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Børresen B, Henriksen JR, Clergeaud G, Jørgensen JS, Melander F, Elema DR, Szebeni J, Engelholm SA, Kristensen AT, Kjær A, Andresen TL, Hansen AE. Theranostic Imaging May Vaccinate against the Therapeutic Benefit of Long Circulating PEGylated Liposomes and Change Cargo Pharmacokinetics. ACS Nano 2018; 12:11386-11398. [PMID: 30372038 DOI: 10.1021/acsnano.8b06266] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The enhanced permeability and retention (EPR) effect increases tumor accumulation of liposomal chemotherapy and should, in theory, increase anticancer effects and lower toxicity. Unfortunately, liposomal chemotherapy has generally not met the expected potential, perhaps because the EPR effect is not ubiquitous. PET imaging using radiolabeled liposomes can identify cancers positive for the EPR effect. In the current study, we show in clinical canine cancer patients that repeated imaging with radiolabeled liposomes (64Cu-liposome) induces the accelerated blood clearance (ABC) phenomenon. This was observed even with very long intervals between PEGylated liposome injections, which contradict previous reporting in experimental animal models. The induction of ABC may be devastating for the theranostic use of liposomal imaging, as this could vaccinate patients against therapeutic efficacy. To investigate and solve this important problem, an additional study part was designed in which rats were subjected to repeated liposomal administrations, including stealth 64Cu-liposome PET imaging and Caelyx chemotherapy. Most importantly, it was found that, by increasing the lipid dose at the first injection or by supplying a small predose before the second 64Cu-liposome injection, ABC could be prevented. Importantly, signs of liposome tracer breakdown with subsequent renal excretion were observed. These findings highlight the importance of the ABC phenomenon for liposomal predictive imaging in a clinically relevant setting and show that carefully planned application is central to avoid potential detrimental effects on patient benefit.
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Affiliation(s)
- Betina Børresen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences , University of Copenhagen , 1870 Frederiksberg C , Denmark
| | - Jonas R Henriksen
- DTU Nanotech, Department of Micro- and Nanotechnology, Center for Nanomedicine and Theranostics , Technical University of Denmark , 2800 Kgs. Lyngby , Denmark
| | - Gael Clergeaud
- DTU Nanotech, Department of Micro- and Nanotechnology, Center for Nanomedicine and Theranostics , Technical University of Denmark , 2800 Kgs. Lyngby , Denmark
| | - Jennifer S Jørgensen
- DTU Nanotech, Department of Micro- and Nanotechnology, Center for Nanomedicine and Theranostics , Technical University of Denmark , 2800 Kgs. Lyngby , Denmark
| | - Fredrik Melander
- DTU Nanotech, Department of Micro- and Nanotechnology, Center for Nanomedicine and Theranostics , Technical University of Denmark , 2800 Kgs. Lyngby , Denmark
| | - Dennis R Elema
- DTU Nutech, Center for Nuclear Technologies , Technical University of Denmark , 4000 Roskilde , Denmark
| | - Janos Szebeni
- Nanomedicine Research and Education Center , Semmelweis University , Budapest 1085 , Hungary
| | - Svend Aage Engelholm
- Department of Radiotherapy , Copenhagen University Hospital , 2100 Copenhagen Ø , Denmark
| | - Annemarie T Kristensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences , University of Copenhagen , 1870 Frederiksberg C , Denmark
| | - Andreas Kjær
- Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, 2100 Copenhagen Ø, Denmark and Cluster for Molecular Imaging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences , University of Copenhagen , 2200 Copenhagen N , Denmark
| | - Thomas L Andresen
- DTU Nanotech, Department of Micro- and Nanotechnology, Center for Nanomedicine and Theranostics , Technical University of Denmark , 2800 Kgs. Lyngby , Denmark
| | - Anders E Hansen
- DTU Nanotech, Department of Micro- and Nanotechnology, Center for Nanomedicine and Theranostics , Technical University of Denmark , 2800 Kgs. Lyngby , Denmark
- Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, 2100 Copenhagen Ø, Denmark and Cluster for Molecular Imaging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences , University of Copenhagen , 2200 Copenhagen N , Denmark
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