Pemetrexed, a new generation
antifolate recently approved for the treatment of
mesothelioma and
non-small cell lung cancer, is an excellent substrate for the
reduced folate carrier (RFC). To explore the carrier's effect on
pemetrexed activity, RFC was inactivated in HCT-15
colon cancer cells by mutagenesis and PT632 selective pressure. A clone (PT1) was obtained with a
glycine to
arginine substitution at
amino acid 401, resulting in the loss of RFC function. PT1 cells were resistant to PT632 (178-fold),
methotrexate (4-fold), and
ZD1694 (
Tomudex,
raltitrexed; 20-fold), but were 3-fold collaterally sensitive to
pemetrexed when grown in 25 nmol/L of
5-formyltetrahydrofolate. PT1 cells transfected with wild-type RFC had
antifolate sensitivities comparable to that of wild-type HCT-15 cells, indicating that the RFC mutation was the sole basis for resistance.
Folate pools were contracted in PT1 cells by 32% or 60%, as measured by radiolabeling intracellular folates or by an
enzyme binding assay, respectively. This was reflected in marked (6.5-fold) collateral sensitivity to
trimetrexate. The initial uptake of
pemetrexed in PT1 cells was markedly reduced ( approximately 85%) but intracellular
pemetrexed levels increased to approximately 60% and approximately 70% to that of wild-type cells after 2 hours and 6 days, respectively. There was increased
pemetrexed inhibition of
glycinamide ribonucleotide transformylase and, to a lesser extent,
thymidylate synthase in PT1 cells growing in
5-formyltetrahydrofolate based on
nucleoside protection analyses. Hence, loss of RFC function leads to collateral sensitivity to
pemetrexed in HCT-15 cells, likely due to cellular
folate pool contraction resulting in partial preservation of
pemetrexed polyglutamylation and increased target
enzyme inhibition. micro