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Abstract
BACKGROUND Angiogenesis studies are limited by the clinical relevance of laboratory model systems. We developed a new method for measuring dead microvascular (MV) cells in clinical tissue, fluid and blood specimens, and applied this system to make several potentially novel observations relating to cancer pharmacology. METHODS Dead MV cells tend to have a hyperchromatic, refractile quality, further enhanced during the process of staining with Fast Green and counterstaining with either haematoxylin-eosin or Wright-Giemsa. We used this system to quantify the relative degree of direct antitumour versus anti-MV effects of cisplatin, erlotinib, imatinib, sorafenib, sunitinib, gefitinib and bevacizumab. RESULTS Bevacizumab had striking anti-MV effects and minimal antitumour effects; cisplatin had striking antitumour effects and minimal anti-MV effects. The ;nib' drugs had mixed antitumour and anti-MV effects. Anti-MV effects of erlotinib and gefitinib were equal to those of sunitinib and sorafenib. There was no detectable VEGF in culture medium without cells; tumour cells secreted copious VEGF, reduced to undetectable levels by bevacizumab, greatly reduced by cytotoxic levels of cisplatin + anguidine, and variably reduced by DMSO and/or ethanol. We observed anti-MV additivity between bevacizumab and other drugs on an individual patient basis. Peripheral blood specimens had numerous MV cells which were strikingly visualized for quantification with public domain image analysis software using bevacizumab essentially as an imaging reagent. CONCLUSIONS This system could be adapted for simple, inexpensive and sensitive/specific detection of tissue and circulating MV cells in a variety of neoplastic and non-neoplastic conditions, and for drug development and individualized cancer treatment.
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Affiliation(s)
- L M Weisenthal
- Weisenthal Cancer Group, Huntington Beach, CA 92647, USA.
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Dimos JT, Rodolfa KT, Niakan KK, Weisenthal LM, Mitsumoto H, Chung W, Croft GF, Saphier G, Leibel R, Goland R, Wichterle H, Henderson CE, Eggan K. Induced pluripotent stem cells generated from patients with ALS can be differentiated into motor neurons. Science 2008; 321:1218-21. [PMID: 18669821 DOI: 10.1126/science.1158799] [Citation(s) in RCA: 1379] [Impact Index Per Article: 86.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The generation of pluripotent stem cells from an individual patient would enable the large-scale production of the cell types affected by that patient's disease. These cells could in turn be used for disease modeling, drug discovery, and eventually autologous cell replacement therapies. Although recent studies have demonstrated the reprogramming of human fibroblasts to a pluripotent state, it remains unclear whether these induced pluripotent stem (iPS) cells can be produced directly from elderly patients with chronic disease. We have generated iPS cells from an 82-year-old woman diagnosed with a familial form of amyotrophic lateral sclerosis (ALS). These patient-specific iPS cells possess properties of embryonic stem cells and were successfully directed to differentiate into motor neurons, the cell type destroyed in ALS.
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Affiliation(s)
- John T Dimos
- Harvard Stem Cell Institute, Stowers Medical Institute, Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA 02138, USA
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Weisenthal LM. Controversy over fat content of meat. Postgrad Med 1996; 99:47-8. [PMID: 8632974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Nagourney RA, Evans SS, Messenger JC, Su YZ, Weisenthal LM. 2 chlorodeoxyadenosine activity and cross resistance patterns in primary cultures of human hematologic neoplasms. Br J Cancer 1993; 67:10-4. [PMID: 8094002 PMCID: PMC1968239 DOI: 10.1038/bjc.1993.3] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
2-Chlorodeoxyadenosine (2-CDA) is an adenosine deaminase resistant analogue of deoxyadenosine which has shown clinical activity in human hematologic neoplasms. The exact mode of action of this drug remains the subject of investigation. We applied the Differential Staining Cytotoxicity (DiSC) assay to 50 human tumour specimens obtained from patients with a variety of hematologic malignancies to characterise the activity spectrum of 2-CDA. We evaluated the disease-specific activity of this agent in vitro and compared its relative cytotoxicity with that of other antineoplastic agents in current clinical use. Comparisons were conducted against nitrogen mustard, doxorubicin, vincristine and cytosine arabinoside. Our results indicate that 2-CDA has activity in myeloid and many lymphoid neoplasms but that multiple myeloma specimens reveal significant resistance. Cross resistance studies reveal a correlation between 2-CDA and the alkylator nitrogen mustard but no correlation between 2-CDA and doxorubicin, vincristine nor cytosine arabinoside. The results suggest 2-CDA activity in many human hematologic neoplasms with the clear exception of multiple myeloma and further suggest a relationship between this agent and alkylators of the mustard class. The DiSC assay may provide useful insights in the pre-clinical evaluation of new antineoplastic drugs and may help to elucidate drug activities and mechanisms of action.
