Tumor-Penetrating Microparticles for Intraperitoneal Therapy of Ovarian Cancer

Intraperitoneal chemotherapy prolongs survival of ovarian cancer patients, but its utility is limited by treatment-related complications and inadequate drug penetration in larger tumors. Previous intraperitoneal therapy used the paclitaxel/Cremophor EL (polyethoxylated castor oil) formulation designed for intravenous use. The present report describes the development of paclitaxel-loaded microparticles designed for intraperitoneal treatment (referred to as tumor-penetrating microparticles or TPM). Evaluation of TPM was performed using intraperitoneal metastatic, human ovarian SKOV3 xenograft tumor models in mice. TPM were retained in the peritoneal cavity and adhered to tumor surface. TPM consisted of two biocompatible and biodegradable polymeric components with different drug release rates; one component released the drug load rapidly to induce tumor priming, whereas the second component provided sustained drug release. Tumor priming, by expanding interstitial space, promoted transport and penetration of particulates in tumors. These combined features resulted in the following advantages over paclitaxel/Cremophor EL: greater tumor targeting (16-times higher and more sustained concentration in omental tumors), lower toxicity to intestinal crypts and less body weight loss, greater therapeutic efficacy (longer survival and higher cure rate), and greater convenience (less frequent dosing). TPM may overcome the toxicities and compliance-related problems that have limited the utility of intraperitoneal therapy.

[1]  D. Alberts,et al.  Phase I clinical and pharmacokinetic study of mitoxantrone given to patients by intraperitoneal administration. , 1988, Cancer research.

[2]  M. Wientjes,et al.  Pharmacodynamics of taxol in human head and neck tumors. , 1996, Cancer research.

[3]  R. Ozols,et al.  Intraperitoneal chemotherapy for ovarian cancer. , 2006, The New England journal of medicine.

[4]  D. Cella,et al.  Health-related quality of life during and after intraperitoneal versus intravenous chemotherapy for optimally debulked ovarian cancer: a Gynecologic Oncology Group Study. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  C. Chen,et al.  Time-and concentration-dependent penetration of doxorubicin in prostate tumors , 2001, AAPS PharmSci.

[6]  S. Rubin,et al.  Phase II trial of intraperitoneal paclitaxel in carcinoma of the ovary, tube, and peritoneum: a Gynecologic Oncology Group Study. , 1998, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[7]  L. Truong,et al.  Serous surface carcinoma of the peritoneum: useful role of cytology in differential diagnosis and follow-up. , 1996, Acta cytologica.

[8]  S. Howell,et al.  Phase I/pharmacokinetic study of intraperitoneal cisplatin and etoposide. , 1987, Cancer research.

[9]  A. Gadducci,et al.  Intraperitoneal versus intravenous cisplatin in combination with intravenous cyclophosphamide and epidoxorubicin in optimally cytoreduced advanced epithelial ovarian cancer: a randomized trial of the Gruppo Oncologico Nord-Ovest. , 2000, Gynecologic oncology.

[10]  Y. Yen,et al.  Phase I trial of intraperitoneal docetaxel in the treatment of advanced malignancies primarily confined to the peritoneal cavity: dose-limiting toxicity and pharmacokinetics. , 2003, Clinical cancer research : an official journal of the American Association for Cancer Research.

[11]  R. Barakat,et al.  Evidence supporting the superiority of intraperitoneal cisplatin compared to intraperitoneal carboplatin for salvage therapy of small-volume residual ovarian cancer. , 1993, Gynecologic oncology.

[12]  J. Au,et al.  Isocratic high-performance liquid chromatographic assay of taxol in biological fluids and tissues using automated column switching. , 1995, Journal of chromatography. B, Biomedical applications.

[13]  R. Langer,et al.  Biodegradable polymeric microspheres and nanospheres for drug delivery in the peritoneum. , 2006, Journal of biomedical materials research. Part A.

[14]  R K Jain,et al.  Taxane-induced apoptosis decompresses blood vessels and lowers interstitial fluid pressure in solid tumors: clinical implications. , 1999, Cancer research.

[15]  D. Alberts,et al.  Intraperitoneal cisplatin plus intravenous cyclophosphamide versus intravenous cisplatin plus intravenous cyclophosphamide for stage III ovarian cancer. , 1996, The New England journal of medicine.

[16]  J. Au,et al.  Tumor Priming Enhances Delivery and Efficacy of Nanomedicines , 2007, Journal of Pharmacology and Experimental Therapeutics.

[17]  Jessie L.-S. Au,et al.  Determinants of Paclitaxel Uptake, Accumulation and Retention in Solid Tumors , 2001, Investigational New Drugs.

