The pharmaceutical stability of trastuzumab after short-term storage at room temperature assessed by analytical techniques and tumour imaging by microSPECT/CT

Biodistribution and Targeted Antitumor Effects of Trastuzumab-Modified Gold Nanorods in Mice with Gastric Cancer

BACKGROUND AND OBJECTIVES

Targeted drug is often engulfed and cleared by the reticuloendothelial system in vivo, resulting in reduced treatment efficacy. This study aimed to explore the biodistribution and HER-2-targeted antitumor effects of trastuzumab-modified gold nanorods (Tra-AuNRs) in a gastric cancer animal model.

METHODS

Gold nanorods were synthesized using a seed-mediated growth method, and then subjected to trastuzumab-targeted modification. Elemental analysis, Fourier transform infrared spectroscopy, and Xray photoelectron spectroscopy were performed; UV-visible absorption peak, photothermal effects, morphology, and size distribution of Tra-AuNRs were characterized. The targeted killing effect of Tra- AuNRs on gastric cancer cells was assessed in vitro. Tra-AuNRs were injected intravenously and intratumorally into gastric cancer-bearing nude mice in vivo and their distribution was detected. Tumor growth inhibition rate and tumor apoptosis-related protein expression were compared between groups.

RESULTS

Tra-AuNRs presented a relatively uniform morphology with an average particle size of 59.9 nm and a longitudinal plasmon resonance absorption peak of 790 nm. The targeted killing rate of gastric cancer cells in vitro by Tra-AuNRs was 87.9%. After intravenous injection, Tra-AuNRs were mainly distributed in the liver, tumor, spleen, and lungs. Comparatively, Tra-AuNRs were mainly distributed in the tumor when intratumorally injected, with a tumor concentration of 6.42 μg/g after 24 h. The tumor growth inhibition rate reached 78.3% in the intratumoral injection group, with significantly higher BAX, BAD, and CASPASE-3 expression than that in the intravenous injection group.

CONCLUSION

The findings suggest that Tra-AuNRs can be used for HER-2-positive gastric cancer treatment. Intratumoral injection of Tra-AuNRs significantly increased the local tumor drug concentration and improved the molecular targeted antitumor growth effect in gastric cancer-bearing nude mice.

Stability of trastuzumab during nanomedicine formulation using SEC-HPLC coupled with polyacrylamide gel electrophoresis

The anti-HER2 antibody trastuzumab has been proven to be an effective targeting ligand for drug delivery. This study investigates the structural integrity of trastuzumab under different stress factors in formulation development and its long-term stability. A validated size exclusion high performance liquid chromatographic (SEC-HPLC) method was first developed. The stability of trastuzumab (0.21-21 mg/ml) under stress conditions (mechanical, freeze-and-thaw, pH and temperature) and long-term storage in the presence of formulation excipients were monitored for up to 12 months, using both the SEC-HPLC method and sodium-dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The anti-proliferation activity of the reconstituted antibody stored at 4 °C against HER2⁺ BT-474 breast cells was also monitored over 12 months. The developed SEC-HPLC method was sensitive and accurate. Solutions of trastuzumab were resistant to mechanical stress and repeated freeze-and-thaw; but were unstable under acidic (pH 2.0 and 4.0) and alkaline (pH 10.0 and 12.0) environments. The samples degraded over 5 days at 60 °C, and within 24 h at 75 °C. Low temperature (-80 °C or 4 °C) and low concentration (0.21 mg/ml) favoured the long-term stability. The anti-proliferation activity was conserved at 4 °C for at least 12 months. This study provided valuable stability information in developing trastuzumab involved nano-formulation as well as in clinical settings.

Formulation of a kit under Good Manufacturing Practices (GMP) for preparing [111In]In-BnDTPA-trastuzumab-NLS injection: a theranostic agent for imaging and Meitner-Auger Electron (MAE) radioimmunotherapy of HER2-positive breast cancer

BACKGROUND

¹¹¹In[In]-BnDTPA-trastuzumab-NLS is a radiopharmaceutical with theranostic applications for imaging and Meitner-Auger electron (MAE) radioimmunotherapy (RIT) of HER2-positive breast cancer (BC). Nuclear localization sequence (NLS) peptides route the radiopharmaceutical to the nucleus of HER2-positive BC cells following receptor-mediated internalization for RIT with subcellular range MAEs. The γ-photons emitted by ¹¹¹In permit tumour imaging by SPECT. Our aim was to formulate a kit under Good Manufacturing Practices conditions to prepare ¹¹¹In[In]-BnDTPA-trastuzumab-NLS injection for a first-in-human clinical trial.