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Affiliation(s)
- R A Nagourney
- Memorial Cancer Institute, Long Beach, California 90806
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Wilbur DW, Camacho ES, Hilliard DA, Dill PL, Weisenthal LM. Chemotherapy of non-small cell lung carcinoma guided by an in vitro drug resistance assay measuring total tumour cell kill. Br J Cancer 1992; 65:27-32. [PMID: 1310250 PMCID: PMC1977362 DOI: 10.1038/bjc.1992.5] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Specimens from 45 patients with previously-untreated non-small cell lung cancer (NSCLC) were tested for in vitro chemosensitivity to ten drugs utilising the DiSC assay, which measures cell kill in the total (largely non-dividing) tumour cell population. Thirty-five assays were successful and 25 patients with advanced disease subsequently received chemotherapy with the 'best' three drugs selected by the assay. Six patients were Karnofsky performance status 60 or less and the median pretreatment weight loss was 8.5%. Nine patients had a partial response (response rate = 36%; 95% confidence interval = 17-55%) and the median survival of all patients was 202 days. Specimens from responding patients were significantly more sensitive in the assay to drugs in general (especially to etoposide and to 'natural product' drugs) and to the drugs used in treatment than were specimens from non-responding patients. In vitro drug resistance differences between responding and non-responding patients were of greater significance than were differences between other clinical and laboratory measurements. Assay results classified patients into two cohorts, having relatively high and low probabilities of responding to chemotherapy. Assay results also identified patient cohorts with above average and below average durations of survival. Five patients (20%) were found to have tumours with extreme drug resistance (EDR), defined as assay results for the average of all ten tested drugs falling greater than one standard deviation more resistant than the median for all tumours assayed, and none of these patients with EDR responded to chemotherapy.
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Affiliation(s)
- D W Wilbur
- Pettis Memorial Veterans Hospital, Loma Linda, CA 92357
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Weisenthal LM, Kern DH. Prediction of drug resistance in cancer chemotherapy: the Kern and DiSC assays. Oncology (Williston Park) 1991; 5:93-103; disc. 104, 111-4, 117-8. [PMID: 1835882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In the opinion of the authors, good medical practice demands the avoidance of ineffective therapies and good cancer chemotherapy generally demands the avoidance of inactive drugs. The authors present their viewpoint that randomized trials are not required to prove that physicians should not administer inactive drugs and that existing cell culture assays are acceptably accurate in identifying inactive drugs. They describe and advocate the use of two such tests to aid in choosing between different forms of therapy that would otherwise be equally acceptable in the absence of test information. Strengths, weaknesses, and applications of the assays are discussed.
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Weisenthal LM, Dill PL, Pearson FC. Effect of prior cancer chemotherapy on human tumor-specific cytotoxicity in vitro in response to immunopotentiating biologic response modifiers. J Natl Cancer Inst 1991; 83:37-42. [PMID: 1984515 DOI: 10.1093/jnci/83.1.37] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Tumor-specific cytotoxicity was measured in fresh human biopsy specimens by a modification of the differential staining cytotoxicity assay. ImuVert, a cytokine inducer derived from Serratia marcescens, which produces broad-spectrum activation of both macrophages and lymphocytes, was dramatically more effective when it was tested in tumors obtained from patients with previously treated, chemotherapy-responsive adenocarcinomas (breast and ovary) than when it was tested in tumors obtained from either previously untreated patients or previously treated patients with chemotherapy-refractory adenocarcinomas (colon, lung, pancreas, stomach, kidney, gallbladder, uterus, and prostate). Similar findings, relating to prior chemotherapy treatment status, were obtained for tumor necrosis factor and interferon gamma, but not for interleukin-2 or interferon alpha. On the basis of these findings and on other evidence in the literature, we speculate that response to chemotherapy produces massive release and processing of tumor antigens. We further speculate that this response leads to a state in which the human immune system is primed (via in situ vaccination) to respond to exogenous macrophage-activation signals with potent, specific antitumor effects.
