Notre travail de thèse a été dédié à la synthèse et à la caractérisation bio-physicochimique de complexes osmium nitrosyle, qui pourraient relarguer l’oxyde nitrique (NO) au sein des cellules tumorales pour conjuguer les propriétés anticancéreuses souvent associés aux complexes du groupe du platine avec la toxicité de l’oxyde nitrique. Le premier chapitre de notre mémoire de thèse présente l’état de l’art dans le domaine des composés anticancéreux et le rôle de l’oxyde nitrique dans l’apoptose cellulaire. Le deuxième chapitre concerne la synthèse et la caractérisation de complexes d’azole (C)[Os(NO)Cl4(A)] (C = Bu4N+, Na+, HA+; A = indazole, pyrazole, benzimidazole, imidazole), où le plus cytotoxique est H2ind[cis-Os(NO)Cl4(indazole)]. Le troisième chapitre est consacré à l’étude cinétique et thermodynamique par RMN de l’isomérisation trans ↔ cis du complexe (Bu4N)[Os(NO)Cl4(indazole)] qui met en évidence un processus d’isomérisation de type dissociatif. Le quatrième chapitre concerne la synthèse et la caractérisation de complexes d’aminoacides (Bu4N)[Os(NO)Cl4(L)] (L = gly, picolinate, L-, D-pro) qui ont une très faible activité antiproliférative. Le dernier chapitre est consacré à la synthèse et à la caractérisation de clusters hétérométalliques [{Os(NO)Cl3(Ox)}4Ln] (Ln = Gd, Tb, Dy, Y ; Ox=oxalate) dans lesquels la coordinance 8 ou 9 du lanthanide dépend de son rayon ionique. Le précurseur {Os(NO)Cl3(Ox)} a l’activité antiproliférative la plus élevée de tous les complexes osmium nitrosyle connus / The PhD thesis was dedicated to the synthesis and bio-physic-chemical characterization of osmium nitrosyl complexes which could release nitric oxide (NO) in tumor cells to combine the anticancer properties of the platinum group complexes and the nitric oxide cytotoxicity. The first chapter presents the state of the art in the field of anticancer compounds and the role of nitric oxide in the apoptosis. The second chapter concerns the synthesis and characterization of azole complexes with the general formulae (C)[Os(NO)Cl4(A)] (C = Bu4N+, Na+, HA+; A = indazole, pyrazole, benzimidazole, imidazole), where the most cytotoxic is H2ind[cis-Os(NO)Cl4(indazole)]. The third chapter focuses on the kinetic and thermodynamic study of the trans ↔ cis isomerisation of (Bu4N)[Os(NO)Cl4(indazole)] complex by NMR, which highlights a dissociative isomerisation process. The fourth chapter concerns the synthesis and the characterization of amino acids complexes with the general formulae (Bu4N)[Os(NO)Cl4(L)] (L = gly, picolinate, L-, D-pro) of whose antiproliferative activity is very low. The last chapter is dedicated to the synthesis and characterization of heterometallic clusters with the general formulae [{Os(NO)Cl3(Ox)}4Ln] (Ln = Gd, Tb, Dy, Y ; Ox = oxalate), where the coordination number 8 or 9 depends on its ionic radius. The precursor {Os(NO)Cl3(Ox)} has the highest antiproliferative activity among of all osmium nitrosyl known so far

A atividade de cisteíno proteases (CP) tem sido relacionada a diferentes patologias, como no caso da leishmaniose, doença de Chagas de alguns tipos de câncer. Devido a homologia entre as cisteíno proteases presentes em altos níveis nesses sistemas celulares, foi investigada aqui a importância dessas enzimas para o desenvolvimento e estabelecimento dessas doenças a partir da atividade biológica in vitro de novos inibidores reversíveis de cisteíno proteases. De maneira geral, as substâncias apresentaram relevante atividade inibitória de cisteíno proteases expressas pelos diferentes sistemas celulares, com máximo de inibição de 42% para o Neq0554 em relação à atividade de CP expressas por Leishmania spp. e 76% em relação a atividade de CP expressas por células de câncer de pâncreas. Diferentes níveis de atividade biológica foram observados entre os sistemas celulares, porém todos apresentaram supressão em relação aos parâmetros citostáticos após a inibição da