Purpose: To study in vitro the effect of carboplatin and/or hyperthermia in
relation to etoposide (VP-16) cytotoxicity in L929 cells. Methodology/resu
lts: Cell survival assays demonstrated that the addition of 41.8 degreesC (
x60 min) hyperthermia and carboplatin to VP-16 produced an antagonistic eff
ect relative to VP-16 cytotoxicity in L929 cells; administering carboplatin
and hyperthermia 24 h before VP-16 reduced this drug resistance; administe
ring carboplatin and hyperthermia 48 h before VP-16, however, produced a su
pra-additive cytotoxicity. In order to gain insight into the molecular basi
s for these observations, we investigated the effect of hyperthermia and/or
carboplatin on the stress protein GRP78, which is known to affect VP-16 cy
totoxicity. Results obtained were consistent with the hypothesis that carbo
platin and hyperthermia perturbation of NAD(+) pools results in down-regula
tion of GRP78 with subsequent modulation of VP-16 cytotoxicity. To further
explicate these results we studied G-361 as a control cell line that had si
gnificantly higher pretreatment NAD(+) levels, which were not affected by c
arboplatin and/or hyperthermia. This cell line did not exhibit a down-regul
ation of GRP78 or modulation of VP-16 cytotoxicity as a function of carbopl
atin and hyperthermia. Conclusions: These data taken collectively, demonstr
ate a sequence effect (regarding the aforementioned antineoplastic agents),
and provide a framework for future studies directed at the therapeutic opt
imization of the sequential application of carboplatin, hyperthermia, and V
P-16.