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Nagourney RA, Messenger JC, Kern DH, Weisenthal LM. Enhancement of anthracycline and alkylator cytotoxicity by ethacrynic acid in primary cultures of human tissues. Cancer Chemother Pharmacol 1990; 26:318-22. [PMID: 1698567 DOI: 10.1007/bf02897285] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Ethacrynic acid [2,3-dichloro-4-(2-methylene-1-oxobutyl)phenoxyl] acetic acid, is a water-soluble diuretic agent that has been shown to potentiate the in vitro cytotoxicity of chemotherapeutic agents in established cell lines. We used the differential staining cytotoxicity (DiSC) assay to determine whether ethacrynic acid at 1 and 3.3 microM would potentiate the cytotoxicity of nitrogen mustard and/or doxorubicin in primary cultures of hematologic neoplasms from heavily pretreated patients and in normal peripheral blood lymphocytes. At 3.3 microM, ethacrynic acid was toxic to 8 of 24 (33%) tumor specimens studied. In subsequent studies, ethacrynic acid at 1 microM was toxic to only 2 of 54 (4%) tumor specimens. Significant enhancement for doxorubicin or nitrogen mustard was confined to lymphatic malignancies and to normal peripheral blood lymphocytes. Interspecimen variability was observed, with no enhancement in most individual specimens, 2-fold enhancement in some specimens, and 4-fold enhancement in occasional specimens. Clinical trials will be required to determine whether the observed in vitro activity for ethacrynic acid is associated with clinical benefit in unselected or assay-selected patients.
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Kern DH, Weisenthal LM. Highly specific prediction of antineoplastic drug resistance with an in vitro assay using suprapharmacologic drug exposures. J Natl Cancer Inst 1990; 82:582-8. [PMID: 2313735 DOI: 10.1093/jnci/82.7.582] [Citation(s) in RCA: 140] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Bayes' theorem has been used to describe the relationship between the accuracy of a predictive test (posttest probability) and the overall incidence of what is being tested (pretest probability). Bayes' theorem indicates that laboratory assays will be accurate in the prediction of clinical drug resistance in tumors with high overall response rates (e.g., previously untreated breast cancer) only when the assays are extremely (greater than 98%) specific for drug resistance. We developed a highly specific drug-resistance assay in which human tumor colonies were cultured in soft agar and drugs were tested at high concentrations for long exposure times. Coefficients for concentration x time exceeded those reported in contemporaneous studies by about 100-fold. We reviewed 450 correlations between assay results and clinical response over an 8-year period. Results were analyzed by subsets, including different tumor histologies, single agents, and drug combinations. Extreme drug resistance (an assay result greater than or equal to SD below the median) was identified with greater than 99% specificity. Only one of 127 patients with tumors showing extreme drug resistance responded to chemotherapy. This negligible posttest probability of response was independent of pretest (expected) probability of response. Once this population of patients with tumors showing extreme drug resistance had been identified, posttest response probabilities for the remaining cohorts of patients varied according to both assay results and pretest response probabilities, precisely according to predictions based on Bayes' theorem. This finding allowed the construction of a nomogram for determining assay-predicted probability of response.
