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Vol. 30, Issue 7, 763-770, July 2002
Department of Pharmaceutics, Ernest Mario School of Pharmacy,
Rutgers, the State University of New Jersey, Piscataway, New Jersey
(F.R.L., P.V.P., A.G., P.S.); and The Cancer Institute of New Jersey,
New Brunswick, New Jersey (E.R., P.S.)
Irinotecan (CPT-11) is a water-soluble camptothecin (CPT)
derivative that has been recently approved in the United States for
patients as a first-line therapy in advanced colorectal cancer. Phase I
clinical trials using oral CPT-11 have shown poor and variable oral
bioavailability. The present study was designed to investigate the
intestinal absorption and efflux mechanisms of CPT-11 using in vitro
cell culture models, Caco-2 cells, and engineered Madine-Darby canine
kidney (MDCK) II cells overexpressing P-glycoprotein (Pgp),
canalicular multispecific organic anion transporter (cMOAT), and
multidrug resistance-associated protein (MRP1). The intestinal
absorptive and secretory transport of CPT-11 was investigated using
Caco-2 cell monolayers. Secretory transport was concentration-dependent
and saturable. The secretory efflux permeability
(Peff) of CPT-11 decreased with decreasing
temperature, with an estimated activation energy of 19.6 ± 2.9 kcal/mol suggesting the involvement of active transporters. The
involvement of potential secretory transporters was further
characterized in MDCK II cells. The secretory efflux carrier
permeability (Pc) was ~4- and ~2-fold greater in MDCK II/Pgp and MDCK II/cMOAT cells than that in MDCK II/wild-type cells. Furthermore, the secretory efflux
Peff of CPT-11 was significantly decreased
by Pgp inhibitors, elacridar (GF120918) (IC50 = 0.38 ± 0.06 µM) and verapamil (IC50 = 234 ± 48 µM) in MDCK II/Pgp cells and by cMOAT inhibitor
3-([{3-(2-[7-chloro-2-quinolinyl]ethyl)phenyl}-{(3-dimethylamino-3-oxoprphyl)-thio}-methyl]-thio) propanoic acid (MK571) (IC50 = 469 ± 60 µM) in MDCK II/cMOAT cells. Overall, the current study suggests that
Pgp and cMOAT are capable of mediating the efflux of CPT-11 in vitro.
Since both Pgp and cMOAT are expressed in the intestine, liver, and
kidney, it is likely that these efflux transporters play a significant
role limiting the oral absorption and disposition of this important anticancer drug.
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