Binding and distribution of Na2B12H11SH on cellular and subcellular level in tumor tissue of glioma patients in boron neutron capture therapy

Boron Cluster Anions Dissolve En Masse in Lipids Causing Membrane Expansion and Thinning

Boron clusters are applied in medicinal chemistry because of their high stability in biological environments and intrinsic ability to capture neutrons. However, their intermolecular interactions with lipid membranes, which are critical for their cellular delivery and biocompatibility, have not been comprehensively investigated. In this study, we combine different experimental methods - Langmuir monolayer isotherms at the air-water interface, calorimetry (DSC, ITC), and scattering techniques (DLS, SAXS) - with MD simulations to evaluate the impact of closo-dodecaborate clusters on model membranes of different lipid composition. The cluster anions interact strongly with zwitterionic membranes (POPC and DPPC) via the chaotropic effect and cause pronounced expansions of lipid monolayers. The resulting lipid membranes contain up to 33 mol % and up to 52 weight % of boron cluster anions even at low aqueous cluster concentrations (1 mM). They show high (μM) affinity to the hydrophilic-hydrophobic interface, affecting the structuring of the lipid chains, and therefore triggering a sequence of characteristic effects: (i) an expansion of the surface area per lipid, (ii) an increase in membrane fluidity, and (iii) a reduction of bilayer thickness. These results aid the design of boron cluster derivatives as auxiliaries in drug design as well as transmembrane carriers and help rationalize potential toxicity effects.

Organotin Dyes Bearing Anionic Boron Clusters as Cell-Staining Fluorescent Probes

Within the cell nucleus, in the nucleoli, ribosomal RNAs are synthesized and participate in several biological processes. To better understand nucleoli-related processes, their visualization is often required, for which specific markers are needed. Herein, we report the design of novel fluorescent organotin compounds derived from 4-hydroxy-N'-((2-hydroxynaphthalen-1-yl)methylene)benzohydrazide and their cytoplasm and nucleoli staining of B16F10 cells in vitro. Tin compounds bearing an aliphatic carbon chain (-C₁₂ H₂₅ ) and an electron-donating group (-OH) were prepared, and the latter could be derivatized to bear the boron cluster anions [B₁₂ H₁₂ ]^2- and [3,3'-Co(1,2-C₂ B₉ H₁₁ )₂ ]^- (COSAN). All of the conjugates have been fully characterized and their luminescence properties have been assessed. In general, they show good quantum yields in solution (24-49 %), those for the COSAN derivatives being lower. Remarkably, the linking of [B₁₂ H₁₂ ]^2- and COSAN to the complexes made them more soluble, without being detrimental to their luminescence properties. Living B16F10 cells were treated with all of the compounds to determine their fluorescence staining properties; the compounds bearing the aliphatic chain showed a reduced staining capacity due to the formation of aggregates. Notably, the complexes bearing different boron clusters showed different staining effects; those bearing [B₁₂ H₁₂ ]^2- showed extraordinary staining of the nucleoli and cytoplasm, whereas those bearing COSAN were only detected in the cytoplasm. The remarkable fluorescence staining properties shown by these organotin compounds make them excellent candidates for fluorescence bioimaging in vitro.

Interaction of Na2B12H11SH with dimyristoyl phosphatidylcholine liposomes

Previous investigations have revealed that the boron cluster compound Na2B12H11SH (BSH) is very potent in causing major structural rearrangements of and leakage from phosphatidylcholine liposomes. This somewhat unexpected finding is interesting from a fundamental point of view and may also constitute the basis of future important pharmaceutical/medical applications of BSH. In order to further explore the BSH-lipid interaction, we have studied the effects caused by BSH on dimyristoyl phosphatidylcholine (DMPC) liposomes. Cryo-transmission electron microscopy showed that BSH induces aggregation, membrane rupture and increasing wall thickness of the liposomes. Differential scanning calorimetry revealed a BSH dependent shift of the gel to liquid crystalline phase transition temperature of DMPC. The zeta potential of the liposomes decreases with increasing BSH concentrations, and an apparent dissociation constant of 0.23 mM was found. BSH caused leakage of liposome-encapsulated carboxyfluorescein; leakage was higher at 23 degrees C (near the phase transition temperature) than at 15 degrees C and 37 degrees C. It induced lipid mixing only at very high concentrations.

