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Kullenberg F, Degerstedt O, Calitz C, Pavlović N, Balgoma D, Gråsjö J, Sjögren E, Hedeland M, Heindryckx F, Lennernäs H. In Vitro Cell Toxicity and Intracellular Uptake of Doxorubicin Exposed as a Solution or Liposomes: Implications for Treatment of Hepatocellular Carcinoma. Cells 2021; 10:cells10071717. [PMID: 34359887 PMCID: PMC8306283 DOI: 10.3390/cells10071717] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 12/11/2022] Open
Abstract
Cytostatic effects of doxorubicin in clinically applied doses are often inadequate and limited by systemic toxicity. The main objective of this in vitro study was to determine the anti-tumoral effect (IC50) and intracellular accumulation of free and liposomal doxorubicin (DOX) in four human cancer cell lines (HepG2, Huh7, SNU449 and MCF7). The results of this study showed a correlation between longer DOX exposure time and lower IC50 values, which can be attributed to an increased cellular uptake and intracellular exposure of DOX, ultimately leading to cell death. We found that the total intracellular concentrations of DOX were a median value of 230 times higher than the exposure concentrations after exposure to free DOX. The intracellular uptake of DOX from solution was at least 10 times higher than from liposomal formulation. A physiologically based pharmacokinetic model was developed to translate these novel quantitative findings to a clinical context and to simulate clinically relevant drug concentration-time curves. This showed that a liver tumor resembling the liver cancer cell line SNU449, the most resistant cell line in this study, would not reach therapeutic exposure at a standard clinical parenteral dose of doxorubicin (50 mg/m2), which is serious limitation for this drug. This study emphasizes the importance of in-vitro to in-vivo translations in the assessment of clinical consequence of experimental findings.
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Affiliation(s)
- Fredrik Kullenberg
- Department of Pharmaceutical Biosciences, Uppsala University, 75 123 Uppsala, Sweden; (F.K.); (O.D.); (J.G.); (E.S.)
| | - Oliver Degerstedt
- Department of Pharmaceutical Biosciences, Uppsala University, 75 123 Uppsala, Sweden; (F.K.); (O.D.); (J.G.); (E.S.)
| | - Carlemi Calitz
- Department of Medical Cell Biology, Uppsala University, 75 123 Uppsala, Sweden; (C.C.); (N.P.); (F.H.)
| | - Nataša Pavlović
- Department of Medical Cell Biology, Uppsala University, 75 123 Uppsala, Sweden; (C.C.); (N.P.); (F.H.)
| | - David Balgoma
- Department of Medicinal Chemistry, Uppsala University, 75 123 Uppsala, Sweden; (D.B.); (M.H.)
| | - Johan Gråsjö
- Department of Pharmaceutical Biosciences, Uppsala University, 75 123 Uppsala, Sweden; (F.K.); (O.D.); (J.G.); (E.S.)
- Department of Medicinal Chemistry, Uppsala University, 75 123 Uppsala, Sweden; (D.B.); (M.H.)
| | - Erik Sjögren
- Department of Pharmaceutical Biosciences, Uppsala University, 75 123 Uppsala, Sweden; (F.K.); (O.D.); (J.G.); (E.S.)
| | - Mikael Hedeland
- Department of Medicinal Chemistry, Uppsala University, 75 123 Uppsala, Sweden; (D.B.); (M.H.)
| | - Femke Heindryckx
- Department of Medical Cell Biology, Uppsala University, 75 123 Uppsala, Sweden; (C.C.); (N.P.); (F.H.)
| | - Hans Lennernäs
- Department of Pharmaceutical Biosciences, Uppsala University, 75 123 Uppsala, Sweden; (F.K.); (O.D.); (J.G.); (E.S.)
