Gemcitabine (gem) is a nucleoside anticancer agent that inhibits cell cycle in S-phase and is registered clinically for the treatment of a number of solid tumors. A prodrug of gemcitabine, LY2334737, was developed for oral administration for metronomic dosing with the aim of growth inhibition of more tumor cells as they go through the cell cycle. LY is well absorbed and systemically cleaved in humans. The rate of hydrolysis is slow resulting in circulating levels of LY that are 10-fold higher than gemcitabine in plasma. Studies with cell lines and recombinant protein indicate that LY is cleaved to gemcitabine by carboxylesterase 2 (CES2). Because LY circulates in the plasma for an extended period of time, we wondered if expression of CES2 by the tumor could alter its response to the prodrug. The present study was undertaken to determine if the expression of CES2 alters cellular response to LY in vitro and in vivo. The constitutive expression of CES2 in SKOV-3 was knocked down by shRNA. A stable subclone was obtained that had CES2 expression reduced by 80%.

Stable HCT-116 transfectants were prepared that overexpressed CES2. Cell lines, transfectants and knock down cells were evaluated for drug sensitivity in a cytotoxicity assay. They were also evaluated for CES2 expression by biochemical cellular assay, Western analysis, and qRT-PCR. A xenograft study was conducted employing transfected HCT-116 cells. Immunohistochemical (IHC) staining was used to evaluate cell lines and tumors for CES2 expression. LY was less cytotoxic to SKOV-3 cells when CES2 was knocked down while sensitivity to gem was unaltered. Transfection of CES2 into low CES2 endogenously expressing HCT-116 cells enhanced LY drug sensitivity with no change in gemcitabine sensitivity. Stably transfected CES2 and mock HCT-116 transfectants were grown as a xenograft. The transfectants had identical growth rates in vivo and were equally sensitive to gem treatment. IHC staining of the tumors indicated that CES2 expression was maintained throughout the growth period. CES2 expressing tumors demonstrated a statistically significant greater response to LY than mock transfectant tumors. Taken together, these studies indicate that CES2 cleaves the prodrug and tumor expression of CES2 can enhance response to treatment with LY2334737.

Citation Information: Clin Cancer Res 2010;16(14 Suppl):B30.