Biodegradable polymersomes loaded with both paclitaxel and doxorubicin permeate and shrink tumors, inducing apoptosis in proportion to accumulated drug.

Cytotoxicity can in principle be maximized if drugs with different activities can be delivered simultaneously to the same cell. However, combination therapy with drugs having distinct properties such as solubility generally requires use of multiple carriers or solvents, limiting the likelihood of simultaneous delivery. In this brief report, we describe the in vivo use of biodegradable polymersomes for systemic delivery of an anticancer cocktail. These polymer-based shells exploit a thick hydrophobic membrane and an aqueous lumen to efficiently carry both hydrophobic and hydrophilic drugs, respectively paclitaxel and doxorubicin. Polymersomes are long-circulating in vivo but also degrade and release their drugs on a time scale of about 1 day, by which time the tumors treated here will otherwise have almost doubled in volume. A single systemic injection of the dual drug combination shows a higher maximum tolerated dose than the free drug cocktail and shrinks tumors more effectively and more sustainably than free drug: 50% smaller tumors are seen at 5 days with polymersomes. The polymersomes cause two-fold higher cell death in tumors than free drug and show quantitatively similar increases in maximum tolerated dose and drug accumulation within the tumors-suggesting promise for multi-drug delivery.

[1]  D. Gustafson,et al.  Pharmacokinetics of combined doxorubicin and paclitaxel in mice. , 2005, Cancer letters.

[2]  F. Szoka,et al.  Characterization, toxicity and therapeutic efficacy of adriamycin encapsulated in liposomes. , 1982, European journal of cancer & clinical oncology.

[3]  M. Lafleur,et al.  On the characterization of pH-sensitive liposome/polymer complexes. , 2003, Biomacromolecules.

[4]  Robert Langer,et al.  Size and temperature effects on poly(lactic-co-glycolic acid) degradation and microreservoir device performance. , 2005, Biomaterials.

[5]  R. Verger,et al.  Hydrolysis kinetics of poly(d,l-lactide) monolayers spread on basic or acidic aqueous subphases , 1997 .

[6]  Y. Oyama,et al.  Cremophor EL, a non-ionic surfactant, promotes Ca(2+)-dependent process of cell death in rat thymocytes. , 2005, Toxicology.

[7]  K. Maruyama,et al.  Size-dependent extravasation and interstitial localization of polyethyleneglycol liposomes in solid tumor-bearing mice. , 1999, International journal of pharmaceutics.

[8]  K. Edwards,et al.  Formation of transition metal-doxorubicin complexes inside liposomes. , 2002, Biochimica et biophysica acta.

[9]  S. Agelaki,et al.  Phase I Study of Paclitaxel (Taxol) and Pegylated Liposomal Doxorubicin (Caelyx) Administered Every 2 Weeks in Patients with Advanced Solid Tumors , 2002, Oncology.

[10]  R. Staugas,et al.  Peripheral Intravenous Line Survival and Phlebitis Prevention in Patients Receiving Intravenous Antibiotics: Heparin/Hydrocortisone versus In-Line Filters , 1994, The Annals of pharmacotherapy.

[11]  F. Chang,et al.  Direct comparison of liposomal doxorubicin with or without polyethylene glycol coating in C-26 tumor-bearing mice: is surface coating with polyethylene glycol beneficial? , 1999, Clinical cancer research : an official journal of the American Association for Cancer Research.

[12]  Fenghua Meng,et al.  Biodegradable polymersomes as a basis for artificial cells: encapsulation, release and targeting. , 2005, Journal of controlled release : official journal of the Controlled Release Society.

[13]  John W. Park Liposome-based drug delivery in breast cancer treatment , 2002, Breast Cancer Research.

[14]  R K Jain,et al.  Openings between defective endothelial cells explain tumor vessel leakiness. , 2000, The American journal of pathology.

[15]  Daniel A. Hammer,et al.  Molecular Weight Dependence of Polymersome Membrane Structure, Elasticity, and Stability , 2002 .

