Synergistic Effect of Resveratrol and Paclitaxel in the Treatment of Malignant Pleural Mesothelioma

Malignant pleural mesothelioma (MPM) is a lethal and aggressive cancer due to exposure to asbestos since this carcinogen is still being used in industrial buildings and housing in several countries. Untreated MPM has a median survival time of 12 months, and most people die within 24 months after diagnosis. If caught early, surgery may be performed. Treatment option for palliative care is limited using platinum with pemetrexed. Malignant transformation of a cell is attributed to a series of genetic and epigenetic events involving alterations in several oncogenes, tumor suppressor genes, and others. Different anticancer and antioxidants with anticancer properties were tested individually and in combination to find the best synergistic effect in killing MSTO-211H, a lung mesothelioma cell line used as model of MPM. Once the combination was identified, assays and staining methods such as MTT, Rhodamine123, Hoechst 33342, Nuclear ID Red/Green, and Western Blot were performed to identify different proteins involved in apoptosis and cell signaling cascade to proof the cytotoxic effect of the combine anticancer and antioxidant treatment. Combination of Paclitaxel (PAC) at 3 µM and Resveratrol (RSV) at 62.5 µM showed synergistic effect on MSTO-211H cells by causing inhibition of epidermal growth factor receptor (EGFR), inhibition of mitogen activated protein kinases (MEKs) 1-4, inhibition of programmed death ligand-1 (PDL-1), inhibition of cell cycle proteins, and induction of caspases 3-8. This study provided possible potential application of using RSV as a chemo-enhancing compound with PAC in the treatment of MPM.