Division of Pharmacoengineering and Molecular Pharmaceutics , Eshelman School of Pharmacy, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina 27599 , United States.
Joint Department of Biomedical Engineering , University of North Carolina at Chapel Hill and North Carolina State University , Raleigh , North Carolina 27695 , United States.
Mol Pharm. 2018 Mar 5;15(3):1309-1318. doi: 10.1021/acs.molpharmaceut.7b01114. Epub 2018 Feb 2.
The primary cause of mortality for glioblastoma (GBM) is local tumor recurrence following standard-of-care therapies, including surgical resection. With most tumors recurring near the site of surgical resection, local delivery of chemotherapy at the time of surgery is a promising strategy. Herein drug-loaded polymer scaffolds with two distinct degradation profiles were fabricated to investigate the effect of local drug delivery rate on GBM recurrence following surgical resection. The novel biopolymer, acetalated dextran (Ace-DEX), was compared with commercially available polyester, poly(l-lactide) (PLA). Steady-state doxorubicin (DXR) release from Ace-DEX scaffolds was found to be faster when compared with scaffolds composed of PLA, in vitro. This increased drug release rate translated to improved therapeutic outcomes in a novel surgical model of orthotopic glioblastoma resection and recurrence. Mice treated with DXR-loaded Ace-DEX scaffolds (Ace-DEX/10DXR) resulted in 57% long-term survival out to study completion at 120 days compared with 20% survival following treatment with DXR-loaded PLA scaffolds (PLA/10DXR). Additionally, all mice treated with PLA/10DXR scaffolds exhibited disease progression by day 38, as defined by a 5-fold growth in tumor bioluminescent signal. In contrast, 57% of mice treated with Ace-DEX/10DXR scaffolds displayed a reduction in tumor burden, with 43% exhibiting complete remission. These results underscore the importance of polymer choice and drug release rate when evaluating local drug delivery strategies to improve prognosis for GBM patients undergoing tumor resection.
胶质母细胞瘤(GBM)的主要致死原因是标准治疗方法(包括手术切除)后的局部肿瘤复发。由于大多数肿瘤在手术切除部位附近复发,因此在手术时局部递送化疗是一种很有前途的策略。在此,我们制备了两种具有不同降解特性的载药聚合物支架,以研究局部药物递送率对手术切除后 GBM 复发的影响。新型生物聚合物乙酰化葡聚糖(Ace-DEX)与市售聚酯聚(L-丙交酯)(PLA)进行了比较。与 PLA 支架相比,在体外,Ace-DEX 支架中的阿霉素(DXR)达到稳态时的释放速度更快。这种增加的药物释放速度在新的原位胶质母细胞瘤切除和复发手术模型中转化为改善的治疗效果。用载 DXR 的 Ace-DEX 支架(Ace-DEX/10DXR)治疗的小鼠在 120 天研究结束时的长期存活率达到 57%,而用载 DXR 的 PLA 支架(PLA/10DXR)治疗的小鼠的存活率仅为 20%。此外,所有用 PLA/10DXR 支架治疗的小鼠在第 38 天都表现出疾病进展,定义为肿瘤生物发光信号增加了 5 倍。相比之下,57%用 Ace-DEX/10DXR 支架治疗的小鼠肿瘤负荷减少,其中 43%的小鼠完全缓解。这些结果强调了在评估局部药物递送策略以改善接受肿瘤切除的 GBM 患者预后时,聚合物选择和药物释放率的重要性。