The potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapy

Bladder cancer ranks as the 9th most common type of cancer worldwide. Approximately 70 % of bladder cancers are diagnosed as non-muscle invasive, and they are treated with transurethral resection followed by intravesical therapy. Doxorubicin is one of the effective cytotoxic drugs used in intravesic...

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Main Authors: Cheng-Huang Shen, Shou-Chieh Wang, Kah-Min Lee, Hsin-Ting Liu, Szu-Wei Huang, Jin-Yi Wu, Yi-Wen Liu
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844024176207
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author Cheng-Huang Shen
Shou-Chieh Wang
Kah-Min Lee
Hsin-Ting Liu
Szu-Wei Huang
Jin-Yi Wu
Yi-Wen Liu
author_facet Cheng-Huang Shen
Shou-Chieh Wang
Kah-Min Lee
Hsin-Ting Liu
Szu-Wei Huang
Jin-Yi Wu
Yi-Wen Liu
author_sort Cheng-Huang Shen
collection DOAJ
description Bladder cancer ranks as the 9th most common type of cancer worldwide. Approximately 70 % of bladder cancers are diagnosed as non-muscle invasive, and they are treated with transurethral resection followed by intravesical therapy. Doxorubicin is one of the effective cytotoxic drugs used in intravesical and systemic therapy, but its cardiotoxicity and nephrotoxicity limit therapeutic dosages. Vorinostat is an anticancer drug used to treat cutaneous T-cell lymphoma, and it demonstrates potent combination effects in various anticancer treatments. We aim to investigate the combined effects and mechanisms of doxorubicin and vorinostat in human bladder cancer cells. Human bladder cancer cells (5637 and BFTC 905) were used in this study. Cell viability of 5637 and BFTC 905 cells decreases in a time- and dose-dependent manner when treated with doxorubicin or vorinostat. Compared to the single drug treatment, the combination of doxorubicin and vorinostat synergistically induces cell death in 5637 and BFTC 905 cells. Combination drug treatment improves the expression of apoptosis-related proteins, including cleaved PARP, cleaved caspase 8, cleaved caspase 9, cleaved caspase-3, and γ-H2AX in both cell lines. Cell viability of combined treatment in both cell lines is partially restored by pre-treating with Z-VAD-FMK, a pan-caspase inhibitor. Z-VAD-FMK also completely reduced the protein expression of cleaved caspase 3 and γ-H2AX, suggesting that combining doxorubicin and vorinostat leads to DNA strand breaks and apoptosis. Pre-treatment with Z-IETD-FMK, a specific caspase 8 inhibitor, shows a slight recovery of cell viability in 5637 and BFTC 905 cells following combined treatment. Cleaved caspase 8, and γ-H2AX proteins in both cell lines are totally inhibited, and cleaved PARP is partially inhibited. Pre-treatment with Ac-LEHD-CMK, a specific caspase 9 inhibitor, no cell viability recovery in both cell lines. These results indicate that the combination of doxorubicin and vorinostat activates the caspase 8 and caspase 9 apoptosis pathways, and induces DNA strand breaks mainly via the caspase 8 pathway. The combination of doxorubicin and vorinostat also significantly inhibits the growth of BFTC 905 tumorspheres and BFTC 905 xenograft tumors in mice. In conclusion, our findings demonstrate that the combination of doxorubicin with vorinostat could potentially serve as a new treatment regimen for urothelial bladder cancer, for avoiding the high-dose side effect of doxorubicin.
