Cancer chemotherapy: new strategies for success

NIR and Reduction Dual-Sensitive Polymeric Prodrug Nanoparticles for Bioimaging and Combined Chemo-Phototherapy

The combination of chemotherapy, photothermal therapy (PTT) and photodynamic therapy (PDT) based on a single nanosystem is highly desirable for cancer treatment. In this study, we developed a versatile Pt(IV) prodrug-based nanodrug, PVPt@Cy NPs, to realize synchronous chemotherapy, PDT and PTT and integrate cancer treatment with bioimaging. To construct PVPt@Cy NPs, the amphiphilic Pt(IV)-based polymeric prodrug PVPt was synthesized by a facile one-pot coupling reaction, and then it was used to encapsulate an optotheranostic agent (HOCyOH, Cy) via hydrophobic interaction-induced self-assembly. These NPs would disaggregate under acidic, reductive conditions and NIR irradiation, which are accompanied by photothermal conversion and reactive oxygen species (ROS) generation. Moreover, the PVPt@Cy NPs exhibited an enhanced in vitro anticancer efficiency with 808-nm light irradiation. Furthermore, the PVPt@Cy NPs showed strong NIR fluorescence and photothermal imaging in H22 tumor-bearing mice, allowing the detection of the tumor site and monitoring of the drug biodistribution. Therefore, PVPt@Cy NPs displayed an enormous potential in combined chemo-phototherapy.

Self-assembled autophagy-inducing polymeric nanoparticles for breast cancer interference in-vivo

A peptide-conjugated poly(β-amino ester) that self-assembles into micelle-like nanoparticles is prepared by a convenient and modular supramolecular approach. The polymer-beclin-1 (P-Bec1) nanoparticles display enhanced cytotoxicity to breast cancer cells through induction of autophagy. This approach overcomes two major limitations of the haploinsufficient tumor suppressor Bec1 compared to small-molecule drugs: poor delivery to tumors owing to enzymatic degradation, and unstable, non-specific bio-distribution and targeting in the tumor tissues.

Oral buccoadhesive films of ondansetron: Development and evaluation

Introduction:

Difficulty or inability in swallowing tablets/capsules during or after chemotherapy is common due to chemotherapy induced nausea and vomiting in patients. Buccoadhesive films of ondansetron hydrochloride were prepared for the prevention and treatment of chemotherapy-induced emesis. Films of varying polymeric composition were prepared in order to facilitate initial as well as prolonged drug release that could take care of acute as well as delayed emesis.

Materials and Methods:

Mucoadhesive films were prepared using polymers such as hydroxypropyl methylcellulose (HPMC) E5, HPMC K100, and Eudragit^® NE 30 D. The effect of concentration of these polymers on physical properties and drug release were studied. All the films were prepared by solvent casting method. In another part of the study, the effect of drug concentration on physical and mucoadhesive properties of film were assessed, keeping the polymer concentration fixed.

Results:

Films containing HPMC showed good mucoadhesion. Increasing the concentration of Eudragit^® NE 30 D in the films retarded drug release and increased residence time, however, reduced mucoadhesion. At a fixed polymer concentration and ratio, films prepared using an increased drug content showed an increased mucoadhesion.

Conclusion:

Films prepared using HPMC E5 (1000 mg), HPMC K100 (500 mg), and Eudragit^® NE 30 D (750 mg) provided initial rapid followed by sustained drug release over a period of 6 h. Given the promising results, the study concluded that the developed buccal films have the potential to release ondansetron required for chemotherapy induced acute and delayed emesis.

The relationship of a novel drug-resistant phenotype in C3H10T1/2 cells selected with alkylating agents to neoplastic transformation and ATP metabolism

We investigated the resistance to alkylating agents in parental, drug-selected and neoplastically transformed C3H10T1/2 (10T1/2) murine fibroblasts. Similar levels of resistance to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) were observed in cells selected for resistance to MNNG or 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) as well as in cells transformed by a single treatment with MNNG. Surprisingly, neither the levels of O6-alkylguanine-DNA alkyltransferase (AT) nor glutathione-S-transferase (GST) were altered in drug-resistant cells. In contrast, changes in ATP metabolism were observed in both transformed and MNNG-selected cells after treatment with MNNG. Specifically, 3 h after treatment with 5 microg/ml MNNG, ATP levels decreased by 85% and 74% in MNNG-selected and transformed cells, respectively, compared to only a 28% decrease in parental cells. Therefore, rather than contributing to cell sensitivity to alkylating agents, the ability to rapidly utilize ATP and tolerate resulting decreases in ATP levels may in some cases play a role in protection from the cytotoxic effects of alkylating agents.

