Shi Minghan, Fortin David, Paquette Benoit, Sanche Léon
Center for Research in Radiotherapy, Department of Nuclear Medicine and Radiobiology, Faculty of Medicine and Heath Science, Université de Sherbrooke, Sherbrooke, Québec, J1H 5N4, Canada.
Department of Surgery, Division of Neurosurgery, Centre Hospitalier Universitaire de Sherbrooke (D.F.), Sherbrooke, Québec, J1H 5N4, Canada.
Invest New Drugs. 2016 Jun;34(3):269-76. doi: 10.1007/s10637-016-0340-0. Epub 2016 Mar 9.
Results of clinical trials with oxaliplatin in treating glioblastoma are dismal. Previous works showed that intravenous (i.v.) delivery of oxaliplatin did not increase the survival of F98 glioma-bearing Fisher rats. Low accumulation of the drug in tumor cells is presumed to be responsible for the lack of antitumor effect. In the present study, convection-enhanced delivery (CED) was used to directly inject oxaliplatin in brain tumor implanted in rats. Since CED can led to severe toxicity, the liposomal formulation of oxaliplatin (Lipoxal™) was also assessed. The maximum tolerated dose (MTD) of oxaliplatin was 10 μg, while that of Lipoxal™ was increased by 3-times reaching 30 μg. Median survival time (MeST) of F98 glioma-bearing rats injected with 10 μg oxaliplatin by CED was 31 days, 7.5 days longer than untreated control (p = 0.0002); while CED of 30 μg Lipoxal™ reached the same result. Compared to previous study on i.v. delivery of these drugs, their injection by CED significantly increased their tumoral accumulations as well as MeSTs in the F98 glioma bearing rat model. The addition of radiotherapy (15 Gy) to CED of oxaliplatin or Lipoxal™ increased the MeST by 4.0 and 3.0 days, respectively. The timing of radiotherapy (4 h or 24 h after CED) produced similar results. However, the treatment was better tolerated when radiotherapy was performed 24 h after CED. In conclusion, a better tumoral accumulation was achieved when oxaliplatin and Lipoxal™ were injected by CED. The liposomal encapsulation of oxaliplatin reduced its toxic, while maintaining its antitumor potential.
奥沙利铂治疗胶质母细胞瘤的临床试验结果令人沮丧。先前的研究表明,静脉注射奥沙利铂并不能提高荷F98胶质瘤的Fisher大鼠的生存率。药物在肿瘤细胞中的低蓄积被认为是缺乏抗肿瘤作用的原因。在本研究中,采用对流增强递送(CED)将奥沙利铂直接注射到植入大鼠的脑肿瘤中。由于CED可能导致严重毒性,还评估了奥沙利铂的脂质体制剂(Lipoxal™)。奥沙利铂的最大耐受剂量(MTD)为10μg,而Lipoxal™的最大耐受剂量增加了3倍,达到30μg。通过CED注射10μg奥沙利铂的荷F98胶质瘤大鼠的中位生存时间(MeST)为31天,比未治疗的对照组长7.5天(p = 0.0002);而30μg Lipoxal™的CED达到了相同的结果。与先前关于这些药物静脉递送的研究相比,在荷F98胶质瘤大鼠模型中,通过CED注射它们显著增加了肿瘤蓄积以及MeST。在奥沙利铂或Lipoxal™的CED中添加放疗(15Gy)分别使MeST增加了4.0天和3.0天。放疗时间(CED后4小时或24小时)产生了相似的结果。然而,当在CED后24小时进行放疗时,治疗的耐受性更好。总之,通过CED注射奥沙利铂和Lipoxal™时可实现更好的肿瘤蓄积。奥沙利铂的脂质体包封降低了其毒性,同时保持了其抗肿瘤潜力。