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spelling doaj-art-09db89d27e7d4d7fb924d7a71b30d73b2025-01-17T04:51:42ZengElsevierHeliyon2405-84402025-01-01111e41589The potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapyCheng-Huang Shen0Shou-Chieh Wang1Kah-Min Lee2Hsin-Ting Liu3Szu-Wei Huang4Jin-Yi Wu5Yi-Wen Liu6Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, 600, Taiwan; SKBIO Technology Corporation, Taipei, 114065, TaiwanDivision of Nephrology, Department of Internal Medicine, Kuang Tien General Hospital, Taichung, 437, TaiwanDepartment of Microbiology, Immunology and Biopharmaceuticals, College of Life Sciences, National Chiayi University, Chiayi City, TaiwanDepartment of Microbiology, Immunology and Biopharmaceuticals, College of Life Sciences, National Chiayi University, Chiayi City, TaiwanDepartment of Veterinary Medicine, College of Veterinary Medicine, National Chiayi University, Chiayi City, TaiwanDepartment of Microbiology, Immunology and Biopharmaceuticals, College of Life Sciences, National Chiayi University, Chiayi City, TaiwanDepartment of Microbiology, Immunology and Biopharmaceuticals, College of Life Sciences, National Chiayi University, Chiayi City, Taiwan; Corresponding author. Department of Microbiology, Immunology and Biopharmaceuticals, College of Life Sciences, National Chiayi University, No. 300, Syuefu Rd, Chiayi City, 600, Taiwan.Bladder cancer ranks as the 9th most common type of cancer worldwide. Approximately 70 % of bladder cancers are diagnosed as non-muscle invasive, and they are treated with transurethral resection followed by intravesical therapy. Doxorubicin is one of the effective cytotoxic drugs used in intravesical and systemic therapy, but its cardiotoxicity and nephrotoxicity limit therapeutic dosages. Vorinostat is an anticancer drug used to treat cutaneous T-cell lymphoma, and it demonstrates potent combination effects in various anticancer treatments. We aim to investigate the combined effects and mechanisms of doxorubicin and vorinostat in human bladder cancer cells. Human bladder cancer cells (5637 and BFTC 905) were used in this study. Cell viability of 5637 and BFTC 905 cells decreases in a time- and dose-dependent manner when treated with doxorubicin or vorinostat. Compared to the single drug treatment, the combination of doxorubicin and vorinostat synergistically induces cell death in 5637 and BFTC 905 cells. Combination drug treatment improves the expression of apoptosis-related proteins, including cleaved PARP, cleaved caspase 8, cleaved caspase 9, cleaved caspase-3, and γ-H2AX in both cell lines. Cell viability of combined treatment in both cell lines is partially restored by pre-treating with Z-VAD-FMK, a pan-caspase inhibitor. Z-VAD-FMK also completely reduced the protein expression of cleaved caspase 3 and γ-H2AX, suggesting that combining doxorubicin and vorinostat leads to DNA strand breaks and apoptosis. Pre-treatment with Z-IETD-FMK, a specific caspase 8 inhibitor, shows a slight recovery of cell viability in 5637 and BFTC 905 cells following combined treatment. Cleaved caspase 8, and γ-H2AX proteins in both cell lines are totally inhibited, and cleaved PARP is partially inhibited. Pre-treatment with Ac-LEHD-CMK, a specific caspase 9 inhibitor, no cell viability recovery in both cell lines. These results indicate that the combination of doxorubicin and vorinostat activates the caspase 8 and caspase 9 apoptosis pathways, and induces DNA strand breaks mainly via the caspase 8 pathway. The combination of doxorubicin and vorinostat also significantly inhibits the growth of BFTC 905 tumorspheres and BFTC 905 xenograft tumors in mice. In conclusion, our findings demonstrate that the combination of doxorubicin with vorinostat could potentially serve as a new treatment regimen for urothelial bladder cancer, for avoiding the high-dose side effect of doxorubicin.http://www.sciencedirect.com/science/article/pii/S2405844024176207ApoptosisBladder cancerDoxorubicinSynergistic effectVorinostat
spellingShingle Cheng-Huang Shen
Shou-Chieh Wang
Kah-Min Lee
Hsin-Ting Liu
Szu-Wei Huang
Jin-Yi Wu
Yi-Wen Liu
The potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapy
Heliyon
Apoptosis
Bladder cancer
Doxorubicin
Synergistic effect
Vorinostat
title The potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapy
title_full The potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapy
title_fullStr The potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapy
title_full_unstemmed The potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapy
title_short The potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapy
title_sort potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapy
topic Apoptosis
Bladder cancer
Doxorubicin
Synergistic effect
Vorinostat
url http://www.sciencedirect.com/science/article/pii/S2405844024176207
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