Pharmaceutical Development of (Investigational) Anticancer Agents for Parenteral Use-A Review

Experimental Evaluation of Anticancer Efficiency and Acute Toxicity of Anthrafuran for Oral Administration

The new antitumor agent anthrafuran has demonstrated a consistent effect in murine tumor models when administered parenterally due to the simultaneous inhibition of multiple cellular targets such as topoisomerases I/II and protein kinases. In this study, we assessed the anticancer efficiency and acute toxicity of anthrafuran administered orally. The action of anthrafuran was studied on transplanted tumor models which included P388 leukemia, Ca755 mammary adenocarcinoma, LLC lung carcinoma, and T47D human breast cancer xenografts on Balb/c nude mice. A significant antitumor efficacy of oral anthrafuran was revealed for all tested tumor models as follows: T/C_max = 219% for P388, TGI_max = 91% for Ca755, TGI_max = 84% with CR_max = 54% for LLC, and T/C = 38% for T47D. The optimal treatment schedule of orally administered anthrafuran was 70–100 mg/kg given daily for five days. The LD₅₀ value of orally administered anthrafuran (306.7 mg/kg) in mice was six times higher than that for i.p. administration (52.5 mg/kg). The rates of antitumor efficacy and acute toxicity indicate the high potential for further research on anthrafuran as a new original oral anticancer multitarget agent with an expected satisfactory tolerability and bioavailability.

Polymeric micelles as drug delivery vehicles

Though much progress has been made in drug delivery systems, the design of a suitable carrier for the delivery of hydrophobic drugs is still a major challenge for researchers.

Designing Paclitaxel drug delivery systems aimed at improved patient outcomes: current status and challenges

Paclitaxel is one of the most widely used and effective antineoplastic agents derived from natural sources. It has a wide spectrum of antitumor activity, particularly against ovarian cancer, breast cancer, nonsmall cell lung cancer, head and neck tumors, Kaposi's sarcoma, and urologic malignancies. It is a highly lipophilic compound with a log P value of 3.96 and very poor aqueous solubility of less than 0.01 mg/mL. In addition, the compound lacks functional groups that are ionizable which could potentially lead to an increase in its solubility with the alteration in pH. Therefore, the delivery of paclitaxel is associated with substantial challenges. Until the introduction of Abraxane, only commercial formulation was solution of paclitaxel in cremophor, which caused severe side effects. However, in recent years, a number of approaches have been reported to solubilize paclitaxel using cosolvents and inclusion complexes. In addition, innovative approaches have been reported for passive targeting of tumors using nanoparticles, nanosuspensions, liposomes, emulsions, micelles, implants, pastes and gels. All approaches for delivery of improved therapeutic outcome have been discussed in this paper.

Role of tumor vascular architecture in drug delivery

Tumor targeted drug delivery has the potential to improve cancer care by reducing non-target toxicities and increasing the efficacy of a drug. Tumor targeted delivery of a drug from the systemic circulation, however, requires a thorough understanding of tumor pathophysiology. A growing or receding (under the impact of therapy) tumor represents a dynamic environment with changes in its angiogenic status, cell mass, and extracellular matrix composition. An appreciation of the salient characteristics of tumor vascular architecture and the unique biochemical markers that may be used for targeting drug therapy is important to overcome barriers to tumor drug therapy and to facilitate targeted drug delivery. This review discusses the unique aspects of tumor vascular architecture that need to be overcome or exploited for tumor targeted drug delivery.

Hydrotropic polymer micelles as versatile vehicles for delivery of poorly water-soluble drugs