- Correspondence:
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2
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Yee C, McCoy D, Yu J, Losey A, Jordan C, Moore T, Stillson C, Oh HJ, Kilbride B, Roy S, Patel A, Wilson MW, Hetts SW. Endovascular Ion Exchange Chemofiltration Device Reduces Off-Target Doxorubicin Exposure in a Hepatic Intra-arterial Chemotherapy Model. Radiol Imaging Cancer 2019; 1:e190009. [PMID: 32300759 DOI: 10.1148/rycan.2019190009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/05/2019] [Accepted: 07/25/2019] [Indexed: 01/08/2023]
Abstract
Purpose To determine if endovascular chemofiltration with an ionic device (ChemoFilter [CF]) can be used to reduce systemic exposure and off-target biodistribution of doxorubicin (DOX) during hepatic intra-arterial chemotherapy (IAC) in a preclinical model. Materials and Methods Hepatic IAC infusions were performed in six pigs with normal livers. Animals underwent two 10-minute intra-arterial infusions of DOX (200 mg) into the common hepatic artery. Both the treatment group and the control group received initial IAC at 0 minutes and a second dose at 200 minutes. Prior to the second dose, CF devices were deployed in and adjacent to the hepatic venous outflow tract of treatment animals. Systemic exposure to DOX was monitored via blood samples taken during IAC procedures. After euthanasia, organ tissue DOX concentrations were analyzed. Alterations in systemic DOX exposure and biodistribution were compared by using one-tailed t tests. Results CF devices were well tolerated, and no hemodynamic, thrombotic, or immunologic complications were observed. Animals treated with a CF device had a significant reduction in systemic exposure when compared with systemic exposure in the control group (P <.009). Treatment with a CF device caused a significant decrease in peak DOX concentration (31%, P <.01) and increased the time to maximum concentration (P <.03). Tissue analysis was used to confirm significant reduction in DOX accumulation in the heart and kidneys (P <.001 and P <.022, respectively). Mean tissue concentrations in the heart, kidneys, and liver of animals treated with CF compared with those in control animals were 14.2 μg/g ± 1.9 (standard deviation) versus 26.0 μg/g ± 1.8, 46.4 μg/g ± 4.6 versus 172.6 μg/g ± 40.2, and 217.0 μg/g ± 5.1 versus 236.8 μg/g ± 9.0, respectively. Fluorescence imaging was used to confirm in vivo DOX binding to CF devices. Conclusion Reduced systemic exposure and heart bioaccumulation of DOX during local-regional chemotherapy to the liver can be achieved through in situ adsorption by minimally invasive image-guided CF devices.© RSNA, 2019.
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Affiliation(s)
- Colin Yee
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - David McCoy
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Jay Yu
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Aaron Losey
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Caroline Jordan
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Terilyn Moore
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Carol Stillson
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Hee Jeung Oh
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Bridget Kilbride
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Shuvo Roy
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Anand Patel
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Mark W Wilson
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
| | - Steven W Hetts
- Department of Radiology and Biomedical Imaging (C.Y., D.M., J.Y., A.L., C.L., T.M., C.S., B.K., A.P., M.W.W., S.W.H.) and Department of Bioengineering and Therapeutic Sciences (S.R.), University of California, San Francisco, 505 Parnassus Ave, L-351, San Francisco, CA 94143-0628; and Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, Calif (H.J.O.).,For members of the ChemoFilter Consortium, please see the Acknowledgments
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3
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Hagan A, Caine M, Press C, Macfarlane WM, Phillips G, Lloyd AW, Czuczman P, Kilpatrick H, Bascal Z, Tang Y, Garcia P, Lewis AL. Predicting pharmacokinetic behaviour of drug release from drug-eluting embolization beads using in vitro elution methods. Eur J Pharm Sci 2019; 136:104943. [PMID: 31152772 DOI: 10.1016/j.ejps.2019.05.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 05/03/2019] [Accepted: 05/27/2019] [Indexed: 12/18/2022]
Abstract
Drug-eluting Embolic Bead - Transarterial Chemoembolisation (DEB-TACE) is a minimally invasive embolising treatment for liver tumours that allows local release of chemotherapeutic drugs via ion exchange, following delivery into hepatic arterial vasculature. Thus far, no single in vitro model has been able to accurately predict the complete kinetics of drug release from DEB, due to heterogeneity of rate-controlling mechanisms throughout the process of DEB delivery. In this study, we describe two in vitro models capable of distinguishing between early phase and late phase drug release by mimicking in vivo features of each phase. First, a vascular flow system (VFS) was used to simulate the early phase by delivering DEB into a silicon vascular cast under high pulsatile flow. This yielded a burst release profile of drugs from DEB which related to the dose adjusted Cmax observed in pharmacokinetic plasma profiles from a preclinical swine model. Second, an open loop flow-through cell system was used to model late phase drug release by packing beads in a column with an ultra-low flow rate. DEB loaded with doxorubicin, irinotecan and vandetanib showed differential drug release rates due to their varying chemical properties and unique drug-bead interactions. Using more representative in vitro models to map discrete phases of DEB drug release will provide a better capability to predict the pharmacokinetics of developmental formulations, which has implications for treatment safety and efficacy.
