The invention provides novel inhibitors of protein translation initiation
and inhibitors of eIF4F activity that can increase chemosensitivity or
diminish or reverse chemoresistance in growth transformed cells and
thereby reduce hyperproliferative conditions, such as cancer progression,
in select patient populations having particular tumor genotypes. The
invention also provides methods which target translation initiation
controls in growth-transformed cells, such as tumor subtypes with altered
expression of a gene activity, including the human akt, bcl-2, eIF4E,
eIF4A or PTEN activities, to restore drug sensitivity in vivo in a
genotype selective manner. In one aspect, the inhibitors of translation
initiation of the invention are rocaglates, i.e.,
cyclopenta[b]benzofurons, which increases chemosensitivity or diminishes
or reverses chemoresistance either alone or in combination, additively or
synergistically, with other agents that alter growth or death.
Preferably, the rocaglate is silvestrol, which is used alone or in
combination with doxorubicin to reverses chemoresistance in
PTEN-deficient lymphomas or eIF4E-over-expressing lymphomas and to
promote cancer remission.