[18]  Joan L. Walker,et al.  Intraperitoneal chemotherapy of ovarian cancer: a review, with a focus on practical aspects of treatment. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  L. Truong,et al.  Serous Surface Carcinoma of the Peritoneum , 1996 .

[20]  M. Wientjes,et al.  Enhancement of paclitaxel delivery to solid tumors by apoptosis-inducing pretreatment: effect of treatment schedule. , 2001, The Journal of pharmacology and experimental therapeutics.

[21]  R. Demicheli,et al.  Pharmacologic Data and Technical Feasibility of Intraperitoneal Doxorubicin Administration , 1985, Tumori.

[22]  M. Wientjes,et al.  Pharmacodynamics of doxorubicin in human prostate tumors. , 1998, Clinical cancer research : an official journal of the American Association for Cancer Research.

[23]  J. Mcvie,et al.  Pentetration of carboplatin and cisplatin into rat peritoneal tumor nodules after intraperitoneal chemotherapy , 2004, Cancer Chemotherapy and Pharmacology.

[24]  A. Hagiwara,et al.  Affinity of intraperitoneally injected activated carbon particles adsorbing mitomycin C to tumor surface of Yoshida sarcoma. , 1990, Anti-Cancer Drug Design.

[25]  D. Alberts,et al.  Intraperitoneal mitomycin C in the treatment of peritoneal carcinomatosis following second-look surgery. , 1988, Seminars in oncology.

[26]  B N Bundy,et al.  Phase III trial of standard-dose intravenous cisplatin plus paclitaxel versus moderately high-dose carboplatin followed by intravenous paclitaxel and intraperitoneal cisplatin in small-volume stage III ovarian carcinoma: an intergroup study of the Gynecologic Oncology Group, Southwestern Oncology Gr , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[27]  F. Zunino,et al.  Comparison of reduced glutathione with 2-mercaptoethane sulfonate to prevent cyclophosphamide-induced urotoxicity. , 1986, Cancer letters.

[28]  R. Olshen,et al.  Intraperitoneal chemotherapy with melphalan. , 1984, Annals of internal medicine.

[29]  J G McVie,et al.  Platinum distribution in intraperitoneal tumors after intraperitoneal cisplatin treatment. , 1990, Cancer chemotherapy and pharmacology.

[30]  M. Wientjes,et al.  Determinants of paclitaxel penetration and accumulation in human solid tumor. , 1999, The Journal of pharmacology and experimental therapeutics.

[31]  G E Visscher,et al.  Biodegradation of and tissue reaction to 50:50 poly(DL-lactide-co-glycolide) microcapsules. , 1985, Journal of biomedical materials research.

[32]  J. Leiby Trimetrexate: a phase 2 study in previously treated patients with metastatic breast cancer. , 1988, Seminars in oncology.

[33]  P. O'dwyer,et al.  Phase I pharmacokinetic study of intraperitoneal etoposide. , 1991, Cancer research.

[34]  E. Topuz,et al.  Intraperitoneal cisplatin-mitoxantrone and intravenous ifosfamide combination as first-line treatment of ovarian cancer. , 1998, European journal of gynaecological oncology.

[35]  D. Kerr,et al.  Pharmacokinetic principles of locoregional chemotherapy. , 1993, Cancer surveys.

[36]  Anderson,et al.  Biodegradation and biocompatibility of PLA and PLGA microspheres. , 1997, Advanced drug delivery reviews.

[37]  R. Barakat,et al.  Phase I trial of intraperitoneal taxol: a Gynecoloic Oncology Group study. , 1992, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[38]  W. Hunter,et al.  Paclitaxel-Loaded Crosslinked Hyaluronic Acid Films for the Prevention of Postsurgical Adhesions , 2002, Pharmaceutical Research.

[39]  Lalit Kumar,et al.  Intraperitoneal Cisplatin and Paclitaxel in Ovarian Cancer , 2006, Indian Journal of Medical and Paediatric Oncology.

[40]  D. Elias,et al.  Pharmacokinetics of heated intraoperative intraperitoneal oxaliplatin after complete resection of peritoneal carcinomatosis. , 2003, Surgical oncology clinics of North America.

[41]  Ze Lu,et al.  Effects of Carrier on Disposition and Antitumor Activity of Intraperitoneal Paclitaxel , 2007, Pharmaceutical Research.

[42]  M. Shive,et al.  Biodegradation and biocompatibility of PLA and PLGA microspheres , 1997 .

[43]  J. Mcvie,et al.  Platinum distribution inintraperitoneal tumors afterintraperitoneal cisplatin treatment , 1990, Cancer Chemotherapy and Pharmacology.

[44]  G. Fleming,et al.  A phase I trial of intraperitoneal sustained-release paclitaxel microspheres (Paclimer) in recurrent ovarian cancer: a Gynecologic Oncology Group study. , 2006, Gynecologic oncology.