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Affiliation(s)
- Alice Hagan
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Moulsecoomb, Brighton BN2 4GJ, UK; Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, UK.
| | - Marcus Caine
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, UK
| | - Cara Press
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, UK
| | - Wendy M Macfarlane
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Moulsecoomb, Brighton BN2 4GJ, UK
| | - Gary Phillips
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Moulsecoomb, Brighton BN2 4GJ, UK
| | - Andrew W Lloyd
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Moulsecoomb, Brighton BN2 4GJ, UK
| | - Peter Czuczman
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, UK
| | - Hugh Kilpatrick
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, UK
| | - Zainab Bascal
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, UK
| | - Yiqing Tang
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, UK
| | - Pedro Garcia
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, UK
| | - Andrew L Lewis
- Biocompatibles UK Ltd, a BTG International Group Company, Lakeview, Riverside Way, Watchmoor Park, Camberley, GU15 3YL, UK.
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4
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Dubbelboer IR, Sjögren E, Lennernäs H. Porcine and Human In Vivo Simulations for Doxorubicin-Containing Formulations Used in Locoregional Hepatocellular Carcinoma Treatment. AAPS JOURNAL 2018; 20:96. [PMID: 30167825 DOI: 10.1208/s12248-018-0251-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/31/2018] [Indexed: 12/21/2022]
Abstract
It is important to be able to simulate and predict formulation effects on the pharmacokinetics of a drug in order to optimize effectivity in clinical practice and drug development. Two formulations containing doxorubicin are used in the treatment of hepatocellular carcinoma (HCC): a Lipiodol-based emulsion (LIPDOX) and a loadable microbead system (DEBDOX). Although equally effective, the formulations are vastly different, and little is known about the parameters affecting doxorubicin release in vivo. However, mathematical modeling can be used to predict doxorubicin release properties from these formulations and its in vivo pharmacokinetic (PK) profiles. A porcine semi-physiologically based pharmacokinetic (PBPK) model was scaled to a human physiologically based biopharmaceutical (PBBP) model that was altered to include HCC. DOX in vitro and in vivo release data from LIPDOX or DEBDOX were collected from the literature and combined with these in silico models. The simulated pharmacokinetic profiles were then compared with observed porcine and human HCC patient data. DOX pharmacokinetic profiles of LIPDOX-treated HCC patients were best predicted from release data sets acquired by in vitro methods that did not use a diffusion barrier. For the DEBDOX group, the best predictions were from the in vitro release method with a low ion concentration and a reduced loading dose. The in silico modeling combined with historical release data was effective in predicting in vivo plasma exposure. This can give useful insights into the release method properties necessary for correct in vivo predictions of pharmacokinetic profiles of HCC patients dosed with LIPDOX or DEBDOX.
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Affiliation(s)
- Ilse R Dubbelboer
- Department of Pharmacy, Uppsala University, Box 580, 751 23, Uppsala, Sweden
| | - Erik Sjögren
- Department of Pharmacy, Uppsala University, Box 580, 751 23, Uppsala, Sweden
| | - Hans Lennernäs
- Department of Pharmacy, Uppsala University, Box 580, 751 23, Uppsala, Sweden.