Polymer micelles have been used widely for delivery of poorly water-soluble drugs. Such drug delivery, however, has been based primarily on hydrophobic interactions. For better drug loading and improved stability, hydrotropic polymer micelles were used. To develop a versatile polymer micelle for solubilizing various poorly soluble drugs, two different hydrotropic agents were examined. The solubilizing properties of two hydrotropic agents, N,N-diethylnicotinamide (DENA) and N,N-dimethylbenzamide (DMBA), in polymeric form were investigated for their ability to solubilize five drugs with low aqueous solubility covering a wide range of hydrophobicity and molecular structures. The hydrotropes were covalently linked to the hydrophobic block of a block copolymer that also had a hydrophilic poly(ethylene glycol) (PEG) block. The solubilizing capacity of the polymeric hydrotropes was compared with that of the non polymeric hydrotropes, as well as of two conventional (non hydrotropic) copolymer systems. The solubilizing capacity of polymeric hydrotropes reflects combined effects of the micellar solubilization by the hydrophobic micelle core and hydrotropic solubilization. Because of the highly localized configuration, hydrotropes in the polymeric form are more powerful solubilizers than in the monomeric (non-polymeric) solution. It is possible to produce 1~3 orders of magnitude increase in solubility with polymeric hydrotropes at the 1% (w/v) level. Of the two hydrotropic polymeric systems in this study, the DENA-based system is highly specific, whereas the DMBA-based system is a general solubilizer of hydrophobic drugs. An additional advantage of polymeric hydrotropes over the non-polymeric form is absence of high concentrations of free hydrotropes in the formulation. Solubilization vehicles based on polymeric hydrotropes are expected to provide a new and versatile means of preparing formulations for various poorly soluble drugs and drug candidates without using organic solvents. This advantage is accompanied with the inherent controlled release property of the hydrotropic polymer micelles, making them ideal for pharmaceutical formulations used in drug candidate screening and toxicology studies.

Polysorbate 80 and Cremophor EL Micelles Deaggregate and Solubilize Nystatin at the Core–Corona Interface

The extent and the location of nystatin solubilization by nonionic surfactant micelles were determined. The critical aggregation concentrations (CAC) of nystatin in 4 x 10(-3) M surfactant were determined by dynamic light scattering. The resulting CAC values for nystatin in Cremophor EL (CrEL), Tween 80 (T80), and Nofable ESO-9920 (NOF) were 150, 150, and 300 microM compared to 10 microM for the phosphate-buffered saline (PBS) control. The surfactants were able to solubilize and deaggregate nystatin from 50 to 75 times more than the PBS control. The core polarity of CrEL micelles, determined by pyrene fluorescence, was significantly lower than T80 and NOF micelles. The micelle-water partition coefficients (P) of nystatin and pyrene were determined by fluorescence spectroscopy. The partition coefficient values of 7.5 microM nystatin in CrEL and NOF micelles were 1100 +/- 60 and 1000 +/- 110, an insignificant difference (p > 0.1). However, there was a significant increase in pyrene partitioning in micelles with lower core polarity. Additionally, the P of nystatin decreased when the nystatin concentration was increased, whereas the pyrene P did not. The unusual partitioning behavior of nystatin revealed a good fit with the Langmuir adsorption isotherm, indicating solubilization at the micellar core-corona interface.

Solubilization of poorly soluble lichen metabolites for biological testing on cell lines

The depside atranorin and depsidone fumarprotocetraric acid, isolated from the lichens Stereocaulon alpinum and Cetraria islandica, respectively, were chosen as prototypes for poorly soluble natural compounds in an effort to facilitate testing in pharmacological models. Solubilizing agents previously identified as being non-toxic towards a malignant leukemic (K-562) cell line and suitable for testing of anti-proliferative activity of the dibenzofuran lichen metabolite (+)-usnic acid were used in solubilization studies of the depside and depsidone. Cyclodextrin derivatives were found to be most suitable for solubilizing the lichen compounds, the greatest rise in solubility being witnessed for fumarprotocetraric acid, increasing almost 300-fold from 0.03 mg/ml in water to 8.98 mg/ml in 10% 2-hydroxypropyl-beta-cyclodextrin (HPbetaCD). Subsequently, the lichen compounds, including (+)-usnic acid, were solubilized in 10% HPbetaCD and tested for effects on three malignant human cell lines; T-47D (breast), Panc-1 (pancreas) and PC-3 (prostate) in a standard proliferation assay. Atranorin and fumarprotocetraric acid did not exhibit anti-proliferative effects but usnic acid was active against all test cell lines with EC50 values of 4.3-8.2 microg/ml. The non-toxic solubilizing agents used in this study could prove useful for pharmacological testing of other poorly soluble natural products.

