Tonak Marcus, Becker Marc, Graf Claudine, Eckhard Lukas, Theobald Matthias, Rommens Pol-Maria, Wehler Thomas C, Proschek Dirk
Department for Orthopaedic and Trauma Surgery, University Hospital Mannheim, Mannheim, Germany Department of Orthopaedics and Traumatology, University Medical Center Mainz, Mainz, Germany.
Interdisciplinary Sarcoma Working Group of First Medical Department, University Medical Center Mainz, Mainz, Germany Department of Internal Medicine V - Pulmonology, Allergology and Respiratory Critical Care Medicine, Saarland University, Homburg, Germany.
Anticancer Res. 2014 Nov;34(11):6459-66.
The treatment of osteosarcoma, especially wide resection, is challenging. An additional local drug therapy after resection using anti-neoplastic bone cement (Polymethylmethacrylate (PMMA)) could help improve the outcome of therapy. In this study, we evaluated the effects of PMMA loaded with valproic acid (VPA) and suberoylanilide hydroxamic acid (SAHA) on the cell activity of a SaOs-2 cell culture, as well as the elution rate of the drugs out of the bone cement.
In our experiments, we used the SaOs-2 osteosarcoma and the SW1353 chondrosarcoma cell line. Bone cement clots (5 g) were prepared and loaded with different drug concentrations of VPA (25 mg and 50 mg) and SAHA (1 mg, 2.5 mg and 5 mg). Two control groups were established, one with a native cement clot, the other with human mesenchymal stem cells, in order to evaluate toxicity on non tumor-cells. Cell activity was measured using an Alamar Blue assay on days 1, 2, 3, 4 and 7. The cement clots were additionally examined in a material testing unit for biomechanical and structural changes.
Tumor cells showed a significant and complete reduction of activity under therapy with VPA and SAHA. Drug release of VPA was extensive between days 0 and 3 and decreased progressively to day 7. Cumulative drug concentration in the medium continuously increased. Biomechanical testing of the cement clots showed no differences in stability and architecture compared to the control group. SaOs-2 and SW1353 cells with medium from native cement clots without drug therapy presented a cell activity of 100% in all groups and during all measurements. Human mesenchymal stem cells were not significantly affected during therapy with VPA and low concentrations of SAHA. In contrast, cell activity of human mesenchymal stem cells was significantly reduced under therapy with higher concentrations of SAHA, with an approximately linear decrease between days 0-3 and a rapidly decreasing activity between days 4-7.
A local cytotoxic therapy in the treatment of osteosarcoma and chondrosarcoma might improve the rate of metastasis and survival of patients. Our results present an encouraging approach to loading PMMA with anti-neoplastic drugs.
骨肉瘤的治疗,尤其是广泛切除,具有挑战性。切除后使用抗肿瘤骨水泥(聚甲基丙烯酸甲酯(PMMA))进行额外的局部药物治疗可能有助于改善治疗效果。在本研究中,我们评估了负载丙戊酸(VPA)和辛二酰苯胺异羟肟酸(SAHA)的PMMA对SaOs-2细胞培养物细胞活性的影响,以及药物从骨水泥中的洗脱率。
在我们的实验中,我们使用了SaOs-2骨肉瘤细胞系和SW1353软骨肉瘤细胞系。制备骨水泥凝块(5克),并负载不同药物浓度的VPA(25毫克和50毫克)和SAHA(1毫克、2.5毫克和5毫克)。设立两个对照组,一组为天然水泥凝块,另一组为人间充质干细胞,以评估对非肿瘤细胞的毒性。在第1、2、3、4和7天使用alamar蓝测定法测量细胞活性。此外,在材料测试单元中检查水泥凝块的生物力学和结构变化。
在VPA和SAHA治疗下,肿瘤细胞的活性显著且完全降低。VPA的药物释放在第0天至第3天广泛,至第7天逐渐减少。培养基中的累积药物浓度持续增加。与对照组相比,水泥凝块的生物力学测试在稳定性和结构方面没有差异。未经药物治疗的天然水泥凝块培养基中的SaOs-2和SW1353细胞在所有组和所有测量中细胞活性均为100%。在VPA和低浓度SAHA治疗期间,人间充质干细胞未受到显著影响。相反,在高浓度SAHA治疗下,人间充质干细胞的细胞活性显著降低,在第0 - 3天之间近似呈线性下降,在第4 - 7天之间活性迅速下降。
骨肉瘤和软骨肉瘤治疗中的局部细胞毒性疗法可能会提高患者的转移率和生存率。我们的结果为在PMMA中负载抗肿瘤药物提供了一种令人鼓舞的方法。