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5
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Dubbelboer IR, Lilienberg E, Sjögren E, Lennernäs H. A Model-Based Approach To Assessing the Importance of Intracellular Binding Sites in Doxorubicin Disposition. Mol Pharm 2017; 14:686-698. [PMID: 28182434 DOI: 10.1021/acs.molpharmaceut.6b00974] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Doxorubicin is an anticancer agent, which binds reversibly to topoisomerase I and II, intercalates to DNA base pairs, and generates free radicals. Doxorubicin has a high tissue:plasma partition coefficient and high intracellular binding to the nucleus and other subcellular compartments. The metabolite doxorubicinol has an extensive tissue distribution. This porcine study investigated whether the traditional implementation of tissue binding, described by the tissue:plasma partition coefficient (Kp,t), could be used to appropriately analyze and/or simulate tissue doxorubicin and doxorubicinol concentrations in healthy pigs, when applying a physiologically based pharmacokinetic (PBPK) model approach, or whether intracellular binding is required in the semi-PBPK model. Two semi-PBPK models were developed and evaluated using doxorubicin and doxorubicinol concentrations in healthy pig blood, bile, and urine and kidney and liver tissues. In the generic semi-PBPK model, tissue binding was described using the conventional Kp,t approach. In the binding-specific semi-PBPK model, tissue binding was described using intracellular binding sites. The best semi-PBPK model was validated against a second data set of healthy pig blood and bile concentrations. Both models could be used for analysis and simulations of biliary and urinary excretion of doxorubicin and doxorubicinol and plasma doxorubicinol concentrations in pigs, but the binding-specific model was better at describing plasma doxorubicin concentrations. Porcine tissue concentrations were 400- to 1250-fold better captured by the binding-specific model. This model adequately predicted plasma doxorubicin concentration-time and biliary doxorubicin excretion profiles against the validation data set. The semi-PBPK models applied were similarly effective for analysis of plasma concentrations and biliary and urinary excretion of doxorubicin and doxorubicinol in healthy pigs. Inclusion of intracellular binding in the doxorubicin semi-PBPK models was important to accurately describe tissue concentrations during in vivo conditions.
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Affiliation(s)
- Ilse R Dubbelboer
- Department of Pharmacy, Uppsala University , Box 580, 751 23 Uppsala, Sweden
| | - Elsa Lilienberg
- Department of Pharmacy, Uppsala University , Box 580, 751 23 Uppsala, Sweden
| | - Erik Sjögren
- Department of Pharmacy, Uppsala University , Box 580, 751 23 Uppsala, Sweden
| | - Hans Lennernäs
- Department of Pharmacy, Uppsala University , Box 580, 751 23 Uppsala, Sweden
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6
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Lilienberg E, Dubbelboer IR, Karalli A, Axelsson R, Brismar TB, Ebeling Barbier C, Norén A, Duraj F, Hedeland M, Bondesson U, Sjögren E, Stål P, Nyman R, Lennernäs H. In Vivo Drug Delivery Performance of Lipiodol-Based Emulsion or Drug-Eluting Beads in Patients with Hepatocellular Carcinoma. Mol Pharm 2017; 14:448-458. [DOI: 10.1021/acs.molpharmaceut.6b00886] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Elsa Lilienberg
- Department
of Pharmacy, Uppsala University, Box 580, 751 23 Uppsala, Sweden
| | - Ilse R. Dubbelboer
- Department
of Pharmacy, Uppsala University, Box 580, 751 23 Uppsala, Sweden
| | - Amar Karalli
- Department
of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
- Department
of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Rimma Axelsson
- Department
of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
- Department
of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Torkel B. Brismar
- Department
of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
- Department
of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | | | - Agneta Norén
- Department
of Surgical Sciences, Uppsala University Hospital, Uppsala University, 751 85 Uppsala, Sweden
| | - Frans Duraj
- Department
of Surgical Sciences, Uppsala University Hospital, Uppsala University, 751 85 Uppsala, Sweden
