Recently, we have reported the therapeutic efficacy of delivering initiator
caspase (caspase-8) or executioner active
caspase (rev-caspase-6) to
telomerase-positive
malignant glioma cells using the human
telomerase reverse transcriptase (hTERT) gene promoter system (hTERT/
caspase-8 or hTERT/rev-
caspase-6). In the present study, we investigated if conventional treatments for
malignant gliomas augment the efficacy of the hTERT/
caspase therapy. First, we demonstrated that hTERT/rev-
caspase-6 exhibited a greater ability to induce apoptosis in
malignant glioma U87-MG and U373-MG cells than hTERT/
caspase-8. Next, as conventional treatments to combine with hTERT/rev-
caspase-6, apoptosis-inducing agents [
cisplatin (CDDP),
paclitaxel (PTX), and
BCNU] and non-apoptosis-inducing
therapies [
temozolomide (TMZ) and gamma-irradiation (IR)] were used. Combination of hTERT/rev-
caspase-6 gene therapy with PTX yielded a dose-dependent additive effect, while CDDP and
BCNU had additive effect only when
tumor cells were treated at IC75 of each agent. A decline in the combination effect of CDDP and
BCNU at IC50 was due to decreased activity of
telomerase in treated
tumor cells prior to the hTERT/rev-
caspase-6 transfer. On the other hand, TMZ or IR had no significant additive effect on induction of apoptosis. These results suggest that agents, which induce apoptosis without inhibiting
telomerase activity are a promising counterpart to combine with hTERT/rev-
caspase-6 therapy for the management of
malignant gliomas.