atividade de CP. Quando testados em Leishmania spp. o crescimento celular foi suprimido em pelo menos 67%, com máximo de inibição de 95% para o Neq0551 a 10 μM. Da mesma maneira, em células de câncer de pâncreas, alterações no ciclo celular e supressão dos processos de migração e formação de colônias foram os resultados mais evidentes, comretenção de 50% da capacidade de formação de colônias das células Mia-Paca2 pelo Neq0554 a 10 μM. Já em relação aos protozoários da capa Y de Trypanosoma cruzi os inibidores testados apresentaram interessante seletividade contra os parasitos, em relação à célula hospedeira LLC-MK2, além de promoverem a supressão de cerca de 80% do processo de invasão celular in vitro quando a célula hospedeira foi previamente tratada com 10 μM do inibidor Neq0662 por 2 h antes do processo de infecção. Por fim, a encapsulação do Neq0554 em apoferritina promoveu um incremento na atividade anticancerígena para células de câncer de pâncreas, com IC50 de 79 μM contra > 200 μM em relação às células de fibroblasto, aumentando sua seletividade. De maneira geral, os resultados corroboram a hipótese de a inibição de cisteíno proteases nos sistemas celulares é eficiente para promover efeitos citostáticos, podendo ser utilizada com controle e supressão do desenvolvimento das patologias. Além disso, a atividade de CP nas células de protozoários e câncer de pâncreas apresentou perfil semelhante de ação, no qual inibidores de CP não promoveram a morte em nível significativo das células, mas ressaltaram os efeitos citostáticos em relação ao crescimento celular. / Cysteine proteases (CP) activity has been related to different pathologies, such as leishmaniasis, Chagas disease and some types of cancer. Due to the homology between cysteine proteases expressed by these cellular systems, it was investigated here the importance of these enzymes for the development and establishment of these diseases based on the in vitro biological activity of novel reversible cysteine protease inhibitors. In general, the inhibitor showed a significant inhibitory activity of cysteine proteases expressed by the different cellular systems, with a maximum inhibition of 42% for Neq0554 concerning the CP activity expressed by Leishmania spp. and 76% to CP activity expressed by pancreatic cancer cells. Different profiles of biological activity were observed between the cellular systems, but all substances had significant CP activity suppression, in cytostatic levels after the inhibition of CPA. When the inhibitors were tested against Leishmania spp., the cell growth was suppressed by at least 67%, with maximum inhibition of 95% for Neq0551 at 10 μM. Similarly in pancreatic cancer cells, changes in the cell cycle profile were the most evident results, as well as the suppression of migration and colony formation ability, with 50% retention of the colony development of Mia-Paca2 cells by Neq0554 at 10 μM. In contrast, to protozoa from Trypanosoma cruzi Y strain, the inhibitors tested showed an interesting selectivity against the parasites concerning the host cell LLC-MK2, also promoting the in vitro cell invasion suppression in about 80% when the host cell was pre-treated with Neq0662 10 μM for 2 h. Finally, the encapsulation of Neq0554 promoted an increase in its anticancer activity against pancreatic cancer cells, with IC50 of 79 μM alongside > 200 μM to fibroblast cells, besides increasing its selectivity. In general, the results corroborate the hypothesis that the inhibition of cysteine proteases in the cellular systems is efficient to promote cytostatic effects, being an interesting tool to be used as control and development suppression of some pathologies. Also, CP activity in protozoa cells and pancreatic cancer showed a similar profile of action, in which cysteine protease inhibitors did not promote death at a significant level for the cells, but emphasized cytostatic effects about cell growth.

