MAL3-101 and MG-132 exhibit synergistic, cytotoxic effects on multiple myeloma tumor cells and endothelial progenitor cells. (a) NCI-H929 cells (1 × 105) were exposed to the indicated concentrations of MAL3-101, MG-132, or a combination of these agents for 40 h, and survival was assessed by an MTS assay; representative data from one of seven independent experiments are shown; error bars represent SDs from replicate data points. Apparent absence of error bars indicates minimal variance. (b) The fraction of nonviable cells compared to control, DMSO-treated cells in this experiment was used for isobologram analysis. In brief, the cellular fraction affected (Fa) was calculated based on the indicated MTS assays using the following formula: Fa = 100 minus the percent of viable cells. Fa values at the indicated drug concentrations were used by CalcuSyn to derive combination index (CI) values, where CI = 1 indicates additive effects, CI < 1 indicates synergy, and CI > 1 indicates antagonism [14]. (c) Bone-marrow-derived tumor cells (black bars) and confluent endothelial progenitor cells (EPCs) (white bars) from multiple myeloma patients were exposed to the indicated concentrations of MAL3-101, MG-132, or their combination, and survival was assessed by an MTS assay. Dunnett's test, after significant one-way repeated-measures analyses of variance (P = 0.004 and 0.002 for tumor cells and EPCs, resp.), compared control values to cell viability in cultures treated with MAL3-101, MG-132, or MAL3-101 + MG-132 (*P ≤ 0.05, **P ≤ 0.001). (d) Normal peripheral blood mononuclear cells (PBMCs, black bars), bone marrow mononuclear cells (BMMCs, gray bars), and confluent bone-marrow-derived EPCs (white bars) were exposed to the indicated concentrations of MAL3-101, MG-132, or a combination of these agents, and survival was assessed by an MTS assay.