Prediction of individual response to anticancer therapy: historical and future perspectives.

Since the introduction of chemotherapy for cancer treatment in the early 20th century considerable efforts have been made to maximize drug efficiency and at the same time minimize side effects. As there is a great interpatient variability in response to chemotherapy, the development of predictive biomarkers is an ambitious aim for the rapidly growing research area of personalized molecular medicine. The individual prediction of response will improve treatment and thus increase survival and life quality of patients. In the past, cell cultures were used as in vitro models to predict in vivo response to chemotherapy. Several in vitro chemosensitivity assays served as tools to measure miscellaneous endpoints such as DNA damage, apoptosis and cytotoxicity or growth inhibition. Twenty years ago, the development of high-throughput technologies, e.g. cDNA microarrays enabled a more detailed analysis of drug responses. Thousands of genes were screened and expression levels were correlated to drug responses. In addition, mutation analysis became more and more important for the prediction of therapeutic success. Today, as research enters the area of -omics technologies, identification of signaling pathways is a tool to understand molecular mechanism underlying drug resistance. Combining new tissue models, e.g. 3D organoid cultures with modern technologies for biomarker discovery will offer new opportunities to identify new drug targets and in parallel predict individual responses to anticancer therapy. In this review, we present different currently used chemosensitivity assays including 2D and 3D cell culture models and several -omics approaches for the discovery of predictive biomarkers. Furthermore, we discuss the potential of these assays and biomarkers to predict the clinical outcome of individual patients and future perspectives.

The ability of the high-throughput comet assay to measure the sensitivity of five cell lines toward methyl methanesulfonate, hydrogen peroxide, and pentachlorophenol.

A new, high-throughput version of the comet assay was developed using human fibroblasts (Stang and Witte, 2009). The present study examines the suitability of other adherent and non-adherent cell types in this high-throughput assay. We found that in addition to V79 human fibroblasts, HeLa cells, Hep-G2 cells, and lymphocytes can be used. The time intervals needed for attachment on the agarose-coated 96-well multi-chamber plate (MCP, specially developed for the high-throughput comet assay) differed for all adherent cell lines mentioned. V79 cells needed 6h for attachment, fibroblasts 2-4h, Hep-G2 required 18 h, and HeLa cells 16 h. After this period, chemical treatment could occur. Non-adherent lymphocytes could be treated with the chemicals directly after they had been pipetted into the wells of the MCP and centrifuged. We compared the sensitivities of these five cell types toward the directly DNA-damaging compounds methyl methanesulfonate (MMS), and hydrogen peroxide (H(2)O(2)), and toward the indirectly acting agent pentachlorophenol (PCP). Except for Hep-G2 cells, exposure to PCP was conducted in the presence of an S9 microsome fraction. DNA damage, measured as an increase in the percentage of DNA in the tail region of the comets, occurred in a concentration-dependent manner. Under the test conditions used in this study, human lymphocytes were the most sensitive cells toward the three chemicals tested, fibroblasts showed a similar sensitivity toward the directly acting MMS and H(2)O(2), but were less sensitive toward PCP. HeLa, V79, and Hep-G2 cells reacted with similar sensitivity.

DNA damage induced by cis- and carboplatin as indicator for in vitro sensitivity of ovarian carcinoma cells.

BACKGROUND: The DNA damage by platinum cytostatics is thought to be the main cause of their cytotoxicity. Therefore the measurement of the DNA damage induced by cis- and carboplatin should reflect the sensitivity of cancer cells toward the platinum chemotherapeutics. METHODS: DNA damage induced by cis- and carboplatin in primary cells of ovarian carcinomas was determined by the alkaline comet assay. In parallel, the reduction of cell viability was measured by the fluorescein diacetate (FDA) hydrolysis assay. RESULTS: While in the comet assay the isolated cells showed a high degree of DNA damage after a 24 h treatment, cell viability revealed no cytotoxicity after that incubation time. The individual sensitivities to DNA damage of 12 tumour biopsies differed up to a factor of about 3. DNA damage after a one day treatment with cis- or carboplatin correlated well with the cytotoxic effects after a 7 day treatment (r = 0,942 for cisplatin r = 0.971 for carboplatin). In contrast to the platinum compounds the correlation of DNA damage and cytotoxicity induced by adriamycin was low (r = 0,692), or did not exist for gemcitabine. CONCLUSION: The measurement of DNA damage induced by cis- and carboplatin is an accurate method to determine the in vitro chemosensitivity of ovarian cancer cells towards these cytostatics, because of its quickness, sensitivity, and low cell number needed.

