Abstract

Repeated intraperitoneal (IP) administration of paclitaxel (PTX) with concurrent systemic chemotherapy is clinically effective for the treatment of peritoneal metastases (PM) from gastric cancer. However, it is unclear how biochemical modifications may affect the pharmacokinetics and bioavailability of IP administered PTX. In a xenograft PM model using human gastric cancer cells, MKN45, fluorescein-conjugated PTX (OG-PTX) was given IP and the intra-tumor distribution of PTX examined with fluorescein microscopy. After IP injection, PTX was seen to directly infiltrate up to several hundred micrometers from the surface of the PM. Co-injection with 5 % non-animal stabilized hyaluronic acid increased PTX infiltration and suppressed the development of PM more efficiently than PTX alone. PTX solubilized with amphiphilic polymer composed of 2-methacryloyloxyethyl phosphorylcholine (MPC) and n-butyl methacrylate (BMA) efficiently formed a micellar formation 50-100 nm in diameter. IP injection of the nanomicellar PTX (PTX-30W) also showed significantly enhanced tumor infiltration and further inhibition of the growth of PM compared with PTX solubilized with Cremophor-ethanol (PTX-Cre). Finally, IP administration of NK105, another nanomicellar PTX, inhibited the growth of subcutaneous tumors as well as PM, compared with conventional PTX-Cre in the same murine model. PTX administered IP directly infiltrates PM and are thus a useful strategy for the treatment of PM. Drug modification with nanotechnology may further enhance penetration of PM resulting in improved clinical efficacy.

Highlights

  • Peritoneal metastases (PM) frequently occur in patients with recurrent abdominal malignancies, such as gastrointestinal and ovarian cancer

  • PMB polymer which is a water-soluble, amphiphilic polymer composed of 2-methacryloyloxyethyl phosphorylcholine (MPC) and nbutyl methacrylate (BMA) was produced in our collaborating laboratory, Department of Materials Engineering and Department of Bioengineering, School of Engineering, University of Tokyo

  • Mixture with HA or nanomicellar PTX greatly increase retention time and enhance the depth of drug penetration in peritoneal metastases (PM), which may lead to improved clinical results

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Summary

Introduction

Peritoneal metastases (PM) frequently occur in patients with recurrent abdominal malignancies, such as gastrointestinal and ovarian cancer. HIPEC combined with cytoreductive surgery (CRS) has been shown to improve the outcome of patients with PM from some malignancies [4,5,6]. Repeated intraperitoneal (IP) administration of paclitaxel (PTX) with concurrent systemic chemotherapy is clinically effective for the treatment of peritoneal metastases (PM) from gastric cancer. It is unclear how biochemical modifications may affect the pharmacokinetics and bioavailability of IP administered PTX. IP administration of NK105, another nanomicellar PTX, inhibited the growth of subcutaneous tumors as Keywords: hyaluronic acid, intraperitoneal chemotherapy, MKN45, nanodrug, paclitaxel, peritoneal metastasis

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