Effects of annealing lyophilized and spray-lyophilized formulations of recombinant human interferon-gamma

The purpose of this study was to examine the effects of adsorption of recombinant human interferon-gamma (rhIFN-gamma) on ice surfaces and subsequent drying during processing by spray-lyophilization and lyophilization. Ice/liquid interfacial areas were manipulated by the freezing method as well as by the addition of an annealing step during lyophilization; that is, rhIFN-gamma adsorption was modified by the addition of nonionic surfactants. rhIFN-gamma was lyophilized or spray-lyophilized at a concentration of 1 mg/mL in 5% sucrose, 5% hydroxyethyl starch (HES) +/- 0.03% polysorbate 20 in 140 mM KCl, and 10 mM potassium phosphate, pH 7.5. After the samples were frozen, half were annealed on the lyophilizer shelf. Recovery of soluble protein was measured at intermediate points during processing. On drying, the secondary structure of rhIFN-gamma was determined by second-derivative infrared (IR) spectroscopy, specific surface areas (SSAs) were measured, scanning electron micrographs (SEM) were taken, and dissolution times were recorded. Adsorption of rhIFN-gamma to ice/liquid interfaces alone was not responsible for aggregation. Rather, drying was necessary to cause aggregation in lyophilized sucrose formulations. Addition of an annealing step to the lyophilization cycle resulted in more native-like secondary protein structure in the dried solid, eliminated cracking of the dried cakes, and suppressed both the formation of air/liquid interfaces and rhIFN-gamma aggregation on reconstitution.

Excipient-drug interactions in parenteral formulations

Excipients are added to parenteral formulations to enhance or maintain active ingredient solubility (solubilizers) and/or stability (buffers, antioxidants, chelating agents, cryo- and lyoprotectants). Excipients also are important in parenteral formulations to assure safety (antimicrobial preservatives), minimize pain and irritation upon injection (tonicity agents), and control or prolong drug delivery (polymers). These are all examples of positive or synergistic interactions between excipients and drugs. However, excipients may also produce negative effects such as loss of drug solubility, activity, and/or stability. This review article will highlight documented interactions, both synergistic and antagonistic, between excipients and drugs in parenteral formulations. The reader will gain better understanding and appreciation of the implications of adding formulation ingredients to parenteral drug products.

Solubilization of the lichen metabolite (+)-usnic acid for testing in tissue culture

The pharmacological testing of natural products can often be hampered by the poor solubility of such compounds in non-toxic solvents. There is thus a need for a suitable agent for solubilization of natural substances to allow testing on a variety of cell lines in-vitro. Such an agent should ideally have no direct effects on any of the commonly used cell lines from a variety of tissues and mammalian species to allow proper comparison. In this study, the lichen metabolite (+)-usnic acid, a dibenzofuran derivative, was used as a prototype for an insoluble natural product with the aim of finding a solvent that was both capable of solubilizing usnic acid and was free of direct activity against a test cell line. Solubilization was measured at different pH values in various concentrations of co-solvents (glycofurol 75, propylene glycol, polyethylene glycol 400), surfactants (polysorbate 20 and Cremophor RH40), and the complexing agent 2-hydroxypropyl-beta-cyclodextrin. The solubility achieved in a 20% aqueous solution was 0.11 mg mL(-1) for propylene glycol, 0.19 for PEG 400, 0.27 for glycofurol 75, 0.57 for Cremophor RH40, 0.68 for 2-hydroxypropyl-beta-cyclodextrin and 0.84 for polysorbate 20. The direct effects of the various solvent systems were tested on the human leukaemia cell line K-562 in a standard proliferation assay. Most of the solvents proved toxic with the exception of propylene glycol, PEG 400 and 2-hydroxypropyl-beta-cyclodextrin. Anti-proliferative activity of usnic acid could be demonstrated with an ED50 (amount of substance required to reduce thymidine uptake to 50% of uptake by untreated control culture) of 4.7 microg mL(-1) using PEG 400 and 2-hydroxypropyl-beta-cyclodextrin but only the latter gave satisfactory solubility. 2-Hydroxypropyl-beta-cyclodextrin was thus identified as a solubilizing agent that fulfilled both set criteria of solubility and lack of toxicity against the test cells.