Depuis le début des années 2000, les traitements anticancéreux oraux (TAO) sont en développement croissant, notamment dans le cancer du sein. Ils permettent aux patients la prise de comprimés par voie orale à domicile améliorant la qualité de vie. On estime que 10 à 34% des tumeurs du sein sur-expriment la protéine HER2 (HER2+) qui augmente le risque de métastases. Deux thérapies ciblées anti-HER2 sont actuellement disponibles : le trastuzumab, anticorps monoclonal administré par voie intraveineuse et le lapatinib, inhibiteur de tyrosine kinase administré par voie orale. D’après les recommandations de l’Agence Nationale d’Accréditation et d’Evaluation en Santé (ANAES, 2003), les TAO devraient être privilégiées par rapport aux formes intraveineuses prises à l’hôpital lorsque leur efficacité est équivalente. Dans la pratique courante des oncologues, les TAO semblent néanmoins sous-utilisées dans certains cas. En plus des freins médicaux connus (adhésion thérapeutique, gestion des effets indésirables), les TAO induisent une consommation de ressources hopitalières supplémentaires qui n’est pas valorisée dans le modèle de tarification à l’activité (T2A) des établissements hospitaliers, lequel repose sur la nature et la quantité d’activité médicale réalisée. Nous supposons que le modèle de T2A représente un frein économique à l’utilisation des TAO entrainant une disparité d’accès entre les traitements anticancéreux oraux et intraveineux. L’objectif de ce travail de thèse était donc de déterminer le rôle de la T2A dans l’accès des patients aux TAO au moyen d’une évaluation médico- économique de l’impact économique et organisationnel des TAO sur le système de soins. Une revue de littérature a permis de mettre en évidence le rôle du mode de financement des soins sur l’accès aux TAO en France et aux Etats-Unis. L’analyse des bases de données nationales hospitalières du Programme Médicalisé des Systèmes d’Information (PMSI) a permis de quantifier l’enjeu économique de la chimiothérapie pour les établissements de soins et qui représente la deuxième activité des hôpitaux en volume après l’hémodialyse. Le bénéfice lié aux séances de chimiothérapie a ainsi été estimé à 108 millions d’Euros en 2010 pour l’ensemble des établissements publics et privés en France. L’analyse a également permis de simuler le transfert d’allocation de ressources de l’hôpital vers les soins de ville induit par la substitution des séances de chimiothérapie par l’utilisation des TAO. Un modèle comparant le coût du traitement intraveineux (trastuzumab) aux TAO (lapatinib et capécitabine) dans le cancer du sein métastatique HER2+ a confirmé des coûts moindres pour les TAO (17 165€ versus 36 077€ par an et par patient) liés à une économie sur les transports médicalisés mais surtout sur les consommations hospitalières et ce, malgré un coût d’acquisition plus élevé des TAO. Malgré cet impact budgétaire négatif pour les hôpitaux, une étude de préférences (Méthode des Choix Discrets) conduite auprès d’un échantillon de 203 médecins hospitaliers et libéraux a montré que l’efficacité d’un traitement anticancéreux restait le déterminant principal de la décision thérapeutique (β=2,214, p<0,0001). L’étude a toutefois révélé que, aux stades avancés du cancer, la voie d’administration et son coût étaient également associés au choix du traitement (β=0,612, p=0,035 ;β=0,506, p<0,0001). Les résultats montrent donc que le modèle de financement de l’activité hospitalière influence le choix des modalités de traitement même si les critères d’ordre médicaux et environnementaux du patient demeurent des déterminants essentiels dans le choix du recours aux TAO (profil clinique du patient, adhésion thérapeutique, préférences du patient, environnement familial et socio-économique, conditions d’accès à l’offre de soins) / Since the early 2000’s, oral anticancer drugs (OADs) are increasingly available especially for the treatment of breast cancer. This route of chemotherapy administration allows patients to take oral tablets at home improving their quality-of-life. We estimate that 10 to 34% of breast tumors over-express the HER2 protein (HER2+) that increases the risk of developing metastasis. Two anti-HER2 targeted therapies are currently available: trastuzumab, a monoclonal antibody administered intravenously and lapatinib, a tyrosine kinase inhibitor administered orally. According to the recommendations of the National Agency for Accreditation and Evaluation in Health (ANAES, 2003), OADs should be administered when their efficacy is equivalent to the one of intravenous forms taken at hospital. In the current practice of oncologists, OADs seem to be underused in some cases. The medical brakes to the use of OADs (i.e. adherence, management of side effects) are well known. Nonetheless, OADs induce additional hospital healthcare resources which are not taken into account in the hospital payment system that is based on the nature and the quantity of medical activities performed (i.e. per-case payment system (PPS)). We assume that the current model of PPS represents an economic barrier to the use of OADs and which induces a disparity of access between oral and intravenous cancer treatments. The objective of this thesis was to determine the role of the PPS on the