Department of Biochemistry, IMRIC, The Hebrew University-Hadassah Medical School, Jerusalem, Israel.
J Control Release. 2010 Sep 15;146(3):326-33. doi: 10.1016/j.jconrel.2010.05.024. Epub 2010 May 25.
There is an opportunity to improve the therapeutic potential of a combination of two drugs using nanoliposomes. The combination of topotecan (TPT) and vincristine (VCR) was selected. The ratio-dependent synergy between these two drugs was evaluated, in an attempt to improve the therapeutic efficacy of this combination in vivo. The interaction between the drugs was evaluated in tissue culture by the median-effect analysis. Certain ratios of combined drugs were synergistic, whereas, others were antagonistic, implying that the most efficacious combinations should be at a specific fixed drug ratio. For in vivo evaluation, nanoliposomes co-remotely loaded simultaneously with both drugs by transmembrane ammonium sulfate gradient were developed. VCR and TPT were successfully co-encapsulated at therapeutically relevant levels in the same nanoliposome (LipoViTo). The nanoliposomes controlled the drugs' "biofate" and maintained a fixed drug ratio in vivo, allowing one to compare the therapeutic efficacy of various predefined drug ratios. Pharmacokinetics and biodistribution studies showed that LipoViTo delivers the two drugs simultaneously to the tumors, where they are released at a predefined ratio. LipoViTo was more efficacious than the free drugs and liposomes with one agent, singly or in combination, in two tumor models in mice. LipoViTo co-loaded with both drugs corresponding to their maximal tolerated dose (MTD) ratio resulted in the best therapeutic efficacy. To summarize: liposomal co-encapsulation of anticancer drug combinations can profoundly influence therapeutic outcomes. Drug combinations can be optimized preclinically through pharmacokinetic control by remote loading into nanoliposomes.
有机会通过使用脂质纳米囊来提高两种药物联合治疗的潜力。选择了拓扑替康(TPT)和长春新碱(VCR)的联合用药。通过中值效应分析评估了这两种药物之间的比率依赖性协同作用,试图改善该组合在体内的治疗效果。通过组织培养中的药物相互作用评估,某些联合用药的比例是协同的,而其他比例则是拮抗的,这意味着最有效的组合应该在特定的固定药物比例。为了进行体内评估,通过跨膜硫酸铵梯度同时远程加载两种药物的纳米脂质体被开发出来。长春新碱和拓扑替康成功地在同一脂质体(LipoViTo)中以治疗相关的水平共包封。纳米脂质体控制药物的“生物命运”,并在体内维持固定的药物比例,从而可以比较各种预定义药物比例的治疗效果。药代动力学和生物分布研究表明,LipoViTo 同时将两种药物递送到肿瘤部位,在那里以预定的比例释放。与游离药物和单独或联合使用一种药物的脂质体相比,LipoViTo 在两种小鼠肿瘤模型中更有效。同时载有两种药物(按其最大耐受剂量比)的 LipoViTo 产生了最佳的治疗效果。总之:脂质体共包封抗癌药物组合可以深刻影响治疗结果。通过远程加载到纳米脂质体中进行药代动力学控制,可以在临床前阶段优化药物组合。