Synergistic drug combinations for a precision medicine approach to interstitial glioblastoma therapy.
Acetalated dextran (Ace-DEX)
Everolimus
LN-229
Paclitaxel
U87-MG
mTOR
Journal
Journal of controlled release : official journal of the Controlled Release Society
ISSN: 1873-4995
Titre abrégé: J Control Release
Pays: Netherlands
ID NLM: 8607908
Informations de publication
Date de publication:
10 07 2020
10 07 2020
Historique:
received:
13
04
2020
accepted:
18
04
2020
pubmed:
27
4
2020
medline:
22
6
2021
entrez:
27
4
2020
Statut:
ppublish
Résumé
Glioblastoma (GBM) is a highly aggressive and heterogeneous form of brain cancer. Genotypic and phenotypic heterogeneity drives drug resistance and tumor recurrence. Combination chemotherapy could overcome drug resistance; however, GBM's location behind the blood-brain barrier severely limits chemotherapeutic options. Interstitial therapy, delivery of chemotherapy locally to the tumor site, via a biodegradable polymer implant can overcome the blood-brain barrier and increase the range of drugs available for therapy. Ideal drug candidates for interstitial therapy are those that are potent against GBM and work in combination with both standard-of-care therapy and new precision medicine targets. Herein we evaluated paclitaxel for interstitial therapy, investigating the effect of combination with both temozolomide, a clinical standard-of-care chemotherapy for GBM, and everolimus, a mammalian target of rapamycin (mTOR) inhibitor that modulates aberrant signaling present in >80% of GBM patients. Tested against a panel of GBM cell lines in vitro, paclitaxel was found to be effective at nanomolar concentrations, complement therapy with temozolomide, and synergize strongly with everolimus. The strong synergism seen with paclitaxel and everolimus was then explored in vivo. Paclitaxel and everolimus were separately formulated into fibrous scaffolds composed of acetalated dextran, a biodegradable polymer with tunable degradation rates, for implantation in the brain. Acetalated dextran degradation rates were tailored to attain matching release kinetics (~3% per day) of both paclitaxel and everolimus to maintain a fixed combination ratio of the two drugs. Combination interstitial therapy of both paclitaxel and everolimus significantly reduced GBM growth and improved progression free survival in two clinically relevant orthotopic models of GBM resection and recurrence. This work illustrates the advantages of synchronized interstitial therapy of paclitaxel and everolimus for post-surgical tumor control of GBM.
Identifiants
pubmed: 32335153
pii: S0168-3659(20)30242-X
doi: 10.1016/j.jconrel.2020.04.028
pmc: PMC7453575
mid: NIHMS1589457
pii:
doi:
Substances chimiques
Drug Combinations
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
282-292Subventions
Organisme : NCI NIH HHS
ID : F32 CA225199
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS097507
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
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