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Prepublished online as a Blood First Edition Paper on March 13, 2003; DOI 10.1182/blood-2002-09-2975.

Submitted October 1, 2002
Accepted March 4, 2003
The proteasome inhibitor PS-341 sensitizes neoplastic cells to TRAIL-mediated apoptosis by reducing levels of c-FLIP
Thomas J Sayers*, Alan D Brooks, Crystal Y Koh, Weihong Ma, Naoko Seki, Arati Raziuddin, Bruce R Blazar, Xia Zhang, Peter J Elliott, and William J Murphy
Center for Cancer Research, National Cancer Institute-Frederick, Frederick, MD, USA
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
Department of Drug Development, Millennium Pharmaceuticals, Boston, MA, USA
* Corresponding author; email: sayers{at}mail.ncifcrf.gov.
Due to the pivotal role the proteasome plays in apoptosis, inhibitors of this enzyme, such as PS-341, provide a great opportunity for exploring synergy between proteasome inhibition and other apoptosis-inducing agents. Tumor necrosis factor-related apoptosis inducing ligand (TRAIL) can selectively induce apoptosis in tumor cells. In overnight assays, combinations of PS-341 and TRAIL were much more effective than either agent alone in promoting apoptosis of a murine myeloid leukemia C1498 and a murine renal cancer Renca. For C1498 cells, apoptosis sensitization by PS-341 affected neither the activity of NF- B, nor the levels of most antiapoptotic proteins. However, reductions in the antiapoptotic protein c-FLIP in response to PS-341 were observed in both C1498 and Renca cells. Treatment of normal bone marrow mixed with C1498 tumor cells for 18 hours with a combination of PS-341 and TRAIL resulted in a specific depletion of the tumor cells. Upon transfer to irradiated syngeneic recipient mice mixtures treated with the PS-341 plus TRAIL combination resulted in enhanced long-term tumor-free survival of mice. These data therefore support the targeting of apoptotic pathways in tumor cells, using combinations of agents such as PS-341 and TRAIL that interact synergistically to preferentially promote tumor cell apoptosis.

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