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Borges R, Zambanini T, Pelosine AM, Justo GZ, Souza ACS, Machado J, Schneider JF, de Araujo DR, Marchi J. A colloidal hydrogel-based drug delivery system overcomes the limitation of combining bisphosphonates with bioactive glasses: in vitro evidence of a potential selective bone cancer treatment allied with bone regeneration. BIOMATERIALS ADVANCES 2023; 151:213441. [PMID: 37167747 DOI: 10.1016/j.bioadv.2023.213441] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/23/2023] [Accepted: 04/21/2023] [Indexed: 05/13/2023]
Abstract
Bisphosphonates are a class of drugs that induce bone cancer cell death and favor bone regeneration, making them suitable for bone cancer treatment. However, when combined with bioactive glasses to enhance bone regeneration, a chemical bond between biphosphonates and the glass surface inactivates their mechanism of action. A new colloidal hydrogel-based drug delivery system could overcome that limitation once bisphosphonates, such as zoledronic acid (ZA), are incorporated into hydrogel micelles, avoiding their interaction with the glass surface. In this work, we proposed formulations based on a poloxamer 407 thermo-responsive hydrogel matrix containing holmium-doped bioactive glass nanoparticles and different concentrations (0.05 and 5 mg/mL) of ZA. We characterized the influence of the glass and the ZA on the hydrogel properties. In addition, a drug concentration screening was performed, and biological characterizations evaluated the best result. The biological characterization consisted of evaluating cytotoxicity and in vitro bone regeneration ability through cell migration and quantification of genes related to osteogeneses through RT-PCR. The results suggest that the addition of glasses and ZA to the poloxamer did not significantly influence the sol-gel transition of the hydrogels (around 13 °C) regardless of the ZA content. However, the ZA at high concentration (PL-ZA100) decreased the enthalpy of gel formation from 68 to 43 kJ.mol-1 when compared with the pure hydrogel formulation (PL), suggesting a water structurer role of ZA, which is withdrawn when glass particles are added to the system (PL-BG5Ho-ZA100). Solid-state 31P nuclear resonance spectroscopy results showed that part of the ZA is chemically bonded to the glass surface, which explains the withdrawal in the water structurer role of ZA when the glasses were incorporated into the hydrogel. Besides, based on the drug release results, we proposed a model where part of the ZA is "free," encapsulated in the hydrogel matrix, while another part of the ZA is bonded to the glass surface. Finally, considering the in vitro results and our proposed model, the ratio between "free" and "bonded" ZA in our drug delivery systems showed in vitro evidence of a cancer treatment that selectively kills osteosarcoma cells while still favoring an osteogenic microenvironment. By overcoming the limitation of combining bisphosphonates with bioactive glasses, hydrogel-based drug delivery systems can be a solution for the development of new formulations proposed for bone cancer treatment in conjunction with bone regeneration.
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Affiliation(s)
- Roger Borges
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil; School of Biomedical Engineering, Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Telma Zambanini
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil
| | - Agatha Maria Pelosine
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil
| | - Giselle Zenker Justo
- Departamento de Biologia Molecular, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil
| | - Ana Carolina S Souza
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil
| | - Joel Machado
- Departamento de Biologia, Universidade Federal do São Paulo, UNIFESP, Diadema, Brazil
| | - Jose Fabian Schneider
- Instituto de Física de São Carlos, Universidade de São Paulo, USP, São Carlos, Brazil
| | - Daniele R de Araujo
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil
| | - Juliana Marchi
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, UFABC, Santo André, Brazil.