Boron neutron capture therapy: cellular targeting of high linear energy transfer radiation

Boron neutron capture therapy (BNCT) is based on the preferential targeting of tumor cells with (10)B and subsequent activation with thermal neutrons to produce a highly localized radiation. In theory, it is possible to selectively irradiate a tumor and the associated infiltrating tumor cells with large single doses of high-LET radiation while sparing the adjacent normal tissues. The mixture of high- and low-LET dose components created in tissue during neutron irradiation complicates the radiobiology of BNCT. Much of the complexity has been unravelled through a combination of preclinical experimentation and clinical dose escalation experience. Over 350 patients have been treated in a number of different facilities worldwide. The accumulated clinical experience has demonstrated that BNCT can be delivered safely but is still defining the limits of normal brain tolerance. Several independent BNCT clinical protocols have demonstrated that BNCT can produce median survivals in patients with glioblastoma that appear to be equivalent to conventional photon therapy. This review describes the individual components and methodologies required for effect BNCT: the boron delivery agents; the analytical techniques; the neutron beams; the dosimetry and radiation biology measurements; and how these components have been integrated into a series of clinical studies. The single greatest weakness of BNCT at the present time is non-uniform delivery of boron into all tumor cells. Future improvements in BNCT effectiveness will come from improved boron delivery agents, improved boron administration protocols, or through combination of BNCT with other modalities.

Subcellular biodistribution of sodium borocaptate (BSH: Na2B12H11SH) in a rat glioma model in boron neutron capture therapy

Mercaptoundecahydrododecaborate (Na2B12H111SH, sodium borocaptate or 'BSH') has been used clinically as a boron compound for boron neutron capture therapy (BNCT) in patients with malignant glioma in Japan and Europe. Boron-10 is known to accumulate selectively only in brain tumor cells. This work was aimed to clarify the subcellular biodistribution of BSH in a rat glioma model using immunohistochemical approach. Wistar rats were used for this experiment. An intracerebral injection of 5.0 x 10(6) C6 glioma cells was introduced into the region of cerebral hemisphere. Fifty milligrams of "'B/kg BSH was infused intravenously two weeks after implantation. Host rats were divided into six groups according to the sampling time: 1, 4, 8, 16, 24 and 48 h after the start of BSH infusion. Immunohistochemical study was carried out using anti-BSH antibody. Boron was already found in a whole cell 1 h after BSH infusion, and then seemed to collect in a cell nuclei around 8-16 h after infusion. It was still recognized in tumor cell 48 h after infusion. This study supports the following hypothesis on selective boron uptake in a tumor. BSH can pass through the disrupted blood-brain barrier (BBB) easily and can come in contact with tumor cells; there, BSH can bind on the extracellular surface of plasma membrane to choline residues. After binding to the plasma membrane, boron with choline residues may be internalized into the cell by endocytic pathways and eventually travel to cell nuclei, and then stay there for a long time.

Tissue uptake of BSH in patients with glioblastoma in the EORTC 11961 phase I BNCT trial

PURPOSE

The uptake of the boron compound Na2B12H10-SH (BSH) in tumor and normal tissues was investigated in the frame of the EORTC phase I trial 'Postoperative treatment of glioblastoma with BNCT at the Petten Irradiation Facility' (protocol 11961).

METHODS AND MATERIALS

The boron concentration in blood, tumor, normal brain, dura, muscle, skin and bone was detected using inductively coupled plasma-atomic emission spectroscopy in 13 evaluable patients. In a first group of 10 patients 100 mg BSH/kg bodyweight (BW) were administered; a second group of 3 patients received 22.9 mg BSH/kg BW. The toxicity due to BSH was evaluated.

RESULTS

The average boron concentration in the tumor was 19.9 +/- 9.1 ppm (1 standard deviation (SD)) in the high dose group and 9.8 +/- 3.3 ppm in the low dose group, the tumor/blood ratios were 0.6 +/- 0.2 and 0.9 +/- 0.2, respectively. The highest boron uptake has been detected in the dura, very low uptake was found in the bone, the cerebro-spinal fluid and especially in the brain (brain/blood ratio 0.2 +/- 0.02 and 0.4 +/- 0.2). No toxicity was detected except flush-like symptoms in 2 cases during a BSH infusion at a much higher speed than prescribed.

