Novel drug combination nanoparticles exhibit enhanced plasma exposure and dose-responsive effects on eliminating breast cancer lung metastasis

• Published in: PloS one 2020-03, Vol.15 (3), p.e0228557
• Main Authors: Mu, Qingxin, Yu, Jesse, Griffin, James I, Wu, Yan, Zhu, Linxi, McConnachie, Lisa A, Ho, Rodney J Y
• Format: Article
• Language: English
• Subjects: Animals; Antineoplastic Agents - blood; Antineoplastic Agents - chemistry; Antineoplastic Agents - pharmacology; Antineoplastic Agents - therapeutic use; Atazanavir; Breast cancer; Breast Neoplasms - pathology; Cancer metastasis; Cancer therapies; Cell Line; Chemotherapy; Colonization; Combination drug therapy; Comparative analysis; Deoxycytidine - analogs & derivatives; Deoxycytidine - blood; Deoxycytidine - chemistry; Deoxycytidine - pharmacology; Deoxycytidine - therapeutic use; Dose-Response Relationship, Drug; Drug abuse; Drug Compounding; Drug dosages; Drug Synergism; Drug therapy; Drugs; Efavirenz; Ethanol; Exhibitions; Exposure; Female; Gemcitabine; Health aspects; HIV; Human immunodeficiency virus; Ixabepilone; Laboratories; Lipids; Lopinavir; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - secondary; Lungs; Lymphatic system; Medical research; Medicine and Health Sciences; Metastases; Metastasis; Mice; Mice, Inbred C57BL; Nanoparticles; Nanoparticles - chemistry; Novels; Paclitaxel; Paclitaxel - blood; Paclitaxel - chemistry; Paclitaxel - pharmacology; Paclitaxel - therapeutic use; Particle size; Pharmaceutical sciences; Physical Sciences; Plasma physics; Receptors; Remission; Research and Analysis Methods; Safety margins; Studies; Toxicity; Treatment Outcome
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0228557

Early diagnosis along with new drugs targeted to cancer receptors and immunocheckpoints have improved breast cancer survival. However, full remission remains elusive for metastatic breast cancer due to dose-limiting toxicities of heavily used, highly potent drug combinations such as gemcitabine and paclitaxel. Therefore, novel strategies that lower the effective dose and improve safety margins could enhance the effect of these drug combinations. To this end, we developed and evaluated a novel drug combination of gemcitabine and paclitaxel (GT). Leveraging a simple and scalable drug-combination nanoparticle platform (DcNP), we successfully prepared an injectable GT combination in DcNP (GT DcNP). Compared to a Cremophor EL/ethanol assisted drug suspension in buffer (CrEL), GT DcNP exhibits about 56-fold and 8.6-fold increases in plasma drug exposure (area under the curve, AUC) and apparent half-life of gemcitabine respectively, and a 2.9-fold increase of AUC for paclitaxel. Using 4T1 as a syngeneic model for breast cancer metastasis, we found that a single GT (20/2 mg/kg) dose in DcNP nearly eliminated colonization in the lungs. This effect was not achievable by a CrEL drug combination at a 5-fold higher dose (i.e., 100/10 mg/kg GT). A dose-response study indicates that GT DcNP provided a therapeutic index of ~15.8. Collectively, these data suggest that GT DcNP could be effective against advancing metastatic breast cancer with a margin of safety. As the DcNP formulation is intentionally designed to be simple, scalable, and long-acting, it may be suitable for clinical development to find effective treatment against metastatic breast cancer.