patient access to OADs based on a medico-economic evaluation of the economical and organizational impacts of OADs on the health care system. A literature review has highlighted the role of the funding of care on the access to OADs in the French and US healthcare systems. From an analysis of the national hospital database (PMSI database), we have quantified the economic implications of chemotherapy administration that is the second hospital activity in volume after hemodialysis. Earnings associated with chemotherapy sessions have been estimated at 108 million Euros in 2010 for all private and public institutions in France. This analysis also allowed us to simulate the transfer of resources allocation from hospital to community setting induced by the substitution of chemotherapy sessions by the use of OADs. A model comparing the cost of intravenous anticancer drug (trastuzumab) to OADs (lapatinib and capecitabine) in the treatment of HER2+ metastatic breast cancer confirmed the lower costs for OADs (€ 17,165 versus € 36,077 per year per patient). The higher acquisition cost of OADs was offset by the cost savings in terms of medical transportation and hospital resources. Despite this negative budget impact for hospitals, a preference study (Discrete Choice Experiment) conducted among 203 physicians showed that the efficacy of cancer treatment remained the main determinant of the therapeutic decision (β=2.214, p<0.0001). The study has also revealed that, in the advanced stages of cancer, the route of administration and its associated cost was also associated with the treatment choice (β=0.612, p= 0.035; =β0.506, p<0.0001). Overall, the results show that the hospital payment system influences the choice of treatment modalities. Nonetheless, medical criterions related to the patient remain essential in the choice of using OADs (clinical profile of the patient, adherence, patient preferences, familial and socio-economic environment, and conditions of access to health care)

Les thérapies anticancéreuses ont apporté un gain largement reconnu en matière de réduction de la charge tumorale, de survie des patients et d’amélioration de leur qualité de vie, dans un certain nombre de cancers. Hélas, ces thérapies exercent un effet immunosuppresseur en détruisant les effecteurs ou en bloquant l’activité de certains facteurs biologiques impliqués dans le recrutement des acteurs du système immunitaire. D’autre part, plusieurs travaux ont permis de démontrer que ces traitements pouvaient avoir un effet contraire en générant ou en favorisant l’induction d’une réponse immunitaire anti-tumorale, soit par effet direct sur le recrutement et l’activation des effecteurs de l’immunité, soit en potentialisant les interactions cellulaires par des mécanismes biologiques. Ces derniers faisant intervenir les cytokines, la stimulation des TLR, l’augmentation des interactions entre cellules du SI; ce qui permet de passer d’une anergie immunologique vers un véritable système d’éradication des cellules cancéreuses.Dans notre laboratoire, nous avons essayé d’évaluer l’implication du système immunitaire dans la réponse thérapeutique induite par des agents cytotoxiques conventionnels. Ici, nous décrivons les effets d’un inhibiteur de cyclines kinases multi-cibles « CDKi PHA-793 887 » testé dans un essai de phase I mené sur deux sites en Europe. C’est le constat inattendu que 6 des 15 patients, traités par ce médicament (PHA-793887) ont développé de graves infections bactériennes et virales et que 6 d’entre eux ont présenté la réactivation du virus de l’herpès qui nous a conduit à étudier ces effets sur le système immunitaire et en particulier sur le dialogue entre cellules dendritiques (CD) et cellules natural killer (NK). Ce travail met en évidence que ce médicament inhibe le signalling des récepteurs toll-like (TLR) réduisant par conséquent l’interaction CD/NK in vitro. Enfin la stimulation des cellules des patients sous traitement démontre une réduction importante de ce signalling ex-vivo. Ainsi, cet effet immunosuppresseur inattendu a permis une réactivation virale chez 40% des patients. La deuxième partie de ce travail, concerne les effets du cyclophosphamide (CTX) utilisé à faible dose. L’injection d'une faible dose chez la souris ou d’un dosage métronomique chez l'homme, promeut la différenciation des cellules lymphocytaires vers Th17 (sécrétant de l’interleukine-17 (IL-17)) et Th1 (sécrétant de l’interféron-γ (IFN)). Ceux-ci ont été retrouvés dans le sang et dans des ascites carcinomateuses de patients. Ainsi, le CTX pourrait participer à la génération de réponses anti-tumorale via la différenciation Th 17 comme cela fut suggéré par de récentes études précliniques montrant l’existence d’une corrélation étroite entre le taux des lymphocytes Th17 infiltrant la tumeur et la destruction tumorale. / Cancer therapies have made a gain widespread recognition in the reduction of tumor burden, patient survival and improved quality of life in a number of cancers. Unfortunately, these therapies exert an immunosuppressive effect by killing effectors or blocking the activity of certain biological factors involved in recruiting of the immune system. On the other hand, several studies have shown that these treatments could have the opposite