Division of Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Cancer Chemother Pharmacol. 2018 Jun;81(6):991-998. doi: 10.1007/s00280-018-3570-3. Epub 2018 Mar 30.
PURPOSE: Effective treatment of patients with locally advanced pancreatic cancer is a significant unmet clinical need. One major hurdle that exists is inadequate drug delivery due to the desmoplastic stroma and poor vascularization that is characteristic of pancreatic cancer. The local iontophoretic delivery of chemotherapies provides a novel way of improving treatment. With the growing practice of highly toxic combination therapies in the treatment of pancreatic cancer, the use of iontophoresis for local delivery can potentiate the anti-cancer effects of these therapies while sparing unwanted toxicity. The objective of this study was to investigate the impact of formulation on the electro-transport of the FOLFIRINOX regimen for the development of a new treatment for pancreatic cancer. METHODS: Three formulations of the FOLFIRINOX regimen (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) were generated at a fixed pH of 6.0 and were referred to as formulation A (single drug solution with all four drugs combined), formulation B (two drug solutions with two drugs per solution), and formulation C (four individual drug solutions). Anodic iontophoresis of the three different formulations was evaluated in orthotopic patient-derived xenografts of pancreatic cancer. RESULTS: Iontophoretic transport of the FOLFIRINOX drugs was characterized according to organ exposure after a single device treatment in vivo. We report that the co-iontophoresis of two drug solutions, leucovorin + oxaliplatin and 5-fluorouracil + irinotecan, resulted in the highest levels of cytotoxic drugs in the tumor compared to drugs delivered individually or combined into one solution. There was no significant difference in plasma, pancreas, kidney, and liver exposure to the cytotoxic drugs delivered by the three different formulations. In addition, we found that reducing the duration of iontophoretic treatment from 10 to 5 min per solution resulted in a significant decrease in drug concentrations. CONCLUSIONS: Underlying the difference in drug transport of the formulations was electrolyte concentrations, which includes both active and inactive components. Electrolyte concentrations can hinder or improve drug electro-transport. Overall, balancing electrolyte concentration is needed for optimal electro-transport.
目的:有效治疗局部晚期胰腺癌是一项重大的未满足的临床需求。存在的一个主要障碍是由于胰腺癌特有的细胞外基质和血管生成不良导致药物输送不足。化疗的局部离子电渗递药为改善治疗提供了一种新方法。随着在胰腺癌治疗中越来越多地采用毒性很高的联合疗法,离子电渗递药局部给药可增强这些疗法的抗癌作用,同时避免不必要的毒性。本研究的目的是研究制剂对 FOLFIRINOX 方案电传递的影响,以期开发一种新的胰腺癌治疗方法。
方法:在固定 pH 值为 6.0 的条件下,生成了 FOLFIRINOX 方案(5-氟尿嘧啶、亚叶酸、伊立替康和奥沙利铂)的三种制剂,分别称为制剂 A(四种药物的单一药物溶液组合)、制剂 B(两种药物溶液,每个溶液两种药物)和制剂 C(四种单独的药物溶液)。在胰腺癌细胞来源的原位异种移植模型中,评估了三种不同制剂的阳极离子电渗。
结果:根据体内单次治疗后器官暴露情况,对 FOLFIRINOX 药物的离子电渗传输进行了特征描述。我们报告说,与单独给药或组合成一种溶液相比,两种药物溶液(亚叶酸+奥沙利铂和 5-氟尿嘧啶+伊立替康)的共离子电渗导致肿瘤中细胞毒性药物的水平最高。三种不同制剂递送的细胞毒性药物在血浆、胰腺、肾脏和肝脏中的暴露量没有显著差异。此外,我们发现将每个溶液的离子电渗治疗时间从 10 分钟缩短至 5 分钟,可显著降低药物浓度。
结论:制剂药物输送的差异源于电解质浓度,包括活性和非活性成分。电解质浓度可以阻碍或改善药物的电传递。总体而言,需要平衡电解质浓度以实现最佳电传递。
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