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Shen YA, Shyu IL, Lu M, He CL, Hsu YM, Liang HF, Liu CP, Liu RS, Shen BJ, Wei YH, Chuang CM. Bypassing the EPR effect with a nanomedicine harboring a sustained-release function allows better tumor control. Int J Nanomedicine 2015; 10:2485-502. [PMID: 25848266 PMCID: PMC4386769 DOI: 10.2147/ijn.s78321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The current enhanced permeability and retention (EPR)-based approved nanomedicines have had little impact in terms of prolongation of overall survival in patients with cancer. For example, the two Phase III trials comparing Doxil(®), the first nanomedicine approved by the US Food and Drug Administration, with free doxorubicin did not find an actual translation of the EPR effect into a statistically significant increase in overall survival but did show less cardiotoxicity. In the current work, we used a two-factor factorial experimental design with intraperitoneal versus intravenous delivery and nanomedicine versus free drug as factors to test our hypothesis that regional (intraperitoneal) delivery of nanomedicine may better increase survival when compared with systemic delivery. In this study, we demonstrate that bypassing, rather than exploiting, the EPR effect via intraperitoneal delivery of nanomedicine harboring a sustained-release function demonstrates dual pharmacokinetic advantages, producing more efficient tumor control and suppressing the expression of stemness markers, epithelial-mesenchymal transition, angiogenesis signals, and multidrug resistance in the tumor microenvironment. Metastases to vital organs (eg, lung, liver, and lymphatic system) are also better controlled by intraperitoneal delivery of nanomedicine than by standard systemic delivery of the corresponding free drug. Moreover, the intraperitoneal delivery of nanomedicine has the potential to replace hyperthermic intraperitoneal chemotherapy because it shows equal efficacy and lower toxicity. In terms of efficacy, exploiting the EPR effect may not be the best approach for developing a nanomedicine. Because intraperitoneal chemotherapy is a type of regional chemotherapy, the pharmaceutical industry might consider the regional delivery of nanomedicine as a valid alternative pathway to develop their nanomedicine(s) with the goal of better tumor control in the future.
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Affiliation(s)
- Yao An Shen
- Institute of Biochemistry and Molecular Biology, School of Life Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Ing Luen Shyu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Maggie Lu
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Chun Lin He
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
| | - Yen Mei Hsu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsiang Fa Liang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Chih Peng Liu
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Ren Shyan Liu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan ; National PET/Cyclotron Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Biing Jiun Shen
- Division of Psychology, Nanyang Technological University, Singapore
| | - Yau Huei Wei
- Institute of Biochemistry and Molecular Biology, School of Life Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Chi Mu Chuang
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
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Phase 1/pharmacology study of intraperitoneal topotecan alone and with cisplatin: potential for consolidation in ovarian cancer. Cancer Chemother Pharmacol 2010; 68:457-63. [DOI: 10.1007/s00280-010-1510-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 10/26/2010] [Indexed: 11/26/2022]
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Venditto VJ, Allred K, Allred CD, Simanek EE. Intercepting the synthesis of triazine dendrimers with nucleophilic pharmacophores: a general strategy toward drug delivery vehicles. Chem Commun (Camb) 2009:5541-2. [PMID: 19753350 PMCID: PMC3881288 DOI: 10.1039/b911353c] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The camptothecin ester of isonipecotic acid is installed on a triazine dendrimer intermediate obtained through an iterative, scalable route to ultimately yield cationic and PEGylated targets with activities in cell culture comparable to free drug.
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Affiliation(s)
- Vincent J. Venditto
- Department of Chemistry, Texas A&M University, College Station, TX 77843, USA. Fax: +1-979-845-9452; Tel: +1-979-845-4242
| | - Kimberly Allred
- Department of Nutrition and Food Science, Texas A&M University, College Station, TX 77843, USA. Fax: +1-979-862-7782; Tel: +1-979-845-0863
| | - Clinton D. Allred
- Department of Nutrition and Food Science, Texas A&M University, College Station, TX 77843, USA. Fax: +1-979-862-7782; Tel: +1-979-845-0863
| | - Eric E. Simanek
- Department of Chemistry, Texas A&M University, College Station, TX 77843, USA. Fax: +1-979-845-9452; Tel: +1-979-845-4242
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