A dual PI3 kinase/mTOR inhibitor BEZ235 reverses doxorubicin resistance in ABCB1 overexpressing ovarian and pancreatic cancer cell lines

Abstract Background Multi-drug resistance (MDR) develops because cancer cells evade toxicity of several structurally unrelated drugs. Besides other mechanisms, MDR is linked to the overexpression of ATP Binding Cassette (ABC), transporters, among which ABCB1 is the best characterized one. Since overactivation of PI3K/Akt/mTOR plays a pivotal role in the growth of human cancers, we hypothesized whether dual PI3K and mTOR inhibitor, BEZ235 (BEZ, dactolisib) reverses resistance to doxorubicin (DOX). Methods Ovarian (A2780) and pancreatic (MiaPaca2) cancer cells were used to generate DOX-resistant clones by overexpressing ABCB1 or stepwise treatment of DOX. Intracellular accumulation of DOX was measured by flow cytometry after treatment with BEZ. Results BEZ treatment caused increase in intracellular levels of DOX which was almost identical to the naive parental cell lines. BEZ was found to be weak substrate for ABCB1 as demonstrated by minimal increase in ATPase activity. BEZ treatment caused dose-dependent decrease in cell viability in combination with DOX which was associated with increase in cleaved PARP expression in the drug resistant clones. Conclusions These results suggest that BEZ is a non-substrate inhibitor of ABCB1 and is able to effectively re-sensitize cells overexpressing ABCB1 to the effects of DOX. General significance Dual PI3 Kinase/mTOR inhibitor, BEZ has the potential to reverse MDR in cancer patients.