Oxidation therapy: the use of a reactive oxygen species-generating enzyme system for tumour treatment

Oxygen radicals induce cytotoxicity via a variety of mechanisms, including DNA damage, lipid peroxidation and protein oxidation. Here, we explore the use of a polyethylene glycol (PEG)-stabilised enzyme capable of producing reactive oxygen species (ROS), glucose oxidase (GO), for the purpose of harnessing the cytotoxic potential of ROS for treating solid tumours. PEG-GO (200 U), administered by two intratumoral injections 3 h apart, produced a significant growth delay in subcutaneous rat 9L gliomas as compared with control animals receiving heat-denatured PEG-GO. Rats were protected from systemic toxicity by subsequent i.v. administration of PEG-superoxide dismutase (PEG-SOD) and PEG-catalase. In vivo tumour metabolic changes, monitored using 31P magnetic resonance spectroscopy (31P-MRS) 6 h following initial administration of PEG-GO, revealed a 96 +/- 2% reduction in the ATP/Pi ratio and a 0.72 +/- 0.10 unit decline in intracellular pH. A 3-fold sensitisation of 9L glioma cells in vitro to hydrogen peroxide could be achieved by a 24 h preincubation with buthionine sulphoximine (BSO). This study suggests that oxidation therapy, the use of an intratumoral ROS-generating enzyme system for the treatment of solid tumours, is a promising area which warrants further exploration.

Magnetic Resonance Imaging and Spectroscopy: Application to Experimental Neuro-Oncology

The development and use of animal brain tumor models over the past 25 years has helped to advance our understanding of both tumor biology and the effectiveness of new therapeutic approaches. The application of MRI and MRS as noninvasive tools for in vivo studies of intracerebral tumor models provides unique possibilities for furthering our knowledge of brain cancer. This article provides a brief background of traditional techniques used to evaluate growth and treatment efficacy in rodent brain tumor models and overviews the use of MR for quantitating intracerebral tumor growth kinetics and therapeutic response of experimental brain tumors from work conducted in this laboratory. The application of MRI and MRS in rodent brain tumor models for evaluation of novel therapeutic approaches, including gene transfer technology, is discussed. Finally, initial results with diffusion MRI for monitoring the treatment of brain tumors is introduced.

Chemical enhancement of cisplatin cytotoxicity in a human ovarian and cervical cancer cell line

While many advances have been made in the chemotherapy of gynecologic cancers, treatment failures remain a major clinical problem. A growing understanding of the mechanisms of tumor cell resistance to antineoplastic drugs provides a framework for the development of chemotherapy regimens containing agents capable of modulating tumor response. Using a short-term ATP bioluminescence assay we studied the ability of two methylxanthines (caffeine, pentoxifylline) and an inhibitor of ADP-ribosyl transferase (3-aminobenzamide) to enhance cisplatin cytotoxicity in gynecologic cancer cell lines. Our findings of significantly enhanced cisplatin-induced cytotoxicity with two different analysis techniques confirms the effectiveness of these agents. These results may have future clinical significance.

Meta-iodobenzylguanidine (MIBG), a novel high-affinity substrate for cholera toxin that interferes with cellular mono(ADP-ribosylation)