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Affiliation(s)
- D H Kern
- Oncotech, Inc., Irvine, CA 92714
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12
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Kurohara W, Colman M, Nagourney RA, Weisenthal LM, Swingle K, Redpath JL. Radiation response of cells from human tumor biopsies as assessed by a dye exclusion technique: a possible predictive assay. Int J Radiat Biol 1989; 56:767-70. [PMID: 2479699 DOI: 10.1080/09553008914552021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- W Kurohara
- Division of Radiation Oncology, University of California, Irvine 92717
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McGuire WL, Kern DH, Von Hoff DD, Weisenthal LM. In vitro assays to predict drug sensitivity and drug resistance. A panel discussion. Breast Cancer Res Treat 1988; 12:7-21. [PMID: 3196887 DOI: 10.1007/bf01805735] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- W L McGuire
- University of Texas Health Science Center, San Antonio
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Weisenthal LM, Su YZ, Duarte TE, Dill PL, Nagourney RA. Perturbation of in vitro drug resistance in human lymphatic neoplasms by combinations of putative inhibitors of protein kinase C. Cancer Treat Rep 1987; 71:1239-43. [PMID: 3480042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Fresh specimens of human lymphatic neoplasms were tested with the differential staining cytotoxicity assay. Cells from relapsed patients with acute lymphoblastic leukemia (ALL) were significantly more resistant to vincristine, dexamethasone, and doxorubicin in the assay than were cells from previously untreated patients. The putative C kinase inhibitors verapamil (V), imipramine (I), lidocaine (L), tamoxifen (T), chlorpromazine (C), and haloperidol (H) were then tested singly, in combination with each other (VILTCH, ITCH, and VL), and in combination with vincristine. At concentrations judged to be clinically achievable, VILTCH itself was occasionally toxic to ALL and chronic lymphocytic leukemia. The VILTCH combination clearly potentiated the cytotoxic activity of vincristine in five of eight ALL specimens from relapsed patients and potentiated vincristine in 18 of 30 chronic lymphocytic leukemia specimens. It also potentiated vincristine in two of six specimens of multiple myeloma and five of six specimens of non-Hodgkin's lymphoma. The VILTCH combination had no significant effects in fresh cultures of normal human lymphocytes. The most active drugs in the VILTCH combination appeared to be verapamil and lidocaine. We conclude that the differential staining cytotoxicity assay is a useful tool to study the circumvention of clinically acquired drug resistance. While the mechanism of the observed enhancement of the cytotoxic effects of vincristine is not known, it is possible that combinations of putative C kinase inhibitors may reduce drug resistance in human lymphatic neoplasms.
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Su YZ, Duarte TE, Dill PL, Weisenthal LM. Selective enhancement by menadiol of in vitro drug activity in human lymphatic neoplasms. Cancer Treat Rep 1987; 71:619-25. [PMID: 3581100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The effect of menadiol (vitamin K3) on fresh specimens of human lymphatic neoplasms (HLN) was tested by means of the differential staining cytotoxicity assay. Menadiol was tested alone and in combination with standard antineoplastic agents. Drug effects were then compared with the effects of the same drugs in normal human lymphocytes and in fresh specimens of human non-small cell lung cancer. By itself, menadiol was moderately toxic to HLN, but not to normal lymphocytes or non-small cell lung cancer. Menadiol, menadione, and two structurally related congeners were equitoxic to HLN cells, but sodium metabisulfite (present in menadiol solutions as a preservative) was nontoxic. Menadiol increased the cytotoxic effects of a number of standard agents in HLN but not in normal lymphocytes. Cell survival times with mechlorethamine, vincristine, and dexamethasone were converted from a range characteristic of drug resistance (ie, range observed in relapsed patients) to a range characteristic of drug sensitivity (ie, range observed in untreated patients) in the presence of menadiol. These effects occurred at a concentration (2.0 micrograms/ml; 4.7 microM) of menadiol which is probably clinically achievable and which did not deplete intracellular glutathione. Menadiol should receive clinical testing as a chemosensitizing agent in HLN.
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Weisenthal LM. Clones, dyes, nuclides, mouse kidneys, and ... virions: a new-clonogenic assay for tumor chemosensitivity. Eur J Cancer Clin Oncol 1987; 23:9-12. [PMID: 3595687 DOI: 10.1016/0277-5379(87)90412-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Weisenthal LM, Dill PL, Finklestein JZ, Duarte TE, Baker JA, Moran EM. Laboratory detection of primary and acquired drug resistance in human lymphatic neoplasms. Cancer Treat Rep 1986; 70:1283-95. [PMID: 2429763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We tested the ability of the differential staining cytotoxicity (DiSC) assay to discriminate between sensitive and resistant cell populations in human lymphatic neoplasms. First, the in vitro activity spectra of the most important drugs paralleled the known clinical activity spectra of the same agents. Second, there were highly significant correlations between in vitro chemosensitivity and the results of clinical chemotherapy. Third, specimens from previously untreated patients were significantly more sensitive to the most important drugs than were specimens from patients who had previously received chemotherapy. Finally, metachronous assays performed on specimens from the same patients showed little change in chemosensitivity if there had been no intervening chemotherapy between the times that the first and second assays were performed. However, if the patients had received intervening chemotherapy between the times of the first and second assays, the specimens in the second assays tended to be significantly more resistant than were the specimens in the first assays. These data indicate that the DiSC assay may be of value in the design of strategies to circumvent drug resistance in human lymphatic neoplasms.