effect by generating or promoting the induction of antitumor immune response, either by direct effect on the recruitment and activation of effectors immunity, either by potentiating cellular interactions by biological mechanisms. The latter involving cytokines, TLR stimulation, increased interactions between cells of the IS; which toggles between immunological anergy to a real system to eradicate cancer cells. In our laboratory, we tried to evaluate the involvement of the immune system in the therapeutic response induced by conventional cytotoxic agents. Here, we describe the effects of an inhibitor of cyclin kinases multi-target "CDKIs PHA-793887" tested in a phase I trial conducted at two sites in Europe. This unexpected finding is that 6 of 15 patients treated with this drug (PHA-793887) developed severe bacterial and viral infections and six of them showed reactivation of the herpes virus that has led us to study these effects on the immune system and in particular on the dialogue between dendritic (DCs) and natural killer (NK) cells. This work shows that this drug inhibits the signaling of toll-like receptor (TLR) thereby reducing the interaction DC / NK in vitro. Finally, stimulation of the cells of treated patients demonstrated a significant reduction of this signaling ex vivo. Thus, this immunosuppressive effect has an unexpected viral reactivation in 40% of patients. The second part of this work concerns the effects of metronomic dose of cyclophosphamide (CTX). The injection of a low dose in mice or metronomic dosing in humans, markedly promotes the differentiation of CD4+ T helper 17 (Th17) cells that can be recovered in both blood and tumor beds. However, CTX does not convert regulatory T cells into Th17 cells and promotes cell differentiation into Th17 lymphocytes (secreting interleukin-17 (IL-17)) and Th1 (secreting interferon-γ (IFN)). These were found in blood and in ascites carcinoma patients. Thus, CTX may participate in the generation of antitumor responses through Th 17 differentiation as was suggested by recent preclinical studies showing the existence of a correlation between the rate of Th17 lymphocytes infiltrating the tumor and tumor destruction.

No description available.

The thesis “Ancillary Ligand Effects on the Anticancer Activity of Ruthenium (II) Piano Stool Complexes” is an effort to design better antitumor metallodrugs based on ruthenium(II) complexes with various H-bond donor/acceptor ligands and to understand their mechanism of action. Chapter 1 presents a brief review of metallodrugs and their mechanism of action. Different classes of metallodrugs are discussed. A short discussion on ruthenium based anticancer drugs and their established mechanism of action is also included in this chapter. Chapter 2 deals with the synthesis, characterization and anticancer activity of Ru(II) complexes with P(III) and P(V) ligands. The effect of a strong hydrogen bond acceptor on the cytotoxicity of the complexes has been investigated which allows comparison of complexes with ligands possessing a strong hydrogen bond donor or hydrogen bond acceptor. Partial oxidation of the tertiary phosphine ligands leads to a decrease in cytotoxicity of the ligand, while coordination to ruthenium resulted in a significant increase in the cytotoxicity. A molecular mechanism of action for these complexes was suggested on the basis of various biophysical studies. These complexes bind DNA through non-intercalative interactions which lead to the destabilization of the double helix of the DNA and also unwinding of the negatively supercoiled DNA. Results show that the presence of a hydrogen bond acceptor on the ligand is not capable of enhancing interactions with DNA in comparison with hydrogen bond donor groups. Cellular studies of these complexes showed that inhibition of DNA synthesis and apoptosis occur on treatment with these complexes. Interestingly, these complexes are found to be not only cytotoxic but also antimetastatic. Chapter 3 deals with the synthesis, characterization and anticancer activity of Ru(II) complexes with biologically active S containing heterocyclic ligands and their mechanistic study. Complexation of ruthenium with mercaptobenzothiazole (MBT) gave the most cytotoxic complex (H3) in the series. Heterocyclic Ru(II) complexes behave differently as evidenced by cellular and biophysical studies. Unlike phosphine complexes, H3 shows biphasic melting of DNA at higher concentrations which suggests two different types of interaction with DNA. Chapter 4 deals with synthesis and characterization of water soluble multiruthenated hydrophilic ruthenium(II) complexes with urotropine. An increase in cytotoxicity and binding affinity has been observed with increase in the number of ruthenium atoms per molecule. The complex with three ruthenium atoms showed the best activity. However cytotoxicity of the complexes decreases with decrease in the lipophilicity of the complexes. Chapter 5 describes studies on the interaction of Ru complexes with water, ss-DNA, AMP, GMP and GSH by various spectroscopic techniques. Hydrolysis of Ru-Cl bond in the complexes correlates with the cytotoxicity. Chapter 6 reports the summary of the observations of the thesis and the future prospects of metallodrugs.

