1
|
Perera RH, Berg FM, Abenojar EC, Nittayacharn P, Kim Y, Wang X, Basilion JP, Exner A. Ultrasound-mediated drug-free theranostics for treatment of prostate cancer. Bioact Mater 2024; 35:45-55. [PMID: 38304914 PMCID: PMC10831121 DOI: 10.1016/j.bioactmat.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/07/2023] [Accepted: 12/16/2023] [Indexed: 02/03/2024] Open
Abstract
Lipid-shelled nanobubbles (NBs) can be visualized and activated using noninvasive ultrasound (US) stimulation, leading to significant bioeffects. Prior work demonstrates that active targeting of NBs to prostate-specific membrane antigen (PSMA) overexpressed in prostate cancer (PCa) results in enhanced cellular internalization and prolongs NB retention with persistent, cancer-cell specific acoustic activity. In this work, we hypothesized that tumor-accumulated PSMA-NBs combined with low frequency unfocused therapeutic US (TUS) will lead to selective damage and induce a specific therapeutic effect in PSMA-expressing tumors compared to PSMA-negative tumors. We observed that the internalized NBs and cellular compartments were disrupted after the PSMA-NB + TUS (targeted NB therapy or TNT) application, yet treated cells remained intact and viable. In vivo, PSMA-expressing tumors in mice receiving TNT treatment demonstrated a significantly greater extent of apoptosis (78.4 ± 9.3 %, p < 0.01) compared to controls. TNT treatment significantly inhibited the PSMA expressing tumor growth and increased median survival time by 103 %, p < 0.001). A significant reduction in tumor progression compared to untreated control was also seen in an orthotopic rabbit PCa model. Results demonstrate that cavitation of PSMA-NBs internalized via receptor-mediated endocytosis into target PCa cells using unfocused ultrasound results in significant, tumor-specific bioeffects. The effects, while not lethal to PSMA-expressing cancer cells in vitro, result in significant in vivo reduction in tumor progression in two models of PCa. While the mechanism of action of these effects is yet unclear, it is likely related to a locally-induced immune response, opening the door to future investigations in this area.
Collapse
Affiliation(s)
| | - Felipe Matias Berg
- Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA
- Hospital Israelita Albert Einstein, São Paulo, SP, 05652-900, Brazil
| | - Eric Chua Abenojar
- Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Pinunta Nittayacharn
- Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Puttamonthon, Nakorn Pathom, 73170, Thailand
| | - Youjoung Kim
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, 44106, OH, USA
| | - Xinning Wang
- Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, 44106, OH, USA
| | - James Peter Basilion
- Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, 44106, OH, USA
| | - Agata Exner
- Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, 44106, OH, USA
| |
Collapse
|
2
|
Perera RH, Berg FM, Abenojar EC, Nittayacharn P, Kim Y, Wang X, Basilion JP, Exner AA. Ultrasound-mediated drug-free theranostics for treatment of prostate cancer. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.13.555594. [PMID: 37745586 PMCID: PMC10515807 DOI: 10.1101/2023.09.13.555594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Rationale Lipid-shelled nanobubbles (NBs) can be visualized and activated using noninvasive ultrasound (US) stimulation, leading to significant bioeffects. We have previously shown that active targeting of NBs to prostate-specific membrane antigen (PSMA) overexpressed in prostate cancer (PCa) enhances the cellular internalization and prolongs retention of NBs with persistent acoustic activity (~hrs.). In this work, we hypothesized that tumor-accumulated PSMA-NBs combined with low frequency therapeutic US (TUS) will lead to selective damage and induce a therapeutic effect in PSMA-expressing tumors compared to PSMA-negative tumors. Methods PSMA-targeted NBs were formulated by following our previously established protocol. Cellular internalization of fluorescent PSMA-NBs was evaluated by confocal imaging using late endosome/lysosome staining pre- and post-TUS application. Two animal models were used to assess the technique. Mice with dual tumors (PSMA expressing and PSMA negative) received PSMA-NB injection via the tail vein followed by TUS 1 hr. post injection (termed, targeted NB therapy or TNT). Twenty-four hours after treatment mice were euthanized and tumor cell apoptosis evaluated via TUNEL staining. Mice with single tumors (either PSMA + or -) were used for survival studies. Tumor size was measured for 80 days after four consecutive TNT treatments (every 3 days). To test the approach in a larger model, immunosuppressed rabbits with orthotopic human PSMA expressing tumors received PSMA-NB injection via the tail vein followed by TUS 30 min after injection. Tumor progression was assessed via US imaging and at the end point apoptosis was measured via TUNEL staining. Results In vitro TNT studies using confocal microscopy showed that the internalized NBs and cellular compartments were disrupted after the TUS application, yet treated cells remained intact and viable. In vivo, PSMA-expressing tumors in mice receiving TNT treatment demonstrated a significantly greater extent of apoptosis (78.45 ± 9.3%, p < 0.01) compared to the other groups. TNT treatment significantly inhibited the PSMA (+) tumor growth and overall survival significantly improved (median survival time increase by 103%, p < 0.001). A significant reduction in tumor progression compared to untreated control was also seen in the rabbit model in intraprostatic (90%) and in extraprostatic lesions (94%) (p = 0.069 and 0.003, respectively). Conclusion We demonstrate for the first time the effect of PSMA-targeted nanobubble intracellular cavitation on cancer cell viability and tumor progression in two animal models. Data demonstrate that the targeted nanobubble therapy (TNT) approach relies primarily on mechanical disruption of intracellular vesicles and the resulting bioeffects appear to be more specific to target cancer cells expressing the PSMA receptor. The effect, while not lethal in vitro, resulted in significant tumor apoptosis in vivo in both a mouse and a rabbit model of PCa. While the mechanism of action of these effects is yet unclear, it is likely related to a locally-induced immune response, opening the door to future investigations in this area.