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Lorange JP, Ramirez Garcia Luna J, Grou-Boileau F, Rosenzweig D, Weber MH, Akoury E. Management of bone metastasis with zoledronic acid: A systematic review and Bayesian network meta-analysis. J Bone Oncol 2023; 39:100470. [PMID: 36860585 PMCID: PMC9969300 DOI: 10.1016/j.jbo.2023.100470] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/19/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
Background While considered the mainstay of treatment for specific bone metastases, ZA is used predominantly to treat osteolytic lesions. The purpose of this network meta-analysis is to compare ZA to other treatment options in its ability to improve specific clinical outcomes in patients with bone metastases secondary to any primary tumor. Methods PubMed, Embase and Web of Science were systematically searched from inception to May 5th, 2022. Keywords used were solid tumor, lung neoplasm, kidney neoplasm, breast neoplasm, prostate neoplasm, ZA and bone metastasis. Every randomized controlled trial and non-randomized quasi-experimental study of systemic ZA administration for patients with bone metastases and any comparator were included. A Bayesian network meta-analysis was done on the primary outcomes including number of SREs, time to developing a first on-study SRE, overall survival, and disease progression-free survival. Secondary outcome was pain at 3, 6 and 12 months after treatment. Results Our search yielded 3861 titles with 27 meeting inclusion criteria. For the number of SRE, ZA in combination with chemotherapy or hormone therapy was statistically superior to placebo (OR 0.079; 95 % CrI: 0.022-0.27). For the time to the first on study SRE, the relative effectiveness of ZA 4 mg was statistically superior to placebo (HR 0.58; 95 % CrI:0.48-0.77). At 3 and 6 months, ZA 4 mg was significantly superior to placebo for reducing pain with a SMD of -0.85 (95 % CrI:-1.6, -0.0025) and -2.6 (95 % CrI:-4.7, -0.52) respectively. Conclusions This systematic review shows the benefits of ZA in decreasing the incidence of SREs, increasing the time to the first on-study SRE, and reducing the pain level at 3 and 6 months.
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Affiliation(s)
| | - Jose Ramirez Garcia Luna
- Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, Quebec, Canada
| | | | - Derek Rosenzweig
- Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, Quebec, Canada
| | - Michael H. Weber
- Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, Quebec, Canada
| | - Elie Akoury
- Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, Quebec, Canada,Corresponding author.
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Cheng X, Wei J, Ge Q, Xing D, Zhou X, Qian Y, Jiang G. The optimized drug delivery systems of treating cancer bone metastatic osteolysis with nanomaterials. Drug Deliv 2021; 28:37-53. [PMID: 33336610 PMCID: PMC7751395 DOI: 10.1080/10717544.2020.1856225] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Some cancers such as human breast cancer, prostate cancer, and lung cancer easily metastasize to bone, leading to osteolysis and bone destruction accompanied by a complicated microenvironment. Systemic administration of bisphosphonates (BP) or denosumab is the routine therapy for osteolysis but with non-negligible side effects such as mandibular osteonecrosis and hypocalcemia. Thus, it is imperative to exploit optimized drug delivery systems, and some novel nanotechnology and nanomaterials have opened new horizons for scientists. Targeted and local drug delivery systems can optimize biodistribution depending on nanoparticles (NPs) or microspheres (MS) and implantable biomaterials with the controllable property. Drug delivery kinetics can be optimized by smart and sustained/local drug delivery systems for responsive delivery and sustained delivery. These delicately fabricated drug delivery systems with special matrix, structure, morphology, and modification can minimize unexpected toxicity caused by systemic delivery and achieve desired effects through integrating multiple drugs or multiple functions. This review summarized recent studies about optimized drug delivery systems for the treatment of cancer metastatic osteolysis, aimed at giving some inspiration in designing efficient multifunctional drug delivery systems.
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Affiliation(s)
- Xi Cheng
- Department of Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Jinrong Wei
- Department of Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Qi Ge
- Department of Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Danlei Xing
- Department of Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Xuefeng Zhou
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing, People's Republic of China
| | - Yunzhu Qian
- Center of Stomatology, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Guoqin Jiang
- Department of Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
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Vona R, Iessi E, Matarrese P. Role of Cholesterol and Lipid Rafts in Cancer Signaling: A Promising Therapeutic Opportunity? Front Cell Dev Biol 2021; 9:622908. [PMID: 33816471 PMCID: PMC8017202 DOI: 10.3389/fcell.2021.622908] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Cholesterol is a lipid molecule that plays an essential role in a number of biological processes, both physiological and pathological. It is an essential structural constituent of cell membranes, and it is fundamental for biosynthesis, integrity, and functions of biological membranes, including membrane trafficking and signaling. Moreover, cholesterol is the major lipid component of lipid rafts, a sort of lipid-based structures that regulate the assembly and functioning of numerous cell signaling pathways, including those related to cancer, such as tumor cell growth, adhesion, migration, invasion, and apoptosis. Considering the importance of cholesterol metabolism, its homeostasis is strictly regulated at every stage: import, synthesis, export, metabolism, and storage. The alterations of this homeostatic balance are known to be associated with cardiovascular diseases and atherosclerosis, but mounting evidence also connects these behaviors to increased cancer risks. Although there is conflicting evidence on the role of cholesterol in cancer development, most of the studies consistently suggest that a dysregulation of cholesterol homeostasis could lead to cancer development. This review aims to discuss the current understanding of cholesterol homeostasis in normal and cancerous cells, summarizing key findings from recent preclinical and clinical studies that have investigated the role of major players in cholesterol regulation and the organization of lipid rafts, which could represent promising therapeutic targets.
