Koch Institute for Integrative Cancer Research at the Massachusetts Institute of Technology, Cambridge, MA, USA.
Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
Expert Opin Drug Deliv. 2022 Jun;19(6):725-732. doi: 10.1080/17425247.2022.2084070. Epub 2022 Jun 2.
On-target, off-tumor toxicity severely limits systemic dosing of cytokines and agonist antibodies for cancer. Intratumoral administration is increasingly being explored to mitigate this problem. Full exploitation of this mode of administration must include a mechanism for sustained retention of the drug; otherwise, rapid diffusion out of the tumor eliminates any advantage.
We focus here on strategies for anchoring immune agonists in accessible formats. Such anchoring may utilize extracellular matrix components, cell surface receptor targets, or exogenously administered particulate materials. Promising alternative strategies not reviewed here include slow release from the interior of a material depot, expression following local transfection, and conditional proteolytic activation of masked molecules.
An effective mechanism for tissue retention is a critical component of intratumorally anchored cytokine therapy, as leakage leads to decreased tumor drug exposure and increased systemic toxicity. Matching variable drug release kinetics with receptor-mediated cellular uptake is an intrinsic requirement for the alternative strategies mentioned above. Bioavailability of an anchored form of the administered drug is key to obviating this balancing act.
在肿瘤靶向、肿瘤外毒性严重限制了细胞因子和激动型抗体用于癌症的全身治疗剂量的情况下,人们越来越多地探索瘤内给药以减轻这个问题。要充分利用这种给药方式,必须包括一种持续保留药物的机制;否则,药物会迅速从肿瘤中扩散出去,从而消除任何优势。
我们在这里重点关注锚定免疫激动剂的可及格式的策略。这种固定可以利用细胞外基质成分、细胞表面受体靶点或外源性给予的颗粒材料。此处未回顾的有前途的替代策略包括从材料库内部缓慢释放、局部转染后的表达以及掩蔽分子的条件蛋白水解激活。
对于瘤内锚定细胞因子治疗,组织保留的有效机制是一个关键组成部分,因为渗漏会导致肿瘤药物暴露减少和全身毒性增加。与受体介导的细胞摄取相匹配的可变药物释放动力学是上述替代策略的内在要求。所给予药物的锚定形式的生物利用度是避免这种平衡行为的关键。