Predictive value and clinical significance of increased SSAT-1 activity in healthy adults

The Association between Spermidine/Spermine N1-Acetyltransferase (SSAT) and Human Malignancies

Spermidine/spermine N¹-acetyltransferase (SSAT) functions as a critical enzyme in maintaining the homeostasis of polyamines, including spermine, spermidine, and putrescine, in mammalian cells. SSAT is a catalytic enzyme that indirectly regulates cellular physiologies and pathways through interaction with endogenous and exogenous polyamines. Normally, SSAT exhibits only at a low cellular level, but upon tumorigenesis, the expression, protein level, and activities of SSAT are altered. The alterations induce cellular damages, including oxidative stress, cell cycle arrest, DNA dynamics, and proliferation by influencing cellular mechanisms and signaling pathways. The expression of SSAT has been reported in various studies to be altered in different cancers, and it has been correlated with tumor development and progression. Tumor grades and stages are associated with the expression levels of SSAT. SSAT can be utilized as a target for substrate binding, and excreted metabolites may be used as a novel cancer biomarker. There is also potential for SSAT to be developed as a therapeutic target. Polyamine analogs could increase SSAT expression and increase the cytotoxicity of chemotherapy to tumor cells. Drugs targeting polyamines and SSAT expression have the potential to be developed into new cancer treatments in the future.

Use of amantadine in the evaluation of response to chemotherapy in lung cancer: a pilot study

Aim:

The assessment of tumor response to therapy is of critical importance as it permits for a prospective end point evaluation and provides a guide to clinicians for making future treatment decisions. However, current practices in early evaluation of chemotherapy are insufficient. Amantadine is a substrate for SSAT-1. The present pilot study tests the hypothesis that SSAT-1 activity within the tumor, as measured by plasma acetylamantadine concentrations, can be used to monitor patient response to therapy.

Results:

In cases with evidence of disease response, there was a reduction in the plasma acetylamantadine concentration at 4 h by approximately 32%. There was a mean increase of approximately 34% at the 4 h collection in the nonresponders.

Conclusion:

Although large-scale studies are required these findings suggest that the amantadine test could allow for determination of the efficacy of therapeutic interventions earlier, providing an effective test to assess response to treatment and for better management of patients.

Aim: It is very important to get early information on the effectiveness of tumor treatment such that clinicians have a better understanding and decide on the next treatment regimen. Current methods are not sufficient to assess whether chemotherapy is effective early during a treatment cycle. We have previously used the presence of the acetylated metabolite of the drug amantadine in urine of patients diagnosed with lung cancer as a biomarker for disease. In the present study, our goal was to test the hypothesis that tumor responsiveness to therapy could be assessed by monitoring changes in the levels of the acetylated form of amantadine in the blood during the course of treatment. Results: In 70% of the patients we were able to relate disease progression or remission/stability to the levels of the acetylated form of amantadine in the blood. Conclusion: Although a larger study with a greater number of patients is required, our test could be used as a simple and effective tool to assess response to treatment and to better tailor treatment of the patient as well as reduce side effects and costs.