RESUMEN
Treatment of intraocular retinoblastoma with vitreous seeding is a challenge. Different routes of chemotherapy administration have been explored in order to attaining pharmacological concentrations into the posterior chamber. Intravitreal drug injection is a promissing route for maximum bioavailability to the vitreous but it requires a well defined dose for achieving tumor control while limited toxicity to the retina. Topotecan proved to be a promising agent for retinoblastoma treatment due to its pharmacological activity and limited toxicity. High and prolonged concentrations were achieved in the rabbit vitreous after 5 µg of intravitreal topotecan. However, whether a lower dose could achieve potentially therapeutic levels remained to be determined. Thus, we here study the pharmacokinetics of topotecan after 0.5 µg and the toxicity profile of intravitreal topotecan in the rabbit eye as a potential treatment of retinoblastoma. A cohort of rabbits was used to study topotecan disposition in the vitreous after a single dose of 0.5 µg of intravitreal topotecan. In addition, an independent cohort of non-tumor bearing rabbits was employed to evaluate the clinical and retinal toxicity after four weekly injections of two different doses of intravitreal topotecan (Group A, 5 µg/dose; Group B, 0.5 µg/dose) to the right eye of each animal. The same volume (0.1 ml) of normal saline was administered to the left eye as control. A third group of rabbits (Group C) served as double control (both eyes injected with normal saline). Animals were weekly evaluated for clinical and hematologic values and ocular evaluations were performed with an inverse ophthalmoscope to establish potential topotecan toxicity. Weekly controls included topotecan quantitation in plasma of all rabbits. Electroretinograms (ERGs) were recorded before and after topotecan doses. One week after the last injection, topotecan concentrations were measured in vitreous of all eyes and samples for retinal histology were obtained. Our results indicate that topotecan shows non linear pharmacokinetics after a single intravitreal dose in the range of 0.5-5 µg in the rabbit. Vitreous concentration of lactone topotecan was close to the concentration assumed to be therapeutically active after 5 h of 0.5 µg intravitreal administration. Eyes injected with four weekly doses of topotecan (0.5 or 5 µg/dose) showed no significant differences in their ERG wave amplitudes and implicit times in comparison with control (p > 0.05). Animals showed no weight, hair loss or significant changes in hematologic values during the study period. There were no significant histologic damage of the retinas exposed to topotecan treatments. After intravitreal administration no topotecan could be detected in plasma during the follow-up period nor in the vitreous of treated and control animals after 1 week of the last injection. The present data shows that four weekly intravitreal injection of 5 µg of topotecan is safe for the rabbit eye. Despite multiple injections of 0.5 µg of topotecan are also safe to the rabbit eye, lactone topotecan vitreous concentrations were potentially active only after 5 h of the administration. We postulate promising translation to clinics for retinoblastoma treatment.
Asunto(s)
Neoplasias de la Retina/tratamiento farmacológico , Retinoblastoma/tratamiento farmacológico , Inhibidores de Topoisomerasa I/administración & dosificación , Inhibidores de Topoisomerasa I/toxicidad , Topotecan/administración & dosificación , Topotecan/toxicidad , Animales , Esquema de Medicación , Electrorretinografía , Inyecciones Intravítreas , Modelos Biológicos , Dinámicas no Lineales , Oftalmoscopía , Conejos , Retina/efectos de los fármacos , Retina/metabolismo , Retina/patología , Inhibidores de Topoisomerasa I/farmacocinética , Topotecan/farmacocinética , Cuerpo Vítreo/metabolismoRESUMEN
Topotecan is an important cytotoxic drug that has gained broad acceptance in clinical use for the treatment of refractory ovarian and small-cell lung cancer. The lactone active form of topotecan can be hydrolyzed in vivo, decreasing the drug's therapeutic efficacy. Lipid encapsulation may promote in vivo stabilization by removing topotecan from aqueous media. Earlier reports of topotecan lipid nanoencapsulation have focused on liposomal encapsulation; however, the higher stability and cost-effectiveness of solid lipid nanoparticles (SLN) highlight the potential of these nanoparticles as an advantageous carrier for topotecan. The initial motivation for this work was to develop, for the first time, solid lipid nanoparticles and nanostructured lipid carriers (NLC) with a high drug loading for topotecan. A microemulsion technique was employed to prepare SLNs and NLCs and produced homogeneous, small size, negatively charged lipid nanoparticles with high entrapment efficiency and satisfactory drug loading. However, low recovery of topotecan was observed when the microemulsion temperature was high and in order to obtain high quality nanoparticles, and precise control of the microemulsion temperature is critical. Nanoencapsulation sustained topotecan release and improved its chemical stability and cytotoxicity. Surprisingly, there were no significant differences between the NLCs and SLNs, and both are potential carriers for topotecan delivery.
