Pilot study of MDR1 gene transfer into hematopoietic stem cells and chemoprotection in metastatic breast cancer patients

Shunji Takahashi, Keisuke Aiba, Yoshinori Ito, Kiyohiko Hatake, Minoru Nakane, Takayuki Kobayashi, Sayuri Minowa, Harumi Shibata, Junko Mitsuhashi, Satomi Tsukahara, Etsuko Ishikawa, Rieko Suzuki, Takashi Tsuruo, Yoshikazu Sugimoto

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

A major problem in high-dose chemotherapy with autologous hematopoietic stem cell transplantation is insufficient function of reconstituted bone marrow that limits the efficacy of post-transplantation chemotherapy. Because transduction of hematopoietic stem cells with the multidrug resistance 1 (MDR1) gene might circumvent this problem, we conducted a pilot study of MDR1 gene therapy against metastatic breast cancer. Peripheral blood stem cells were harvested, and one-third of the cells were transduced with MDR1 retrovirus. After the reconstitution of bone marrow function, the patients received high-dose chemotherapy with transplantation of both MDR1-transduced and unprocessed peripheral blood stem cells. The patients then received docetaxel chemotherapy. Two patients received transplantation of the MDR1-transduced cells in 2001. Peripheral blood MDR1-transduced leukocytes were 3-5% of the total cells after transplantation, but decreased gradually. During docetaxel chemotherapy, an increase in the rate of MDR1-transduced leukocytes (up to 10%) was observed. Comparison of docetaxel-induced granulocytopenia in the two patients suggested a bone marrow-protective effect of the MDR1-transduced cells. No serious side-effect was observed, and the patients were in complete remission for more than 3 years. The MDR1-transduced cells gradually decreased and disappeared almost entirely by the end of 2004. Results of linear amplification-mediated polymerase chain reaction of the MDR1-transduced leukocytes suggested no sign of abnormal amplification of the transduced cells. A third patient received transplantation of the MDR1 -transduced cells in 2004. These results suggest the feasibility of our MDR1 gene therapy against metastatic breast cancer, and follow-up is ongoing.

Original languageEnglish
Pages (from-to)1609-1616
Number of pages8
JournalCancer science
Volume98
Issue number10
DOIs
Publication statusPublished - 2007 Oct 1

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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