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Lipid-Nanoparticle-Mediated Delivery of Docetaxel Prodrug for Exploiting Full Potential of Gold Nanoparticles in the Treatment of Pancreatic Cancer. Cancers (Basel) 2022; 14:cancers14246137. [PMID: 36551622 PMCID: PMC9776798 DOI: 10.3390/cancers14246137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Current chemoradiation therapy suffers from normal tissue toxicity. Thus, we are proposing incorporating gold nanoparticles (GNPs) and docetaxel (DTX), as they have shown very promising synergetic radiosensitization effects. Here, we explored the effect of a DTX prodrug encapsulated in lipid nanoparticles (LNPDTX-P) on GNP uptake in pancreatic cancer models in vitro and in vivo. For the in vitro experiment, a pancreatic cancer cell line, MIA PaCa-2, was cultured and dosed with 1 nM GNPs and 45 nM free DTX or an equivalent dose of LNPDTX-P. For the in vivo experiment, MIA PaCa-2 cells were implanted subcutaneously in NRG mice, and the mice were dosed with 2 mg/kg of GNPs and 6 mg/kg of DTX or an equivalent dose of LNPDTX-P. The results show that LNPDTX-P-treated tumour samples had double the amount GNPs compared to control samples, both in vitro and in vivo. The results are very promising, as LNPDTX-P have superior targeting of tumour tissues compared to free DTX due to their nanosize and their ability to be functionalized. Because of their minimal toxicity to normal tissues, both GNPs and LNPDTX-P could be ideal radiosensitization candidates in radiotherapy and would produce very promising synergistic therapeutic outcomes.
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Cailleteau A, Sargos P, Saad F, Latorzeff I, Supiot S. Drug Intensification in Future Postoperative Radiotherapy Practice in Biochemically-Relapsing Prostate Cancer Patients. Front Oncol 2022; 11:780507. [PMID: 35004302 PMCID: PMC8739777 DOI: 10.3389/fonc.2021.780507] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/30/2021] [Indexed: 12/26/2022] Open
Abstract
Although salvage prostate bed radiotherapy is highly effective in biochemically-relapsing prostate cancer patients following prostatectomy, relapses remain frequent and improvements are needed. Randomized phase 3 trials have shown the benefit of adding androgen-depriving therapy to irradiation, but not all patients benefit from this combination. Preclinical studies have shown that novel agents targeting the androgen receptor, DNA repair, PI3K/AKT/mTOR pathways, or the hypoxic microenvironment may help increase the response to prostate bed irradiation while minimizing potential side effects. This perspective review focuses on the most relevant molecules that may have an impact when combined with salvage radiotherapy, and underlines the strategies that need to be developed to increase the efficacy of salvage post-prostatectomy radiotherapy in prostate cancer patients.
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Affiliation(s)
- Axel Cailleteau
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Nantes Saint-Herblain, France
| | - Paul Sargos
- Department of Radiation Oncology, Institut Bergonié, Bordeaux, France
| | - Fred Saad
- Department of Urology, Université de Montréal, Montreal, QC, Canada
| | - Igor Latorzeff
- Department of Radiation Oncology, Oncorad Clinique Pasteur, Toulouse, France
| | - Stéphane Supiot
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Nantes Saint-Herblain, France.,University of Nantes, CRCINA (CNRS, Inserm), Nantes, France
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Combining Gold Nanoparticles with Other Radiosensitizing Agents for Unlocking the Full Potential of Cancer Radiotherapy. Pharmaceutics 2021; 13:pharmaceutics13040442. [PMID: 33805917 PMCID: PMC8064393 DOI: 10.3390/pharmaceutics13040442] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022] Open
Abstract
About half of cancer patients (50%) receive radiotherapy (RT) for the treatment of local tumors. However, one of the main obstacles in RT is the close proximity of adjacent organs at risk, resulting in treatment doses being limited by significant tissue toxicity, hence preventing the necessary dose escalation that would guarantee local control. Effective local cancer therapy is needed to avoid progression of tumors and to decrease the development of systemic metastases which may further increase the possibility of resection. In an effort to do so, radiosensitizing agents are introduced to further increase damage to the tumor while minimizing normal tissue toxicity. Cisplatin and docetaxel (DTX) are currently being used as radiation dose enhancers in RT. Recent research shows the potential of gold nanoparticles (GNPs) as a radiosensitizing agent. GNPs are biocompatible and have been tested in phase I clinical trials. The focus will be on exploring the effects of adding other radiosensitizing agents such as DTX and cisplatin to the GNP-RT platform. Therefore, a combined use of local radiosensitizing agents, such as GNPs, with currently available radiosensitizing drugs could make a significant impact in future RT. The ultimate goal is to develop treatments that have limited or nonexistent side effects to improve the quality of life of all cancer patients.