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Affiliation(s)
- Rosa Vona
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità [Italian National Institute of Health], Rome, Italy
| | - Elisabetta Iessi
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità [Italian National Institute of Health], Rome, Italy
| | - Paola Matarrese
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità [Italian National Institute of Health], Rome, Italy
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Akoury E, Ramirez Garcia Luna AS, Ahangar P, Gao X, Zolotarov P, Weber MH, Rosenzweig DH. Anti-Tumor Effects of Low Dose Zoledronate on Lung Cancer-Induced Spine Metastasis. J Clin Med 2019; 8:E1212. [PMID: 31416169 PMCID: PMC6722631 DOI: 10.3390/jcm8081212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/06/2019] [Accepted: 08/10/2019] [Indexed: 02/06/2023] Open
Abstract
Zoledronate (Zol) is an anti-resorptive/tumoral agent used for the treatment of many cancers including spinal bone metastasis. High systemic administration of a single dose is now the standard clinical care, yet it has been associated with several side effects. Here, we aimed to evaluate the effects of lower doses Zol on lung cancer and lung cancer-induced bone metastasis cells over a longer time period. Human lung cancer (HCC827) and three bone metastases secondary to lung cancer (BML1, BML3 and BML4) cells were treated with Zol at 1, 3 and 10 µM for 7 days and then assessed for cell proliferation, migration, invasion and apoptosis. Low Zol treatment significantly decreased cell proliferation (1, 3 and 10 µM), migration (3 and 10 µM) and invasion (10 µM) while increasing apoptosis (10 µM) in lung cancer and metastatic cells. Our data exploits the potential of using low doses Zol for longer treatment periods and reinforces this approach as a new therapeutic regimen to impede the development of metastatic bone cancer while limiting severe side effects following high doses of systemic drug treatment.
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Affiliation(s)
- Elie Akoury
- Department of Surgery, Division of Orthopaedic Surgery, McGill University and the Research Institute of the McGill University Health Centre, Injury Repair & Recovery program, Montreal, QC H3G 1A4, Canada
| | - Ana Sofia Ramirez Garcia Luna
- Department of Surgery, Division of Orthopaedic Surgery, McGill University and the Research Institute of the McGill University Health Centre, Injury Repair & Recovery program, Montreal, QC H3G 1A4, Canada
- Medical Faculty Mannheim, Heidelberg University, D-68167 Mannheim, Germany
| | - Pouyan Ahangar
- Department of Surgery, Division of Orthopaedic Surgery, McGill University and the Research Institute of the McGill University Health Centre, Injury Repair & Recovery program, Montreal, QC H3G 1A4, Canada
| | - Xiaoya Gao
- Department of Surgery, Division of Orthopaedic Surgery, McGill University and the Research Institute of the McGill University Health Centre, Injury Repair & Recovery program, Montreal, QC H3G 1A4, Canada
| | - Pylyp Zolotarov
- Department of Pathology, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Michael H Weber
- Department of Surgery, Division of Orthopaedic Surgery, McGill University and the Research Institute of the McGill University Health Centre, Injury Repair & Recovery program, Montreal, QC H3G 1A4, Canada
| | - Derek H Rosenzweig
- Department of Surgery, Division of Orthopaedic Surgery, McGill University and the Research Institute of the McGill University Health Centre, Injury Repair & Recovery program, Montreal, QC H3G 1A4, Canada.