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Weiner RS, Kramer BS, Clamon GH, Feld R, Evans W, Moran EM, Blum R, Weisenthal LM, Pee D, Hoffman FA. Effects of intravenous hyperalimentation during treatment in patients with small-cell lung cancer. J Clin Oncol 1985; 3:949-57. [PMID: 2991475 DOI: 10.1200/jco.1985.3.7.949] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
One hundred nineteen patients were entered onto a randomized trial of the role of intravenous hyperalimentation (IVH) in patients with small-cell lung cancer. IVH was given during the first 30 days of induction chemotherapy to 54 patients. IVH did not effect any improvement in response or survival from therapy. In view of the lack of benefits from IVH, an analysis was made of the toxicities suffered by the 54 patients receiving IVH as well as any effects IVH might have made on chemotherapy-induced toxicity. Toxicities observed included mechanical difficulties with the catheter leading to temporary or permanent discontinuation of the IVH (11 patients), subclavian vein thrombosis (one patient), sepsis in nine patients v none of the 62 control patients, fluid overload (27 patients), hyponatremia (25 patients), and hyperglycemia requiring insulin (13 patients). Patients receiving IVH had higher granulocyte counts on days 14 and 21 of the first cycle of chemotherapy. Analysis shows that this difference is likely caused by fever and infection associated with IVH rather than any nutritional effect on granulopoiesis. In this population of patients, IVH had significant complications but did not ameliorate chemotherapy-induced toxicity and it did not effect any clinical benefit. Future studies of adjunctive nutritional therapy must consider the significant risk in this older population and must limit IVH volume or exclude patients with even mild compromise in cardiovascular functions. Further, any new trial must have a significant rationale for adjunctive use to justify the potential risks.
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Weisenthal LM, Lippman ME. Clonogenic and nonclonogenic in vitro chemosensitivity assays. Cancer Treat Rep 1985; 69:615-32. [PMID: 3893692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We need practical laboratory methods for predicting the chemosensitivity of human neoplasms. Over the past 20 years, numerous investigators have implied or stated with increasing certitude that clonogenic assays are the most valid (or only valid) approach to predictive chemosensitivity testing. We feel that this point of view may have insufficient scientific validity and may be harmful to progress in this area. In addition to well-known technical problems, there are serious theoretical problems with clonogenic assays. These include the disruption of normal cell-to-cell interactions, the possibility that true tumor stem cells may be largely nondividing (G0) cells, while cells forming colonies are exclusively dividing cells, the possibility that clonogenic cells may largely represent cells which are not true stem cells, and the fact that clonogenic assays have the ability to measure cell kill over a narrow log range, while meaningful clinical responses require a multiple-log cell kill. This latter fact mandates the use of unrealistically low drug concentrations to avoid excessive false-positive results. Neither theoretical concepts, direct experimental data, nor clinical correlations support the alleged superiority of clonogenic assays. Clonogenic assays may not be advantageous compared to other more practical methods of estimating the general chemosensitivity of proliferating cells. In contrast, there is a growing body of literature which indicates that early evidence of cell damage in the entire tumor cell population may accurately predict for a multiple-log stem cell kill and meaningful clinical response. Future studies should continue to develop and test assays based on alternative methods for detecting cell kill in the proliferating and total tumor cell populations.
