Hepatic drug metabolism may have significant impact on the efficacy and off-target toxicity of anticancer drugs.​ We present here an in vitro assay, the metabolism-dependent cytotoxicity assay (MDCA), for the evaluation of the roles of specific pathways on the toxicity of anticancer drugs.​​

The assay employs a novel in vitro hepatic metabolic system, the permeabilized cofactor-supplemented human hepatocytes (MetMax Human Hepatocytes, MMHH), as an exogenous metabolic activating system for the evaluation of the in vitro cytotoxicity of anticancer agents towards a designated tumor and nontumor cells.​

MMHH are derived by permeabilization of cryopreserved human hepatocytes isolated from human livers procured for but not used for transplantation.​ Drug metabolism pathways can be selected by cofactor specification (e.g. NADPH/NAD+ for phase 1 oxidation; Uridine 5′-diphosphoglucuronic acid (UDPGA) for glucuronidation; 3′-phosphoadenosine 5′-phosphosulfate (PAPS) for sulfation; N-acetyl coenzyme A for N-acetylation). ​

We present here a proof-of-concept study to evaluate the role of various hepatic metabolic pathways towards the cytotoxicity of cyclophosphamide, a commonly used drug for the treatment of renal carcinoma, towards a renal cancer cell line, HEK293 cells.

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