CONCLUSION

BSH proved to be safe for clinical application at a dose of 100 mg BSH/kg infused and at a dose rate of 1 mg/kg/min. The study underlines the importance of a further investigation of BSH uptake in order to obtain enough data for significant statistical analysis. The boron concentration in blood seems to be a quite reliable parameter to predict the boron concentration in other tissues.

Boron concentrations in brain during boron neutron capture therapy: in vivo measurements from the phase I trial EORTC 11961 using a gamma-ray telescope

PURPOSE

Gamma-ray spectroscopic scans to measure boron concentrations in the irradiated volume were performed during treatment of 5 patients suffering from brain tumors with boron neutron capture therapy (BNCT). In BNCT, the dose that is meant to be targeted primarily to the tumor is the dose coming from the reaction 10B(n,alpha)7Li, which is determined by the boron concentration in tissue and the thermal neutron fluence rate. The boron distribution throughout the head of the patient during the treatment is therefore of major interest. The detection of the boron distribution during the irradiation was until now not possible.

METHODS AND MATERIALS

Five patients suffering from glioblastoma multiforme and treated with BNCT in a dose escalation study were administered the boron compound, boron sulfhydryl (BSH; Na(2)B(12)H(11)SH). Boron concentrations were reconstructed from measurements performed with the gamma-ray telescope which detects locally the specific gamma rays produced by neutron capture in 10B and 1H.

RESULTS

For all patients, at a 10B concentration in blood of 30 ppm, the boron concentration in nonoperated areas of the brain was very low, between 1 and 2.5 ppm. In the target volume, which included the area where the tumor had been removed and where remaining tumor cells have to be assumed, much higher boron concentrations were measured with large variations from one patient to another. Superficial tissue contained a higher concentration of 10B than the nonoperated areas of the brain, ranging between 8 and 15 ppm.

CONCLUSIONS

The measured results correspond with previous tissue uptake studies, confirming that normal brain tissue hardly absorbs the boron compound BSH. Gamma-ray telescope measurements seem to be a promising method to provide information on the biodistribution of boron during therapy. Furthermore, it also opens the possibility of in vivo dosimetry.

Vascular targeted endoradiotherapy of tumors using alpha-particle-emitting compounds: theoretical analysis

PURPOSE

To establish the theoretical framework and study the feasibility of (211)At-labeled anti-tenascin chimeric 81C6 monoclonal antibody (mAb) as anti-vascular endoradiotherapy for the treatment of glioblastoma multiforme (GBM) tumors.

METHODS AND MATERIALS

The morphology of blood vessels from histologic images was analyzed and used along with reaction-diffusion equations to assess the activity concentration of (211)At-labeled chimeric 81C6 mAb in GBM tumor and normal-brain tissue. Alpha particle microdosimetry was then used to assess the survival probability and average absorbed dose for tumor and normal tissue endothelial cells (ECs) per unit vascular cumulated activity concentration q(source) (MBq-s g(-1)). In turn, these survival probabilities were used to assess the probability of failure Phi for a single vessel. Furthermore, using the vessel density, the specific tumor control probability per unit mass of tumor tissue (tcp) and the specific normal-tissue complication probability per unit mass of normal-brain tissue (ntcp) were estimated. The specific tumor control probability, tcp, was used to assess the overall tumor control probability (TCP) as a function of tumor mass.

RESULTS

The levels of (211)At-labeled ch81C6 mAb cumulated activity concentration in GBM tumor tissue were approximately five times higher than that in normal-brain tissue. Thus, the average absorbed dose to tumor ECs was higher than that of normal tissue ECs, and the survival probability for GBM ECs was lower than for normal-brain tissue ECs. Consequently, the resulting vessel-failure probability, Phi, for GBM tumor and for normal-brain tissue differ considerably, yielding a q(source) range between 10(3) and 10(4) MBq-s g(-1).

