Liposome-associated Doxorubicin Research Articles

Direct quantification of unencapsulated doxorubicin in liposomal doxorubicin formulations using capillary electrophoresis

To understand the quality, efficacy, and safety of liposomal drugs, it is necessary to develop a robust and accurate method for the separation and the quantification of unencapsulated and liposome-associated drugs (or liposomal encapsulated drugs). Conventional methods involve separation of unencapsulated and liposome-associated drug using solid phase extraction and further drug quantification. This is a lengthy process, and sometimes solid phase extraction induces drug leakage from the liposomes causing erroneous results. In this study, a capillary electrophoresis (CE) with UV–Vis detection method was developed for the simultaneous separation and quantification of unencapsulated drug from liposome-associated drug using a doxorubicin-containing liposome formulation as the model drug. CE separates the unencapsulated drug and liposomal drugs based on their electrophoretic mobility under the electric field. Liposomal drugs were diluted to the appropriate concentrations with running buffer or 5% dextrose before hydrodynamic sample injection. Using a high-sensitivity detection cell, the doxorubicin detection sensitivity was enhanced about 10-fold compared to the conventional on-column UV–Vis detection with a 75 µm i.d. capillary column. The optimal separation of unencapsulated doxorubicin from liposome-associated doxorubicin with minimal perturbation of liposomes was accomplished using phosphate buffer (20 mM, pH 6.5) in the presence of 10% sucrose.

A comparison of changes to doxorubicin pharmacokinetics, antitumor activity, and toxicity mediated by PEGylated dendrimer and PEGylated liposome drug delivery systems

The pharmacokinetics, biodistribution, and antitumor efficacy of three doxorubicin formulations (doxorubicin in saline, conjugated to a polylysine dendrimer, and encapsulated within a stealth liposome) were investigated in Walker 256 tumor-bearing rats. Liposomal and dendrimer-based delivery systems resulted in more prolonged plasma exposure of total doxorubicin when compared to administration of doxorubicin in saline, although concentrations of free doxorubicin remained low in both cases. Biodistribution profiles revealed enhanced accumulation of dendrimer- and liposome-associated doxorubicin in tumors when compared to doxorubicin alone, although all three doxorubicin formulations reduced tumor growth to a similar extent. Markers of systemic toxicity (spleen weight, white blood cell counts, body weight, and cardiotoxicity) were more pronounced in rats that received doxorubicin and liposomal doxorubicin when compared to dendrimer-doxorubicin. The data provide preliminary evidence that dendrimer-doxorubicin displays similar antitumor efficacy to PEGylated liposomal doxorubicin, but with lower systemic toxicity (resulting from reduced drug exposure to nontarget organs). From the Clinical Editor In this manuscript, three different doxorubicin preparations are compared and preliminary evidence suggests that dendrimer-doxorubicin displays similar antitumor efficacy to PEGylated liposomal doxorubicin, but with lower systemic toxicity.

Low-dose tumor necrosis factor-alpha augments antitumor activity of stealth liposomal doxorubicin (DOXIL) in soft tissue sarcoma-bearing rats.

It has previously been demonstrated in the setting of an isolated limb perfusion that application of high-dose TNF-alpha in combination with chemotherapy (melphalan, doxorubicin) results in strong synergistic antitumor effects in both the clinical and preclinical settings. In this study, we demonstrate that systemic administration of low-dose TNF-alpha augments the antitumor activity of a liposomal formulation of doxorubicin (DOXIL(R)). Addition of TNF-alpha to a DOXIL(R) regimen, which by itself induced some tumor growth delay, resulted in massive necrosis and regression of tumors. Furthermore, we could demonstrate a significant increase of liposomal drug in the tumor tissue when TNF-alpha had been co-administered. Administration of TNF-alpha augmented DOXIL(R) accumulation only after repeated injections, whereas accumulation of free doxorubicin was not affected by TNF-alpha. Drug levels in the tumor interstitium appeared crucial as intracellular levels of free or liposome-associated doxorubicin were not increased by TNF-alpha. Therefore, we hypothesize that low-dose TNF-alpha augments leakage of liposomal drug into the tumor interstitium, explaining the observed improved antitumor effects. Regarding the effects of systemic administration of low doses of TNF-alpha, these findings may be important for enhanced tumor targeting of various liposomal drug formulations.