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Schmidt Hegemann NS, Rogowski P, Eze C, Schäfer C, Stief C, Lang S, Spohn S, Steffens R, Li M, Gratzke C, Schultze-Seemann W, Ilhan H, Fendler WP, Bartenstein P, Ganswindt U, Buchner A, Grosu AL, Belka C, Meyer PT, Kirste S, Zamboglou C. Outcome After 68Ga-PSMA-11 versus Choline PET-Based Salvage Radiotherapy in Patients with Biochemical Recurrence of Prostate Cancer: A Matched-Pair Analysis. Cancers (Basel) 2020; 12:cancers12113395. [PMID: 33207785 PMCID: PMC7698293 DOI: 10.3390/cancers12113395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022] Open
Abstract
The purpose of this analysis was primarily to analyze biochemical-recurrence free survival (BRFS) after positron emission tomography (PET)-guided salvage radiotherapy (sRT) in a large cohort, and to further compare BRFS after PSMA vs. choline PET/ computer tomography (CT)-based sRT. This retrospective analysis is based on 421 patients referred for PSMA or choline PET/CT after radical prostatectomy due to biochemically recurrent or persistent disease. BRFS (PSA: 0.2 ng/mL) was defined as the study endpoint. Cox regression analyses were performed to assess the impact of different clinical parameters on BRFS. Additionally, propensity score matching was performed to adjust patient cohorts (PSMA vs. choline PET/CT-based sRT). The median follow-up time was 30 months. BRFS at three years after sRT was 58%. In the multivariate analysis, only PSA before PET imaging and PSA before sRT were significantly associated with BRFS (p < 0.05). After propensity score matching, 272 patients were further analyzed; there was no significant difference in three-year BRFS between patients with PSMA PET-based vs. choline PET-based sRT (55% vs. 63%, p = 0.197). The present analysis confirmed the overall high BRFS rates after PET-based sRT and the strong prognostic effect of PSA level prior to sRT. PSMA PET-based sRT did not have superior BRFS rates when compared with choline PET-based sRT.
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Affiliation(s)
- Nina-Sophie Schmidt Hegemann
- Department of Radiation Oncology, University Hospital, 81377 LMU Munich, Germany; (N.-S.S.H.); (P.R.); (C.E.); (C.S.); (R.S.); (M.L.); (C.B.)
| | - Paul Rogowski
- Department of Radiation Oncology, University Hospital, 81377 LMU Munich, Germany; (N.-S.S.H.); (P.R.); (C.E.); (C.S.); (R.S.); (M.L.); (C.B.)
| | - Chukwuka Eze
- Department of Radiation Oncology, University Hospital, 81377 LMU Munich, Germany; (N.-S.S.H.); (P.R.); (C.E.); (C.S.); (R.S.); (M.L.); (C.B.)
| | - Christian Schäfer
- Department of Radiation Oncology, University Hospital, 81377 LMU Munich, Germany; (N.-S.S.H.); (P.R.); (C.E.); (C.S.); (R.S.); (M.L.); (C.B.)
| | - Christian Stief
- Department of Urology, University Hospital, 81377 LMU Munich, Germany; (C.S.); (A.B.)
| | - Sebastian Lang
- Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (S.L.); (S.S.); (A.-L.G.); (S.K.)
| | - Simon Spohn
- Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (S.L.); (S.S.); (A.-L.G.); (S.K.)
| | - Rieke Steffens
- Department of Radiation Oncology, University Hospital, 81377 LMU Munich, Germany; (N.-S.S.H.); (P.R.); (C.E.); (C.S.); (R.S.); (M.L.); (C.B.)
| | - Minglun Li
- Department of Radiation Oncology, University Hospital, 81377 LMU Munich, Germany; (N.-S.S.H.); (P.R.); (C.E.); (C.S.); (R.S.); (M.L.); (C.B.)