CONCLUSIONS

This theoretical analysis demonstrated that (211)At-labeled chimeric 81C6 is an effective anti-vascular therapy for the treatment of GBM tumors, yielding a tcp higher than 0.999 for vascular cumulated activity concentrations q(source) higher than 1 x 10(4) MBq-s g(-1), while yielding a low probability for normal-brain tissue damage.

Towards in vivo monitoring of neutron distributions for quality control of BNCT

Dose delivery in boron neutron capture therapy (BNCT) is complex because several components contribute to the dose absorbed in tissue. This dose is largely determined by local boron concentration, thermal neutron distribution and patient positioning. In vivo measurements of these factors would considerably improve quality control and safety. During therapy, a y-ray telescope measures the y-rays emitted following neutron capture by hydrogen and boron in a small volume of the head of a patient. Scans of hydrogen y-ray emissions could be used to verify the actual distribution of thermal neutrons during neutron irradiation. The method was first tested on different phantoms. These measurements showed good agreement with calculations based on thermal neutron distributions derived from a treatment planning program and from Monte Carlo N-particle (MCNP) simulations. Next, the feasibility of telescope scans during patient irradiation therapy was demonstrated. Measurements were reproducible between irradiation fractions. In theory, this method can be used to verify the positioning of the patient in vivo and the delivery of thermal neutrons in tissue. However, differences between measurements and calculations based on a routine treatment planning program were observed. These differences could be used to refine the treatment planning. Further developments will be necessary for this method to become a standard quality control system.

Determination of the subcellular distribution of mercaptoundecahydro-closo-dodecaborate (BSH) in human glioblastoma multiforme by electron microscopy

The subcellular distribution of mercaptoundecahydro-closo-dodecaborate (BSH) in glioblastoma multiforme tissue sections of several patients having received BSH prior to surgery was investigated by transmission electron microscopy (TEM) using antibodies against BSH and electron energy loss spectroscopy (EELS) and electron spectroscopic imaging (ESI). These microscopic techniques show that BSH is associated with extracellular structures, the cell membrane as well as with the chromatin in the nucleus.

Validation of the scanning -gamma-ray telescope for in vivo dosimetry and boron measurements during BNCT

Gamma-ray telescope scans of a box phantom with inhomogeneous boron concentrations have proven the feasibility of in vivo measurements of different boron distributions in the head of a patient during boron neutron capture therapy (BNCT). Small structures with enhanced boron concentration can be reconstructed in a head phantom, even if the brain compartment of the phantom is surrounded by a skin layer with a ten times higher boron concentration. The motor-controlled telescope can scan the head/phantom, detecting boron and hydrogen prompt y-rays emitted at neutron capture reactions with a two-dimensional spatial resolution of 14 mm full width at half maximum. For reconstruction of the boron concentrations from the measured y-ray detection rates, a mathematical reconstruction algorithm is derived and discussed. Proper reconstruction requires position-dependent y-ray measurements combined with treatment planning programme calculations of the thermal neutron distribution. In a head phantom, in which the brain and the skull (bulk) were represented using a homogeneous boron distribution of 5.2 +/- 0.5 ppm 10B, surrounded by a skin layer with a ten times higher boron concentration, the bulk concentration was reconstructed to 4.7 +/- 0.3 ppm 10B. Telescope scans along and perpendicular to the beam axis showed the influence of inhomogeneities with a high boron concentration such as skin and a simulated blood vessel, respectively with a low boron concentration such as white matter. The profiles of the boron and hydrogen y-ray detection rates indicate how future patient measurements can be interpreted. In clinical trials, the telescope can then be used to investigate the averaged boron concentration in the bulk of a patient and local enhanced boron concentrations (e.g. in tumour tissue) in order to relate the measured boron dose distributions to the clinical effects of BNCT. Simultaneously, it can serve as quality control of the dosimetry during the irradiation.