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Weisenthal LM, Shoemaker RH, Marsden JA, Dill PL, Baker JA, Moran EM. In vitro chemosensitivity assay based on the concept of total tumor cell kill. Recent Results Cancer Res 1984; 94:161-73. [PMID: 6494576 DOI: 10.1007/978-3-642-82295-7_16] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Abstract
Clinically significant hemorrhage immediately after percutaneous liver biopsy is an uncommon, although well-recognized risk of the procedure. However, hemorrhage from the biopsy site delayed a day or more after the procedure is a seldom-appreciated potential complication. Delayed hemorrhage from the liver biopsy site may go unsuspected; in fact, the patient may no longer be under direct medical surveillance. We describe two cases of such delayed hemorrhage which we attribute to intrahepatic hematoma at the site of biopsy. Neither patient had a prebiopsy contraindication to the procedure. One patient suffered a fatal intraperitoneal hemorrhage 15 days after liver biopsy, the other a massive, but nonfatal intrahepatic hemorrhage 41 hours after the procedure. In the first patient, a hemorrhagic diathesis developed in the immediate period after biopsy; no predisposition to hemorrhage could be identified in the latter patient, even retrospectively. The admittedly rare possibility of delayed hemorrhage should be considered whenever a liver biopsy is performed.
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Abstract
The chemosensitivity of fresh specimens of human transitional cell carcinoma was tested using a novel dye exclusion assay based upon Fast Green staining, cytocentrifugation, and H & E counterstaining. Assays were successful (three or more drugs tested) in 22/24 specimens obtained by cytoscopy and 2/2 specimens obtained by open biopsy. Three of 17 specimens had more than 70% cell kill after a 1-hour exposure to thiotepa (500 micrograms/ml), compared with 10/18 after exposure to mitomycin C (250 micrograms/ml), and 19/19 after exposure to doxorubicin (100 micrograms/ml). There was a trend for specimens with high histologic grades or low control viabilities in short-term culture to be more sensitive to mitomycin C than specimens with low histologic grades or high control viabilities. Comparison of these data with published clinical data suggests that intrinsic chemosensitivity may be the most important determinate of clinical response to intravesical chemotherapy with thiotepa, while drug penetration to the tumor cells may primarily determine clinical response to intravesical doxorubicin. Thiotepa may be most valuable in treating large lesions which are intrinsically sensitive, while doxorubicin may be valuable in nearly all small lesions. Improved drug distribution to tumor sites could improve intravesical therapy with doxorubicin.
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Weisenthal LM, Marsden JA, Dill PL, Macaluso CK. A novel dye exclusion method for testing in vitro chemosensitivity of human tumors. Cancer Res 1983; 43:749-57. [PMID: 6184155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Dissociated cancer cells are exposed to antineoplastic drugs (5 X 10(4) viable cells/drug for 1 hr or continuously) and cultured for 4 to 6 days in liquid medium. Cells are then stained with Fast green dye, sedimented onto slides with a Cytospin centrifuge, and counterstained with a modified hematoxylin and eosin technique. Dead cells stain with Fast green, and living cells stain with hematoxylin and eosin. Cell kill is calculated as percentage of control based on the relative numbers of living tumor cells, living non-tumor cells, and dead cells. Drug sensitivity could be assayed in 125 of 162 specimens of human neoplasms obtained from malignant effusions (16 of 18), excisional biopsies (31 of 44), needle biopsies (34 of 47), endoscopic biopsies (18 of 23), peripheral blood samples (19 of 20), and bone marrow aspirates (five of seven). The assays were successful (median of ten drugs tested) in: 46 of 64 adenocarcinomas; four of 11 squamous cell carcinomas; five of seven lymphomas; six of seven melanomas; two of four sarcomas; 18 of 20 transitional-cell carcinomas; 14 of 15 small-cell carcinomas; seven of eight myelomas; 12 of 12 chronic lymphocytic leukemias; seven of nine acute leukemias, and four of five "undifferentiated" carcinomas. The assay results demonstrated a strong correlation between the in vitro chemosensitivity of different types of tumors and the known clinical response patterns of these tumors. This assay can be used to determine which specific cells are killed in a heterogeneous cell population. Further work is needed to determine if this assay may be useful in blind screening trials for antineoplastic agents or if it may be of clinical use in predicting response to agents which are not cycle specific.