| | - Mikael Hedeland
- Department
of Chemistry, Environment and Feed Hygiene, National Veterinary Institute (SVA), 751 89 Uppsala, Sweden
| | - Ulf Bondesson
- Department
of Chemistry, Environment and Feed Hygiene, National Veterinary Institute (SVA), 751 89 Uppsala, Sweden
| | - Erik Sjögren
- Department
of Pharmacy, Uppsala University, Box 580, 751 23 Uppsala, Sweden
| | - Per Stål
- Unit
of Gastroenterology, Deptartment of Internal Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department
of Digestive Diseases, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Rickard Nyman
- Department
of Radiology, Uppsala University Hospital, Uppsala University, 751
85 Uppsala, Sweden
| | - Hans Lennernäs
- Department
of Pharmacy, Uppsala University, Box 580, 751 23 Uppsala, Sweden
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7
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Lilienberg E, Dubbelboer IR, Sjögren E, Lennernäs H. Lipiodol does not affect the tissue distribution of intravenous doxorubicin infusion in pigs. J Pharm Pharmacol 2016; 69:135-142. [DOI: 10.1111/jphp.12665] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 10/16/2016] [Indexed: 11/29/2022]
Abstract
Abstract
Objectives
In liver cancer treatment, lipiodol is used as a pharmaceutical excipient to improve delivery of the cytostatic drug doxorubicin (DOX). As DOX and its metabolite doxorubicinol (DOXol) cause serious off-target adverse effects, we investigated the effects of drug-free lipiodol or ciclosporin (CsA) on the tissue distribution (Kp) of DOX and DOXol in relevant pig tissues.
Methods
Four treatment groups (TI–TIV) all received an intravenous DOX solution at 0 and 200 min. Before the second dose, the pigs received a portal vein infusion of saline (TI), lipiodol (TII), CsA (TIII) or lipiodol and CsA (TIV). After 6 h, the pigs were euthanised, and liver, kidney, heart and intestine samples were collected and analysed.
Key findings
The tissue DOX concentrations were highest in the kidney (TI–TIV). All the investigated tissues showed extensive DOX Kp. Lipiodol had no effect on the Kp of DOX to any of the tissues. However, the tissue concentrations of DOX were increased by CsA (in liver, kidney and intestine, P < 0.05).
Conclusion
Lipiodol injected into the portal vein does not affect the tissue distribution of DOX and DOXol.
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Affiliation(s)
| | | | - Erik Sjögren
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Hans Lennernäs
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
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Manno RA, Grassetti A, Oberto G, Nyska A, Ramot Y. The minipig as a new model for the evaluation of doxorubicin-induced chronic toxicity. J Appl Toxicol 2015; 36:1060-72. [PMID: 26614124 DOI: 10.1002/jat.3266] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 10/15/2015] [Accepted: 10/23/2015] [Indexed: 11/09/2022]
Abstract
Doxorubicin can cause life-threatening toxic effects in several organs, with cardiotoxicity being the major concern. Although a large number of animal models have been utilized to study doxorubicin toxicity, several restrictions limit their use. Since the Göttingen minipig is an accepted species for non-clinical safety assessment and translation to man, we aimed at exploring its use as a non-rodent animal model for safety assessment and regulatory toxicity studies using doxorubicin. Three groups of three males and three females adult Göttingen minipigs received 1.5 mg kg(-1) , 3/2.3 mg kg(-1) or vehicle at intervals of 3 weeks for 7 cycles. Doxorubicin treatment resulted in a dose-related decrease in the erythrocytes, hemoglobin and hematocrit count, accompanied by leukopenia and thrombocytopenia. Bone marrow smears revealed dose-related hypocellularity. Urea and creatinine levels were elevated in treated animals, associated with proteinuria and hematuria. Histopathological evaluation detected nephropathy and atrophy of hematopoietic tissues/organs, mucosa of the intestinal tract and male genital tract. Cardiac lesions including chronic inflammation, endocardial hyperplasia, hemorrhage and myxomatous changes were evident in hematoxylin and eosin stains, and evaluation of semi-thin sections showed the presence of dose-related vacuolation in the atrial and ventricular cardiomyocytes. Cardiac troponin levels were increased in the high-dose group, but there was no direct correlation to the severity of the histopathological lesions. This study confirms that the Göttingen minipig has a comparable toxicity profile to humans and considering its anatomical, physiological, genetic and biochemical resemblance to humans, it should be considered as the non-rodent species of choice for studies on doxorubicin toxicity. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Rosa Anna Manno
