Koshkina N V, Kleinerman E S, Waidrep C, Jia S F, Worth L L, Gilbert B E, Knight V
Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas 77030, USA.
Clin Cancer Res. 2000 Jul;6(7):2876-80.
The response rates of relapsed osteosarcoma and melanoma pulmonary metastases to traditional i.v. chemotherapeutic regimens have been disappointing. Direct drug delivery of chemotherapy to the lungs could increase the drug concentration in the tumor area and may offer a new therapeutic approach for these patients. Previous studies demonstrated that drugs delivered to the respiratory tract in liposomal formulation resulted in high pulmonary drug concentration, reduced systemic toxicity, and reduced dosage requirements compared with parenteral and oral administration. To determine whether this approach has utility against pulmonary metastases, the efficacy of aerosol therapy with liposome-encapsulated 9-nitrocamptothecin (L-9NC) was determined using two different experimental lung metastasis models. C57BL/6 mice were treated the day after the i.v. injection of B16 melanoma cells with aerosol L-9NC for 1 h (153 microg 9-nitrocamptothecin/kg) for 5 days per week for up to 3 weeks. Aerosol L-9NC treatment resulted in a reduction in lung weights (P = 0.005) and number of tumor foci (P < 0.001). Visible tumor nodules were fewer and smaller in the 9-nitrocamptothecin-treated group than in untreated control mice (P < 0.001). Using a newly developed human osteosarcoma experimental metastasis model in nude mice, we demonstrated that aerosol L-9NC was also effective against established lung metastases. Aerosol therapy initiated on the ninth week after i.v. tumor injection and continued for 8 or 10 weeks produced highly significant reductions in the number of animals with both visible and microscopic disease (P < 0.02), the total number of tumor foci in the lungs (P < 0.005), and the size of the individual tumor nodules (P < 0.02). These data suggest that L-9NC aerosol therapy may offer significant advantage over existing methods in the treatment of melanoma and osteosarcoma pulmonary metastases.
复发性骨肉瘤和黑色素瘤肺转移对传统静脉化疗方案的反应率一直令人失望。将化疗药物直接递送至肺部可提高肿瘤部位的药物浓度,并可能为这些患者提供一种新的治疗方法。先前的研究表明,与肠胃外给药和口服给药相比,脂质体制剂的药物经呼吸道给药可导致肺部药物浓度升高、全身毒性降低且所需剂量减少。为了确定这种方法对肺转移是否有效,我们使用两种不同的实验性肺转移模型,测定了脂质体包裹的9-硝基喜树碱(L-9NC)雾化治疗的疗效。在静脉注射B16黑色素瘤细胞后的第二天,对C57BL/6小鼠进行雾化L-9NC治疗,持续1小时(153微克9-硝基喜树碱/千克),每周5天,持续3周。雾化L-9NC治疗导致肺重量减轻(P = 0.005)和肿瘤病灶数量减少(P < 0.001)。与未治疗的对照小鼠相比,9-硝基喜树碱治疗组中可见的肿瘤结节更少、更小(P < 0.001)。我们使用新开发的裸鼠人骨肉瘤实验性转移模型证明,雾化L-9NC对已形成的肺转移也有效。在静脉注射肿瘤后的第九周开始雾化治疗,并持续8或10周,可使出现可见和微观病变的动物数量(P < 0.02)、肺内肿瘤病灶总数(P < 0.005)以及单个肿瘤结节大小(P < 0.02)显著减少。这些数据表明,L-9NC雾化治疗在治疗黑色素瘤和骨肉瘤肺转移方面可能比现有方法具有显著优势。