Meta-iodobenzylguanidine (MIBG) is a guanidine analogue of the neurotransmitter norepinephrine. Radioiodinated [131I]MIBG is clinically used as a tumor-targeted radiopharmaceutical in the diagnosis and treatment of adrenergic tumors. Moreover, non-radiolabelled MIBG exerts several cell-biological effects, tentatively ascribed to interference with cellular mono(ADP-ribosyl) transferases (Smets, L.A., Bout, B. and Wisse, J. (1988) Cancer Chemother. Pharmacol. 21, 9-13; Smets, L.A., Metwally, E.A.G., Knol, E. and Martens, M. (1988) Leukemia Res. 12, 737-743). In the present study it was investigated whether MIBG could serve as an acceptor for the ribosyl transferase activity of cholera toxin and of erythrocyte membranes. MIBG appeared a substrate for the cholera toxin-catalyzed transfer of the ADP-ribose moiety of NAD to arginine-like residues with the highest affinity for this enzyme reported as yet (Km = 6.5 microM). MIBG was also ADP-ribosylated by the mono(ADP-ribosyl)transferase(s) of turkey erythrocyte membranes. Moreover, the drug appeared a potent affector of the ADP-ribose linkage to membrane proteins by these enzymes. Interference by MIBG was stronger than by related guanyltyramine, the monoamine precursors of MIBG, meta-iodobenzylamine had no effect at all. In contrast, the drug failed to affect endogenous, O-linked poly(ADP-ribose) polymerase, induced in nuclei of S49-leukemia cells by deoxyribonuclease. Since MIBG is the first described drug that specifically interferes with the cellular N-linked mono(ADP-ribosyl) transferase reactions, it may be an important tool to elucidate the physiological role of this posttranscriptional protein modification.

Radiation and chemotherapy sensitizers and protectors

Radiosensitizers and radioprotectors are part of the chemical modifier approach to cancer therapy whereby the state of the tumor cells and/or normal tissues are modified such that a therapeutic gain is achieved using conventional radiation or chemotherapy. Radiosensitization can be achieved by the use of oxygen-mimetic compounds, agents that alter DNA sensitivity to irradiation, maneuvers that alter DNA repair processes, and manipulation of tissue oxygenation. Standard chemotherapeutic agents such as cisplatin can be utilized in a manner that optimizes the radiosensitization properties. Protection and sensitization can occur by altering the thiol status of the cell. The chemical modifiers field is both developing novel approaches to cancer treatment and increasing the understanding of basic cancer biology.

VP-16-induced nucleotide pool changes and poly(ADP-ribose) synthesis: the role of VP-16 in interphase death

Exposure of human promyelocytic leukemia cell line (HL-60) to VP-16 resulted in accumulation of DNA strand breaks. Concomitantly, intracellular NAD levels fell at 1 h, followed by declines in ATP at 2 h and in GTP, CTP, and UTP at 3 h. Furthermore, marked morphological changes, such as loss of microvilli or bleb formation, appeared at 4 h and cell death by 8-10 h. The addition of an inhibitor of poly(ADP-ribose) polymerase, 3-aminobenzamide (5 mM), theophylline (2 mM), or thymidine (1 mM), prevented these sequential reductions of nucleotide pools and cell death. In fact, the activation of poly(ADP-ribose) synthesis was detectable within a few hours after treatment with VP-16, although it was smaller than that induced by N-methyl-N'-nitro-N-nitrosoguanidine. These results may suggest the possible role of activation of poly(ADP-ribosyl)ation in VP-16-induced nucleotide pool changes and subsequent interphase death.

Metoclopramide enhances the effect of cisplatin on xenografted squamous cell carcinoma of the head and neck

The chromatin-bound enzyme adenosine diphosphate ribosyl transferase is activated by DNA-damaging agents. Substances that inhibit the enzyme, such as benzamide analogues, are known to increase the cytotoxicity of ionising radiation and cytotoxic drugs. The purpose of the present study was to investigate whether the anti-emetic drug metoclopramide, a benzamide derivative (4-amino-N-2-(diethylaminoethyl)-5-chloro-2-methoxybenzamide; MCA), potentiates the effect of cisplatin (cis-diammine-dichloroplatinum; CDDP) on squamous cell carcinoma (SCC). For that purpose human SCC of the head and neck (i.e. tumour line AB and EH) xenografted to nude mice were used. Two administration schedules were tested: (a) MCA (2.0 mg kg-1 i.p.) one hour before CDDP (7.5 mg kg-1 i.p.); and (b) MCA (3 x 2.0 mg kg-1) given concomitant to, 24 and 48 hours after CDDP (7.5 mg kg-1) administration. Treatment efficacies were compared using the area under the growth curves (AUC), tumour volumes and specific growth delay (SGD). There was no mortality and no weight loss of significance in any treatment group. MCA alone did not induce any significant reduction in AUC, tumour volume or SGD with either treatment schedule. CDDP alone gave a significant reduction of tumour growth in tumour line AB but not in tumour line EH. In schedule (a) the addition of MCA did not give any additive effect. However, in schedule (b), for both tumour lines, MCA enhanced the effect of CDDP by significantly reducing the AUC (AB: P less than 0.0001; EH: P less than 0.001) and increasing SGD (AB: P less than 0.012; EH: P less than 0.001) when compared to the tumours given CDDP alone. These effects were observed at a MCA dose currently being administered to humans.