Metagenomics has revealed that the marine microbial biosphere is immensely more diverse than originally considered, and is an almost untapped reservoir for the potential discovery of microbial natural products. Despite numerous advances in culturing, biosynthetic engineering and genomic-based screening efforts to uncover much of this diversity in relatively accessible environments, a high rediscovery rate has resulted in the investigation of unique, relatively unexplored ecosystems harboring phylogenetically diverse communities of marine organisms. The focus of this research was to establish a culture repository of microorganisms collected from the Red Sea and from deep-sea hydrothermal vents, and to assess their biosynthetic potential for the production of new chemical scaffolds. Cultivation of marine cyanobacteria from the Red Sea has led to the identification of five new cyclic depsipeptides, apratoxin H, grassypeptolides D and E, Ibu-epidemethoxylyngbyastin 3 and leptochelin, the latter possessing a unique chemical scaffold capable of binding metals. A collection of deep-sea hydrothermal vent sediment and microbial mat samples led to the isolation of 64 unique bacterial strains, with eight assigned as members of the order Actinomycetales. Importantly, these isolates, along with a collection of deep-vent invertebrates and microbes, have led to the development of methods for the collection, culturing and biological screening of organisms from this extreme environment for future natural products research. / Graduation date: 2013

Τα ινδολοκαρβαζόλια είναι αλκαλοειδή και παρουσιάζουν ενα ευρύ φάσμα βιολογικών ιδιοτήτων, όπως αντιβακτηριακές, αντιμυκησιακές, αντιικές, υποτασικές, νευροπροστατευτικές ιδιότητες. Όμως η σημαντικότερη δράση τους είναι η αντικαρκινική. Η εργασία αυτή είναι ένα review των συνθετικών μεθόδων και των βιολογικών ιδιοτήτων των ινδολοκαρβαζολίων. Επίσης σχολιάζονται η βιοσύνθεσή τους, παράγωγες ενώσεις των ινδολοκαρβαζολίων αλλά και υποψήφια φάρμακα με δομή ινδοκαρβαζολίου. / Indolocarbazoles are alkaloids which display a wide range of biological properties including antibacterial, antifungal, hypotensive and neuroprotective properties. Their greatest interest is their antitumour properties. This is a review of the synthetic methods and biological properties of indolocarbazoles. Τheir biosynthesis, their derivatives and possible drugs are also included.

No description available.

En aquesta tesi s'han estudiat les propietats antitumorals d'una variant de la ribonucleasa pancreàtica humana anomenada PE5 que incorpora un senyal de localització nuclear. Aquest estudi mostra que PE5 indueix l'apoptosi de les cèl·lules tractades i que aquesta mort és independent de l'activitat de p53. A més, l'efecte citotòxic no es veu afectat per un fenotip de resistència a múltiples drogues. Les dades també mostren que l'activitat citotòxica de PE5 és selectiva per a cèl·lules tumorals in vitro i que la capacitat citotòxica de les dues ribonucleases és semblant. S'ha estudiat l'efecte d'aquestes dues ribonucleases sobre el cicle cel·lular, l'activació de diferents caspases i l'expressió de proteïnes relacionades amb l'apoptosi i el cicle cel·lular. Els resultats indiquen que PE5 i l'onconasa maten les cèl·lules a través de mecanismes diferents. A més, PE5 però no l'onconasa, redueix l'acumulació de glicoproteïna-P en dues línies cel·lulars resistents a múltiples drogues. / In this thesis the antitumor properties of PE5, a variant of human pancreatic ribonuclease carrying a nuclear localization signal, have been investigated. This study shows that the cytotoxicity of PE5 is produced through apoptosis and that this ribonuclease does not require the activity of p53 to trigger the cell death. In addition, the cytotoxic effect is not prevented by a multiple drug resistance phenotype. The data also show that in vitro PE5 is selective for tumor cells and that PE5 and onconase induce cell death to the same extent. Effects of both ribonucleases on the cell cycle, on the activation of different caspases and on the expression of different apoptosis- and cell cycle-related proteins have been investigated. The results show that PE5 and onconase kill the cells through mechanisms with significant differences. In addition, PE5 but not onconase, reduces the accumulation of P-glycoprotein in two different multidrug-resistant cell lines.