- Department of Pathology, Research Toxicology Centre, Pomezia, Italy
| | - Andrea Grassetti
- Department of Pathology, Research Toxicology Centre, Pomezia, Italy
| | - Germano Oberto
- Scientific Director, Research Toxicology Centre, Pomezia, Italy
| | - Abraham Nyska
- Department of Pathology, Sackler School of Medicine, University of Tel Aviv, and Consultant in Toxicologic Pathology, Timrat, Israel
| | - Yuval Ramot
- Hadassah - Hebrew University Medical Center, Jerusalem, Israel
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Boulin M, Schmitt A, Delhom E, Cercueil JP, Wendremaire M, Imbs DC, Fohlen A, Panaro F, Herrero A, Denys A, Guiu B. Improved stability of lipiodol-drug emulsion for transarterial chemoembolisation of hepatocellular carcinoma results in improved pharmacokinetic profile: Proof of concept using idarubicin. Eur Radiol 2015; 26:601-9. [PMID: 26060065 DOI: 10.1007/s00330-015-3855-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 05/06/2015] [Accepted: 05/20/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To investigate the relationship between the improved stability of an anticancer drug-lipiodol emulsion and pharmacokinetic (PK) profile for transarterial chemoembolisation (TACE) of hepatocellular carcinoma (HCC). METHODS The stability of four doxorubicin- or idarubicin-lipiodol emulsions was evaluated over 7 days. PK and clinical data were recorded after TACE with the most stable emulsion in eight unresectable HCC patients, after institutional review board approval. RESULTS The most stable emulsion was the one that combined idarubicin and lipiodol (1:2 v:v). At 7 days, the percentages of aqueous, persisting emulsion and oily phases were 50-0-50, 33-0-67, 31-39-30, and 10-90-0 for the doxorubicin-lipiodol (1:1 v:v), doxorubicin-lipiodol (1:2 v:v), idarubicin-lipiodol (1:1 v:v), and the idarubicin-lipiodol (1:2 v:v) emulsion, respectively. After TACE, mean idarubicin Cmax and AUC0-24h were 12.5 ± 9.4 ng/mL and 52 ± 16 ng/mL*h. Within 24 h after injection, 40% of the idarubicin was in the liver, either in vessels, tumours, or hepatocytes. During the 2 months after TACE, no clinical grade >3 adverse events occurred. One complete response, five partial responses, one stabilisation, and one progression were observed at 2 months. CONCLUSION This study showed a promising and favourable PK and safety profile for the idarubicin-lipiodol (1:2 v:v) emulsion for TACE. KEY POINTS • Transarterial chemoembolisation (TACE) regimens that improve survival in hepatocellular carcinoma are needed. • Improved emulsion stability for TACE resulted in a favourable pharmacokinetic profile. • Preliminary safety and efficacy data for the idarubicin-lipiodol emulsion for TACE were encouraging.
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Affiliation(s)
- Mathieu Boulin
- EA 4184, University of Burgundy and Department of Pharmacy, Dijon University Hospital, 14 rue Gaffarel, 21000, Dijon, France.
| | - Antonin Schmitt
- EA 4184, University of Burgundy and Department of Pharmacy, Georges-François Leclerc Anticancer Center, Dijon, France
| | - Elisabeth Delhom
- Department of Radiology, Saint-Eloi University Hospital, Montpellier, France
| | | | - Maëva Wendremaire
- Department of Pharmacoloy-Toxicology, University Hospital, Dijon, France
| | | | - Audrey Fohlen
- Department of Radiology, University Hospital, Caen, France
| | - Fabrizio Panaro
- Department of General and Liver Transplant Surgery, Saint-Eloi University Hospital, Montpellier, France
| | - Astrid Herrero
- Department of General and Liver Transplant Surgery, Saint-Eloi University Hospital, Montpellier, France
| | - Alban Denys
- Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Boris Guiu
- Department of Radiology, Saint-Eloi University Hospital, Montpellier, France
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