Novel carbonic anhydrase IX-targeted therapy enhances the anti-tumour effects of cisplatin in small cell lung cancer

Int J Cancer. 2018 Jan 1;142(1):191-201. doi: 10.1002/ijc.31042. Epub 2017 Oct 3.


Small cell lung cancer (SCLC) has an extremely poor prognosis and methods of improving chemotherapeutic intervention are much sought after. A promising approach lies in inhibiting the tumour-associated enzyme, carbonic anhydrase IX (CA IX), which supports tumour cell survival. The aim of this study was to assess the potential of CA IX inhibition using 4-(3'-(3″,5″-dimethylphenyl)ureido)phenyl sulfamate (S4), for the treatment of human SCLC alone and in combination with cisplatin chemotherapy. Treating SCLC cell lines (DMS 79 and COR-L24) with 100 µM S4 reduced viability in vitro and enhanced cell death when combined with 7 µM cisplatin, most prominently under hypoxic conditions (0.1% O2 ). When either cell line was grown as a xenograft tumour in nude mice, intraperitoneal injection of 50 mg/kg S4 alone and in combination with 3 mg/kg cisplatin led to significantly reduced tumour growth. Combination therapy was superior to single agents and response was greatly accentuated when administering repeated doses of cisplatin in DMS 79 tumours. The mechanism of therapeutic response was investigated in vitro, where S4 treatment increased apoptosis under hypoxic conditions in both DMS 79 and COR-L24 cells. DMS 79 tumours receiving S4 in vivo also displayed increased apoptosis and necrosis. Combining S4 with cisplatin reduced both the area of hypoxia and CA IX-positive cells within tumours and increased necrosis, suggesting hypoxia-specific targeting. This study presents a novel, targeted approach to improving current SCLC therapy via inhibition of CA IX, which enhances apoptosis and significantly inhibits xenograft tumour growth when administered alone and in combination with cisplatin chemotherapy.

Keywords: carbonic anhydrase IX; chemotherapy; hypoxia; small cell lung cancer; xenografts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacology*
  • Carbonic Anhydrase IX / antagonists & inhibitors*
  • Cell Line, Tumor
  • Cisplatin / pharmacology
  • Drug Synergism
  • Enzyme Inhibitors / pharmacology*
  • Humans
  • Lung Neoplasms / drug therapy*
  • Mice
  • Mice, Nude
  • Phenylurea Compounds / pharmacology*
  • Small Cell Lung Carcinoma / drug therapy*
  • Sulfonic Acids / pharmacology*
  • Xenograft Model Antitumor Assays


  • 4-(3'-(3'',5''-dimethylphenyl)ureido)phenyl sulfamate
  • Antineoplastic Agents
  • Enzyme Inhibitors
  • Phenylurea Compounds
  • Sulfonic Acids
  • sulfamic acid
  • Carbonic Anhydrase IX
  • Cisplatin