Camptothecin-11 (CPT-11) is a new derivative of camptothecin, a plant alkaloid antitumor agent. Previous studies indicated that antitumor activity of CPT-11 was mediated through interaction of the drugs with its target enzyme, DNA topoisomerase I (topo I). In this study, we studied the relation between sensitivity to CPT–11 and topo I activity of glioma cells. Furthermore, we established CPT-11 resistant cell lines in order to elucidate the potential mechanisms of drug resistance. A clear correlation between the sensitivities to CPT-11 and topo I activities in surgical glioma specimens was demonstrated. Activities of topo I in the CPT-11-sensitive group (IC50 values for CPT-11; <50 μg/ml) tended to be higher than those in the CPT-11-resistant group (IC50 values, ≥50). Topo I activity may serve as a novel marker to predict the sensitivity of gliomas to topo inhibitors. CPT-11-resistant cell lines (T98G/CPT-11 and C6), respectively, exhibit a 5.4- and 7.3-fold increase in resistance to CPT-11. No differences in topo I activity and intracellular accumulation of CPT-11 were observed between the parent and CPT-11-resistant lines. On the other hand, topo I from T98G/CPT-11 and C6-CPT-11 cells was at least 4- and 2-fold resistant to the inhibitory effect of the CPT-11 on the relaxation activity of topo I, in comparison with their parent lines. This enzymological difference may be responsible for the resistance to CPT-11. © 1993 Wiley-Liss, Inc.