RESULTS

Trastuzumab was derivatized with p-SCN-BnDTPA to introduce Bn-DTPA for complexing ¹¹¹In, then modified with maleimide groups for conjugation to the thiol on cysteine in NLS peptides [CGYGPKKKRKVGG]. BnDTPA-trastuzumab-NLS (5 mg in 1.0 mL of 0.05 M ammonium acetate buffer, pH 5.5) was dispensed into unit dose sterile glass vials to produce kits for labeling with 100-165 MBq of ¹¹¹In[In]Cl₃. The kits met specifications for protein concentration (4.5-5.5 mg/mL), volume (0.95-1.05 mL), pH (5.5-6.0), appearance (clear, pale-yellow, particulate-free), BnDTPA substitution level (2.0-7.0 BnDTPA/trastuzumab), purity and homogeneity (SDS-PAGE and SE-HPLC), ¹¹¹In labeling efficiency (> 90%), binding to HER2-positive SK-BR-3 human breast cancer cells (K_a = 1-8 × 10⁸ L/mmol; B_max = 0.5-2 × 10⁶ sites/cell), NLS peptide conjugation (upward band shift on SDS-PAGE), sterility (USP Sterility Test) and endotoxins (USP Bacterial Endotoxins Test). ¹¹¹In-BnDTPA-trastuzumab-NLS injection met specifications for pH (5.5-6.5), radiochemical purity (≥ 90%), radionuclide purity (≥ 99%), appearance (clear, colourless, particle-free) and sterility (retrospective USP Sterility Test). Kits were stable stored at 2-8 °C for up to 661 days (d) meeting all key specifications. Protein concentration remained within or just slightly greater than the specification for up to 139 d. ¹¹¹In[In]-BnDTPA-trastuzumab-NLS injection was stable for up to 24 h. An expiry of 180 d was assigned for the kits and 8 h for the final radiopharmaceutical.

CONCLUSION

A kit was formulated under GMP conditions for preparing ¹¹¹In[In]-BnDTPA-trastuzumab-NLS injection. This radiopharmaceutical was safely administered to 4 patients with HER2-positive BC to trace the uptake of trastuzumab into brain metastases before and after MRI-guided focused ultrasound (MRIg-FUS) by SPECT imaging.

Tracking the physicochemical stability of teduglutide (Revestive®) clinical solutions over time in different storage containers

Teduglutide, the active ingredient of the medicine Revestive® (5 mg), is a recombinant therapeutic peptide that mimics the effects of the endogenous glucagon-like peptide 2 (GLP-2). It stimulates intestinal growth, adaptation and function in patients with Short Bowel Syndrome who are dependent on parenteral nutrition. The Summary of Product Characteristics recommends immediate use of the reconstituted solutions and the discarding of any subsequent surplus. This study aims to carry out a long-term stability study that reproduces hospital conditions of use which provide sound evidence regarding the use of teduglutide surplus beyond the Summary Product Characteristics recommendations. We conducted a stability study of teduglutide solutions prepared from a 5 mg vial of Revestive®. Some of the solutions were stored in their original vial after reconstitution, while others were repackaged in plastic syringes to evaluate their physicochemical stability over time. For this purpose, we applied a set of previously validated analytical methodologies to evaluate the main critical quality attributes of teduglutide, i.e., primary (including post-tralational modifications), secondary and tertiary structures, aggregates, particulate, concentration and pH. The results indicate that the solutions maintain high physicochemical stability over time, regardless of the storage temperature (4ºC or -20ºC) or the storage container (vials or syringes). This research provides new data on the stability of Revestive® that will be of great value to hospital pharmacists. This comprehensive assessment of the physicochemical long-term stability of TGT has demonstrated that under the storage conditions and over the period studied here, the medicine maintains its quality, efficacy and safety profiles.