Mechanisms of cytotoxicity caused by antitumour drugs.

Although the nature of the interaction between a drug or toxin and its target is of critical importance in determining the fate of a cell, we have argued here that the biological outcome of that interaction will also be determined by the nature of cellular events "downstream" of the initial interactions. We suggest that some type of coupling must take place between the formation of a drug-target interaction (the stimulus?) and the response of the cell. That response will depend upon the phenotypically determined repertoire of response open to the cell as well as upon the quantitative and qualitative measures of the events that the drug induces (DNA or protein damage, inhibition of growth etc.). For example we have described how the HL-60 cell appears to respond to low levels of toxins by engaging a programme of terminal differentiation whilst at greater concentrations apoptosis becomes engaged. Consideration of the cellular response to a toxic insult may provide valuable insights into the selective toxicity of agents as well as providing avenues for the discovery of toxins which might be useful in the treatment of cancer.