The P-glycoprotein-mediated relative decrease in cytosolic free drug concentration is similar for several anthracyclines with varying lipophilicity.

We have used a new methodology to measure the activity of P-glycoprotein (P-gp) in multidrug-resistant (MDR) tumor cells. This activity leads to a lower cytosolic concentration and a lower cytotoxicity of the classical anthracyclines, daunorubicin (DNR), and doxorubicin (DOX). It has been reported that the anthracycline idarubicin (IDA), which is more lipophilic, has a higher clinical efficacy in acute myeloid leukemias (AML) than DNR and DOX. In our study, the aim was to determine for a series of anthracyclines how variations in the passive drug influx rate as well as the P-gp-mediated drug pumping rate affect their cytosolic free drug concentrations and how these parameters are related to drug cytotoxicity. We selected six anthracyclines: DOX, DNR, epidoxorubicin (EPI), IDA, cyano-morpholino-doxorubicin (CMD), and carminomycin (CAR), ordered according to their increasing octanol/PBS buffer concentration ratios, respectively. To measure the passive permeation coefficient, the P-gp-mediated drug pumping rate, and the cytosolic free drug concentration, we used a flow-through system in which cells were exposed to a flowing medium containing drugs. We used the MDR P-gp-containing cell line KB8-5. It was shown that the passive drug permeation coefficient as well as the drug pumping rate of P-gp increased with increasing lipophilicity in this series of anthracyclines. The cytosolic free drug concentration was lowered by P-gp to a similar extent in KB8-5 cells for all drugs tested (40-50% of the extracellular drug concentration). CMD, IDA, and CAR had lower IC50 values and lower resistance factors in comparison to DOX, DNR, and EPI. Verapamil reversed the resistance for all anthracyclines tested. In conclusion, for several anthracyclines the activity of P-gp leads to a similar relative decrease in the cytosolic free drug concentration; consequently, the reported lower resistance factor of IDA compared to that of DNR is not due to the inability of P-gp to export IDA from cells.