The anti-cancer effects of combination of Ad-shRRM1 and GEM on RRM1 highly expressing bladder cancer cells. RRM1 inhibition with Ad-shRRM1 specifically sensitizes RRM1 highly expressed 253J (A) and RT112 cells (B) to GEM, but not to CDDP (C) and (D), respectively. Cells were infected with Ad-shRRM1 at series MOI of 5, 10, and 20 for 24 h, then treated with GEM or CDDP at gradually increasing concentrations. IC50 was evaluated by MTT assay 3 days after drug administration. Cell viability at starting point of non indicates the pure effect of adenoviral vector on the cell proliferation reference to cell viability treated with medium respectively. (IC50: drug concentration that inhibited cell growth by 50%; MOI, multiplicity of infection; GEM: gemcitabine; CDDP: cisplatin).