Determination of Free and Liposome-Associated Doxorubicin and Vincristine Levels in Plasma under Equilibrium Conditions Employing Ultrafiltration Techniques

A thorough understanding of the pharmacodynamic relationships associated with toxicity and efficacy behavior of liposome-encapsulated anticancer agents such as doxorubicin and vincristine will rely on the ability to accurately separate and quantify the free and liposome-associated drug fractions in plasma after administration. We have investigated the use of ultrafiltration as a method of isolating free doxorubicin and vincristine from liposomal drug under equilibrium conditions and compared it to previously developed nonequilibrium procedures based on solid-phase extraction. Adsorption of drugs dissolved in saline to the ultrafiltration devices resulted in concentration-dependent ultrafiltrate drug recoveries ranging from 41 to 96%. However, concentration-independent quantitative recovery of vincristine in saline solutions could be obtained by passivating the ultrafiltration devices with PEG-8000 and device drug adsorption was ameliorated for both agents by plasma. The ultrafiltration method provided a more reliable separation of free and protein-bound drug, whereas solid-phase extraction yielded artificially high free drug concentrations due to process-induced protein-bound drug complex dissocation. Also, coelution of liposomes with the free drug fraction using solid-phase extraction was 64- to 418-fold higher than observed with ultrafiltration. Taken together, these properties indicated a significantly increased degree of accuracy in measuring the amount of free doxorubicin and vincristine in samples containing liposomal formulations employing ultrafiltration compared to solid-phase extraction. The importance of this improvement was highlighted by observations that determinations of free drug concentrations in the plasma of mice injected with liposomal doxorubicin and vincristine were 3- to 12-fold higher using solid-phase extraction compared to ultrafiltration. Finally, the ultrafiltration procedure is rapid, versatile, and can be used for a wide range of drug and liposome concentrations and free drug/liposomal drug ratios.

Preparation and Characterization of Liposomal Doxorubicin for Human Use

AbstractA liposome-associated doxorubicin formulation that has been utilized in two phase I clinical trials at two separate medical centers is described. This work deals with formulation optimization, process development, quality control assays on raw materials, characterization assays for these liposomes, and their short-term stability. One of the main goals of this work is to provide a model for the production of liposomal formulations of sufficient quantity and quality to be used in clinical trials.

Optimization and Upscaling of Doxorubicin-Containing Liposomes for Clinical Use

This work describes the optimization of a doxorubicin (DXR)-containing liposome formulation and its upscaling for human therapy. Multilamellar vesicles (MLV) composed of egg phosphatidylcholine, egg-derived phosphatidylglycerol, cholesterol, and the drug were prepared in 0.9% sterile, pyrogen-free NaCl by five different hydration methods. The optimal hydration was shown to be the formation of a thin lipid film with high surface area. Alternative hydration methods based on freeze-drying techniques of the lipids in tertiary butanol or based on "alcohol" premixing procedures of the dry DXR-lipid mixture showed smaller DXR loading capacities and lower DXR incorporation per phospholipid. Maximal DXR entrapment was obtained at a molar concentration of phosphatidylglycerol of 30mol % of total phospholipid. This and previous studies led to a final lipid composition of phosphatidylcholine:phosphatidylglycerol:cholesterol in a molar ratio of 7:3:4. Oligolamellar DXR-liposomes with an average diameter in the range 0.3–0.5 μM were prepared from DXR-MLV by extrusion through polycarbonate membranes using moderate pressures (up to 100 psi). At this size range, maximal entrapment of DXR per phospholipid was obtained. The extrusion process also ensures the sterilization of the final product. Free DXR was removed from liposome-associated DXR (L-DXR) by the use of a cation-exchange resin. The L-DXR formulation was shown to have reasonable stability on storage at 4°C.