Microelectrochemical modulation of micropatterned cellular environments.

Patterned cell cultures obtained by microcontact printing have been modified in situ by a microelectrochemical technique. It relies on lifting cell-repellent properties of oligo(ethylene glycol)-terminated self-assembled monolayers (SAMs) by Br2, which is produced locally by an ultramicroelectrode of a scanning electrochemical microscope (SECM). After Br2 treatment the SAM shows increased permeability and terminal hydrophobicity as characterized by SECM approach curves and contact angle measurements, respectively. Polarization-modulation Fourier transform infrared reflection-absorption spectroscopic (PM FTIRRAS) studies on macroscopic samples show that the Br2 treatment removes the oligo(ethelyene glycol) part of the monolayer within a second time scale while the alkyl part of the SAM degrades with a much slower rate. The lateral extension of the modification can be limited because heterogeneous electron transfer from the gold support destroys part of the electrogenerated Br2 once the monolayer is locally damaged in a SECM feedback configuration. This effect has been reproduced and analyzed by exposing SAM-modified samples to Br2 in the galvanic cell Au|SAM|5 microM Br2 + 0.1 M Na2SO4||10 microM KBr + 0.1 M Na2SO4|Au followed by an PM FTIRRAS characterization of the changes in the monolayer system.

Genetic toxicity assessment: employing the best science for human safety evaluation part III: the comet assay as an alternative to in vitro clastogenicity tests for early drug candidate selection.

Early screening of drug candidates for genotoxicity typically includes an analysis for mutagenicity in bacteria and for clastogenicity in cultured mammalian cells. In addition, in recent years, an early assessment of photogenotoxicity potential has become increasingly important. Also, for screening purposes, expert computer systems can be used to identify structural alerts. In cases where structural alerts are identified, mutagenicity testing limited to bacteria can be conducted. The sequence of computer-aided analysis and limited testing using bacteria allows for screening a comparatively large number of drug candidates. In contrast, considerably more resources, in terms of supplies, technical time, and the amount of a test substance needed, are required when screening for clastogenic activity in mammalian cells. In addition, the relatively large percentage of false positive results for rodent carcinogenicity associated with clastogenicity assays is of considerable concern. As a consequence, mammalian cell-based alternatives to clastogenicity assays are needed for early screening of mammalian genotoxicity. The comet assay is a relatively fast, simple, and sensitive technique for the analysis of DNA damage in mammalian cells. This assay seems especially useful for screening purposes because false positives associated with excessive toxicity appear to occur less frequently, only relatively small amounts of a test compound are needed, and certain steps of the test procedure can be automated. Therefore, the in vitro comet assay is proposed as an alternative to cytogenetic assays in early genotoxicity/photogenotoxicity screening of drug candidates.

Differences in genotoxicity of H(2)O(2) and tetrachlorohydroquinone in human fibroblasts.

During autoxidation of the pentachlorophenol (PCP) metabolite tetrachlorohydroquinone (TCHQ) the semiquinone is formed as well as reactive oxygen species (ROS). It was examined if *OH or the semiquinone are the cause of TCHQ-induced genotoxicity by direct comparison of TCHQ- and H(2)O(2)-induced DNA damage in human cells. All endpoints tested (DNA damage, DNA repair, and mutagenicity) revealed a greater genotoxic potential for TCHQ than for H(2)O(2). In the comet assay, TCHQ induced DNA damage at lower concentrations than H(2)O(2). The damaging rate by TCHQ (tail moment (tm)/concentration) was 10-fold greater than by H(2)O(2). DNA repair was lower for TCHQ than for H(2)O(2) treatment. This was shown by measuring DNA repair in the unscheduled DNA synthesis (UDS) assay and the persistence of the DNA damage in the comet assay. In contrast to H(2)O(2), TCHQ in non-toxic concentrations was mutagenic in the hypoxanthine-guanine phosphoribosyltransferase (HPRT) locus of V79 cells. Finally, there were also differences observed in cytotoxicity (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay) of TCHQ and H(2)O(2). Whereas the TCHQ cytotoxicity was enhanced during a 21h recovery phase, the H(2)O(2) cytotoxicity did not change. The results demonstrated that the pronounced genotoxic properties of TCHQ in human cells were not caused by *OH radicals but more likely by the tetrachlorosemiquinone (TCSQ) radical.