Antineoplastic activity and toxicity of some alkylating cytostatics (cyclophosphamide, CCNU, cytostasan) encapsulated in liposomes in different murine tumour models

The combination effects of bendamustine with antimetabolites against childhood acute lymphoblastic leukemia cells

Bendamustine combined with other drugs is clinically efficacious for some adult lymphoid malignancies, but to date there are no reports of the use of such combinatorial approaches in pediatric patients. We investigated the in vitro activity of bendamustine combined with other antimetabolite drugs on B cell precursor acute lymphoblastic leukemia (BCP-ALL) cell lines established from pediatric patients with refractory or relapsed ALL. We also developed a mathematically drown improved isobologram method to assess the data objectively. Three BCP-ALL cell lines; YCUB-2, YCUB-5, and YCUB-6, were simultaneously exposed to various concentrations of bendamustine and cladribine, cytarabine, fludarabine, or clofarabine. Cell growth inhibition was determined using the WST-8 assay. Combinatorial effects were estimated using our improved isobologram method with IC80 (drug concentration corresponding to 80 % of maximum inhibition). Bendamustine alone inhibited ALL cell growth with mean IC80 values of 11.30-18.90 μg/ml. Combinations of bendamustine with other drugs produced the following effects: (1) cladribine; synergistic-to-additive on all cell lines; (2) cytarabine; synergistic-to-additive on YCUB-5 and YCUB-6, and synergistic-to-antagonistic on YCUB-2; (3) fludarabine; additive-to-antagonistic on YCUB-5, and synergistic-to-antagonistic on YCUB-2 and YCUB-6; (4) clofarabine; additive-to-antagonistic on all cell lines. Flow cytometric analysis also showed the combination effects of bendamustine and cladribine. Bendamustine/cladribine or bendamustine/cytarabine may thus represent a promising combination for salvage treatment in childhood ALL.

Liposomes as carriers of cancer chemotherapy. Current status and future prospects

Chemotherapy is a modality of cancer therapy that needs much improvement. Development of a new chemical entity is very costly and time consuming, but improvements in delivery of existing agents may yield more rapid clinical results. Liposomes and other lipid-based drug delivery systems have the advantage, in this context, of utilising no new chemical entities. In terms of mechanism of action, tumour targeting has been the focus of much work in liposomal drug delivery. The recent development of liposomes with longer circulation times has led to improved tumour targeting in animal studies. Other mechanisms of action, such as release from drug depot formulations, heat-triggered local drug release, and transfection of genetic materials, may prove to be useful in humans. Liposomal formulations of more than a dozen antineoplastic agents have shown promise in vitro and in animal models. Somewhat mundane, but nevertheless crucial, issues of medical rationale and formulation engineering, and commercial considerations, have slowed testing in patients with cancer. However, 3 antineoplastic agents, doxorubicin, daunorubicin and cytarabine, are in advanced stages of clinical testing in humans. One or more of these should prove to be a medically useful and commercially viable product within the next few years.

In vivo distribution and antitumour activity of liposomal 3',5'-O-dipalmitoyl-5-fluoro-2'-deoxyuridine

3',5'-O-dipalmitoyl-5-fluoro-2'-deoxyuridine (FUdR-dipalmitate), a lipophilic prodrug of 5-fluoro-2'-deoxyuridine (FUdR), was incorporated in different types of liposomes. The in vivo distribution and intrahepatic deacylation of liposomal FUdR-dipalmitate was found to be strongly dependent on liposome composition and on drug to lipid ratio. The use of fluid-type liposomes (egg PC/PS/CHOL) rendered FUdR-dipalmitate more susceptible to enzymatic breakdown than solid-type liposomes (DSPC/DPPG/CHOL). A decrease of the retention of the drug in the body was also obtained when FUdR-dipalmitate was incorporated in solid-type liposomes with high drug to lipid ratio (1:10) than with low ratio (1:50). In spite of these substantial differences in the rates at which FUdR was liberated from liposomes with different fluidity, size, or drug to lipid ratio, only minor differences in therapeutic effect were observed in a number of murine tumour models (P388 leukaemia, Lewis Lung carcinoma, B16 melanoma and a C26 adenocarcinoma liver metastasis model). The lipophilic prodrug of FUdR exhibited antitumour activity at 100-600 times lower doses than the free drug. However, at these therapeutic doses FUdR-dipalmitate was also far more toxic. This prohibited the use of higher doses to increase antitumour activity.

Cancer chemotherapy administered by activated carbon particles and liposomes

In cancer chemotherapy, a specific drug delivery system is expected since many anticancer drugs show toxicity against not only cancer cells but also against normal tissues. The dosage form comprising anticancer drugs adsorbed on activated carbon particles or encapsulated in liposomes is developed as a drug-delivery system which enhances the therapeutic efficacy and reduces the adverse effects. The dosage forms are versatile in size and electric charge, so that large amounts of the drugs are distributed to the "targeted" organs or tissues and lesser amounts are distributed to the whole body. The dosage forms are designed to release the drugs slowly for a long time at local sites. Through this process, practical use of the dosage forms as an anticancer drug carrier results in an enhancement of anticancer efficacy on the local lesion and a decrease of systemic toxicity.