Method for rapid separation of liposome-associated doxorubicin from free doxorubicin in plasma

To understand and predict the efficacy and/or toxicity of liposomal drugs in vivo, it is essential to have rapid, reliable methods of separating and quantitating both the free and the liposomal forms of the drug. A method using solid-phase extraction chromatography columns was developed to separate and quantitate unencapsulated doxorubicin and liposome-associated doxorubicin in plasma following the intravenous injection of liposomal doxorubicin. The method facilitated the recovery and quantitation of free and liposomal drug. The separation and recovery of doxorubicin were linear across the entire range of possible mixtures (0 to 100%) of the two forms of the drug in plasma. Free drug and liposomal drug were readily separated for liposomal doxorubicin systems varying in size (0.1-1.0 μm) and lipid composition (egg yolk phosphatidylcholine/cholesterol and distearylphosphatidylcholine/cholesterol). The method is rapid and allows for multiple samples to be processed simultaneously.

Preclinical and Clinical Experience with a Doxorubicin-Liposome Preparation

AbstractEntrapment of doxorubicin in liposomes results in increased drug concentrations in liver and spleen and decreased uptake by the heart muscle. these pharmacologic changes can be exploited to reduce the drug's toxicity and increase its therapeutic index in selected neoplastic conditions. We review here our preclinical and phase I clinical data with liposome-associated doxorubicin. these studies, together with preliminary observations on the pharmacokinetics of the liposome-associated drug and on the imaging of radiolabeled vesicles in patients, suggest that the maximal tolerated dosage is significantly increased over that of the free drug and that the reticuloendothelial system is responsible for the rapid and dominant pathway of liposome clearance. the implications of various pharmacologic aspects of liposome behavior in the circulation are also discussed.

Systemic administration of doxorubicin-containing liposomes in cancer patients: a phase I study

A clinical study was designed to evaluate the tolerance of cancer patients to liposome-associated doxorubicin (L-DXR). The liposomes used contain phosphatidylglycerol, phosphatidylcholine, cholesterol, and DXR intercalated in the lipid bilayer, and have a mean size in the range of 0.3–0.5 μm. Thirty-two patients, most of them with primary or metastatic liver cancer refractory to conventional therapy, were entered into the study. A total of 69 courses of therapy was administered by intravenous infusion of a suspension of L-DXR (0.5-2.0 mg DXR/ml) in physiologic saline at an approximate rate of 2 ml/min given on a 3-week intermittent schedule. The L-DXR and phospholipid doses were escalated from 20 mg/m2 and 0.3 g/m2 to 120 mg/m2 and 3.2 g/m2 respectively. Treatment was generally well tolerated and acute toxic effects such as nausea and vomiting were mild and infrequent. Chills and fever (>38.0°C) were observed in three patients during infusion of L-DXR and in seven patients 6–12 h after the end of infusion. Median WBC nadir counts were 2700, 2300 and 700/μl at 85, 100 and 120 mg/m2 respectively. All three patients receiving 120 mg/m2 developed grade 4 leukopenia and fever requiring intravenous antibiotics, and, in two of them, severe stomatitis (grades 3 and 4) was observed. Significant hair loss was apparent in all patients receiving doses higher than 50 mg/m2. The maximal tolerated dose of L-DXR appears to be 120 mg/m2, with leukopenia and stomatitis being the dose-limiting factors. While the subacute toxicity of L-DXR appears to be qualitatively similar to that of free DXR, its tolerance exceeds the recommended dose of free DXR (75 mg/m2) in the standard 3-weekly schedule.