Cytotoxic and antitumor effects of the norepinephrine analogue meta-iodo-benzylguanidine (MIBG)

Meta-iodo-benzylguanidine (MIBG) is an analogue of the neurotransmitter norepinephrine. In its radioiodinated form, MIBG is clinically used as a tumor-targeted radiopharmaceutical in the diagnosis and treatment of adrenergic tumors. The potential cytotoxicity of the unlabeled drug was tested. MIBG appeared cytotoxic in a large panel of histogenetically different cell lines without preference against tumor cells of neural origin. The cytotoxicity of MIBG was higher than of the related mono-amine precursor, meta-iodo-benzylamine (MIBA). Drugs that block adrenergic receptors and inhibitors of tyrosinase or tyrosine hydroxylase had no effect on the cytostatic properties of MIBG. However, its activity was potentiated by the pharmacological inhibition of catecholamine degradation and by inhibitors of intracellular storage. MIBG had anti-tumor effects on L1210 leukemia and N1E115 neuroblastoma, grown as subcutaneous tumors in animals treated with MIBG in non-toxic schedules. The observations suggest that MIBG is cytotoxic in its native form and may contribute by this property to the clinical responses obtained with the radiolabeled drug at high concentrations.

In vitro effects of ethylene-dimethane sulfonate (EDS) on Leydig cells: inhibition of steroid production and cytotoxic effects are dependent on species and age of rat

A number of proteins in Leydig cells isolated from immature rats, mature rats and tumour tissue as well as protein in Sertoli cells, hepatocytes and blood plasma are alkylated after incubation of cells with 14C-labelled ethylene-dimethane sulfonate (EDS) for 5 h. LH-stimulated and 22R-hydroxycholesterol-supported steroid production by Leydig cells from immature and mature rats and from rat tumour tissue but not from testes of mature mice was strongly or completely inhibited after incubation with EDS. EDS had no effects on ATP levels in Leydig cells from mature rats after an incubation period of 24 h but ATP levels were almost zero after 72 h. In Leydig cells from tumour tissue the ATP level was decreased to 10% of the original value after 24 h EDS and decreased further during the following 48 h period. In Leydig cells from immature rats EDS had no effect on ATP levels after 72 h incubation. Ultrastructural evidence of cell damage by EDS was observed in cells from mature rats and tumour tissue but not in cells from immature rats. Discrepancies between biochemical and morphological indications for cell damage were noticed after 24 h incubation with EDS but not after 72 h. The results show that EDS exerts a direct inhibitory effect on both mature and immature rat Leydig cells but does not affect LH-stimulated steroid production by mouse Leydig cells. A cytotoxic response to EDS develops in rat Leydig cells during maturation. However, the molecular basis for these very specific effects of EDS on Leydig cells is at present not understood.

Effects of carbamoylating agents on tumor metabolism

Carbamoylation of macromolecules occurs by the displacement of hydrogen on several groups, but the most stable addition at neutral pH is on amino groups. This reaction occurs predominantly with proteins and results from the administration in vivo of inorganic cyanate or organic isocyanates. The latter act more rapidly, but also are more rapidly hydrolyzed in aqueous solution. This instability has been a factor limiting study of the pharmacological properties of organic isocyanates. However, organic isocyanates are released from some nitrosoureas of value in cancer therapy such as 1,3-bis(2-chlorethyl)-1-nitrosourea (BCNU) and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU). The carbamoylating activities of BCNU and CCNU are generally considered less significant than their alkylating activity in the action of these drugs on tumors, but carbamoylation may serve to inhibit DNA repair. There is evidence that carbamoylating agents can exert selective inhibitory effects on metabolite uptake and macromolecular synthesis in neoplastic tissues. Such selectivity is much more notable in vivo than in vitro. In the case of cyanate, the selectivity in vivo has been variously attributed to a requirement for metabolic activation, to selective effects on circulation in solid tumors, and to diminished pH in tumors. It is the distinction between such factors and the identification of critical cellular targets which provide major challenges in present studies on the effects of carbamoylating agents on tumor metabolism.