Clinical and experimental observations indicate that resistance to anticancer drugs may be spontaneously reversible over time, but the mechanisms of this reversal are unknown. The resistance of cultured hepatoma cells to methotrexate (MTX) and cisplatin was followed for 9 months. Cells were exposed to three treatments: MTX 200 nM for 24 h or 15 nM continuously and cisplatin 50 μM for 2 h. We investigated the relation between the temporal pattern of cell resistance and the previously reported fluctuations in cell proliferation rate, telomere length and telomerase activity. Spontaneous major peaks in resistance to each drug fell in time windows of 2–3 months (60–70 population doublings) and were at different times for each drug. The frequency of the fluctuations in drug resistance was the same as that of variations in cell growth rate, but amplitudes were unrelated. By contrast, resistance was directly related to telomere length dynamics in the same cells. MTX resistance occurred when telomeres shortened and cisplatin resistance when they were elongated. Furthermore, peaks of resistance to the continuous treatment with MTX were observed at 350-bp intervals of mean telomere length (9.06, 9.41, and 9.76 kbp) during the two 2-month phases of telomere shortening. Statistical analysis demonstrates the sinusoidal relationship between intermittent MTX resistance and telomere length. Possibly, erosion of telomeres encroaches on periodically spaced nucleosomal proteins, defining the onset of resistance phases. This evidence that resistance of tumoral cells to anticancer drugs may be intermittent and that onset of resistance is dictated by telomere length has major implications for clinical practice.
aINSERM U347, Le Kremlin-Bicêtre, France
bLaboratory of Applied BioStatistics, Le Chemin de la Birotte, Esvres/Indre, France
Sponsorship: This work was supported by the Ligue contre le Cancer (Comité de l'Essonne), the Association pour la Recherche contre le Cancer (ARC) and l'Association ‘Biologie du Cancer et Dynamiques complexes’ (L'ABCD). J. D. is a CNRS fellow.
Correspondence to C. Wolfrom, INSERM U347, 80 rue du Général Leclerc, 94276 Le Kremlin-Bicêtre, France
Tel: + 33 01 49591829; fax: + 33 01 49591959;
Received 2 March 2004 Accepted 13 May 2004