College of Pharmacy, The Ohio State University, Columbus, 43210, USA.
J Control Release. 2013 Dec 28;172(3):737-44. doi: 10.1016/j.jconrel.2013.09.011. Epub 2013 Sep 20.
Intraperitoneal therapy (IP) has demonstrated survival advantages in patients with peritoneal cancers, but has not become a widely practiced standard-of-care in part due to local toxicity and sub-optimal drug delivery. Paclitaxel-loaded, polymeric microparticles were developed to overcome these limitations. The present study evaluated the effects of microparticle properties on paclitaxel release (extent and rate) and in vivo pharmacodynamics. In vitro paclitaxel release from microparticles with varying physical characteristics (i.e., particle size, copolymer viscosity and composition) was evaluated. A method was developed to simulate the dosing rate and cumulative dose released in the peritoneal cavity based on the in vitro release data. The relationship between the simulated drug delivery and treatment outcomes of seven microparticle compositions was studied in mice bearing IP human pancreatic tumors, and compared to that of the intravenous Cremophor micellar paclitaxel solution used off-label in previous IP studies. Paclitaxel release from polymeric microparticles in vitro was multi-phasic; release was greater and more rapid from microparticles with lower polymer viscosities and smaller diameters (e.g., viscosity of 0.17 vs. 0.67 dl/g and diameter of 5-6 vs. 50-60 μm). The simulated drug release in the peritoneal cavity linearly correlated with treatment efficacy in mice (r(2)>0.8, p<0.001). The smaller microparticles, which distribute more evenly in the peritoneal cavity compared to the large microparticles, showed greater dose efficiency. For single treatment, the microparticles demonstrated up to 2-times longer survival extension and 4-times higher dose efficiency, relative to the paclitaxel/Cremophor micellar solution. Upon repeated dosing, the paclitaxel/Cremophor micellar solution showed cumulative toxicity whereas the microparticle that yielded 2-times longer survival did not display cumulative toxicity. The efficacy of IP therapy depended on both temporal and spatial factors that were determined by the characteristics of the drug delivery system. A combination of fast- and slow-releasing microparticles with 5-6 μm diameter provided favorable spatial distribution and optimal drug release for IP therapy.
腹腔内治疗 (IP) 在患有腹膜癌的患者中显示出生存优势,但由于局部毒性和药物输送不理想,并未成为广泛应用的标准治疗方法。载紫杉醇的聚合物微球的开发旨在克服这些限制。本研究评估了微粒性质对紫杉醇释放(程度和速度)和体内药效学的影响。评估了具有不同物理特性(即粒径、共聚物粘度和组成)的微球的体外紫杉醇释放。开发了一种方法,根据体外释放数据模拟腹腔内给药率和累积释放剂量。在腹腔内荷有人胰腺肿瘤的小鼠中,研究了七种微球组成物的模拟药物输送与治疗结果之间的关系,并与之前 IP 研究中标签外使用的静脉注射 Cremophor 胶束紫杉醇溶液进行了比较。聚合物微球在体外的紫杉醇释放是多相的;从粘度较低和直径较小的微球(例如,粘度为 0.17 与 0.67dl/g,直径为 5-6 与 50-60μm)中释放的紫杉醇更多且更快。腹腔内模拟药物释放与小鼠治疗效果呈线性相关(r²>0.8,p<0.001)。与大微球相比,分布在腹腔内更均匀的小微球显示出更高的剂量效率。单次治疗时,与紫杉醇/Cremophor 胶束溶液相比,微球的生存延长时间延长了 2 倍,剂量效率提高了 4 倍。重复给药时,紫杉醇/Cremophor 胶束溶液显示出累积毒性,而延长生存 2 倍的微球则没有显示出累积毒性。腹腔内治疗的疗效取决于由药物输送系统特性决定的时间和空间因素。具有 5-6μm 直径的快速和缓慢释放微球的组合为腹腔内治疗提供了有利的空间分布和最佳的药物释放。