Our studies have shown that unconjugated antibody therapy targeted to the B-cell marker CD20 by the anti-CD20 antibody, C2B8, inhibits the growth of B-cell lymphomas in vitro. We have also demonstrated that B-lymphoma tumor cells can be sensitized to subtoxic doses of therapeutic drugs by the same antibody.
The objective of these studies is to delineate the mechanism by which C2B8 alters B lymphoma cells, leading to inhibition of tumor cell growth and sensitization to chemotherapeutic drugs. This study was designed to examine: (1) whether C2B8 sensitizes the drug- and toxin-resistant 2F7 cell line to tumor necrosis factor-alpha (TNF-alpha), cisplatin(Drug information on cisplatin) (Platinol), fludarabine (Fludara), doxorubicin(Drug information on doxorubicin) (Adriamycin and others), and diphtheria toxin (DTX); (2) whether C2B8 regulates interleukin-10 (IL-10) secretion; (3) whether IL-10 is a resistance factor in 2F7; and (4) whether C2B8 sensitization regulates oncogenes and/or tumor-suppressor genes.
We demonstrate that C2B8 sensitizes 2F7 to doxorubicin, fludarabine, TNF-alpha, and DTX-mediated cytotoxicity in a synergistic manner. Furthermore, C2B8-targeted 2F7 downregulates IL-10 expression and secretion after 24 and 72 hours of treatment.
Interleukin-10 has been shown to function as a resistance factor and protects the tumor cells from the cytotoxic effects of therapeutic drugs. We postulate that one method by which CD20 activation reverses drug resistance involves IL-10 autocrine loops, which modulate regulatory apoptotic proteins within the cell. This postulate is verified by demonstrating that the addition of exogenous IL-10 to C2B8-treated 2F7 caused a recovery of the cells, decreasing the ability of C2B8 to sensitize.
We have also shown that C2B8 treatment downregulates the expression of bcl-2 after only 4 hours. Involvement of bcl-2 could explain resistance involved (and reversed) in an array of cytotoxic drugs. Furthermore, C2B8 induces the upregulation of BTG-1 in 2F7 cells. BTG-1 is a member of a family of proteins that induce cell cycle arrest.
CONCLUSION: The present findings demonstrate that the C2B8 antibody exerts many activities on B-cell lymphoma, namely: (1) inhibition of cell growth; (2) downregulation of the secretion of the protective factor IL-10; (3) downregulation of the antiapoptotic Bcl-2 protein; and (4) sensitization of lymphoma to several cytotoxic drugs through IL-10 and Bcl-2 modulation.
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A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