Significant differences in the retention of the borocaptate monomer (BSH) and dimer (BSSB) in malignant cells

The (10)B enriched form of Na(2)B(12)H(11)SH (BSH) is used in a binary cancer radiation treatment, known as boron neutron capture therapy (BNCT). The BSH anion can also form a dimer, [B(24)H(22)S(2)](4-) (BSSB), previously used in animal model studies. It is demonstrated here that the retention of BSSB in mouse M2R melanoma and rat C6 glioma cells is significantly longer than that of the monomer BSH. The washout of the BNCT agents from cultured cells was followed using (11)B nuclear magnetic resonance spectroscopy. One hour after switching to boron-free culture medium, the relative amount of BSSB retained in M2R cells was at least about six times higher than that of BSH. The initial washout rate (over the first approximately 4 h) of BSSB was 4x10(-3) min(-1) (t(1/2), approximately 3 h) for M2R cells, and of the same order of magnitude for glioma cells.

Optimal timing of neutron irradiation for boron neutron capture therapy after intravenous infusion of sodium borocaptate in patients with glioblastoma

PURPOSE

A cooperative study in Europe and Japan was conducted to determine the pharmacokinetics and boron uptake of sodium borocaptate (BSH: Na(2)B(12)H(11)SH), which has been introduced clinically as a boron carrier for boron neutron capture therapy in patients with glioblastoma.

METHODS AND MATERIALS

Data from 56 patients with glioblastoma who received BSH intravenous infusion were retrospectively reviewed. The pharmacokinetics were evaluated in 50 patients, and boron uptake was investigated in 47 patients. Patients received BSH doses between 12 and 100 mg/kg of body weight. For the evaluation, the infused boron dose was scaled linearly to 100 mg/kg BSH.

RESULTS

In BSH pharmacokinetics, the average value for total body clearance, distribution volume of steady state, and mean residence time was 3.6 +/- 1.5 L/h, 223.3 +/- 160.7 L, and 68.0 +/- 52.5 h, respectively. The average values of the boron concentration in tumor adjusted to 100 mg/kg BSH, the boron concentration in blood adjusted to 100 mg/kg BSH, and the tumor/blood boron concentration ratio were 37.1 +/- 35.8 ppm, 35.2 +/- 41.8 ppm, and 1.53 +/- 1.43, respectively. A good correlation was found between the logarithmic value of T(adj) and the interval from BSH infusion to tumor tissue sampling. About 12-19 h after infusion, the actual values for T(adj) and tumor/blood boron concentration ratio were 46.2 +/- 36.0 ppm and 1.70 +/- 1.06, respectively. The dose ratio between tumor and healthy tissue peaked in the same interval.

CONCLUSION

For boron neutron capture therapy using BSH administered by intravenous infusion, this work confirms that neutron irradiation is optimal around 12-19 h after the infusion is started.

On-line reconstruction of low boron concentrations by in vivo gamma-ray spectroscopy for BNCT

Boron neutron capture therapy (BNCT) is a radiation therapy in which the neutron capture reaction of 10B is used for the selective destruction of tumours. At the High Flux Reactor (HFR) in Petten, a therapy facility with an epithermal neutron beam has been built. In the first instance, patients with brain tumours will be treated. The doses delivered to the tumour and to the healthy tissue depend on the thermal neutron fluence and on the boron concentrations in these regions. An accurate determination of the patient dose during therapy requires knowledge of these time-dependent concentrations. For this reason, a gamma-ray telescope system, together with a reconstruction formalism, have been developed. By using a gamma-ray detector in a telescope configuration, boron neutron capture gamma-rays of 478 keV emitted by a small specific region can be detected. The reconstruction formalism can calculate absolute boron concentrations using the measured boron gamma-ray detection rates. Besides the boron gamma-rays, a large component of 2.2 MeV gamma-rays emitted at thermal neutron capture in hydrogen is measured. Since the hydrogen distribution is almost homogeneous within the head, this component can serve as a measure of the total number of thermal neutrons in the observed volume. By using the hydrogen gamma-ray detection rate for normalization of the boron concentration, the reconstruction tool eliminates the greater part of the influence of the inhomogeneity of the thermal neutron distribution. MCNP calculations are used as a tool for the optimization of the detector configuration. Experiments on a head phantom with 5 ppm 10B in healthy tissue showed that boron detection with a standard deviation of 3% requires a minimum measuring time of 2 min live time. From two position-dependent measurements, boron concentrations in two compartments (healthy tissue and tumour) can be determined. The reconstruction of the boron concentration in healthy tissue can be done with a standard deviation of 6%. The gamma-ray telescope can also be used for in vivo dosimetry.

