College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China.
College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, China.
Acta Biomater. 2023 Mar 15;159:275-288. doi: 10.1016/j.actbio.2023.01.050. Epub 2023 Jan 26.
Chemotherapeutics have been recommended as the standard protocol for inoperable patients with triple-negative breast cancer (TNBC) at advanced stage, yet limited success has been achieved in prolonging survival rates by this monotherapy. A major reason for this failure is the chemo-resistance from traditional apoptotic pathways resulting in poor therapeutic effect. Ferroptosis has become a powerful modality of no-apoptotic cell death, which can effectively evade chemo-resistance in apoptotic pathways. Herein, we propose an active-targeting small-molecular self-assembly nano-prodrug for co-delivery of chemotherapeutics (CPT), Ferrocene (Fc) and GPX4 inhibitor (RSL3) to overcome the chemo-resistance from traditional apoptotic pathways. In this nano-prodrug, the disulfide linkage not only serves as a GSH-responsive trigger, but also exhibits a stable self-assembly behavior that forms nanoparticle. Interestingly, the RSL3 can be loaded during this self-assembly process that forms a three-components nano-prodrug. In tumor environment, the high GSH level can disassemble the nano-prodrug to trigger the release of the parent drug, which can improve the therapeutic effect by synergistic effects of ferroptosis and apoptosis. In different TNBC mice models, the nano-prodrug is encapsulated into RGD-modified phospholipid micelles (DSPE-PEG2000-RGD) and exhibits high anti-tumor and anti-metastasis efficacy, especially in orthotopic models. The application of ferroptosis to assist the enhancement of chemotherapeutics may serve as a promising strategy for TNBC treatment. STATEMENT OF SIGNIFICANCE: Chemotherapeutics have been recommended as the standard of care for palliative and adjuvant treatment in patients with triple-negative breast cancer (TNBC), yet limited success has been achieved in prolonging the overall survival of patients by this monotherapy. A major reason for this failure is the chemo-resistance from traditional apoptotic pathways resulting in poor therapeutic effect. Thus, the co-delivery of the apoptosis and ferroptosis drug may overcome or evade the resistance in chemotherapy-induced apoptotic pathways and provide a promising strategy to combat TNBC. In this work, we developed a small-molecular self-assembly nano-prodrug for co-delivery of chemotherapeutics (CPT), Ferrocene (Fc) and ferroptosis resistance inhibitor (RSL3), which could overcome the chemo-resistance and improve the therapeutic effect by synergistic effects of ferroptosis and apoptosis.
化疗已被推荐作为晚期三阴性乳腺癌(TNBC)不可手术患者的标准治疗方案,但这种单一疗法在延长生存率方面的效果有限。造成这种失败的一个主要原因是传统凋亡途径的化疗耐药导致治疗效果不佳。铁死亡已成为一种强大的非凋亡性细胞死亡方式,可以有效地规避凋亡途径中的化疗耐药性。在此,我们提出了一种主动靶向小分子自组装纳米前药,用于联合递送化疗药物(CPT)、二茂铁(Fc)和谷胱甘肽过氧化物酶 4(GPX4)抑制剂(RSL3),以克服传统凋亡途径的化疗耐药性。在这个纳米前药中,二硫键不仅作为 GSH 响应性触发,还表现出稳定的自组装行为,形成纳米颗粒。有趣的是,RSL3 可以在自组装过程中加载,形成三组分纳米前药。在肿瘤环境中,高 GSH 水平可以使纳米前药解体,触发原药释放,通过铁死亡和凋亡的协同作用提高治疗效果。在不同的 TNBC 小鼠模型中,该纳米前药被包封在 RGD 修饰的磷脂胶束(DSPE-PEG2000-RGD)中,表现出高抗肿瘤和抗转移疗效,尤其是在原位模型中。将铁死亡应用于辅助增强化疗药物可能成为治疗 TNBC 的一种有前途的策略。
意义声明:化疗已被推荐为三阴性乳腺癌(TNBC)患者姑息治疗和辅助治疗的标准治疗方法,但这种单一疗法在延长患者总生存期方面的效果有限。造成这种失败的一个主要原因是传统凋亡途径的化疗耐药导致治疗效果不佳。因此,联合递送凋亡和铁死亡药物可能克服或规避化疗诱导的凋亡途径中的耐药性,并为治疗 TNBC 提供一种有前途的策略。在这项工作中,我们开发了一种小分子自组装纳米前药,用于联合递送化疗药物(CPT)、二茂铁(Fc)和铁死亡耐药抑制剂(RSL3),通过铁死亡和凋亡的协同作用克服化疗耐药性并提高治疗效果。
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