Collapse
Affiliation(s)
| | - Felipe Matias Berg
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Eric Chua Abenojar
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
| | - Pinunta Nittayacharn
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
| | - Youjoung Kim
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Xinning Wang
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - James P. Basilion
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Agata A. Exner
- Department of Radiology, Case Western Reserve University, Cleveland, OH, United States
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
3
|
Tosoian JJ, Mamawala M, Patel HD, Alam R, Epstein JI, Ross AE, Carter HB. Tumor Volume on Biopsy of Low Risk Prostate Cancer Managed with Active Surveillance. J Urol 2018; 199:954-960. [DOI: 10.1016/j.juro.2017.10.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Jeffrey J. Tosoian
- Department of Urology, The James Buchanan Brady Urological Institute, Baltimore, Maryland
- Department of Pathology (JIE), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mufaddal Mamawala
- Department of Urology, The James Buchanan Brady Urological Institute, Baltimore, Maryland
- Department of Pathology (JIE), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hiten D. Patel
- Department of Urology, The James Buchanan Brady Urological Institute, Baltimore, Maryland
- Department of Pathology (JIE), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ridwan Alam
- Department of Urology, The James Buchanan Brady Urological Institute, Baltimore, Maryland
- Department of Pathology (JIE), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan I. Epstein
- Department of Urology, The James Buchanan Brady Urological Institute, Baltimore, Maryland
- Department of Pathology (JIE), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashley E. Ross
- Department of Urology, The James Buchanan Brady Urological Institute, Baltimore, Maryland
- Department of Pathology (JIE), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - H. Ballentine Carter
- Department of Urology, The James Buchanan Brady Urological Institute, Baltimore, Maryland
- Department of Pathology (JIE), Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
4
|
Ploussard G, Hennequin C, Rozet F. [Active surveillance of prostate cancer]. Cancer Radiother 2017; 21:437-441. [PMID: 28847461 DOI: 10.1016/j.canrad.2017.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 07/11/2017] [Indexed: 10/19/2022]
Abstract
Several prospective studies have demonstrated the safety of active surveillance as a first treatment of prostate cancer. It spares many patients of a useless treatment, with its potential sequelae. Patients with a low-risk cancer are all candidates for this approach, as recommended by the American Society of Clinical Oncology (ASCO). Some patients with an intermediate risk could be also concerned by active surveillance, but this is still being discussed. Currently, the presence of grade 4 lesions on biopsy is a contra-indication. Modalities included a repeated prostate specific antigen test and systematic rebiopsy during the first year after diagnosis. MRI is now proposed to better select patients at inclusion and also during surveillance. No life style changes or drugs are significantly associated with a longer duration of surveillance.
Collapse
Affiliation(s)
- G Ploussard
- Clinique Saint-Jean-du-Languedoc, 20, route de Revel, 31400 Toulouse, France
| | - C Hennequin
- Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefeaux, 75475 Paris, France
| | - F Rozet
- Service d'urologie, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France.
| |
Collapse
|
5
|
Chen RC, Rumble RB, Jain S. Reply to J.J. Tosoian et al. J Clin Oncol 2016; 34:4453. [PMID: 27998225 DOI: 10.1200/jco.2016.70.2084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ronald C Chen
- Ronald C. Chen, University of North Carolina, Chapel Hill, NC; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; and Suneil Jain, Queen's University Belfast, Belfast, United Kingdom
| | - R Bryan Rumble
- Ronald C. Chen, University of North Carolina, Chapel Hill, NC; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; and Suneil Jain, Queen's University Belfast, Belfast, United Kingdom
| | - Suneil Jain
- Ronald C. Chen, University of North Carolina, Chapel Hill, NC; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; and Suneil Jain, Queen's University Belfast, Belfast, United Kingdom
| |
Collapse
|