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关于脂质体顺铂(Lipoplatin)的临床概述:一种成功的顺铂脂质体制剂。

Clinical overview on Lipoplatin: a successful liposomal formulation of cisplatin.

机构信息

Regulon, Inc., 715 N. Shoreline Blvd., Mountain View, CA 94043, USA.

出版信息

Expert Opin Investig Drugs. 2009 Aug;18(8):1197-218. doi: 10.1517/13543780903114168.

Abstract

Nanoparticle formulations for packaging existing drugs have been used to treat cancer. Lipoplatin is a liposomal cisplatin encapsulated into liposome nanoparticles of an average diameter of 110 nm. Lipoplatin has substantially reduced the renal toxicity, peripheral neuropathy, ototoxicity, myelotoxicity as well as nausea/vomiting and asthenia of cisplatin in Phase I, II and III clinical studies with enhanced or similar efficacy to cisplatin. During clinical development, 10- to 200-fold higher accumulation of Lipoplatin in solid tumors compared to adjacent normal tissue was found in patients. Targeting of tumor vasculature by Lipoplatin in animals suggested its antiangiogenesis potential and Lipoplatin was proposed to act like a double-sword: as chemotherapy and an antiangiogenesis drug. Lipoplatin has finished successfully one Phase III non-inferiority clinical study as first-line against NSCLC in its combination with paclitaxel showing statistically significant reduction in nephrotoxicity; two more Phase III studies are in progress, one in NSCLC with gemcitabine also showing noninferiority with reduced toxicity and another in squamous cell carcinoma of the head and neck with 5-fluorouracil. A registrational Phase II/III study against pancreatic cancer is in progress under the orphan drug status granted to Lipoplatin by the European Medicines Agency. Phase II studies are continuing in advanced breast cancer with vinorelbine and gastrointestinal cancers with radiotherapy and 5-fluorouracil. The highlights of the clinical development of Lipoplatin are reviewed.

摘要

纳米颗粒制剂已被用于包装现有药物来治疗癌症。脂质体顺铂是一种包封在平均直径为 110nm 的脂质体纳米颗粒中的脂质体顺铂。脂质体顺铂在 I、II 和 III 期临床研究中显著降低了顺铂的肾毒性、周围神经病变、耳毒性、骨髓毒性以及恶心/呕吐和乏力,同时保持了与顺铂相似的疗效。在临床开发过程中,发现患者的实体瘤中脂质体顺铂的积累比相邻正常组织高 10-200 倍。脂质体顺铂在动物中的肿瘤血管靶向作用表明其具有抗血管生成潜力,脂质体顺铂被提议像双刃剑一样发挥作用:作为化疗药物和抗血管生成药物。脂质体顺铂已成功完成了一项 III 期非劣效性临床试验,作为一线治疗非小细胞肺癌,与紫杉醇联合使用可显著降低肾毒性;另外两项 III 期研究正在进行中,一项是吉西他滨治疗非小细胞肺癌,另一项是 5-氟尿嘧啶治疗头颈部鳞状细胞癌,均显示出毒性降低的非劣效性。在欧洲药品管理局授予脂质体顺铂孤儿药地位的情况下,针对胰腺癌的注册性 II/III 期研究正在进行中。脂质体顺铂的 II 期研究继续在晚期乳腺癌中与长春瑞滨联合使用,以及在胃肠道癌症中与放疗和 5-氟尿嘧啶联合使用。本文综述了脂质体顺铂的临床开发要点。

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