Pharmaceutical development of anticancer agents derived from marine sources

The marine ecosystem is more and more acknowledged as a source of potential anticancer agents. After the identification of a potential substance several hurdles have to be overcome before a marine candidate can enter the clinic. Amongst these are the establishment of a method which ensures sufficient supply and, which is the focus of this review, the development of a clinically useful pharmaceutical formulation. General issues with respect to the pharmaceutical development of marine anticancer agents will be discussed, which will be illustrated by highlighting aspects of the pharmaceutical development and clinical use of some representative compounds.

Cremophor EL causes (pseudo-) non-linear pharmacokinetics of paclitaxel in patients

The non-linear plasma pharmacokinetics of paclitaxel in patients has been well established, however, the exact underlying mechanism remains to be elucidated. We have previously shown that the non-linear plasma pharmacokinetics of paclitaxel in mice results from Cremophor EL. To investigate whether Cremophor EL also plays a role in the non-linear pharmacokinetics of paclitaxel in patients, we have established its pharmacokinetics in patients receiving paclitaxel by 3-, 24- or 96-h intravenous infusion. The pharmacokinetics of Cremophor EL itself was non-linear as the clearance (Cl) in the 3-h schedules was significantly lower than when using the longer 24- or 96-h infusions (Cl175-3 h = 42.8+/-24.9 ml h(-1) m(-2); CI175-24 h = 79.7+/-24.3; P = 0.035 and Cl135-3 h = 44.1+/-21.8 ml h(-1) m(-1); Cl140-96 h = 211.8+/-32.0; P < 0.001). Consequently, the maximum plasma levels were much higher (0.62%) in the 3-h infusions than when using longer infusion durations. By using an in vitro equilibrium assay and determination in plasma ultrafiltrate we have established that the fraction of unbound paclitaxel in plasma is inversely related with the Cremophor EL level. Despite its relatively low molecular weight, no Cremophor EL was found in the ultrafiltrate fraction. Our results strongly suggest that entrapment of paclitaxel in plasma by Cremophor EL, probably by inclusion in micelles, is the cause of the apparent nonlinear plasma pharmacokinetics of paclitaxel. This mechanism of a (pseudo-)non-linearity contrasts previous postulations about saturable distribution and elimination kinetics and means that we must re-evaluate previous assumptions on pharmacokinetics-pharmacodynamics relationships.

Clinical pharmacology of anticancer agents in relation to formulations and administration routes

In the past years, alternative administration routes and pharmaceutical formulations of anticancer agents have been investigated in order to improve conventional chemotherapy treatment. The impact of these adjustments on the pharmacokinetics and pharmacodynamics is discussed. A review of the literature shows many examples of alternative administration forms of anticancer agents with improved pharmacokinetics. Local administration routes have been investigated in order to reduce the systemic toxicity and to enhance the local efficacy of conventional chemotherapy. Oral administration of anticancer agents is preferred by patients for its convenience and its potential for outpatient treatment. In addition, oral administration facilitates a prolonged exposure to the cytotoxic agent. However, poor bioavailability and substantial interpatient variability are noted as limitations for oral chemotherapy. Increased tumour selectivity can also be achieved by the use of specific pharmaceutical formulations, such as liposomes and macromolecular drug conjugates. The composition of these formulations often determine the pharmacokinetic behaviour of the formulated drug. In conclusion, several alternative administration forms of anticancer agents have been designed in the past years, with the potential for improvement of conventional chemotherapy, however, more extensive clinical evaluation of these novel strategies is warranted to prove their real clinical value.

Alternative formulations of paclitaxel

Paclitaxel, a novel antitumour agent, is active clinically against advanced ovarian and breast cancer and under investigation for various other cancers. One of the problems associated with the intravenous administration of paclitaxel is its low solubility in water. The current pharmaceutical formulation consists of a 1:1 (v/v) mixture of ethanol and Cremophor EL. This formulation, however, has been demonstrated to cause some severe hypersensitivity reactions. Therefore the development of a safer intravenous formulation devoid of Cremophor EL is an important investigational issue. This review deals with some of the most promising formulation alternatives.