The therapeutic potential of misonidazole enhancement of alkylating agent cytotoxicity.

The effect of prolonged exposure to low misonidazole (MISO) levels on the cytotoxicity of three alkylating agents was studied in mouse tumors. A concentration of 100 micrograms/ml was maintained in the plasma for 7 hr by multiple injections of MISO. Cyclophosphamide (CYC). Melphalan (L-PAM), or CCNU were given after 4 hrs of MISO exposure. In each case, prolonged low level MISO exposure enhanced tumor response as measured by regrowth delay or a cloning assay. The effect of this treatment was also studied in several normal tissues: bone marrow, white blood cell counts, and spermatogonia. In none of these was any enhancement seen after prolonged MISO exposure. These encouraging results show that clinically relevant exposures to MISO can greatly improve tumor response to alkylating agents without increased normal tissue toxicity.