[16]  I. Tannock,et al.  Reduction of Intracellular pH as a Strategy to Enhance the pH-Dependent Cytotoxic Effects of Melphalan for Human Breast Cancer Cells , 2005, Clinical Cancer Research.

[17]  Yang Wang,et al.  Enhancement of the Efficacy of Chemotherapy for Lung Cancer by Simultaneous Suppression of Multidrug Resistance and Antiapoptotic Cellular Defense , 2004, Cancer Research.

[18]  F. Szoka,et al.  Steric stabilization of fusogenic liposomes by a low-pH sensitive PEG--diortho ester--lipid conjugate. , 2001, Bioconjugate chemistry.

[19]  J. Kopeček,et al.  Efficacy of the chemotherapeutic action of HPMA copolymer‐bound doxorubicin in a solid tumor model of ovarian carcinoma , 2000, International journal of cancer.

[20]  H. Gogas,et al.  Combination of pegylated liposomal doxorubicin (PLD) and paclitaxel in patients with advanced soft tissue sarcoma: a phase II study of the Hellenic Cooperative Oncology Group , 2004, British Journal of Cancer.

[21]  F. Bates,et al.  Polymer vesicles in vivo: correlations with PEG molecular weight. , 2003, Journal of controlled release : official journal of the Controlled Release Society.

[22]  Sérgio Simões,et al.  On the formulation of pH-sensitive liposomes with long circulation times. , 2004, Advanced drug delivery reviews.

[23]  N. Pavlidis,et al.  Interaction pharmacokinetics of pegylated liposomal doxorubicin (Caelyx) on coadministration with paclitaxel or docetaxel , 2004, Cancer Chemotherapy and Pharmacology.

[24]  Theresa M Allen,et al.  Rate of biodistribution of STEALTH liposomes to tumor and skin: influence of liposome diameter and implications for toxicity and therapeutic activity. , 2003, Biochimica et biophysica acta.

[25]  J. Klaveness,et al.  Biodistribution of pH-responsive liposomes for MRI and a novel approach to improve the pH-responsiveness. , 2004, Journal of controlled release : official journal of the Controlled Release Society.

[26]  Francis C Szoka,et al.  Polyester dendritic systems for drug delivery applications: in vitro and in vivo evaluation. , 2002, Bioconjugate chemistry.

[27]  Christine Allen,et al.  pH gradient loading of anthracyclines into cholesterol-free liposomes: enhancing drug loading rates through use of ethanol. , 2004 .

[28]  M. Bally,et al.  Uptake of adriamycin into large unilamellar vesicles in response to a pH gradient. , 1986, Biochimica et biophysica acta.

[29]  Dennis E Discher,et al.  Self-porating polymersomes of PEG-PLA and PEG-PCL: hydrolysis-triggered controlled release vesicles. , 2004, Journal of controlled release : official journal of the Controlled Release Society.

[30]  J. Gehl,et al.  Combined doxorubicin and paclitaxel in advanced breast cancer: effective and cardiotoxic. , 1996, Annals of oncology : official journal of the European Society for Medical Oncology.

[31]  F. Dosio,et al.  Preparation, characterization, cytotoxicity and pharmacokinetics of liposomes containing docetaxel. , 2003, Journal of controlled release : official journal of the Controlled Release Society.

[32]  N. Pavlidis,et al.  Weekly paclitaxel combined with pegylated liposomal doxorubicin (CaelyxTM) given every 4 weeks: dose-finding and pharmacokinetic study in patients with advanced solid tumors. , 2004, Annals of oncology : official journal of the European Society for Medical Oncology.

[33]  K. Belguise,et al.  FRA-1 expression level regulates proliferation and invasiveness of breast cancer cells , 2005, Oncogene.

[34]  D. Tzemach,et al.  Long-circulating liposomes for drug delivery in cancer therapy: a review of biodistribution studies in tumor-bearing animals , 1997 .