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Weisenthal LM, Dill PL, Kurnick NB, Lippman ME. Comparison of dye exclusion assays with a clonogenic assay in the determination of drug-induced cytotoxicity. Cancer Res 1983; 43:258-64. [PMID: 6571706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The following factors must be considered when dye exclusion assays are interpreted. (a) It may require several days for lethally damaged cells to lose their membrane integrity following a cytotoxic insult. (b) During this time, the "surviving" cells may continue to proliferate. (c) Also during this time, some lethally damaged cells may undergo an early disintegration, so that they are not present to be stained with dye at the end of the culture period. Factors b and c may cause an underestimate of cell kill when the results of the assay are based upon the traditional "percent viability" expression. In order to overcome these problems, an internal standard was developed and tested. This was based upon the addition of a constant number of permanently fixed duck erythrocytes to the cultures of cells from two different established tumor cell lines. Results were based upon comparisons of the ratios of "viable" tumor cells to duck erythrocytes on permanent cytocentrifuge slides prepared from the cultures. This novel "ratio" method was found to be a more sensitive index of drug-induced cell kill than the traditional percent viability method. A standard agar cloning assay gave somewhat higher estimates of cell kill than the ratio method, although both assays were in qualitative agreement for the drugs tested. All three assays demonstrated a clear dose-effect relationship for most of the drugs tested. Dye exclusion assays may have a useful role in chemosensitivity testing in vitro.
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Weisenthal LM. In vitro assays in preclinical antineoplastic drug screening. Semin Oncol 1981; 8:362-76. [PMID: 7034203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Weisenthal LM. Treatment of small cell lung cancer - 1981. Arch Intern Med 1981; 141:1499-501. [PMID: 6269510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Abstract
Cells from bronchoscopy washings from 30 patients with lung cancer were plated in tissue culture using a human tumor stem cell assay technique. These culture results were subsequently compared to routine cytology readings carried out on the same specimens. The stem cell culture showed colony growth from 9 of 11 cytologically positive bronchoscopy washing specimens. More colonies grew from cytologically positive specimens (average of six colonies per plate) than from cytologically negative specimens (average of 0.8 colonies per plate). With additional refinements, the stem cell culture system could be used to improve the diagnostic yield of bronchoscopy washings. However, at present, the low number of tumor colonies grown from the washings precludes performing chemosensitivity studies on tumor cells from the bronchoscopy washing specimens.
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Ruddon RW, Weisenthal LM, Lundeen DE, Bessler W, Goldstein IJ. Stimulation of mitogenesis in normal and leukemic human lymphocytes by divalent and tetravalent lima bean lectins. Proc Natl Acad Sci U S A 1974; 71:1848-51. [PMID: 4525297 PMCID: PMC388339 DOI: 10.1073/pnas.71.5.1848] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Two hemagglutinating components purified from the lima bean and composed of identical 62,000-molecular-weight subunits have mitogenic activity in normal and leukemic human lymphocyte cultures. Component II (247,000 molecular weight), a tetramer with four saccharide binding sites, is severalfold more active than component III (124,000 molecular weight), a dimer with two binding sites per molecule, as a mitogen for normal lymphocytes. Component II also stimulates mitogenesis in populations of cultured leukemic lymphocytes and appears to have greater activity than phytohemagglutinin-P in leukemic lymphocyte cultures obtained from some patients. Lima bean component III has minimal mitogenic activity toward leukemic lymphocytes. Components II and III appear to compete for the same cell-surface binding sites, but component II has a much greater capacity than component III to trigger DNA synthesis at low concentrations (2.5-25 mug/ml) in normal lymphocyte cultures. These results suggest that the mitogenic activity of lima bean lectin components is directly related to their valence.
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Weisenthal LM, Ruddon RW. Catabolism of nuclear proteins in control and phytohemagglutinin-stimulated human lymphocytes, leukemic leukocytes, and Burkitt lymphoma cells. Cancer Res 1973; 33:2923-35. [PMID: 4355986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Weisenthal LM, Ruddon RW. Characterization of human leukemia and Burkitt lymphoma cells by their acidic nuclear protein profiles. Cancer Res 1972; 32:1009-17. [PMID: 4502171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Weisenthal LM, Hug CC, Weisbrodt NW, Bass P. Adrenergic mechanisms in the relaxation of guinea-pig taenia coli in vitro. J Pharmacol Exp Ther 1971; 178:497-508. [PMID: 5571900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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