Uptake and washout of borocaptate sodium and borono-phenylalanine in cultured melanoma cells: a multi-nuclear NMR study

The cellular uptake and washout of the two principal boron neutron capture therapy (BNCT) agents, borocaptate sodium (BSH) and borono-phenylalanine (BPA), were monitored on-line, noninvasively, using nuclear magnetic resonance (NMR) spectroscopy. The uptake and washout of inorganic borate (B(i)) was also followed for comparison. M2R mouse melanoma cells grown on polystyrene microspheres were perfused inside the NMR sample tube. (11)B NMR was used to detect the presence of B(i), BSH and BPA, and (19)F NMR was applied to detect fluorinated BPA ((19)F-BPA). The results revealed chemical modifications of BSH due to spontaneous formation of the borocaptate dimer, BSSB, in the culture medium. BPA readily formed a complex with glucose contained in the culture medium but was also converted in the cells to a yet unidentified compound in a reaction that probably involves the hydrolysis of BPA and the release of B(i). The cellular accumulation ratio for BPA was significantly higher than 1 and was also significantly higher than that for BSH. On the other hand, the cellular retention time observed for BSH was much longer than for BPA, indicating a strong trapping of BSH in cells.

Spectromicroscopy of boron in human glioblastomas following administration of Na2B12H11SH

Boron neutron capture therapy (BNCT) is an experimental, binary treatment for brain cancer which requires as the first step that tumor tissue is targeted with a boron-10 containing compound. Subsequent exposure to a thermal neutron flux results in destructive, short range nuclear reaction within 10 microm of the boron compound. The success of the therapy requires than the BNCT agents be well localized in tumor, rather than healthy tissue. The MEPHISTO spectromicroscope, which performs microchemical analysis by x-ray absorption near edge structure (XANES) spectroscopy from microscopic areas, has been used to study the distribution of trace quantities of boron in human brain cancer tissues surgically removed from patients first administered with the compound Na2B12H11SH (BSH). The interpretation of XANES spectra is complicated by interference from physiologically present sulfur and phosphorus, which contribute structure in the same energy range as boron. We addressed this problem with the present extensive set of spectra from S, B, and P in relevant compounds. We demonstrate that a linear combination of sulfate, phosphate and BSH XANES can be used to reproduce the spectra acquired on boron-treated human brain tumor tissues. We analyzed human glioblastoma tissue from two patients administered and one not administered with BSH. As well as weak signals attributed to BSH, x-ray absorption spectra acquired from tissue samples detected boron in a reduced chemical state with respect to boron in BSH. This chemical state was characterized by a sharp absorption peak at 188.3 eV. Complementary studies on BSH reference samples were not able to reproduce this chemical state of boron, indicating that it is not an artifact produced during sample preparation or x-ray exposure. These data demonstrate that the chemical state of BSH may be altered by in vivo metabolism.

Interaction of mercaptoundecahydrododecaborate (BSH) with phosphatidylcholine: relevance to boron neutron capture therapy

The interaction of mercaptoundecahydrododecaborate (B12H11SH2-, BSH) with phosphatidylcholine was investigated in this study in order to illuminate possible uptake mechanisms of BSH in tumor cells. BSH has been used clinically in Japan as a boron containing agent in patients with malignant brain tumors for boron neutron capture therapy (BNCT). After infusion, BSH accumulates selectively in tumor tissue. Little is known for the mechanism of boron uptake to tumor cells. Fourier transform infrared (FTIR) spectrometry was used to quantify BSH (at wavenumber 2490 cm-1) and phosphatidylcholine (at wavenumber 2850-2970 cm-1). After extraction into carbon tetrachloride (CCl4), we could find an absorbance maximum at 2490 cm-1 as a B-H band in the mixture of BSH with phosphatidylcholine, which is attributed to a BSH-phosphatidylcholine complex, which could dissolve well in CCl4. The molar ratio of BSH to phosphatidylcholine in the CCl4 solution was at most one mole of BSH to two moles of phosphatidylcholine independent of the excess BSH. The doubly negatively charged BSH can interact with two phosphatidylcholine molecules through their singly positively charged choline residues. These ion pairs could be responsible for membrane binding and penetration, and for cell internalization.