumors in patients. In this setting, the chemosensitivity test is expected to show its potential for predicting activity of anticancer agents against human tumors.Various in vitro drug sensitivity tests have been used to assay the responsiveness of tumors to anticancer agents.
2-7)Among various techniques, the colony-forming assay may be the most widely applied in vitro assay for clinical use. 8) In a large study of prospective trials using colony-forming assay, it was shown that true-positive rate was 60% and true-negative rate was 85% based on clinical response. 9) Although this assay seems to be reliable for predicting the clinical response to chemotherapies, it is time-and cost-consuming, laborintensive, and suffers from a low success rate.10) In addition, this assay requires preparations of a single-cell suspension, which renders considerable damage to the tumor cells.We have used direct in vitro measurements of apoptosis as a chemosensitivity test. Two different methods have been employed; morphological examinations of the nuclear damage, such as the chromatin condensation or degradation, 5) and flow cytometric (FCM) analysis of DNA integrity which shows apoptosis as the sub-G1 population.11) The FCM assay Correlations between TAC and PPC were examined for 16 clinically available anticancer agents, and it was found that TAC at 7n (the modified Fibonacci's dose-escalation scheme) of 14 drugs corresponded well with each one-tenth of PPC. By defining a 30% or more reduction in the integrated diploid peak as effective and a 60% or more reduction as definitely effective, TAS-103 at 5 m mg/ml (7n) showed significantly higher effective rates and definitely effective rates than those of all other investigational new drugs, as well as almost all clinically available anticancer agents, against various malignancies, including nonsmall cell lung cancer, brain tumor and renal cancer. These results strongly suggest that TAS-103 will be expected to show excellent antitumor activities against a wide range of human tumors.