Separation of liposome-associated doxorubicin from non-liposome-associated doxorubicin in human plasma: Implications for pharmacokinetic studies

To characterize the pharmacokinetics of liposome-associated drugs, the fraction of drug circulating in liposome-associated form and the absolute plasma drug levels must be determined. In this report, we describe our methodological approach to quantitate plasma liposome-associated doxorubicin separately from protein-bound and free doxorubicin. The method is based on the affinity of a cation-exchange resin for doxorubicin and the repulsion by the same resin of negatively-charged liposomes. The methodology is technically simple and reproducible, and lends itself to the analysis of multiple plasma samples as required in pharmacokinetic studies. The validity of this approach was confirmed by separation of liposome-associated from non-liposome-associated drug using gel exclusion chromatography.

Comparative Long-Term Study of the Toxicities of Free and Liposome-Associated Doxorubicin in Mice After Intravenous Administration<xref ref-type="fn" rid="FN1">2</xref>

The toxicities of free doxorubicin (F-DOX) and liposome-associated doxorubicin (L-DOX) were investigated in inbred BALB/c and outbred Sabra mice treated iv with 5, 7.5, and 10 mg doxorubicin (DOX)/kg body weight every 2 weeks up to 8 injections and observed for 6 months. Sonicated liposomes containing phosphatidylcholine, phosphatidylglycerol, and cholesterol were used. The lethal effect was reduced in mice treated with L-DOX as compared to mice treated with F-DOX. At a dose of 7.5 mg DOX/kg, 100% of mice receiving the L-DOX survived a cumulative dose of 60 mg/kg administered over 98 days, while 92% of mice receiving the F-DOX died. Two distinct patterns of death were observed: an acute phase type occurring early after injection of high doses of DOX and apparently related to gastrointestinal toxicity and a delayed phase type requiring a long latency after initial drug exposure and characterized by a complex pattern of abnormalities. Delivery of DOX by liposomes effectively protected against both types of lethal effects. Reduced toxicity of L-DOX resulted in reduced body and organ weight losses, reduced severity of pathologic changes, and fewer blood biochemical alterations. The pathological damage to the heart muscle found in mice treated with L-DOX was less severe than with F-DOX, and in some cases it was reversible. Nephrotoxicity was extremely frequent and severe among F-DOX-treated mice, while it was totally insignificant among L-DOX-treated mice. Hyperlipidemia, hypoglycemia, and glycogen-depleted hepatocytes were characteristic findings in mice treated with F-DOX. Altogether, the data obtained in this study indicate that liposomes significantly diminish the toxicity of DOX with the use of an intermittent schedule of chemotherapy. In addition to changes in tissue distribution as a mechanism of reduced toxicity, it is proposed that DOX associated with liposomal lipids interacts less efficiently than the free drug with target intracellular phospholipids.

Stability of doxorubicin-liposomes on storage: as an aqueous dispersion, frozen or freeze-dried

Shelf-life of doxorubicin (DXR) containing negatively charged liposomes was studied under various conditions. The following parameters were monitored: DXR-latency, stability against aggregation or fusion, and chemical stability of bilayer components and associated DXR. An ion exchange resin was used to remove free DXR from liposome-associated DXR. As an alternative for storing aqueous dispersions, the liposomes were frozen and freeze-dried. Variables under investigation were: type of cryoprotectant (saccharides, polyvinylpyrrolidone and mannitol), particle size (about 0.1, 0.25 and 0.65 μm), physical state of the bilayer (“gel”- or “fluid”-like, inclusion of α-tocopherolacetate). A comparison was made between the behaviour of a bilayer interacting compound (DXR) and a non-interacting compound (carboxyfluorescein, CF). When stored as aqueous dispersions extruded multilamellar structures (0.25 μm) showed lower DXR leakage rates than sonicated vesicles (0.1 μm). In the presence of various saccharides freezing and freeze-drying resulted in similar DXR latencies on thawing or rehydration; they provided adequate protection against aggregation or fusion. Other cryoprotectants failed. Latency of a bilayer-interacting drug like DXR, was hardly sensitive to variation of the bilayer structure; in contrast to this observation, latency of CF strongly depended on the bilayer composition. Under the experimental conditions no effects of ageing could be observed in terms of changing leakage profiles, aggregation behaviour or chemical decomposition of DXR.