| | - Christian Gratzke
- Department of Urology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.G.); (W.S.-S.)
| | - Wolfgang Schultze-Seemann
- Department of Urology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (C.G.); (W.S.-S.)
| | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital, 81377 LMU Munich, Germany; (H.I.); (P.B.)
| | - Wolfgang Peter Fendler
- Department of Nuclear Medicine, University of Duisburg-Essen, 47057 Essen, Germany;
- German Cancer Consortium (DKTK), University Hospital Essen, 45147 Essen, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, 81377 LMU Munich, Germany; (H.I.); (P.B.)
| | - Ute Ganswindt
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, 6020 Innsbruck, Austria;
| | - Alexander Buchner
- Department of Urology, University Hospital, 81377 LMU Munich, Germany; (C.S.); (A.B.)
| | - Anca-Ligia Grosu
- Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (S.L.); (S.S.); (A.-L.G.); (S.K.)
- German Cancer Consortium (DKTK), Partner Site Freiburg, 79106 Freiburg, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, 81377 LMU Munich, Germany; (N.-S.S.H.); (P.R.); (C.E.); (C.S.); (R.S.); (M.L.); (C.B.)
- German Cancer Consortium (DKTK), Partner Site Munich, 81377 Munich, Germany
| | - Philipp Tobias Meyer
- Department of Nuclear Medicine, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany;
| | - Simon Kirste
- Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (S.L.); (S.S.); (A.-L.G.); (S.K.)
| | - Constantinos Zamboglou
- Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (S.L.); (S.S.); (A.-L.G.); (S.K.)
- German Cancer Consortium (DKTK), Partner Site Freiburg, 79106 Freiburg, Germany
- Bertha-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Correspondence: ; Tel.: +49-761-2709-4610; Fax: +49-761-2709-4720
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Wilke D, Wood L, Cwajna S, Rutledge R, Hollenhorst H, Bowes D, Patil N, Ago CT, Pignol JP. Sequence Inversion to Facilitate Concurrent Radiotherapy and Systemic Therapy. A Proof of Principle Study in the Setting of a Phase II Randomized Trial in Prostate Cancer. Front Oncol 2020; 10:570660. [PMID: 33102224 PMCID: PMC7556110 DOI: 10.3389/fonc.2020.570660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/24/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Concomitant chemo-radiation for pelvic cancers remains challenging to be delivered at full doses. We hypothesized that fewer delays in chemotherapy would occur if the sequence of radiotherapy would be reversed, starting with the boost volume followed by the elective nodal volume. We report the result of a Phase II randomized study for high risk prostate cancer. Patients and Method: The study was a double-blinded phase II randomized trial. Patients were eligible if they had non-metastatic high-risk prostate cancer. All patients received 2.5 years of hormonal therapy and 46.5 Gy in 25 fractions to the pelvic lymph nodes. Patients received a radiation boost to the prostate, either before or after whole pelvic irradiation. Concurrent (20 mg/m2) Docetaxel was given on the first day of radiotherapy and weekly thereafter for a total of eight treatments until predefined toxicity stopping rules. Results: Ninety patients were included and randomized. Four were ineligible for the analysis. In total, 42 patients were randomized to the standard sequence, 44 patients to the experimental sequence. There were statistically fewer GI or GU toxicities leading to a docetaxel dose reduction or omission in the experimental sequence compared to the standard sequence, 5 vs. 15 events (p = 0.027). There was no difference in overall survival, cause-specific survival, or biochemical-relapse free survival between the two sequences. Conclusions: This is the first study to test sequence inversion for pelvic radio-chemotherapy in a randomized double-blind trial. Less chemotherapy interruptions or dose reductions occurred by inverting the radiation sequence of the large field and the boost. The trial was registered with Clinicaltrials.gov: NCT00452556.
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Affiliation(s)
- Derek Wilke
- Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
| | - Lori Wood
- Division of Medical Oncology, Department of Internal Medicine, Dalhousie University, Halifax, NS, Canada
| | - Slawa Cwajna
- Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
| | - Robert Rutledge
- Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
| | - Helmut Hollenhorst
- Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
| | - David Bowes
- Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
| | - Nikhilesh Patil
- Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
| | - Casely T Ago
- Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
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