58 ± 0.84 0.006 ± 0.010 0.63 ± 0.03 Predicted learn more Interaction Synergistic Highly Synergistic Synergistic GEM 24 h > PAC 24 h 0.60 ± 0.91 0.34 ± 0.41 0.50 ± 0.57 Predicted Interaction Synergistic Synergistic Synergistic Mean (± standard deviation) CI values after exposure to paclitaxel for 24 hours followed by gemcitabine for 24 hours or gemcitabine for 24 hours followed by paclitaxel 24 hours. The mean CI values represent the average of the CI at the fraction affected of 0.50, 0.75, 0.90 and 0.95. Cells were seeded in 6-well flat bottom plates in duplicate at 5 separate concentrations of constant ratio based
on the ratio of the observed IC-50 values. Three independent counts were conducted for each well with a total of six replicates and the CI was determined using an algebraic estimation algorithm with the aide of CalcuSyn (v 2.0, Biosoft). Figure 1 Combination index values and fraction of cells
affected for three non-small cell GANT61 lung cancer cell lines exposed to paclitaxel followed by gemcitabine or gemcitabine followed by paclitaxel at 24 hours interval with a total culture time of 48 h. (a) H460, squamous cell carcinoma; (b) H838, adenocarcinoma carcinoma and (c) H520, large cell carcinoma. Comparing the fraction affected indicates a check details sequence dependent effect in two of the three cell lines (H460, H838); the sequence gemcitabine-paclitaxel was favored in these two cell lines compared to the sequence paclitaxel-gemcitabine (paclitaxel-gemcitabine vs. gemcitabine-paclitaxel, P < 0.05). However, the percentage of apoptotic cells largely favors sequential paclitaxel-gemcitabine with significantly more apoptosis CYTH4 found in H838 cells (P < 0.01). Effects of gemcitabine and paclitaxel on cell cycle distribution Flow cytometric measurements were completed to compare the effects of sequential paclitaxel-gemcitabine and gemcitabine-paclitaxel on the cell cycle distribution. Table 2 summarizes the effects of gemcitabine and paclitaxel on cell cycle distribution.
These cells were exposed to sequential gemcitabine-paclitaxel or the reverse sequence. As anticipated, paclitaxel-gemcitabine produced a sequence dependent increase in the number of G2/M cells as noted in H520 cells (paclitaxel-gemcitabine vs. gemcitabine-paclitaxel, P < 0.05) and gemcitabine-paclitaxel produced an increase in the number of G0/G1 cells as noted in H520 cells (P < 0.05). Effects of paclitaxel on gene expression, protein and activity of dCK The effects of paclitaxel on dCK mRNA levels were measured by quantitative RT-PCR using ΔΔCT method (Figure 2). The mRNA expression was significantly decreased in paclitaxel vs. vehicle-control treated H460 (52%, P < 0.05) and H520 (39%, P < 0.05) cells. The mRNA expression was relatively unchanged in the H838 cells. Figure 2 Effects of paclitaxel on dCK and CDA.