Objective
SDX-101 is the non-cyclooxygenase 2-inhibiting R-enantiomer of the non-steroid anti-inflammatory drug etodolac, and has anti-tumour activity in chronic lymphocytic leukaemia
(CLL). SDX-308 and SDX-309 are more potent, structurally related indole–pyran analogues of SDX-101. The current study was
performed to investigate and quantify the cytotoxic potentiating effects resulting from a combination of either SDX-101, SDX-308
or SDX-309 with standard cytotoxic agents used in the CLL treatment today.
Methods
The lymphoma cell line U937-gtb was used, together with primary tumour cells isolated from seven CLL patients. Combinations
between
chlorambucil and each one of the agents etodolac, SDX-101, SDX-308 and SDX-309 were studied. In addition,
SDX-309 was combined with fludarabine, doxorubicin or vincristine. Both simultaneous and sequential exposures were explored
using the median-effect method.
Results
Most combinations were additive, which could be of clinical benefit since SDX-101 has been shown to be well tolerated. At
the 70% effect level, synergy was observed between SDX-308 and chlorambucil in U937-gtb cells and in two-third of the CLL
samples. Since chlorambucil is the most important drug in CLL therapy today and SDX-308 is presently targeted as the lead
clinical candidate, this combination would be interesting for further studies. Vincristine and SDX-309 were synergistic in
two-fourth of CLL samples.
Conclusions
To conclude, the non-COX-inhibiting etodolac-derivatives SDX-101, SDX-308 and SDX-309 are potential candidates for combination
treatment of CLL. Especially, SDX-308 in combination with chlorambucil warrants further evaluation.
Keywords Combination - Etodolac - CalcuSyn - SDX-101 - SDX-308