Asunto(s)
Sistemas de Liberación de Medicamentos , Nanopartículas/química , Inhibidores de Topoisomerasa I/química , Topotecan/química , Supervivencia Celular/fisiología , Preparaciones de Acción Retardada , Portadores de Fármacos/química , Composición de Medicamentos , Evaluación Preclínica de Medicamentos , Estabilidad de Medicamentos , Emulsiones/química , Liofilización , Humanos , Células K562 , Lípidos/química , Nanopartículas/administración & dosificación , Nanopartículas/toxicidad , Nanoestructuras/análisis , Nanoestructuras/química , Nanoestructuras/toxicidad , Tamaño de la Partícula , Solubilidad , Propiedades de Superficie , Temperatura , Inhibidores de Topoisomerasa I/administración & dosificación , Inhibidores de Topoisomerasa I/metabolismo , Inhibidores de Topoisomerasa I/toxicidad , Topotecan/administración & dosificación , Topotecan/metabolismo , Topotecan/toxicidad , Azul de TripanoRESUMEN
PURPOSE: To determine the extent and the mechanism by which topotecan, a candidate agent for the treatment of retinoblastoma, gains access to the vitreous when administered by periocular injection or intravenous infusion. METHODS: In vivo experiments were conducted in which albino rabbits received 1 mg topotecan by periocular injection (POI group; n = 30) or as a 30-minute intravenous infusion (IV group; n = 16). Plasma and vitreal topotecan concentrations were analyzed during the 10 hours after administration. A population pharmacokinetic model was fit to the data. Additionally, periocular injections were performed postmortem to study the effect of removing the blood vasculature barrier. RESULTS: Potentially active lactone topotecan levels were detected in the vitreous in the POI and IV groups. Both administration schedules induced high total topotecan plasma exposures because of absorption from the periocular depot, though plasma lactone area under the curve (AUC) was significantly higher in the IV group. Similar vitreal concentrations were found in treated and control eyes in the POI group. The transfer from the periocular compartment to the vitreous was negligible. The absence of drug levels in the control eye of the postmortem-injected rabbits confirmed the systemic delivery of topotecan. Local toxicity was not observed. CONCLUSIONS: As a consequence of a favored passage across the blood-retinal barrier, considerable topotecan vitreous levels were detected in a rabbit model after systemic or periocular administration. Transscleral entry in vivo was constrained by rapid clearance from the administration site.
Asunto(s)
Antineoplásicos/farmacocinética , Neoplasias de la Retina/tratamiento farmacológico , Retinoblastoma/tratamiento farmacológico , Topotecan/farmacocinética , Animales , Antineoplásicos/farmacología , Antineoplásicos/toxicidad , Barrera Hematorretinal , Infusiones Intravenosas , Inyecciones , Modelos Biológicos , Conejos , Topotecan/farmacología , Topotecan/toxicidad , Cuerpo Vítreo/metabolismoRESUMEN
Estudiar los niveles de topotecan total y lactona en el vitreo luego de la administración periocular en un modelo animal. Material y métodos: Se administró 1 mg de topotecan periocular en ambos ojos a 9 conejos sin retinoblastoma y se midieron niveles en el vitreo a las 0.25, 0.5, 1, 2, 4 y 24 horas. Se midieron niveles plasmáticos en 2 animales a las 2 horas. Se midió topotecan total y lactona por HPLC. Todos los animales fueron enucleados al completar el experimento y los ojos fueron examinados patológicamente para evalur toxicidad. Resultados: Tanto el topotecan total como la lactona alcanzaron niveles en el vitreo, mostrando un pico a los 30 minutos de la administración periocular. Los niveles medios en el pico fueron de 158 ng/ml para el topotecan total y 122 ng/ml para el topotecan lactona decayendo con una vida media de 2.44 hs. y 2.8 hs. para el topotecan total y lactona respectivamente. Se encontraron bajos niveles plasmáticos en los 2 animales estudiados a las 2 hs. de la administración de topotecan periocular ((32.0 ng7ml). No se evidencio toxicidad significativa. Conclusiones: En este estudio preliminar, el topotecan mostro lograr pernetrar al vitreo luego de la administración periocular a concentraciones potencialmente tumoricidas. Nuestro grupo proseguirá con estudios más detallados para evaluar su comportamiento famacocinético con el fin de utilizarlo potencialmente en paciente con retinoblastoma.
Asunto(s)
Conejos , Cuerpo Vítreo , Retinoblastoma , Topotecan/farmacocinética , Topotecan/toxicidad , Topotecan/uso terapéuticoRESUMEN
The genotoxicity of camptothecin (CPT) and its clinical antineoplastic analogues irinotecan (CPT-11) and topotecan (TPT) were evaluated using the wing somatic mutation and recombination test (SMART) in Drosophila melanogaster. These compounds stabilize and trap the topoisomerase I-DNA complex, preventing the religation step of the breakage/rejoining reaction mediated by the enzyme. The standard version of the wing SMART was used to evaluate the three compounds and to compare the wing spots induced in marker-heterozygous and balancer-heterozygous flies. The results demonstrate that all compounds tested have a significant genotoxic effect in both genotypes analysed. At the same time, a comparison of the clone induction frequencies in marker-heterozygous and balancer-heterozygous flies shows that mitotic recombination is the prevalent mechanism through which the three compounds induce all categories of wing spots (78-93% recombination). TPT was the most genotoxic compound, probably because substitutions of amino groups for the 9-carbon of the CPT A ring leads to compounds with greater in vivo activity. CPT and CPT-11 induced, respectively, about 7 and 28 times fewer mutant clones per millimolar exposure unit than TPT.