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Ahangar P, Aziz M, Rosenzweig DH, Weber MH. Advances in personalized treatment of metastatic spine disease. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:223. [PMID: 31297388 DOI: 10.21037/atm.2019.04.41] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The spine is one of the most common sites of bony metastases, and its involvement leads to significant patient morbidity. Surgical management in these patients is aimed at improving quality of life and functional status throughout the course of the disease. Resection of metastases often leads to critical size bone defects, presenting a challenge to achieving adequate bone regeneration to fill the void. Current treatment options for repairing these defects are bone grafting and commercial bone cements; however, each has associated limitations. Additionally, tumor recurrence and tumor-induced bone loss make bone regeneration particularly difficult. Systemic therapeutic delivery, such as bisphosphonates, have become standard of care to combat bone loss despite unfavorable systemic side-effects and lack of local efficacy. Developments from tissue engineering have introduced novel materials with osteoinductive and osteoconductive properties which also act as structural support scaffolds for bone regeneration. These new materials can also act as a therapeutic reservoir to sustainably release drugs locally as an alternative to systemic therapy. In this review, we outline recent advancements in tissue engineering and the role of translational research in developing implants that can fully repair bone defects while also delivering local therapeutics to curb tumor recurrence and improve patient quality of life.
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Affiliation(s)
- Pouyan Ahangar
- Division of Orthopedic Surgery, McGill University, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Injury, Repair and Recovery Program, Montreal, QC, Canada.,Montreal General Hospital C10.148.6, Montreal, QC, Canada
| | - Mina Aziz
- Division of Orthopedic Surgery, McGill University, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Injury, Repair and Recovery Program, Montreal, QC, Canada.,Montreal General Hospital C10.148.6, Montreal, QC, Canada.,Clinical Investigator Program, McGill University, Montreal, QC, Canada
| | - Derek H Rosenzweig
- Division of Orthopedic Surgery, McGill University, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Injury, Repair and Recovery Program, Montreal, QC, Canada.,Montreal General Hospital C10.148.6, Montreal, QC, Canada
| | - Michael H Weber
- Division of Orthopedic Surgery, McGill University, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Injury, Repair and Recovery Program, Montreal, QC, Canada.,Montreal General Hospital C10.148.6, Montreal, QC, Canada
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Akoury E, Weber MH, Rosenzweig DH. 3D-Printed Nanoporous Scaffolds Impregnated with Zoledronate for the Treatment of Spinal Bone Metastases. ACTA ACUST UNITED AC 2019. [DOI: 10.1557/adv.2019.156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Akoury E, Ahangar P, Nour A, Lapointe J, Guérard KP, Haglund L, Rosenzweig DH, Weber MH. Low-dose zoledronate for the treatment of bone metastasis secondary to prostate cancer. Cancer Cell Int 2019; 19:28. [PMID: 30787671 PMCID: PMC6368819 DOI: 10.1186/s12935-019-0745-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 02/01/2019] [Indexed: 12/12/2022] Open
Abstract
Background Bisphosphonates (BPs) including zoledronate (zol) have become standard care for bone metastases as they effectively inhibit tumor-induced osteolysis and associated pain. Several studies have also suggested that zol has direct anti-tumor activity. Systemic administration at high doses is the current approach to deliver zol, yet it has been associated with debilitating side effects. Local therapeutic delivery offers the ability to administer much lower total dosage, while at the same time maintaining sustained high-local drug concentration directly at the target treatment site. Here, we aimed to assess effects of lower doses of zol on bone metastases over a longer time. Methods Prostate cancer cell line LAPC4 and prostate-induced bone metastasis cells were treated with zol at 1, 3 and 10 µM for 7 days. Following treatment, cell proliferation was assessed using Almarblue®, Vybrant MTT®, and Live/Dead® viability/cytotoxicity assays. Additionally, cell migration and invasion were carried out using Falcon™ cell culture inserts and Cultrex® 3D spheroid cell invasion assays respectively. Results We show that treatment with 3–10 µM zol over 7-days significantly decreased cell proliferation in both the prostate cancer cell line LAPC4 and cells from spine metastases secondary to prostate cancer. Using the same low-dose and longer time course for treatment, we demonstrate that 10 µM zol also significantly inhibits tumor cell migration and 3D-cell growth/invasion. Conclusions This project harnesses the potential of using zol at low doses for longer treatment periods, which may be a viable treatment modality when coupled with biomaterials or biodevices for local delivery. Electronic supplementary material The online version of this article (10.1186/s12935-019-0745-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elie Akoury
