Abraham Sheela A, McKenzie Cheryl, Masin Dana, Ng Rebecca, Harasym Troy O, Mayer Lawrence D, Bally Marcel B
Division of Medical Oncology, Department of Advanced Therapeutics, BC Cancer Agency, Vancouver, British Columbia, Canada.
Clin Cancer Res. 2004 Jan 15;10(2):728-38. doi: 10.1158/1078-0432.ccr-1131-03.
There is an opportunity to augment the therapeutic potential of drug combinations through use of drug delivery technology. This report summarizes data obtained using a novel liposomal formulation with coencapsulated doxorubicin and vincristine. The rationale for selecting these drugs is due in part to the fact that liposomal formulations of doxorubicin and vincristine are being separately evaluated as components of drug combinations.
Doxorubicin and vincristine were coencapsulated into liposomes using two distinct methods of drug loading. A manganese-based drug loading procedure, which relies on drug complexation with a transition metal, was used to encapsulate doxorubicin. Subsequently the ionophore A23187 was added to induce formation of a pH gradient, which promoted vincristine encapsulation.
Plasma elimination studies in mice indicated that the drug:drug ratio before injection [4:1 doxorubicin:vincristine (wt:wt ratio)] changed to 20:1 at the 24-h time point, indicative of more rapid release of vincristine from the liposomes than doxorubicin. Efficacy studies completed in MDA MB-435/LCC6 tumor-bearing mice suggested that at the maximum tolerated dose, the coencapsulated formulation was therapeutically no better than liposomal vincristine. This result was explained in part by in vitro cytotoxicity studies evaluating doxorubicin and vincristine combinations analyzed using the Chou and Talalay median effect principle. These data clearly indicated that simultaneous addition of vincristine and doxorubicin resulted in pronounced antagonism.
These results emphasize that in vitro drug combination screens can be used to predict whether a coformulated drug combination will act in an antagonistic or synergistic manner.
通过使用药物递送技术,有机会增强药物组合的治疗潜力。本报告总结了使用一种新型脂质体制剂共包封阿霉素和长春新碱所获得的数据。选择这些药物的部分原因是阿霉素和长春新碱的脂质体制剂正在分别作为药物组合的成分进行评估。
使用两种不同的载药方法将阿霉素和长春新碱共包封到脂质体中。一种基于锰的载药程序,该程序依赖于药物与过渡金属的络合,用于包封阿霉素。随后加入离子载体A23187以诱导pH梯度的形成,从而促进长春新碱的包封。
小鼠体内血浆消除研究表明,注射前的药物:药物比例[阿霉素:长春新碱为4:1(重量:重量比)]在24小时时间点变为20:1,表明长春新碱从脂质体中的释放比阿霉素更快。在携带MDA MB - 435/LCC6肿瘤的小鼠中完成的疗效研究表明,在最大耐受剂量下,共包封制剂的治疗效果并不优于脂质体长春新碱。这一结果部分是通过使用Chou和Talalay中位效应原理分析阿霉素和长春新碱组合的体外细胞毒性研究来解释的。这些数据清楚地表明,同时添加长春新碱和阿霉素会导致明显的拮抗作用。
这些结果强调,体外药物组合筛选可用于预测共配制的药物组合将以拮抗还是协同方式起作用。