- 1Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, QC Canada
| | - Pouyan Ahangar
- 1Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, QC Canada
| | - Antone Nour
- 1Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, QC Canada
| | - Jacques Lapointe
- 2Department of Surgery, Division of Urology, McGill University and The Research Institute of the McGill University Health Centre, Cancer Research Program, Montreal, QC Canada
| | - Karl-Philippe Guérard
- 2Department of Surgery, Division of Urology, McGill University and The Research Institute of the McGill University Health Centre, Cancer Research Program, Montreal, QC Canada
| | - Lisbet Haglund
- 1Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, QC Canada
| | - Derek H Rosenzweig
- 1Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, QC Canada
| | - Michael H Weber
- 1Department of Surgery, Division of Orthopaedics, McGill University and The Research Institute of the McGill University Health Centre, Injury Repair Recovery Program, Montreal, QC Canada
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Ahangar P, Akoury E, Ramirez Garcia Luna AS, Nour A, Weber MH, Rosenzweig DH. Nanoporous 3D-Printed Scaffolds for Local Doxorubicin Delivery in Bone Metastases Secondary to Prostate Cancer. MATERIALS 2018; 11:ma11091485. [PMID: 30134523 PMCID: PMC6165313 DOI: 10.3390/ma11091485] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/17/2018] [Accepted: 08/18/2018] [Indexed: 12/28/2022]
Abstract
The spine is the most common site of bone metastasis, often originating from prostate, lung, and breast cancers. High systemic doses of chemotherapeutics such as doxorubicin (DOX), cisplatin, or paclitaxel often have severe side effects. Surgical removal of spine metastases also leaves large defects which cannot spontaneously heal and require bone grafting. To circumvent these issues, we designed an approach for local chemotherapeutic delivery within 3D-printed scaffolds which could also potentially serve as a bone substitute. Direct treatment of prostate cancer cell line LAPC4 and patient derived spine metastases cells with 0.01 µM DOX significantly reduced metabolic activity, proliferation, migration, and spheroid growth. We then assessed uptake and release of DOX in a series of porous 3D-printed scaffolds on LAPC4 cells as well as patient-derived spine metastases cells. Over seven days, 60–75% of DOX loaded onto scaffolds could be released, which significantly reduced metabolic activity and proliferation of both LAPC4 and patient derived cells, while unloaded scaffolds had no effect. Porous 3D-printed scaffolds may provide a novel and inexpensive approach to locally deliver chemotherapeutics in a patient-specific manner at tumor resection sites. With a composite design to enhance strength and promote sustained drug release, the scaffolds could reduce systemic negative effects, enhance bone repair, and improve patient outcomes.
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Affiliation(s)
- Pouyan Ahangar
- Division of Orthopedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada.
| | - Elie Akoury
- Division of Orthopedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada.
| | - Ana Sofia Ramirez Garcia Luna
- Division of Orthopedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada.
- Medical Faculty Mannheim, Heidelberg University, D-68167 Heidelberg, Germany.
| | - Antone Nour
- Division of Orthopedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada.
| | - Michael H Weber
- Division of Orthopedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada.
- The Research Institute of the McGill University Health Centre, Montreal, QC H3H 2L9, Canada.
| | - Derek H Rosenzweig
- Division of Orthopedic Surgery, McGill University, Montreal, QC H3G 1A4, Canada.
- The Research Institute of the McGill University Health Centre, Montreal, QC H3H 2L9, Canada.
- Montreal General Hospital C10.148.6, 1650 Cedar Ave, Montreal, QC H3G 1A4, Canada.
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